Nephrology, Shenzhen Second People's Hospital, Shenzhen, Guangdong, China.
Nephrology, The First Affiliated Hospital of Shenzhen University, Shenzhen, Guangdong, China.
PeerJ. 2024 Sep 26;12:e18166. doi: 10.7717/peerj.18166. eCollection 2024.
BACKGROUND: Fibrosis after nephrotoxic injury is common. Activation of the paraventricular nucleus (PVN) renin-angiotensin system (RAS) and sympathetic nervous system (SNS) are common mechanism of renal fibrosis. However, there have limited knowledge about which brain regions are most affected by Angiotensin II (Ang II) after nephrotoxic injury, what role does Angiotensin II type 1a receptors (AT1R) signaling play and how this affects the outcomes of the kidneys. METHODS: In nephrotoxic folic acid-induced chronic kidney disease (FA-CKD) mouse models, we have integrated retrograde tracer techniques with studies on AT1afl/fl mice to pinpoint an excessively active central pathway that connects the paraventricular nucleus (PVN) to the rostral ventrolateral medulla (RVLM). This pathway plays a pivotal role in determining the kidney's fibrotic response following injury induced by folic acid. RESULTS: FA-CKD ( sham) had increased in the kidney SNS activity and Ang II expression in the central PVN. The activation of Ang II in the PVN triggers the activation of the PVN-RVLM pathway, amplifies SNS output, thus facilitating fibrosis development in FA-CKD mouse. Blocking sympathetic traffic or deleting AT1a in the PVN alleviated renal fibrosis in FA-CKD mice. CONCLUSIONS: The FA-CKD mice have increased the expression of Ang II in PVN, thereby activating AT1a-positive PVN neurons project to the RVLM, where SNS activity is engaged to initiate fibrotic processes. The Ang II in PVN may contribute to the development of kidney fibrosis after nephrotoxic folic acid-induced kidney injury.
背景:肾毒性损伤后的纤维化很常见。室旁核(PVN)肾素-血管紧张素系统(RAS)和交感神经系统(SNS)的激活是肾纤维化的常见机制。然而,对于血管紧张素 II(Ang II)在肾毒性损伤后哪些脑区受到的影响最大、Angiotensin II type 1a receptors(AT1R)信号的作用是什么以及这如何影响肾脏的结局,我们的了解还很有限。
方法:在肾毒性叶酸诱导的慢性肾病(FA-CKD)小鼠模型中,我们将逆行示踪技术与 AT1afl/fl 小鼠的研究相结合,以确定连接室旁核(PVN)和延髓腹外侧头(RVLM)的异常活跃的中枢通路。该通路在决定叶酸诱导的损伤后肾脏的纤维化反应中起着关键作用。
结果:FA-CKD(假手术)小鼠的肾脏 SNS 活性和中央 PVN 中的 Ang II 表达增加。PVN 中 Ang II 的激活触发了 PVN-RVLM 通路的激活,放大了 SNS 的输出,从而促进了 FA-CKD 小鼠的纤维化发展。阻断交感神经流量或在 PVN 中删除 AT1a 可减轻 FA-CKD 小鼠的肾纤维化。
结论:FA-CKD 小鼠中 PVN 中 Ang II 的表达增加,从而激活了向 RVLM 投射的 AT1a 阳性 PVN 神经元,其中 SNS 活性被募集以启动纤维化过程。PVN 中的 Ang II 可能有助于肾毒性叶酸诱导的肾损伤后肾脏纤维化的发展。
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