Diabetic nephropathy (DN) closely relates to morphological and functional changes of podocytes, and anaerobic glycolysis represents the predominant energy source of podocytes. However, it is unknown whether lactate accumulation in chronic high glucose causes epithelial-mesenchymal transition (EMT) of podocytes through lactate-derived histone lysine lactylation (HKla). Lactate levels increased in high glucose-stimulated mouse podocyte cell line MPC and blood and the kidney of diabetic mice. High glucose or exogenous lactate decreased nephrin levels while increased collagen IV and HKla levels in MPC, but co-treatment with oxamate or dichloroacetate reduced lactate levels and alleviated the decreases in nephrin and zonula occludens- 1 levels and the increases in collagen IV and α-smooth muscle actin as well as HKla levels in high glucose-cultured MPC. However, co-treatment with rotenone diversely affected these indices. Eleven intersection genes were screened in lactate raising and lowering interventions in podocytes using RNA sequencing and four genes were validated by qPCR. Furthermore, lactate-lowering treatments attenuated renal functions, EMT, and histone lactylation in the kidney of diabetic mice. Additionally, the increased lactate might result from the upregulated monocarboxylate transporter 2 in the mitochondria and the decreased pyruvate dehydrogenase activity. Together, we reveal the role of histone lactylation in driving the EMT phenotype of podocytes in chronic high glucose state, subsequently promoting the pathological process of DN. Our study provides a reference for the study of the relationship between lactate-induced histone lactylation modification and diabetic complications.
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