Abstract
BackgroundIncreased expression of the pro-fibrotic protein connective tissue growth factor (CTGF) has been detected in injured kidneys and elevated urinary levels of CTGF are discussed as prognostic marker of chronic kidney disease. There is evidence that epithelial cells lining the renal tubular system contribute to uptake and secretion of CTGF. However, the role of different types of tubular epithelial cells in these processes so far has not been addressed in primary cultures of human cells.ResultsTubular epithelial cells of proximal and distal origin were isolated from human kidneys and cultured as polarized cells in insert wells. The pro-fibrotic stimuli lysophosphatidic acid (LPA) and transforming growth factor β (TGF-β) were used to induce CTGF secretion.LPA activated CTGF secretion in proximal tubular cells when applied from either the apical or the basolateral side as shown by immunocytochemistry. CTGF was secreted exclusively to the apical side. Signaling pathways activated by LPA included MAP kinase and Rho kinase signaling. TGF-β applied from either side also stimulated CTGF secretion primarily to the apical side with little basolateral release.Interestingly, TGF-β activation induced different signaling pathways depending on the side of TGF-β application. Smad signaling was almost exclusively activated from the basolateral side most prominently in cells of distal origin. Only part of these cells also synthesized CTGF indicating that Smad activation alone was not sufficient for CTGF induction. MAP kinases were involved in apical TGF-β-mediated activation of CTGF synthesis in proximal cells and a subset of epithelial cells of distal origin. This subpopulation of distal tubular cells was also able to internalize recombinant apical CTGF, in addition to proximal cells which were the main cells to take up exogenous CTGF.ConclusionsAnalysis of polarized human primary renal epithelial cells in a transwell system shows that vectorial secretion of the pro-fibrotic protein CTGF depends on the cell type, the stimulus and the signaling pathway activated. In all conditions, CTGF was secreted mainly to the apical side upon TGF-β and LPA treatment and therefore, likely contributes to increased urinary CTGF levels in vivo. Moreover, CTGF secreted basolaterally may be active as paracrine pro-fibrotic mediator.
Highlights
Increased expression of the pro-fibrotic protein connective tissue growth factor (CTGF) has been detected in injured kidneys and elevated urinary levels of CTGF are discussed as prognostic marker of chronic kidney disease
Connective tissue growth factor (CTGF, CCN2) is a secreted matricellular protein which has been associated with fibrotic diseases, often mediating the pro-fibrotic effects of transforming growth factor β (TGF-β) [1,2]
More recently activation of LPA1 receptors was reported in the ureter obstruction (UUO) model of renal fibrosis, which was ameliorated upon LPA1 inhibition [27]. Along this line we have shown earlier that lysophosphatidic acid (LPA) is a potent inducer of CTGF in several cell types, among them mesangial cells and renal fibroblasts [28,29]
Summary
Increased expression of the pro-fibrotic protein connective tissue growth factor (CTGF) has been detected in injured kidneys and elevated urinary levels of CTGF are discussed as prognostic marker of chronic kidney disease. Elevated levels of CTGF have been described in conditions of tissue injury and inflammation, in different animal models of kidney injury and in human biopsy specimens [3,4,5]. An increased number of cells expressing CTGF mRNA was observed in human biopsies specimens at sites of chronic tubulointerstitial damage, the majority of which co-expressed alphasmooth muscle actin [7]. Analysis of human kidney sections showed CTGF mRNA and protein in severely damaged human tubules but not in normal epithelial cells [7,13]. Depending on the pathophysiological setting, tubular epithelial cells may be a source or sink for urinary CTGF
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