Abstract

Peritoneal fibrosis is a frequent complication of peritoneal dialysis following repeated low grade inflammatory and pro-fibrotic insults. This pathological process may lead to ultrafiltration failure and eventually to the discontinuing of the therapy. Fibrosis is linked to epithelial to mesenchymal transition (EMT) of the peritoneal mesothelial cells, which acquire invasive and fibrogenic abilities. Here, we analyzed the role of the transforming growth factor-activated kinase-1 (TAK1) in the EMT of primary mesothelial cells from human peritoneum. The inhibition of TAK1 in mesenchymal-like mesothelial cells from the effluents of patients undergoing peritoneal dialysis led to the reacquisition of the apical to basolateral polarity, to increased expression of epithelial and to down-regulation of mesenchymal markers. TAK1 inhibition also resulted in decreased migratory/invasive abilities of effluent-derived mesothelial cells. Simultaneous inhibition of ERK1/2 and TAK1 pathways did not lead to an additive effect in the reacquisition of the epithelial phenotype. Inhibition of TAK1 also blocked EMT in vitro and reduced the levels of PAI-1, which is involved in fibrosis and invasion. Analysis of signalling pathways downstream of TAK1 involved in EMT induction, showed that TAK1 inhibition reduced the transcriptional activity of NF-κB and Smad3, as well as the phosphorylation of c-jun, while enhancing Smad1–5–8 activity. These results demonstrate that TAK1 is a cross-point in a network including different pro-EMT transcription factors, such as NF-κB, Snail, AP-1 and Smads. The identification of TAK1 as a main biochemical mediator of EMT and fibrosis in mesothelial cells from human peritoneum and the study of signalling pathways induced by its activity may be relevant in the design of new therapies aimed to counteract peritoneal fibrosis.

Highlights

  • The main complication of the peritoneal dialysis is the instauration of peritoneal fibrosis

  • transforming growth factor-activated kinase-1 (TAK1) inhibition leads to the reversal of the epithelial to mesenchymal transition (EMT) phenotype (MET) in mesothelial cells (MCs) derived from peritoneal effluent of peritoneal dialysis (PD) patients

  • Biochemical and functional analyses, we demonstrated that the inhibition of TAK1 activity induces reversal towards the epithelial phenotype, and we provided mechanistic insight about it

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Summary

Introduction

The main complication of the peritoneal dialysis is the instauration of peritoneal fibrosis. Besides TGF-b1 and BMPs, other stimuli, such as FGF, CTGF, TNFa, IL-1b, HGF as well as extracellular matrix (ECM) proteins such as fibronectin and collagen may play a role in the induction of peritoneal EMT and fibrosis [1]. This concept implicates that, at least during the first stages, the epithelial/mesenchymal status of MCs is reversible, and may actively be modified by extracellular factors To this purpose, the reversal from a mesenchymal to an epithelial status (MET: Mesenchymal to Epithelial transition) has been already demonstrated in MCs [9,10,11], and may depend on the presence of proteins of the TGFb family such as BMP7, HGF, corticosteroids or vitamin D analogues [9,10,12,13]

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