Kong Deyang, Yang Zhuohang, Zhang Xiaoting, Song Yifan, Anayyat Umer, Li Yanping, Liu Hao, Ou Zhanci, Pang Shuo, Wang Xiaomei
Department of Nephrology, Shenzhen Bao'an District Songgang People's Hospital, Shenzhen, 518000, China.
School of Pharmacy, Shenzhen University Medical School, Shenzhen University, Shenzhen, Guangdong, 518055, China.
Regen Ther. 2025 Sep 1;30:719-729. doi: 10.1016/j.reth.2025.08.016. eCollection 2025 Dec.
Acute kidney injury (AKI) results from cisplatin chemotherapeutic agents in 30 %-46 % of patients, but clinically effective preventive and therapeutic approaches are lacking. Bone marrow mesenchymal stem cells-derived exosomes (BMSCs-exo) have potential in tissue repair, but the mechanism by which they attenuate cisplatin-induced kidney injury is unknown.
To explore the therapeutic effect of BMSCs-exo on cisplatin-induced AKI and to analyze the key molecular mechanism involved.
BMSCs-exo were extracted via ultracentrifugation and identified via transmission electron microscopy, nanoparticle analysis and Western blot. C57BL/6 mice were divided into a control group (Con), a cisplatin model group (Cis), and a BMSCs-exo treatment group (BMSCs-exo), and renal function was dynamically tested. PAS staining was used to observe histopathological changes in mouse kidney tissues, while immunohistochemistry was employed to assess the expression levels of Wnt4, β-catenin, FZD5, CD31, and the tubular injury markers NGAL and KIM1. Western blot was used to detect the expression of Wnt4, β-catenin, FZD5 and CD31. High-throughput sequencing was used to screen for differential miRNAs, and GO/KEGG enrichment analysis of target genes was performed.
Blood creatinine and urea nitrogen levels were significantly higher in the Cis group than in the Con group, and renal tubular epithelial cells exhibited necrosis, confirming successful AKI model establishment. BMSCs-exo alleviated renal dysfunction, histopathological alterations, and tubular injury in vivo, as evidenced by NGAL and KIM1 expression. We further demonstrated that BMSCs-exo specifically localized to the injured kidney. MiRNA sequencing of renal tissues from the Con, Cis and BMSCs-exo groups identified mmu-miR-874-3p-enriched in Wnt signaling and angiogenesis pathways-as a key mediator of the renoprotective effects of BMSCs-exo, with FZD5 as its downstream target. Moreover, treatment with BMSCs-exo markedly prevented microvascular loss. In the BMSCs-exo group, Wnt4, β-catenin and CD31 expression were upregulated, whereas FZD5 expression was downregulated, consistent with the immunohistochemistry results.
BMSCs-exo protect kidneys against cisplatin-induced AKI(-AKI) by attenuating injury to the renal microvasculature and tubule epithelial cells, primarily through mmu-miR-874-3p-mediated inhibition of FZD5 activation and promotion of Wnt/β-catenin pathway activation.
顺铂化疗药物可导致30%-46%的患者发生急性肾损伤(AKI),但目前缺乏临床有效的预防和治疗方法。骨髓间充质干细胞来源的外泌体(BMSCs-exo)在组织修复方面具有潜力,但其减轻顺铂诱导的肾损伤的机制尚不清楚。
探讨BMSCs-exo对顺铂诱导的AKI的治疗作用,并分析其关键分子机制。
通过超速离心提取BMSCs-exo,并通过透射电子显微镜、纳米颗粒分析和蛋白质免疫印迹进行鉴定。将C57BL/6小鼠分为对照组(Con)、顺铂模型组(Cis)和BMSCs-exo治疗组(BMSCs-exo),动态检测肾功能。采用PAS染色观察小鼠肾组织的组织病理学变化,采用免疫组织化学法评估Wnt4、β-连环蛋白、FZD5、CD31以及肾小管损伤标志物NGAL和KIM1的表达水平。采用蛋白质免疫印迹法检测Wnt4、β-连环蛋白、FZD5和CD31的表达。采用高通量测序筛选差异miRNA,并对靶基因进行GO/KEGG富集分析。
Cis组血肌酐和尿素氮水平显著高于Con组,肾小管上皮细胞出现坏死,证实成功建立AKI模型。BMSCs-exo可减轻体内肾功能障碍、组织病理学改变和肾小管损伤,NGAL和KIM1表达可证明这一点。我们进一步证明BMSCs-exo特异性定位于受损肾脏。对Con、Cis和BMSCs-exo组肾组织进行miRNA测序,发现富含Wnt信号和血管生成途径的mmu-miR-874-3p是BMSCs-exo肾脏保护作用的关键介质,FZD5是其下游靶点。此外,BMSCs-exo治疗可显著防止微血管丢失。在BMSCs-exo组中,Wnt4、β-连环蛋白和CD31表达上调,而FZD5表达下调,与免疫组织化学结果一致。
BMSCs-exo主要通过mmu-miR-874-3p介导的对FZD5激活的抑制和Wnt/β-连环蛋白途径激活的促进,减轻肾微血管和肾小管上皮细胞损伤,从而保护肾脏免受顺铂诱导的AKI。