Role of intestinal claudin-2 in calcium transport and kidney stone disease

Abstract

Background: Kidney stone disease is characterized by intestinal hyperabsorption of calcium and hypercalciuria, leading to the formation of calcium crystals in the kidney. Claudin-2 is a tight junction protein that forms paracellular cation pores and mutations in its gene are associated with kidney stone disease. We have recently shown that mice deficient in Cldn2 are hypercalciuric due to both decreased renal reabsorption and increased intestinal absorption of calcium and develop medullary mineral deposits reminiscent of kidney stone formers. We, therefore, hypothesized that intestinal claudin-2 is important for calcium secretion, especially in the colon, and that loss of claudin-2 results in increased net intestinal calcium absorption, thereby contributing to kidney stone disease. Method: Villin-Cre (Vil1-Cre/1000Gum) mice were crossed to Cldn2 floxed mice to generate intestine-specific claudin-2 knockout mice. Successful knockout of claudin-2 was confirmed at the mRNA and protein level using qPCR, immunofluorescence staining, and western blot. Male and female littermates were characterized for hypercalciuria from age 3-10 weeks. Circulating levels of parathyroid hormone and 1,25-dihydroxyvitamin D (1,25(OH)2D) were measured by ELISA, and mRNA levels of seven paracellular and transcellular calcium transport genes in the ileum, cecum, distal colon, and nine in the kidney assessed by qPCR. Result: In females, Cldn2 expression was knocked out in the intestine but not in the kidney. However, in males, Cldn2 was knocked out in the intestine and also partially knocked out in the kidneys (where villin is also expressed). Knockout females had normal urine calcium, but knockout males had significantly higher urine calcium at weaning (3 weeks of age) compared to wildtype, which was normalized by 4 weeks of age. At 4 weeks, Cldn19 mRNA was downregulated in knockout mice of both sexes. Male knockout mice had a reduction in intestinal Cldn12, Cldn15, Slc8a1, and increased intestinal Cacnad1, increased renal Cyp27b1 expression, and increased circulating 1,25(OH)2D. Conclusion: Our results suggest that intestine-specific loss of claudin-2, which was only observed in villin-Cre, Cldn2 floxed females, does not cause hypercalciuria. Ongoing whole-body calcium balance and everted sac calcium permeability experiments will determine whether this is because intestinal calcium hyperabsorption is masked by compensatory mechanisms. NIH. This is the full abstract presented at the American Physiology Summit 2024 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.