Department of Clinical Laboratory Medicine, Shanghai Tenth People's Hospital, School of Life Sciences and Technology, Tongji University, Shanghai, China.
Department of Kidney Transplantation, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, China.
Free Radic Biol Med. 2021 Sep;173:81-96. doi: 10.1016/j.freeradbiomed.2021.07.025. Epub 2021 Jul 21.
Iron deficiency is the most common micronutrient deficiency worldwide. While iron deficiency is known to suppress embryonic organogenesis, its effect on the adult organ in the context of clinically relevant damage has not been considered. Here we report that iron deficiency is a risk factor for nephrotoxic intrinsic acute kidney injury of the nephron (iAKI). Iron deficiency exacerbated cisplatin-induced iAKI by markedly increasing non-heme catalytic iron and Nox4 protein which together catalyze production of hydroxyl radicals followed by protein and DNA oxidation, apoptosis and ferroptosis. Crosstalk between non-heme catalytic iron/Nox4 and downstream oxidative damage generated a mutual amplification cycle that facilitated rapid progression of cisplatin-induced iAKI. Iron deficiency also exacerbated a second model of iAKI, rhabdomyolysis, via increasing catalytic heme-iron. Heme-iron induced lipid peroxidation and DNA oxidation by interacting with Nox4-independent mechanisms, promoting p53/p21 activity and cellular senescence. Our data suggests that correcting iron deficiency and/or targeting specific catalytic iron species are strategies to mitigate iAKI in a wide range of patients with diverse forms of kidney injury.
缺铁是全球最常见的微量营养素缺乏症。虽然已知缺铁会抑制胚胎器官发生,但在与临床相关的损伤背景下,其对成人器官的影响尚未得到考虑。在这里,我们报告缺铁是肾单位内在急性肾损伤(iAKI)的肾毒性的一个危险因素。缺铁通过显著增加非血红素催化铁和 Nox4 蛋白来加剧顺铂诱导的 iAKI,这两者共同催化产生羟自由基,随后导致蛋白质和 DNA 氧化、细胞凋亡和铁死亡。非血红素催化铁/Nox4 与下游氧化损伤之间的串扰产生了一个相互放大的循环,促进了顺铂诱导的 iAKI 的快速进展。缺铁还通过增加催化血红素铁来加剧第二种 iAKI 模型横纹肌溶解症。血红素铁通过与 Nox4 独立的机制相互作用,引发脂质过氧化和 DNA 氧化,促进 p53/p21 活性和细胞衰老。我们的数据表明,纠正缺铁和/或针对特定的催化铁物种是减轻各种形式肾损伤患者 iAKI 的策略。