Abstract BACKGROUND AND AIMS Copper is an essential trace element for eukaryotes and a vital cofactor for various enzymes for a multiplicity of functions. Our previous study indicated that intracellular copper overload plays an important role in renal fibrosis. However, the underlying mechanism invoked by copper overload in renal fibrosis remains largely unknown. In this study, we found copper ions in cells were mainly accumulated in mitochondria, which damage the structure and function of mitochondria. Furthermore, copper transporter 1 (CTR1), the major transporter for the copper influx, was significantly increased in fibrotic kidneys. The activity of cytochrome C oxidase (COX), a copper coenzyme mediating the final step in the electron transport chain, was decreased. Therefore, we proposed that CTR1 might be involved in mitochondrial copper overload and renal fibrosis. METHOD The expression of CTR1 was examined in ischemia-reperfusion injury (IRI 28d) mice model. The regulatory mechanisms of CTR1 in vitro were investigated by treating renal tubule epithelium cell line (NRK-52E) with TGF-β1 or copper ions with or without copper chelator tetrathiomolybdate (TM) and in vivo, we use CTR1 transgenic mice subjected to IRI operation. ICP-MS, mitoSOX Red, electron microscopy, realtime-PCR and western blot analysis were applied in the current study. RESULTS We found that stimulated by TGF-β1, COX activity was declined. Mitochondria and cytosol, especially mitochondria, accumulated a large amount of copper in fibrotic kidney tissues. Furthermore, we found Copper transporter 1 (CTR1) expression was increased in fibrotic kidneys from chronic kidney disease patients, experimental fibrosis model mice and in vitro. More importantly, compared with WT mice, CTR1+/- mice subjected to an ischemia-reperfusion injury (IRI) had reduced mitochondrial copper level and ameliorated mitochondrial function and renal fibrosis, as evidenced by improving mitochondrial structure, inhibiting mtROS production and reducing expression of α-smooth muscle actin (α-SMA), collagen I and fibronectin. In addition, after treatment with the copper chelator tetrathiomolybdate (TM), mitochondrial function and kidney fibrosis were improved. CONCLUSION Collectively, our study showed that copper overload in mitochondria could damage the mitochondrial function and lead to renal fibrosis and CTR1 is involved in the mitochondrial copper overload. Copper overload inhibits the activity of COX and impairs mitochondria, subsequently leading to renal fibrosis.
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