ANP-induced signalling cascade and its implications in renal pathophysiology

The balance between vasoconstrictor/sodium retaining and vasodilator/natriuretic systems is essential for maintaining body fluid and electrolyte homeostasis. Natriuretic peptides, such as atrial natriuretic protein (ANP) belong to the vasodilator/natriuretic system. ANP is produced by the conversion of pro-ANP into ANP which is achieved by a proteolytical cleavage executed by corin. In the kidney, ANP binds to the natriuretic peptide receptor-A (NPR-A) and enhances its guanylyl cyclase activity, thereby increasing intracellular cyclic guanosine monophosphate production to promote natriuretic and renoprotective responses. In the glomerulus, ANP increases glomerular permeability and filtration rate and antagonizes the deleterious effects of the renin-angiotensin-aldosterone system activation. Along the nephron, natriuretic and diuretic actions of ANP are mediated by inhibiting the basolaterally expressed Na⁺/K⁺-ATPase, reducing apical sodium, potassium and protein organic cation transporter in the proximal tubule, and decreasing the Na⁺-K⁺-2Cl- co-transporter activity and the renal concentration efficiency in the thick ascending limb. In the medullary collecting duct, ANP reduces sodium reabsorption by inhibiting the cyclic nucleotide gated cation channels, the epithelial sodium channel, and the heteromeric channel transient receptor potential-vanilloid 4 and -polycystin 2 and diminishes vasopressin-induced water reabsorption. Long term ANP treatment may lead to NPR-A desensitization and ANP-resistance, resulting in augmented sodium and water reabsorption. In mice, corin deficiency impairs sodium excretion and causes salt-sensitive hypertension. Characteristics of ANP resistance and corin deficiency are also encountered in patients with edema-associated diseases, highlighting the importance of ANP-signalling in salt-water balance and renal pathophysiology

Intravital imaging reveals angiotensin II–induced transcytosis of albumin by podocytes

Albuminuria is a hallmark of kidney disease of various etiologies and usually caused by deterioration of glomerular filtration barrier integrity. We recently showed that angiotensin II (Ang II) acutely increases albumin filtration in the healthy kidney. Here, we used intravital microscopy to assess the effects of Ang II on podocyte function in rats. Acute infusion of 30, 60, or 80 ng/kg per minute Ang II enhanced the endocytosis of albumin by activation of the type 1 Ang II receptor and resulted in an average (±SEM) of 3.7±2.2, 72.3±18.6 (Pµm³ (P<0.001) albumin-containing vesicles per glomerulus, respectively, compared with none at baseline or 10 ng/kg per minute Ang II. Immunostaining of Ang II–infused kidneys confirmed the presence of albumin-containing vesicles, which colocalized with megalin, in podocin-positive cells. Furthermore, podocyte endocytosis of albumin was markedly reduced in the presence of gentamicin, a competitive inhibitor of megalin-dependent endocytosis. Ang II infusion increased the concentration of albumin in the subpodocyte space, a potential source for endocytic protein uptake, and gentamicin further increased this concentration. Some endocytic vesicles were acidified and colocalized with LysoTracker. Most vesicles migrated from the capillary to the apical aspect of the podocyte and were eventually released into the urinary space. This transcytosis accounted for approximately 10% of total albumin filtration. In summary, the transcellular transport of proteins across the podocyte constitutes a new pathway of glomerular protein filtration. Ang II enhances the endocytosis and transcytosis of plasma albumin by podocytes, which may eventually impair podocyte function

Aldosterone modulates the association between NCC and ENAC

Distal sodium transport is a final step in the regulation of blood pressure. As such, understanding how the two main sodium transport proteins, the thiazide-sensitive sodium chloride cotransporter (NCC) and the epithelial sodium channel (ENaC), are regulated is paramount. Both are expressed in the late distal nephron; however, no evidence has suggested that these two sodium transport proteins interact. Recently, we established that these two sodium transport proteins functionally interact in the second part of the distal nephron (DCT2). Given their co-localization within the DCT2, we hypothesized that NCC and ENaC interactions might be modulated by aldosterone (Aldo). Aldo treatment increased NCC and αENaC colocalization (electron microscopy) and interaction (coimmunoprecipitation). Finally, with co-expression of the Aldo-induced protein serum- and glucocorticoid-inducible kinase 1 (SGK1), NCC and αENaC interactions were increased. These data demonstrate that Aldo promotes increased interaction of NCC and ENaC, within the DCT2 revealing a novel method of regulation for distal sodium reabsorption

Albumin evokes Ca 2+ -induced cell oxidative stress and apoptosis through TRPM2 channel in renal collecting duct cells reduced by curcumin

In proteinuric nephropathies of chronic kidney disease, the epithelial cells of the nephron including the collecting duct are exposed to high concentrations of luminal albumin. Albumin is taken up from collecting duct cells by endocytosis causing excessive reactive oxygen species (ROS) production and a proinflammatory response. Curcumin used in the traditional medicine possesses anti-inflammatory and antioxidant effects. ROS and ADP-ribose (ADPR) activate the cation channel TRPM2. We hypothesize, that albumin-induced cell stress and proinflammatory response are mediated by Ca2+ and can be reduced by curcumin. The cortical collecting duct (CCD) cells mpkCCDc14 exhibit spontaneous and inducible Ca2+ oscillations, which can be blocked by pre-treatment with curcumin. Curcumin accumulates in plasma membrane and intracellular vesicles, where it interferes with TRPM2 and decreases the influx of Ca2+. Albumin reduces cell viability and increases apoptosis, NF-κB activation, and mitochondrial membrane depolarization via Ca2+-dependent signaling, which results in increased ROS production. Albumin-induced cell stress is diminished by the inhibition of TRPM2 after administration of curcumin and ADPR (PARP1) inhibitors. Curcumin did not reduce the Ca2+ elevation induced by thapsigargin in Ca2+-free medium, but it reduced the function of store-operated Ca2+ channels and ATP-evoked Ca2+ response. In conclusion, albumin-induced oxidative stress is mediated by Ca2+-dependent signaling via TRPM2 and leads to cell damage and a proinflammatory response, strengthening the role of CCD cells in the progression of chronic kidney disease

Short-term functional adaptation of aquaporin-1 surface expression in the proximal tubule, a component of glomerulotubular balance

Transepithelial water flow across the renal proximal tubule is mediated predominantly by aquaporin-1 (AQP1). Along this nephron segment, luminal delivery and transepithelial reabsorption are directly coupled, a phenomenon called glomerulotubular balance. We hypothesized that the surface expression of AQP1 is regulated by fluid shear stress, contributing to this effect. Consistent with this finding, we found that the abundance of AQP1 in brush border apical and basolateral membranes was augmented >2-fold by increasing luminal perfusion rates in isolated, microperfused proximal tubules for 15 minutes. Mouse kidneys with diminished endocytosis caused by a conditional deletion of megalin or the chloride channel ClC-5 had constitutively enhanced AQP1 abundance in the proximal tubule brush border membrane. In AQP1-transfected, cultured proximal tubule cells, fluid shear stress or the addition of cyclic nucleotides enhanced AQP1 surface expression and concomitantly diminished its ubiquitination. These effects were also associated with an elevated osmotic water permeability. In sum, we have shown that luminal surface expression of AQP1 in the proximal tubule brush border membrane is regulated in response to flow. Cellular trafficking, endocytosis, an intact endosomal compartment, and controlled protein stability are the likely prerequisites for AQP1 activation by enhanced tubular fluid shear stress, serving to maintain glomerulotubular balance

Physiological and Molecular Responses to Altered Sodium Intake in Rat Pregnancy

In pregnancy, a high plasma volume maintains uteroplacental perfusion and prevents placental ischemia, a condition linked to elevated maternal blood pressure (BP). Reducing BP by increasing Na+ intake via plasma volume expansion appears contra‐ intuitive. We hypothesize that an appropriate Na+ intake in pregnancy reduces maternal BP and adapts the renin‐angiotensin system in a pregnancy‐specific manner.Methods and Results: BP was measured by implanted telemetry in Sprague‐ Dawley rats before and throughout pregnancy. Pregnant and nonpregnant animals received either a normal‐salt (0.4%; NS), high‐salt (8%; HS), or low‐salt (0.01%; LS) diet, or HS (days 1–14) followed by LS (days 14–20) diet (HS/LS). Before delivery (day 20), animals were euthanized and organs collected. Food, water, and Na+ intake were monitored in metabolic cages, and urinary creatinine and Na+ were analyzed. Na+ intake and retention increased in pregnancy (NS, LS), leading to a positive Na+ balance (NS, LS). BP was stable during LS, but reduced in HS conditions in pregnancy. The renin‐angiotensin system was adapted as expected. Activating cleavage of α‐ and γ‐subunits of the renal epithelial Na+ channel and expression of‐ full length medullary β‐subunits, accentuated further in all LS conditions, were upregulated in pregnancy.Conclusions: Pregnancy led to Na+ retention adapted to dietary changes. HS exposure paradoxically reduced BP. Na+ uptake while only modestly linked to the renin‐angiotensin system is enhanced in the presence of posttranslational renal epithelial Na+ channel modifications. This suggests (1) storage of Na+ in pregnancy upon HS exposure, bridging periods of LS availability; and (2) that potentially non–renin‐angiotensin–related mechanisms participate in ENaC activation and consecutive Na+ retention

MTOR regulates endocytosis and nutrient transport in proximal tubular cells

Renal proximal tubular cells constantly recycle nutrients to ensure minimal loss of vital substrates into the urine. Although most of the transport mechanisms have been discovered at the molecular level, little is known about the factors regulating these processes. Here, we show that mTORC1 and mTORC2 specifically and synergistically regulate PTC endocytosis and transport processes. Using a conditional mouse genetic approach to disable nonredundant subunits of mTORC1, mTORC2, or both, we showed that mice lacking mTORC1 or mTORC1/mTORC2 but not mTORC2 alone develop a Fanconi-like syndrome of glucosuria, phosphaturia, aminoaciduria, low molecular weight proteinuria, and albuminuria. Interestingly, proteomics and phosphoproteomics of freshly isolated kidney cortex identified either reduced expression or loss of phosphorylation at critical residues of different classes of specific transport proteins. Functionally, this resulted in reduced nutrient transport and a profound perturbation of the endocytic machinery, despite preserved absolute expression of the main scavenger receptors, MEGALIN and CUBILIN. Our findings highlight a novel mTOR–dependent regulatory network for nutrient transport in renal proximal tubular cells

Cathepsin B increases ENaC activity leading to hypertension early in nephrotic syndrome

The NPHS2 gene, encoding the slit diaphragm protein podocin, accounts for genetic and sporadic forms of nephrotic syndrome (NS). Patients with NS often present symptoms of volume retention, such as oedema formation or hypertension. The primary dysregulation in sodium handling involves an inappropriate activation of the epithelial sodium channel, ENaC. Plasma proteases in a proteinuria‐dependent fashion have been made responsible; however, referring to the timeline of symptoms occurring and underlying mechanisms, contradictory results have been published. Characterizing the mouse model of podocyte inactivation of NPHS2 (Nphs2∆pod) with respect to volume handling and proteinuria revealed that sodium retention, hypertension and gross proteinuria appeared sequentially in a chronological order. Detailed analysis of Nphs2∆pod during early sodium retention, revealed increased expression of full‐length ENaC subunits and αENaC cleavage product with concomitant increase in ENaC activity as tested by amiloride application, and augmented collecting duct Na+/K+‐ATPase expression. Urinary proteolytic activity was increased and several proteases were identified by mass spectrometry including cathepsin B, which was found to process αENaC. Renal expression levels of precursor and active cathepsin B were increased and could be localized to glomeruli and intercalated cells. Inhibition of cathepsin B prevented hypertension. With the appearance of gross proteinuria, plasmin occurs in the urine and additional cleavage of γENaC is encountered. In conclusion, characterizing the volume handling of Nphs2∆pod revealed early sodium retention occurring independent to aberrantly filtered plasma proteases. As an underlying mechanism cathepsin B induced αENaC processing leading to augmented channel activity and hypertension was identified

Parakrine Signalwege der Niere

Zu den vielfältigen Aufgaben der Niere gehören die tubuläre Rückresorption körperwichtiger Substanzen sowie die Regulation des renalen und systemischen Blutdrucks. Brennpunkte der vorliegenden Arbeit waren die Kontrollparameter der tubulo-glomerulären Regulation sowie Aspekte des epithelialen Transports im distalen Nephron und Sammelrohr. Das L-Arginin-Stickstoffmonoxyd (NO)-System und die Komponenten renaler Prostaglandinsynthese nehmen hier eine wichtige Stellung ein. Die Schlüssel-Syntheseenzyme NO-Synthase 1 (NOS1) und Zyklooxygenase (COX) Typ 2 sind in der Macula densa lokalisiert. Sie sind im Zusammenhang mit der Filtratbildung reguliert. Weitere Komponenten ihrer Reaktionskaskaden sind jedoch in ihrer zellspezifischen Rolle noch unklar. Wir haben diese daher näher untersucht. Mit histochemischen und biochemischen Methoden (immunhistochemische Färbungen, RT-PCR, In situ Hybridisierung, Western blot und spezifischen cGMP Nachweisen in Gewebe- und Zellextrakten) wurden NO-Rezeptor (lösliche Guanylatzyklase; sGC), COX-1, COX-2 und die membrangebundene Prostaglandin E2-Synthase (mPGES) nachgewiesen. Außerdem wurde die Interaktion von NOS1 und COX-2 im 2 Nieren-1 Clip (Goldblatt)-Modell bei der Ratte sowie bei NOS1-defizienten Mäusen untersucht. Die sGC wurde in den glomerulären Arteriolen, den Renin-produzierenden Zellen, dem Mesangium, den Vasa recta, den interstitiellen Fibroblasten und den Ito-Zellen der Leber detektiert. COX-2 wurde zusammen mit mPGES in der kortikalen aufsteigenden Schleife und der Macula densa gefunden. COX-1 wurde zusammen mit mPGES im terminalen distalen Konvolut, im Verbindungstubulus und im Sammelrohr detektiert. Die medullären interstitiellen Zellen exprimierten gleichzeitig COX-1, COX-2 und mPGES. Im Goldblatt-Modell bestand unilateral (stenotische Seite) eine Stimulation der juxtaglomerulären NOS1 sowie der COX-2 Expression. Entgegen früheren Annahmen konnten wir jedoch keine Hinweise für eine zell-bezogene Interaktion zwischen beiden Produkten finden. Dieses wurde durch die Verwendung der NOS1-defizienten Maus bestätigt, die im Experiment keine Veränderung der COX-2 Expression zeigte. Die spezifische Lokalisation von NO-Rezeptor und Komponenten der Prostaglandinsynthese unterstreicht ihre Bedeutung für die Regulation von Blutdruck, Salz- und Wasserhomöostase. Die juxtaglomeruläre Synthese von NO und Prostaglandinen folgt ähnlichen Stimuli, ist jedoch voneinander unabhängig.Priciple functions of the kidneys are tubular reabsorption of important solutes and regulation of renal and systemic blood pressure. This work has been focused on parameters to control the tubulo-glomerular feedback and epithelial transport in the distal tubule and collecting duct system. The L-arginine-nitric oxide (NO)-system and components of the renal prostaglandin synthesis are thought to play major roles therein. Key-enzymes are NO-Synthase 1 (NOS1) and cyclooxygenase-2 (COX-2), both are localized in the macula densa and are regulated in dependence of the filtrate formation. The cell-specific role of further components in the signalling cascades remains unclear. For investigation we used histochemical and biochemical methods (immunohistochemistry, RT-PCR, in situ hybridisation, western blotting and specific cGMP measurements in tissue and cell extracts to localize the NO-receptor (soluble guanylyl cyclase, sGC), COX-1, COX-2 and the membranous prostaglandin E2-synthase (mPGES). Moreover we analyzed the interaction of NOS1 and COX-2 in the 2 kidney-1 clip (Goldblatt)-model of the rat and in NOS1 deficient mice. The sGC could be detected in glomerular arterioles, renin-producing cells, mesangium, vasa recta, interstitial fibroblasts and Ito-cells of the liver. COX-2 was co-localized with mPGES in the cortical thick ascending limb and macula densa. COX-1 was co-localized with mPGES in the terminal distal convolutions, connecting tubule and collecting duct. The medullary interstitial cells were positive stained for COX-1, COX-2 and mPGES. In the Goldblatt-model we found an increased expression of juxtaglomerular NOS1 and COX-2 in the stenotic kidney. Against former hypothesises we were unable to find evidences for a cell-specific interaction between both products. This was supported by the evaluation of NOS1 deficient mice which revealed no difference of COX-2 expression under control and variable conditions. The specific localization of NO-receptor and components of the prostaglandin synthesis emphasizes their relevance for the regulation of blood pressure and salt- and water homeostasis. The juxtaglomerular synthesis of NO and prostaglandins are similarly regulated while COX-2 is NO-independently expressed

Acute endotoxemia in mice induces downregulation of megalin and cubilin in the kidney

Severe sepsis is often accompanied by acute renal failure with renal tubular dysfunction. Albuminuria is a common finding in septic patients and we studied whether it was due to an impairment of proximal tubular endocytosis of filtered albumin. We studied the regulation of megalin and cubilin, the two critical multiligand receptors responsible for albumin absorption, during severe experimental endotoxemia. Lipopolysaccharide (LPS) caused a time- and dose-dependent suppression of megalin and cubilin expression that was paralleled by a decrease in plasma albumin levels and an increase in the urine concentration of albumin in mice. Incubation of rat renal cortical slices with LPS also reduced the mRNA expression of megalin and cubilin. Further, LPS suppressed megalin and cubilin mRNA expression in murine primary proximal tubule cells and decreased the uptake of FITC albumin in these cells. In addition, the increase in urine levels of albumin in response to ischemia/reperfusion-induced acute renal failure was paralleled by a decrease in the expression of megalin and cubilin. Thus, our data indicate that the expression of megalin and cubilin is decreased during experimental endotoxemia and in response to renal ischemia/reperfusion injury. This downregulation may contribute, in part, to an increase in urine levels of albumin during acute renal failure