Department of Cellular and Molecular Physiology, Yale University School of Medicine, New Haven, Connecticut, USA.
Department of Sciences, University of Basilicata, Potenza, Italy.
Physiol Rep. 2021 Oct;9(20):e15058. doi: 10.14814/phy2.15058.
Autosomal dominant polycystic kidney disease (ADPKD) disrupts renal parenchyma through progressive expansion of fluid-filled cysts. The only approved pharmacotherapy for ADKPD involves the blockade of the vasopressin type 2 receptor (V2R). V2R is a GPCR expressed by a subset of renal tubular cells and whose activation stimulates cyclic AMP (cAMP) accumulation, which is a major driver of cyst growth. The β3-adrenergic receptor (β3-AR) is a GPCR expressed in most segments of the murine nephron, where it modulates cAMP production. Since sympathetic nerve activity, which leads to activation of the β3-AR, is elevated in patients affected by ADPKD, we hypothesize that β3-AR might constitute a novel therapeutic target. We find that administration of the selective β3-AR antagonist SR59230A to an ADPKD mouse model (Pkd1 ;Pax8 ;TetO-Cre) decreases cAMP levels, producing a significant reduction in kidney/body weight ratio and a partial improvement in kidney function. Furthermore, cystic mice show significantly higher β3-AR levels than healthy controls, suggesting a correlation between receptor expression and disease development. Finally, β3-AR is expressed in human renal tissue and localizes to cyst-lining epithelial cells in patients. Thus, β3-AR is a potentially interesting target for the development of new treatments for ADPKD.
常染色体显性多囊肾病(ADPKD)通过充满液体的囊肿进行性扩张破坏肾脏实质。ADKPD 的唯一批准的药物治疗涉及血管加压素 2 型受体(V2R)的阻断。V2R 是一种 G 蛋白偶联受体,由肾脏管状细胞的一部分表达,其激活刺激环磷酸腺苷(cAMP)的积累,这是囊肿生长的主要驱动因素。β3-肾上腺素能受体(β3-AR)是一种在大多数鼠肾单位段表达的 G 蛋白偶联受体,在那里它调节 cAMP 的产生。由于在 ADPKD 患者中,导致β3-AR 激活的交感神经活动升高,我们假设β3-AR 可能构成新的治疗靶点。我们发现,将选择性β3-AR 拮抗剂 SR59230A 施用于 ADPKD 小鼠模型(Pkd1 ; Pax8 ; TetO-Cre)可降低 cAMP 水平,导致肾脏/体重比显著降低,并部分改善肾功能。此外,囊性小鼠的β3-AR 水平明显高于健康对照,表明受体表达与疾病发展之间存在相关性。最后,β3-AR 在人类肾组织中表达,并定位于患者的囊壁上皮细胞。因此,β3-AR 是开发 ADPKD 新治疗方法的一个潜在有趣的靶点。