Department of Critical Care Medicine, Zhongnan Hospital of Wuhan University, Wuhan, China.
Clinical Research Center of Hubei Critical Care Medicine, Wuhan, China.
Am J Physiol Cell Physiol. 2024 May 1;326(5):C1353-C1366. doi: 10.1152/ajpcell.00577.2023. Epub 2024 Mar 18.
The tissue inhibitor of metalloproteinases 2 (TIMP2) has emerged as a promising biomarker for predicting the risk of sepsis-associated acute kidney injury (SA-AKI). However, its exact role in SA-AKI and the underlying mechanism remains unclear. In this study, we investigated the impact of kidney tubule-specific Timp2 knockout mice on kidney injury and inflammation. Our findings demonstrated that Timp2-knockout mice exhibited more severe kidney injury than wild-type mice, along with elevated levels of pyroptosis markers NOD-like receptor protein 3 (NLRP3), Caspase1, and gasdermin D (GSDMD) in the early stage of SA-AKI. Conversely, the expression of exogenous TIMP2 in TIMP2-knockout mice still protected against kidney damage and inflammation. In in vitro experiments, using recombinant TIMP2 protein, TIMP2 knockdown demonstrated that exogenous TIMP2 inhibited pyroptosis of renal tubular cells stimulated by lipopolysaccharide (LPS). Mechanistically, TIMP2 promoted the ubiquitination and autophagy-dependent degradation of NLRP3 by increasing intracellular cyclic adenosine monophosphate (cAMP), which mediated NLRP3 degradation through recruiting the E3 ligase MARCH7, attenuating downstream pyroptosis, and thus alleviating primary tubular cell damage. These results revealed the renoprotective role of extracellular TIMP2 in SA-AKI by attenuating tubular pyroptosis, and suggested that exogenous administration of TIMP2 could be a promising therapeutic intervention for SA-AKI treatment. Tissue inhibitor of metalloproteinase 2 (TIMP-2) has been found to be the best biomarker for predicting the risk of sepsis-associated acute kidney injury (SA-AKI). However, its role and the underlying mechanism in SA-AKI remain elusive. The authors demonstrated in this study using kidney tubule-specific knockout mice model of SA-AKI and primary renal tubule cells stimulated with lipopolysaccharide (LPS) that extracellular TIMP-2 promoted NOD-like receptor protein 3 (NLRP3) ubiquitination and autophagy-dependent degradation by increasing intracellular cyclic adenosine monophosphate (cAMP), thus attenuated pyroptosis and alleviated renal damage.
组织金属蛋白酶抑制剂 2(TIMP2)已成为预测脓毒症相关急性肾损伤(SA-AKI)风险的有前途的生物标志物。然而,其在 SA-AKI 中的确切作用及其潜在机制尚不清楚。在这项研究中,我们研究了肾小管特异性 Timp2 敲除小鼠对肾损伤和炎症的影响。我们的研究结果表明,与野生型小鼠相比,Timp2 敲除小鼠在 SA-AKI 的早期阶段表现出更严重的肾损伤,同时,NOD 样受体蛋白 3(NLRP3)、半胱天冬酶 1 和 Gasdermin D(GSDMD)等细胞焦亡标志物的水平升高。相反,外源性 TIMP2 在 TIMP2 敲除小鼠中的表达仍然可以防止肾损伤和炎症。在体外实验中,使用重组 TIMP2 蛋白,TIMP2 敲低表明,外源性 TIMP2 抑制了脂多糖(LPS)刺激的肾小管细胞的细胞焦亡。从机制上讲,TIMP2 通过增加细胞内环磷酸腺苷(cAMP)促进 NLRP3 的泛素化和自噬依赖性降解,从而通过募集 E3 连接酶 MARCH7 介导 NLRP3 降解,减弱下游细胞焦亡,从而减轻原代肾小管细胞损伤。这些结果揭示了细胞外 TIMP2 通过减轻肾小管细胞焦亡在 SA-AKI 中的肾保护作用,并表明外源性 TIMP2 给药可能是治疗 SA-AKI 的有前途的治疗干预措施。组织金属蛋白酶抑制剂 2(TIMP-2)已被发现是预测脓毒症相关急性肾损伤(SA-AKI)风险的最佳生物标志物。然而,其在 SA-AKI 中的作用及其潜在机制仍不清楚。作者在这项研究中使用 SA-AKI 的肾小管特异性敲除小鼠模型和用脂多糖(LPS)刺激的原代肾小管细胞表明,细胞外 TIMP-2 通过增加细胞内环磷酸腺苷(cAMP)促进 NOD 样受体蛋白 3(NLRP3)的泛素化和自噬依赖性降解,从而减弱细胞焦亡并减轻肾损伤。
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