Département de Médecine, Université de Montréal, Centre de recherche du Centre hospitalier de l'Université de Montréal (CRCHUM), Montréal, QC, Canada.
Division of Nephrology, Department of Internal Medicine, Saint Louis University, St. Louis, MO, USA.
Diabetologia. 2021 Nov;64(11):2589-2601. doi: 10.1007/s00125-021-05538-9. Epub 2021 Aug 9.
AIMS/HYPOTHESIS: We previously reported that renal tubule-specific deletion of heterogeneous nuclear ribonucleoprotein F (Hnrnpf) results in upregulation of renal angiotensinogen (Agt) and downregulation of sodium-glucose co-transporter 2 (Sglt2) in Hnrnpf knockout (KO) mice. Non-diabetic Hnrnpf KO mice develop hypertension, renal interstitial fibrosis and glycosuria with no renoprotective effect from downregulated Sglt2 expression. Here, we investigated the effect of renal tubular Hnrnpf deletion on hyperfiltration and kidney injury in Akita mice, a model of type 1 diabetes.
Akita Hnrnpf KO mice were generated through crossbreeding tubule-specific (Pax8)-Cre mice with Akita floxed-Hnrnpf mice on a C57BL/6 background. Male non-diabetic control (Ctrl), Akita, and Akita Hnrnpf KO mice were studied up to the age of 24 weeks (n = 8/group).
Akita mice exhibited elevated systolic blood pressure as compared with Ctrl mice, which was significantly higher in Akita Hnrnpf KO mice than Akita mice. Compared with Akita mice, Akita Hnrnpf KO mice had lower blood glucose levels with increased urinary glucose excretion. Akita mice developed kidney hypertrophy, glomerular hyperfiltration (increased glomerular filtration rate), glomerulomegaly, mesangial expansion, podocyte foot process effacement, thickened glomerular basement membranes, renal interstitial fibrosis and increased albuminuria. These abnormalities were attenuated in Akita Hnrnpf KO mice. Treatment of Akita Hnrnpf KO mice with a selective A1 adenosine receptor inhibitor resulted in an increase in glomerular filtration rate. Renal Agt expression was elevated in Akita mice and further increased in Akita Hnrnpf KO mice. In contrast, Sglt2 expression was increased in Akita and decreased in Akita Hnrnpf KO mice.
CONCLUSIONS/INTERPRETATION: The renoprotective effect of Sglt2 downregulation overcomes the renal injurious effect of Agt when these opposing factors coexist under diabetic conditions, at least partly via the activation of tubuloglomerular feedback.
目的/假设:我们之前报道过,肾近端小管特异性敲除异质核核糖核蛋白 F(Hnrnpf)可导致敲除 Hnrnpf (KO)小鼠肾血管紧张素原(Agt)上调和钠-葡萄糖协同转运蛋白 2(Sglt2)下调。非糖尿病型 Hnrnpf KO 小鼠发生高血压、肾间质纤维化和糖尿,但 Sglt2 表达下调没有起到肾保护作用。在此,我们研究了肾近端小管 Hnrnpf 敲除对 1 型糖尿病模型 Akita 小鼠高滤过和肾损伤的影响。
通过将 Pax8-Cre 小鼠与 C57BL/6 背景下的 Akita floxed-Hnrnpf 小鼠杂交,生成了肾小管特异性(Pax8)-Cre 敲除 Hnrnpf (KO)小鼠。雄性非糖尿病对照(Ctrl)、Akita 和 Akita Hnrnpf KO 小鼠分别在 24 周龄(每组 8 只)时进行研究。
与 Ctrl 小鼠相比,Akita 小鼠的收缩压升高,而 Akita Hnrnpf KO 小鼠的收缩压明显高于 Akita 小鼠。与 Akita 小鼠相比,Akita Hnrnpf KO 小鼠的血糖水平较低,尿糖排泄增加。Akita 小鼠发生肾脏肥大、肾小球高滤过(肾小球滤过率增加)、肾小球肿大、肾小球系膜扩张、足细胞足突消失、肾小球基底膜增厚、肾间质纤维化和白蛋白尿增加。这些异常在 Akita Hnrnpf KO 小鼠中减轻。用选择性 A1 腺苷受体抑制剂治疗 Akita Hnrnpf KO 小鼠可增加肾小球滤过率。Akita 小鼠的肾血管紧张素原表达升高,而 Akita Hnrnpf KO 小鼠的肾血管紧张素原表达进一步升高。相反,Sglt2 表达在 Akita 小鼠中增加,在 Akita Hnrnpf KO 小鼠中减少。
结论/解释:在糖尿病条件下,当这些对立因素共存时,Sglt2 下调的肾保护作用克服了 Agt 的肾损伤作用,至少部分是通过激活管球反馈。