Abstract

AKI, due to the fact of altered oxygen supply after kidney transplantation, is characterized by renal ischemia–reperfusion injury (IRI). Recent data suggest that AKI to CKD progression may be driven by cellular senescence evolving from prolonged DNA damage response (DDR) following oxidative stress. Cellular communication factor 2 (CCN2, formerly called CTGF) is a major contributor to CKD development and was found to aggravate DNA damage and the subsequent DDR–cellular senescence–fibrosis sequence following renal IRI. We therefore investigated the impact of CCN2 inhibition on oxidative stress and DDR in vivo and in vitro. Four hours after reperfusion, full transcriptome RNA sequencing of mouse IRI kidneys revealed CCN2-dependent enrichment of several signaling pathways, reflecting a different immediate stress response to IRI. Furthermore, decreased staining for γH2AX and p-p53 indicated reduced DNA damage and DDR in tubular epithelial cells of CCN2 knockout (KO) mice. Three days after IRI, DNA damage and DDR were still reduced in CCN2 KO, and this was associated with reduced oxidative stress, marked by lower lipid peroxidation, protein nitrosylation, and kidney expression levels of Nrf2 target genes (i.e., HMOX1 and NQO1). Finally, silencing of CCN2 alleviated DDR and lipid peroxidation induced by anoxia-reoxygenation injury in cultured PTECs. Together, our observations suggest that CCN2 inhibition might mitigate AKI by reducing oxidative stress-induced DNA damage and the subsequent DDR. Thus, targeting CCN2 might help to limit post-IRI AKI.

Highlights

  • Tamoxifen-induced recombination resulted in 77% reduction in communication network factor 2 (CCN2) mRNA in both sham and ischemia–reperfusion injury (IRI) kidneys (p = 0.005 and p = 0.008, respectively; Figure S1A)

  • Our observations indicate that DNA damage and DNA damage response (DDR) in the kidney doxorubicin-induced oxidative stress and cell death [47]

  • Main mechanisms by which CCN2 might contribute to oxidative stress following renal IRI include increased mitochondrial oxidative phosphorylation and reactive oxygen species (ROS) generation, and decreased ROS scavenging

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Summary

Introduction

Acute kidney injury (AKI) that requires renal replacement therapy is associated with over 50% mortality, and the severity of AKI in hospitalized patients correlates to mortality, length of hospital stay, and healthcare costs [1,2]. AKI predisposes to chronic kidney disease (CKD) development later in life, in part due to the excessive fibrosis associated with tubular injury [3]. Ischemia–reperfusion injury (IRI) is a leading cause of AKI, which occurs in 30–50% of patients receiving deceased donor kidneys and, in this context, often leads to delayed graft function [4,5].

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