Abstract
Sepsis-induced acute kidney injury (AKI) contributes to the high mortality and morbidity in patients. Although the pathogenesis of AKI during sepsis is poorly understood, it is well accepted that plasminogen activator inhibitor-1 (PAI-1) and vitronectin (Vn) are involved in AKI. However, the functional cooperation between PAI-1 and Vn in septic AKI has not been completely elucidated. To address this issue, mice were utilized lacking either PAI-1 (PAI-1−/−) or expressing a PAI-1-mutant (PAI-1R101A/Q123K) in which the interaction between PAI-1 and Vn is abrogated, while other functions of PAI-1 are retained. It was found that both PAI-1−/− and PAI-1R101A/Q123K mice are associated with decreased renal dysfunction, apoptosis, inflammation, and ERK activation as compared to wild-type (WT) mice after LPS challenge. Also, PAI-1−/− mice showed attenuated fibrin deposition in the kidneys. Furthermore, a lack of PAI-1 or PAI-1-Vn interaction was found to be associated with an increase in activated Protein C (aPC) in plasma. These results demonstrate that PAI-1, through its interaction with Vn, exerts multiple deleterious mechanisms to induce AKI. Therefore, targeting of the PAI-1-Vn interaction in kidney represents an appealing therapeutic strategy for the treatment of septic AKI by not only altering the fibrinolytic capacity but also regulating PC activity.
Highlights
Sepsis initiated by gram-negative bacteria is often accompanied by acute kidney injury (AKI)
In order to understand the in vivo role of the plasminogen activator inhibitor-1 (PAI-1)-Vn interaction in septic AKI, PAI-1R101A/Q123K mice that express a PAI-1-mutant in which the interaction between PAI-1 and Vn is selectively abrogated while other functions are retained, were utilized in these studies [21]
The present study demonstrates that loss of PAI-1 or selective abrogation of the PAI-1-Vn interaction in mice has a protective effect on kidney function, morphology, and cell survival, as compared to WT animals during septic AKI
Summary
Sepsis initiated by gram-negative bacteria is often accompanied by acute kidney injury (AKI). Development of AKI during sepsis is associated with higher mortality, increased morbidity, and often results in multiple organ damage, and is a major public health concern in patients [1,2,3,4]. No effective treatment is available for preventing life-threatening septic AKI, due to a general lack of mechanistic relationships between the inflammatory response, PLOS ONE | DOI:10.1371/journal.pone.0120728. No effective treatment is available for preventing life-threatening septic AKI, due to a general lack of mechanistic relationships between the inflammatory response, PLOS ONE | DOI:10.1371/journal.pone.0120728 March 23, 2015
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