Department of Pharmacology and Toxicology, University of Louisville, Louisville, Kentucky.
Department of Biochemistry and Molecular Genetics, University of Louisville, Louisville, Kentucky.
Kidney360. 2022 Feb 10;3(5):818-833. doi: 10.34067/KID.0006442021. eCollection 2022 May 26.
Cisplatin-induced kidney injury remains a major obstacle in utilizing cisplatin as a chemotherapeutic for solid-organ cancers. Thirty percent of patients treated with cisplatin develop acute kidney injury (AKI), and even patients who do not develop AKI are at risk for long-term declines in kidney function and development of chronic kidney disease (CKD). Modeling cisplatin-induced kidney injury in mice has revealed that repeated low doses of cisplatin lead to development of kidney fibrosis. This model can be used to examine AKI-to-CKD transition processes. Macrophages play a role in some of these processes, including immune response, wound healing, and tissue remodeling. Depleting macrophage populations in the kidney reduced fibrosis development in other models of renal fibrosis.
We used either C57BL/6 mice with a Ccr2 genetic knockout or liposome encapsulated clodronate (Clodrosome) to deplete macrophage populations during repeated 9 mg/kg cisplatin treatments. We assessed how immune cell populations were altered in the blood and kidney of these mice and how these alterations affected development of renal fibrosis and kidney injury.
We found that Clodrosome treatment decreased collagen deposition, myofibroblast accumulation, and inflammatory cytokine production, whereas Ccr2 genetic knockout had no effect on these markers after cisplatin treatment. Additionally, Ccr2 mice had decreased levels of F4/80 infiltrating macrophages in the kidney after cisplatin treatments, but Clodrosome treatment depleted F4/80 resident and CD206 M2 macrophages.
These data suggest that Clodrosome depletion of F4/80 and M2 macrophages in the kidney attenuates development of renal fibrosis after repeated low doses of cisplatin.
顺铂诱导的肾损伤仍然是将顺铂用作实体瘤癌症化疗药物的主要障碍。接受顺铂治疗的患者中有 30%发生急性肾损伤(AKI),即使未发生 AKI 的患者也存在肾功能长期下降和慢性肾脏病(CKD)发展的风险。在小鼠中模拟顺铂诱导的肾损伤表明,重复给予低剂量顺铂会导致肾纤维化的发展。该模型可用于研究 AKI 向 CKD 转变的过程。巨噬细胞在这些过程中发挥作用,包括免疫反应、伤口愈合和组织重塑。在其他肾纤维化模型中,耗尽肾脏中的巨噬细胞群可减少纤维化的发展。
我们使用 C57BL/6 小鼠,其中 Ccr2 基因敲除或脂质体包裹的氯膦酸(Clodrosome)在重复给予 9mg/kg 顺铂治疗期间耗竭巨噬细胞群。我们评估了这些小鼠的血液和肾脏中的免疫细胞群如何发生改变,以及这些改变如何影响肾纤维化和肾损伤的发展。
我们发现,Clodrosome 处理可减少胶原沉积、肌成纤维细胞积累和炎性细胞因子的产生,而 Ccr2 基因敲除在顺铂处理后对这些标志物没有影响。此外,顺铂处理后 Ccr2 小鼠肾脏中的 F4/80 浸润巨噬细胞水平降低,但 Clodrosome 处理耗尽了 F4/80 固有和 CD206 M2 巨噬细胞。
这些数据表明,Clodrosome 耗尽肾脏中的 F4/80 和 M2 巨噬细胞可减轻重复低剂量顺铂后肾纤维化的发展。