Wang Yujing, Xiao Min, Cai Feng, Li Yang, Shi Tianli, Zhou Xiaoyan, Tian Shuhong, Huang Denggao
Department of Hemodialysis, Haikou Affiliated Hospital of Central South University Xiangya School of Medicine, Haikou, China.
Department of Clinical Laboratory, Strategic Support Force Medical Center, Beijing, China.
Environ Toxicol. 2024 Apr;39(4):2363-2373. doi: 10.1002/tox.24116. Epub 2023 Dec 29.
Vascular calcification (VC) is a common complication of chronic kidney disease (CKD). VC is a gene-regulated process similar to osteogenic differentiation. There are still no convincing schemes to prevent and reduce the development of VC. It has been reported that hypoxia-inducing factor 1α (HIF-1α) and endothelin-1(ET-1) are related to VC. In this study, we found that the expression of ET-1 and HIF-1α was enhanced after VC, the interaction between HIF-1α and ET-1 was confirmed by CO-IP and luciferase experiments. We found that ET-1 was an upregulated differential gene of calcified vascular smooth muscle cells (VSMCs) through gene sequencing. However, hypoxia-inducing factor 2α (HIF-2α) and HIF-1α have antagonistic effects on each other. HIF-1α is a pro-inflammatory cytokine, and HIF-2α can improve inflammation and fibrosis. Roxadustat, as a selective PHD3 inhibitor, preferentially activates HIF-2α. It is still unclear whether roxadustat improves VC in CKD by regulating the expression of HIF-2α/HIF-1α. Alizarin red staining and western blot as well as immunohistochemical results showed that roxadustat could significantly reduce the degree of vascular and VSMCs calcification in CKD rats. Serum HIF-1α and ET-1 were significantly decreased after roxadustat treatment. In addition, western blot results showed that roxadustat could decrease the expression of HIF-1α and ET-1 in vascular tissues and calcified VSMC, but HIF-2α expression significantly increased. Interestingly, our study confirmed that activation of HIF-1α or inhibition of HIF-2α reversed the ameliorating effect of roxadustat on VC, proving that the effect mediated by roxadustat is HIF-2α/HIF-1α dependent. We have demonstrated for the first time that roxadustat improves VC in CKD rats by regulating HIF-2α/HIF-1α, thus providing a new idea for the application of roxadustat in VC of CKD.
血管钙化(VC)是慢性肾脏病(CKD)的常见并发症。VC是一个与成骨分化类似的基因调控过程。目前仍没有令人信服的预防和减少VC发展的方案。据报道,缺氧诱导因子1α(HIF-1α)和内皮素-1(ET-1)与VC有关。在本研究中,我们发现VC后ET-1和HIF-1α的表达增强,通过免疫共沉淀(CO-IP)和荧光素酶实验证实了HIF-1α与ET-1之间的相互作用。通过基因测序我们发现ET-1是钙化血管平滑肌细胞(VSMC)的上调差异基因。然而,缺氧诱导因子2α(HIF-2α)与HIF-1α相互拮抗。HIF-1α是一种促炎细胞因子,而HIF-2α可改善炎症和纤维化。罗沙司他作为一种选择性脯氨酰羟化酶3(PHD3)抑制剂,优先激活HIF-2α。罗沙司他是否通过调节HIF-2α/HIF-1α的表达来改善CKD中的VC仍不清楚。茜素红染色、蛋白质免疫印迹以及免疫组化结果显示,罗沙司他可显著降低CKD大鼠的血管和VSMC钙化程度。罗沙司他治疗后血清HIF-1α和ET-1显著降低。此外,蛋白质免疫印迹结果显示,罗沙司他可降低血管组织和钙化VSMC中HIF-1α和ET-1的表达,但HIF-2α表达显著增加。有趣的是,我们的研究证实激活HIF-1α或抑制HIF-2α可逆转罗沙司他对VC的改善作用,证明罗沙司他介导的作用依赖于HIF-2α/HIF-1α。我们首次证明罗沙司他通过调节HIF-2α/HIF-1α改善CKD大鼠的VC,从而为罗沙司他在CKD的VC中的应用提供了新思路。