Steviol retards renal cyst growth through reduction of CFTR expression and inhibition of epithelial cell proliferation in a mouse model of polycystic kidney disease (690.2)

Abstract

Cyst growth in ADPKD is associated with cAMP‐activated proliferation of cyst‐lining epithelial cells and transepithelial fluid secretion into the cyst lumen via CFTR chloride channel. It will eventually lead to renal insufficiency and renal failure for which no effective treatment is currently available. We previously reported that steviol retards MDCK cyst growth by inhibiting CFTR channel activity and promoting proteasomal‐mediated CFTR degradation. However, the MDCK cells do not carry the mutated PKD genes and do not recapitulate the complexity of PKD pathogenesis. Therefore, it is imperative to examine the effect of steviol in animal model that closely resembles PKD. In this study, we determined the effect of steviol on renal cyst growth in an orthologous mouse model of human ADPKD (Pkd1flox/flox :Pkhd1‐Cre). The results showed that daily treatment with both 200 mg/kg BW of steviol and 1,000 mg/kg BW of stevioside for 14 days markedly decreased kidney weight and cystic index in these mice. Surprisingly, only steviol markedly reduced blood urea nitrogen and creatinine values. It also reduced cell proliferation but had no effect on cell apoptosis. In addition, steviol suppressed CFTR and mTOR/S6K expressions but stimulated AMP‐activated protein kinase (AMPK) in renal cyst‐lining epithelial cells. These findings indicate that steviol slows cyst progression in PKD mouse model, in part, through the activation of AMPK which subsequently inhibits both CFTR expression and renal epithelial cell proliferation via mTOR/S6K pathway. Most importantly, steviol could markedly improve kidney function in a mouse model of PKD. Steviol thus has potential application for further development as therapeutic compound for the treatment of polycystic kidney disease.Grant Funding Source: Supported by Thailand Research Fund and Faculty of Science, Mahidol University, Bangkok, Thailand