Luo Peiyue, Chen Tao, Zheng Liying, Zou Junrong, Zou Jun, Li Wei, Chen Qi, Cheng Le, Qian Biao
The First Clinical College, Gannan Medical University, Ganzhou, Jiangxi, China.
Department of Urology, The First Affiliated hospital of Gannan Medical University, Ganzhou, Jiangxi, China.
Front Pharmacol. 2024 Dec 4;15:1477122. doi: 10.3389/fphar.2024.1477122. eCollection 2024.
The calcium-sensitive receptor (CaSR) has been identified as a key factor in the formation of kidney stones. A substantial body of research has illuminated the function of CaSR in stone formation with respect to oxidative stress, epithelial injury, crystal adhesion, and stone-associated proteins. Nevertheless, as a pivotal molecule in renal calcium excretion, its pathway that contributes to stone formation by regulating calcium supersaturation remains underexplored.
An in vitro rat calcium oxalate kidney stone model was established through the co-cultivation of calcium oxalate monohydrate (COM) with NRK-52E cells, while an in vivo model was constructed using the ethylene glycol method. Subsequently, the level of the CaSR-claudin-14 pathway was determined. To further elucidate the molecular pathway of CaSR-mediated regulation of claudin-14, drugs were selectively added to the in vitro and ex vivo kidney stone models, and the expression of claudin-14 and the levels of stone formation were detected. Moreover, the direct regulation of claudin-14 by CaSR with STAT3 serving as a transcription factor was examined via the dual luciferase assay. Eventually, a Cldn-14 knockout rat model and a model of kidney stone induction by ethylene glycol were generated using CRISPR-Cas9 technology to further clarify the role of claudin-14 in the CaSR-regulated formation of kidney stones.
In vitro and in vivo observations revealed that calcium oxalate induces high expression of CaSR-claudin-14. Specifically, CaSR regulates claudin-14 expression through phosphorylation modification of STAT3 via protein kinase A (PKA). In vitro, the intervention of PKA and STAT3 reversed the elevated claudin-14 levels and stone formation induced by CaSR. Finally, we generated cldn-14 knockout rats using CRISPR-Cas9 technology and observed that ethylene glycol still induced stone formation in these animals. Nevertheless, the specific activation or inhibition of CaSR demonstrated no notable impact on stone formation.
The results of our study indicate that calcium oxalate crystals induce the activation of the pro-stone pathway of CaSR. That is, activated CaSR regulates claudin-14 levels via the PKA-STAT3 pathway, which further promotes calcium salt stone formation. The role of CaSR in the regulation of stone homeostasis is further enriched.
钙敏感受体(CaSR)已被确定为肾结石形成的关键因素。大量研究阐明了CaSR在结石形成中关于氧化应激、上皮损伤、晶体黏附及结石相关蛋白方面的功能。然而,作为肾脏钙排泄中的关键分子,其通过调节钙过饱和度促进结石形成的途径仍未得到充分探索。
通过一水合草酸钙(COM)与NRK-52E细胞共培养建立体外大鼠草酸钙肾结石模型,同时采用乙二醇法构建体内模型。随后,测定CaSR-紧密连接蛋白14(claudin-14)通路的水平。为进一步阐明CaSR介导的紧密连接蛋白14调节的分子途径,将药物选择性添加到体外和离体肾结石模型中,并检测紧密连接蛋白14的表达及结石形成水平。此外,通过双荧光素酶测定法检测以信号转导和转录激活因子3(STAT3)作为转录因子时CaSR对紧密连接蛋白14的直接调节作用。最终,利用CRISPR-Cas9技术构建紧密连接蛋白14基因敲除大鼠模型和乙二醇诱导的肾结石模型,以进一步阐明紧密连接蛋白14在CaSR调节的肾结石形成中的作用。
体外和体内观察结果显示,草酸钙诱导CaSR-紧密连接蛋白14的高表达。具体而言,CaSR通过蛋白激酶A(PKA)对STAT3进行磷酸化修饰来调节紧密连接蛋白14的表达。在体外,PKA和STAT3的干预逆转了由CaSR诱导的紧密连接蛋白14水平升高和结石形成。最后,我们利用CRISPR-Cas9技术生成了紧密连接蛋白14基因敲除大鼠,并观察到乙二醇仍能在这些动物中诱导结石形成。然而,CaSR的特异性激活或抑制对结石形成无显著影响。
我们的研究结果表明,草酸钙晶体诱导CaSR的促结石途径激活。即,激活的CaSR通过PKA-STAT3途径调节紧密连接蛋白14水平,进而促进钙盐结石形成。CaSR在调节结石内环境稳定中的作用得到进一步充实。