Abstract

BackgroundThe platelet-derived growth factor receptor β (PDGFRβ)+ perivascular cell activation becomes increasingly recognized as a main source of scar-associated kidney myofibroblasts and recently emerged as a new cellular therapeutic target.AimsIn this regard, we first confirmed the presence of PDGFRβ+ perivascular cells in a human case of end-stage aristolochic acid nephropathy (AAN) and thereafter we focused on the early fibrosis events of transforming growth factor β (TGFβ) inhibition in a rat model of AAN.Materials and MethodsNeutralizing anti-TGFβ antibody (1D11) and its control isotype (13C4) were administered (5 mg/kg, i.p.) at Days -1, 0, 2 and 4; AA (15 mg/kg, sc) was injected daily.ResultsAt Day 5, 1D11 significantly suppressed p-Smad2/3 signaling pathway improving renal function impairment, reduced the score of acute tubular necrosis, peritubular capillaritis, interstitial inflammation and neoangiogenesis. 1D11 markedly decreased interstitial edema, disruption of tubular basement membrane loss of brush border, cytoplasmic edema and organelle ultrastructure alterations (mitochondrial disruption and endoplasmic reticulum edema) in proximal tubular epithelial cells. Moreover, 1D11 significantly inhibited p-PERK activation and attenuated dysregulation of unfolded protein response (UPR) pathways, endoplasmic reticulum and mitochondrial proteostasis in vivo and in vitro.ConclusionsThe early inhibition of p-Smad2/3 signaling pathway improved acute renal function impairment, partially prevented epithelial-endothelial axis activation by maintaining PTEC proteostasis and reduced early PDGFRβ+ pericytes-derived myofibroblasts accumulation.

Highlights

  • We first confirmed the presence of platelet-derived growth factor receptor β (PDGFRβ)+ perivascular cells in a human case of end-stage aristolochic acid nephropathy (AAN) and thereafter we focused on the early fibrosis events of transforming growth factor β (TGFβ) inhibition in a rat model of Aristolochic acid nephropathy (AAN)

  • Tubulointerstitial fibrosis is a multistage process arising form different causes closely related to the progression of all chronic kidney diseases (CKD). [1, 2] Both tubular epithelial and endothelial cells (EC) by forming epithelial-endothelial axis together with dendritic and interstitial mesenchymal cells are involved in kidney scaring. [3,4,5] This axis serves as a resident cellular unit sensing and mediating the renal insult regardless of its origin

  • Contribution of tubular and EC throughout their transdifferentiation into the mesenchymal cells (EMT and endoMT, respectively) in renal myofibroblasts generation remains controversial. [5, 9] Recently, the pericytes and resident fibroblasts became increasingly recognized as the main source of scar-associated kidney myofibroblasts. [10,11,12,13,14] They emerged as a new cellular therapeutic target for chronic kidney disease (CKD)

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Summary

Aims

We first confirmed the presence of PDGFRβ+ perivascular cells in a human case of end-stage aristolochic acid nephropathy (AAN) and thereafter we focused on the early fibrosis events of transforming growth factor β (TGFβ) inhibition in a rat model of AAN

Materials and Methods
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