Department of Urology, Xiangya Hospital, Central South University, Changsha, 410008, Hunan, China.
Cell Mol Life Sci. 2021 Dec;78(23):7831-7849. doi: 10.1007/s00018-021-03972-x. Epub 2021 Nov 1.
Randall's plaques (RP) are well established as precursor lesions of idiopathic calcium oxalate (CaOx) stones, and the process of biomineralization driven by osteogenic-like cells has been highlighted in RP formation, but the mechanism is poorly understood. Given the inhibitory role of α-Klotho (KL), an aging suppressor protein with high expression in kidneys, in ectopic calcification and the close association between KL gene polymorphisms and urolithiasis susceptibility, we determined the potential role of KL in RP formation. This study found that both soluble KL (s-KL) and transmembrane KL (m-KL) were downregulated, and that s-KL but not m-KL was inversely correlated with upregulation of osteogenic markers in RP tissues. Additionally, s-KL expression was markedly suppressed in human renal interstitial fibroblasts (hRIFs) and slightly suppressed in HK-2 cells after osteogenic induction, intriguingly, which was echoed to the greater osteogenic capability of hRIFs than HK-2 cells. Further investigations showed the inhibitory effect of s-KL on hRIF osteogenic differentiation in vitro and in vivo. Moreover, coculture with recombinant human KL (r-KL) or HK-2 cells suppressed osteogenic differentiation of hRIFs, and this effect was abolished by coculture with KL-silenced HK-2 cells or the β-catenin agonist SKL2001. Mechanistically, s-KL inactivated the Wnt-β-catenin pathway by directly binding to Wnt2 and upregulating SFRP1. Further investigations identified activation of the Wnt-β-catenin pathway and downregulation of SFRP1 and DKK1 in RP tissues. In summary, this study identified s-KL deficiency as a pathological feature of RP and revealed that s-KL released from HK-2 cells inhibited osteogenic differentiation of hRIFs by inactivating the Wnt-β-catenin pathway, not only providing in-depth insight into the role of s-KL in renal interstitial biomineralization but also shedding new light on the interaction of renal tubular epithelial cells with interstitial cells to clarify RP formation.
兰德尔氏斑(RP)是特发性草酸钙(CaOx)结石的前体病变,成骨样细胞驱动的生物矿化过程在 RP 形成中得到了强调,但机制尚不清楚。鉴于衰老抑制蛋白 α-Klotho(KL)在肾脏中高表达,在异位钙化中的抑制作用以及 KL 基因多态性与尿石症易感性之间的密切关联,我们确定了 KL 在 RP 形成中的潜在作用。本研究发现,可溶性 KL(s-KL)和跨膜 KL(m-KL)均下调,s-KL 而非 m-KL 与 RP 组织中成骨标志物的上调呈负相关。此外,s-KL 在人肾间质成纤维细胞(hRIFs)中的表达明显受到抑制,在 HK-2 细胞中的表达受到轻微抑制,令人惊讶的是,这与 hRIFs 的成骨能力强于 HK-2 细胞相呼应。进一步的研究表明,s-KL 在体外和体内抑制 hRIF 成骨分化。此外,与重组人 KL(r-KL)或 HK-2 细胞共培养抑制 hRIF 成骨分化,而与 KL 沉默的 HK-2 细胞或 β-连环蛋白激动剂 SKL2001 共培养则消除了这种作用。在机制上,s-KL 通过直接与 Wnt2 结合并上调 SFRP1 使 Wnt-β-连环蛋白通路失活。进一步的研究确定了 Wnt-β-连环蛋白通路的激活以及 RP 组织中 SFRP1 和 DKK1 的下调。总之,本研究确定 s-KL 缺乏是 RP 的病理特征,并揭示了从 HK-2 细胞释放的 s-KL 通过使 Wnt-β-连环蛋白通路失活抑制 hRIF 成骨分化,不仅为 s-KL 在肾间质生物矿化中的作用提供了深入的见解,也为阐明 RP 形成提供了新的视角,即肾小管上皮细胞与间质细胞的相互作用。