DiKun Krysta M, Tang Xiao-Han, Fu Leiping, Choi Mary E, Lu Changyuan, Gudas Lorraine J
Department of Pharmacology, Weill Cornell Medical College of Cornell University, New York, NY 10065.
Weill Cornell Graduate School of Medical Sciences, New York, NY 10065.
Proc Natl Acad Sci U S A. 2024 Feb 13;121(7):e2311803121. doi: 10.1073/pnas.2311803121. Epub 2024 Feb 8.
Chronic kidney disease (CKD) is characterized by a gradual loss of kidney function and affects ~13.4% of the global population. Progressive tubulointerstitial fibrosis, driven in part by proximal tubule (PT) damage, is a hallmark of late stages of CKD and contributes to the development of kidney failure, for which there are limited treatment options. Normal kidney development requires signaling by vitamin A (retinol), which is metabolized to retinoic acid (RA), an endogenous agonist for the RA receptors (RARα, β, γ). RARα levels are decreased in a mouse model of diabetic nephropathy and restored with RA administration; additionally, RA treatment reduced fibrosis. We developed a mouse model in which a spatiotemporal (tamoxifen-inducible) deletion of RARα in kidney PT cells of adult mice causes mitochondrial dysfunction, massive PT injury, and apoptosis without the use of additional nephrotoxic substances. Long-term effects (3 to 4.5 mo) of RARα deletion include increased PT secretion of transforming growth factor β1, inflammation, interstitial fibrosis, and decreased kidney function, all of which are major features of human CKD. Therefore, RARα's actions in PTs are crucial for PT homeostasis, and loss of RARα causes injury and a key CKD phenotype.
慢性肾脏病(CKD)的特征是肾功能逐渐丧失,影响全球约13.4%的人口。进行性肾小管间质纤维化,部分由近端小管(PT)损伤驱动,是CKD晚期的标志,并且促成肾衰竭的发展,而针对肾衰竭的治疗选择有限。正常的肾脏发育需要维生素A(视黄醇)发出信号,维生素A可代谢为视黄酸(RA),这是一种RA受体(RARα、β、γ)的内源性激动剂。在糖尿病肾病小鼠模型中,RARα水平降低,给予RA后可恢复;此外,RA治疗可减少纤维化。我们建立了一种小鼠模型,在成年小鼠肾脏PT细胞中时空性(他莫昔芬诱导)缺失RARα会导致线粒体功能障碍、大量PT损伤和细胞凋亡,而无需使用其他肾毒性物质。RARα缺失的长期影响(3至4.5个月)包括PT分泌转化生长因子β1增加、炎症、间质纤维化以及肾功能下降,所有这些都是人类CKD的主要特征。因此,RARα在PT中的作用对于PT内环境稳定至关重要,RARα的缺失会导致损伤和关键的CKD表型。
Proc Natl Acad Sci U S A. 2024-2-13
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