Department of Nephrology, Second Xiangya Hospital of Central South University, Changsha, Hunan, China.
Hunan Key Laboratory of Kidney Disease and Blood Purification, Changsha, Hunan, China.
Nephrol Dial Transplant. 2022 Nov 23;37(12):2366-2385. doi: 10.1093/ndt/gfac164.
Acute kidney injury (AKI) is a public health problem with no specific therapies in the clinic and the underlying pathogenesis of AKI remains obscure. Bombesin receptor-activated protein (BRAP, C6ORF89 protein) was initially discovered as a ligand for a previously orphan G-protein-coupled receptor bombesin-like receptor-3. At present, accepted biological effects of BRAP include cell cycle progression, wound repair and the activation of histone deacetylases. However, its role in kidney disease is unknown. In this study we have investigated the role of BRAP and underlying mechanisms involved in cisplatin (CP)-induced AKI.
Here we used Bc004004 (homologous of C6ORF89 in mice) knockout mice and HK2 cells to investigate the effect of BRAP on AKI in vitro and in vivo. We analyzed ChIP-Seq and RNA-Seq data to search for the upstream regulators of BRAP and downstream mediators of BRAP action in AKI. Immunostaining, real-time polymerase chain reaction (PCR), co-immunoprecipitation, a dual-luciferase reporter assay and ChIP-PCR assay were applied to reveal the upstream and downstream regulation mechanism of BRAP during cisplatin-induced AKI.
BRAP was downregulated in mice and human kidneys with AKI. Global Bc004004 deletion alleviated tubular cell apoptosis and necroptosis in CP-induced AKI mice, whereas local overexpression of BRAP in kidneys aggravated them. Pan-caspase inhibitor Z-VAD pretreatment attenuated CP-induced blood creatinine increase and kidney injury in wild-type mice but not in BRAP -/- mice. The activation of mixed lineage kinase like-domain was magnified by Z-VAD in CP-treated mice, especially in BRAP -/- mice. The cytoprotective effect of Z-VAD was more substantial than necrostatin-1 (Nec-1, an inhibitor of necroptosis) in CP-treated human kidney proximal tubular epithelial (HK2) cells. Furthermore, Nec-1 pretreatment reduced the CP-induced cell death in BRAP overexpression HK2 cells but did not work in cells with normal BRAP levels. We determined that CP treatment activated the nuclear factor-κB subunit P65 and inhibition of P65 increased the messenger RNA (mRNA) levels of BRAP in HK2 cells. The chromatin immunoprecipitation assay and dual-luciferase reporter gene assay verified P65 binding to the C6ORF89 promoter and reduced its mRNA expression upon CP treatment. Next we found that sirtuin 2 (SIRT2) was downregulated in CP-induced AKI and BRAP levels directly impacted the protein levels of SIRT2. Our findings further confirmed that BRAP regulates the SIRT2 protein levels by affecting SIRT2's interactions with E3 ubiquitin ligase HRD1 and subsequent proteasomal degradation.
Our results demonstrated that BRAP played an important role in tubular cell apoptosis and necroptosis during CP-induced AKI. Safe and efficient BRAP inhibitors might be effective therapeutic options for AKI.
急性肾损伤(AKI)是一个公共健康问题,临床上尚无特异性治疗方法,其发病机制仍不清楚。脑肠肽受体激活蛋白(BRAP,C6ORF89 蛋白)最初被发现是先前孤儿 G 蛋白偶联受体脑肠肽样受体-3 的配体。目前,BRAP 的公认生物学效应包括细胞周期进展、伤口修复和组蛋白去乙酰化酶的激活。然而,其在肾脏疾病中的作用尚不清楚。在本研究中,我们研究了 BRAP 在顺铂(CP)诱导的 AKI 中的作用及其潜在机制。
我们使用 Bc004004(小鼠同源物 C6ORF89)敲除小鼠和 HK2 细胞,在体外和体内研究 BRAP 对 AKI 的影响。我们分析了 ChIP-Seq 和 RNA-Seq 数据,以寻找 BRAP 在 AKI 中的上游调节剂和下游效应物。免疫染色、实时聚合酶链反应(PCR)、共免疫沉淀、双荧光素酶报告基因测定和 ChIP-PCR 测定用于揭示 CP 诱导的 AKI 过程中 BRAP 的上下游调控机制。
在 AKI 小鼠和人肾脏中,BRAP 表达下调。全局 Bc004004 缺失减轻了 CP 诱导的 AKI 小鼠肾小管细胞凋亡和坏死性凋亡,而肾脏中 BRAP 的局部过表达则加重了这种情况。泛半胱天冬酶抑制剂 Z-VAD 预处理可减轻野生型小鼠中 CP 诱导的血肌酐升高和肾损伤,但不能减轻 BRAP-/-小鼠的损伤。CP 处理后,混合谱系激酶样结构域的激活被 Z-VAD 放大,尤其是在 BRAP-/-小鼠中。Z-VAD 在 CP 处理的人肾近端小管上皮(HK2)细胞中的保护作用比坏死抑制剂 1(Nec-1)更强。此外,Nec-1 预处理可减少 CP 诱导的 BRAP 过表达 HK2 细胞中的细胞死亡,但在 BRAP 水平正常的细胞中无效。我们确定 CP 处理激活了核因子-κB 亚单位 P65,抑制 P65 可增加 CP 处理 HK2 细胞中 BRAP 的信使 RNA(mRNA)水平。染色质免疫沉淀测定和双荧光素酶报告基因测定证实了 P65 与 C6ORF89 启动子结合,并降低了 CP 处理后的其 mRNA 表达。接下来,我们发现 CP 诱导的 AKI 中 SIRT2 下调,BRAP 水平直接影响 SIRT2 蛋白水平。我们的研究结果进一步证实,BRAP 通过影响 SIRT2 与 E3 泛素连接酶 HRD1 的相互作用及其随后的蛋白体降解来调节 SIRT2 蛋白水平。
我们的研究结果表明,BRAP 在 CP 诱导的 AKI 中肾小管细胞凋亡和坏死性凋亡中发挥重要作用。安全有效的 BRAP 抑制剂可能是 AKI 的有效治疗选择。