Abstract

Acute kidney injury, often caused by an ischemic insult, is associated with significant short-term morbidity and mortality, and increased risk of chronic kidney disease. The factors affecting the renal response to injury following ischemia and reperfusion remain to be clarified. We found that the Stem cell antigen-1 (Sca-1), commonly used as a stem cell marker, is heavily expressed in renal tubules of the adult mouse kidney. We evaluated its potential role in the kidney using Sca-1 knockout mice submitted to acute ischemia reperfusion injury (IRI), as well as cultured renal proximal tubular cells in which Sca-1 was stably silenced with shRNA. IRI induced more severe injury in Sca-1 null kidneys, as assessed by increased expression of Kim-1 and Ngal, rise in serum creatinine, abnormal pathology, and increased apoptosis of tubular epithelium, and persistent significant renal injury at day 7 post IRI, when recovery of renal function in control animals was nearly complete. Serum creatinine, Kim-1 and Ngal were slightly but significantly elevated even in uninjured Sca-1-/- kidneys. Sca-1 constitutively bound both TGFβ receptors I and II in cultured normal proximal tubular epithelial cells. Its genetic loss or silencing lead to constitutive TGFβ receptor—mediated activation of canonical Smad signaling even in the absence of ligand and to KIM-1 expression in the silenced cells. These studies demonstrate that by normally repressing TGFβ-mediated canonical Smad signaling, Sca-1 plays an important in renal epithelial cell homeostasis and in recovery of renal function following ischemic acute kidney injury.

Highlights

  • Hospital-associated acute kidney injury (AKI) remains a significant clinical problem worldwide [1], affecting ~15% of all hospitalized patients [2, 3]

  • We found no significant change in phosphorylated p38 MAPK in Stem cell antigen-1 (Sca-1)-/- kidneys or Sca-1 silenced proximal tubular epithelial cells (S3B and S3C Fig), suggesting that Sca-1 mainly influences TGFβ1directed canonical Smad signaling in kidney epithelium

  • TGFβ signaling is a key mediator of renal scarring that leads to kidney failure [35]

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Summary

Introduction

Hospital-associated acute kidney injury (AKI) remains a significant clinical problem worldwide [1], affecting ~15% of all hospitalized patients [2, 3]. IRI is associated with a rise in serum creatinine, induction of renal injury markers such as Kidney injury molecule-1 (Kim-1/Tim-1) and neutrophil gelatinase-associated lipocalin (Ngal)[8, 9] and epithelial cell death. These renal injury markers resolve in normal mice by day 7 following a single episode of acute IRI, but can persist in predisposed epithelium, resulting in interstitial fibrosis and chronic kidney disease [10]. The nature of the factors that affect the kidney response to acute IRI injury remain to be fully elucidated

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