Department of Cardiology, Sun Yat-sen Memorial Hospital, Sun Yat-sen University, Guangzhou, China.
Department of Cardiology, the Eighth Affiliated Hospital, Sun Yat-sen University, Shenzhen, China.
J Clin Invest. 2021 Jul 15;131(14). doi: 10.1172/JCI146985.
Vascular calcification (VC) predicts cardiovascular morbidity and mortality in chronic kidney disease (CKD). To date, the underlying mechanisms remain unclear. We detected leukocyte DNA N6-methyladenine (6mA) levels in patients with CKD with or without aortic arch calcification. We used arteries from CKD mice infected with vascular smooth muscle cell-targeted (VSMC-targeted) adeno-associated virus encoding alkB homolog 1 (Alkbh1) gene or Alkbh1 shRNA to evaluate features of calcification. We identified that leukocyte 6mA levels were significantly reduced as the severity of VC increased in patients with CKD. Decreased 6mA demethylation resulted from the upregulation of ALKBH1. Here, ALKBH1 overexpression aggravated whereas its depletion blunted VC progression and osteogenic reprogramming in vivo and in vitro. Mechanistically, ALKBH1-demethylated DNA 6mA modification could facilitate the binding of octamer-binding transcription factor 4 (Oct4) to bone morphogenetic protein 2 (BMP2) promoter and activate BMP2 transcription. This resulted in osteogenic reprogramming of VSMCs and subsequent VC progression. Either BMP2 or Oct4 depletion alleviated the procalcifying effects of ALKBH1. This suggests that targeting ALKBH1 might be a therapeutic method to reduce the burden of VC in CKD.
血管钙化 (VC) 可预测慢性肾脏病 (CKD) 患者的心血管发病率和死亡率。迄今为止,其潜在机制尚不清楚。我们检测了伴有或不伴有主动脉弓钙化的 CKD 患者的白细胞 DNA N6-甲基腺嘌呤 (6mA) 水平。我们使用靶向血管平滑肌细胞 (VSMC) 的腺相关病毒 (AAV) 感染 CKD 小鼠,该病毒编码 AlkB 同源物 1 (Alkbh1) 基因或 Alkbh1 shRNA,以评估钙化的特征。我们发现,随着 CKD 患者 VC 严重程度的增加,白细胞 6mA 水平显著降低。6mA 去甲基化减少是由于 ALKBH1 的上调。在这里,ALKBH1 的过表达加重了 VC 进展和体内体外成骨重编程,而其耗竭则减轻了 VC 进展和体内体外成骨重编程。从机制上讲,ALKBH1 去甲基化 DNA 6mA 修饰可以促进八聚体结合转录因子 4 (Oct4) 与骨形态发生蛋白 2 (BMP2) 启动子结合,并激活 BMP2 转录。这导致 VSMC 成骨重编程和随后的 VC 进展。BMP2 或 Oct4 的耗竭减轻了 ALKBH1 的促钙化作用。这表明靶向 ALKBH1 可能是一种减轻 CKD 患者 VC 负担的治疗方法。
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