Division of Nephrology and Hypertension, University of California San Diego, San Diego, California.
VA San Diego Healthcare System, San Diego, California.
Kidney360. 2023 Aug 1;4(8):1080-1094. doi: 10.34067/KID.0000000000000153. Epub 2023 May 24.
KEY POINTS: There is significant enrichment in metabolic pathways in early stages in the subtotal nephrectomy model of CKD. Proximal tubular mitochondrial respiration is suppressed likely from mitochondrial dysfunction in substrate utilization and ATP synthesis. There is significant suppression of pyruvate dehydrogenase and increased glycolysis in proximal tubules. BACKGROUND: CKD is a significant contributor to morbidity and mortality. A better understanding of mechanisms underlying CKD progression is indispensable for developing effective therapies. Toward this goal, we addressed specific gaps in knowledge regarding tubular metabolism in the pathogenesis of CKD using the subtotal nephrectomy (STN) model in mice. METHODS: Weight- and age‐matched male 129X1/SvJ mice underwent sham or STN surgeries. We conducted serial GFR and hemodynamic measurements up to 16 weeks after sham and STN surgery and established the 4-week time point for subsequent studies. RESULTS: For a comprehensive assessment of renal metabolism, we conducted transcriptomic analyses, which showed significant enrichment of pathways involved in fatty acid metabolism, gluconeogenesis, glycolysis, and mitochondrial metabolism in STN kidneys. Expression of rate-limiting fatty acid oxidation and glycolytic enzymes was increased in STN kidneys, and proximal tubules in STN kidneys exhibited increased functional glycolysis but decreased mitochondrial respiration, despite an increase in mitochondrial biogenesis. Assessment of the pyruvate dehydrogenase complex pathway showed significant suppression of pyruvate dehydrogenase, suggesting decreased provision of acetyl CoA from pyruvate for the citric acid cycle to fuel mitochondrial respiration. CONCLUSION: Metabolic pathways are significantly altered in response to kidney injury and may play an important role in the disease progression.
要点:在 CKD 的次全肾切除模型的早期阶段,代谢途径有明显的富集。近端肾小管线粒体呼吸受到抑制,可能是由于底物利用和 ATP 合成中的线粒体功能障碍。近端肾小管中丙酮酸脱氢酶显著抑制,糖酵解增加。
背景:CKD 是发病率和死亡率的重要原因。为了开发有效的治疗方法,了解 CKD 进展的机制至关重要。为此,我们使用小鼠的次全肾切除术(STN)模型,针对肾小管代谢在 CKD 发病机制中的具体知识空白进行了研究。
方法:体重和年龄匹配的 129X1/SvJ 雄性小鼠接受假手术或 STN 手术。我们进行了连续的 GFR 和血液动力学测量,直到假手术和 STN 手术后 16 周,并建立了随后研究的 4 周时间点。
结果:为了全面评估肾脏代谢,我们进行了转录组分析,结果显示 STN 肾脏中涉及脂肪酸代谢、糖异生、糖酵解和线粒体代谢的途径明显富集。STN 肾脏中限速脂肪酸氧化和糖酵解酶的表达增加,尽管线粒体生物发生增加,但 STN 肾脏的近端肾小管表现出增加的功能性糖酵解,但线粒体呼吸减少。丙酮酸脱氢酶复合物途径的评估表明,丙酮酸脱氢酶显著抑制,表明从丙酮酸提供的乙酰辅酶 A 减少,用于柠檬酸循环为线粒体呼吸提供燃料。
结论:代谢途径对肾脏损伤有明显的改变,可能在疾病进展中发挥重要作用。
Kidney360. 2023-8-1
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