Lai Han, Chen Anqun, Cai Hong, Fu Jia, Salem Fadi, Li Yu, He John C, Schlondorff Detlef, Lee Kyung
Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Department of Nephrology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China.
Department of Medicine, Division of Nephrology, Icahn School of Medicine at Mount Sinai, New York, New York, USA; Division of Nephrology, Zhongshan Hospital, Xiamen University, Xiamen, China.
Kidney Int. 2020 Sep;98(3):601-614. doi: 10.1016/j.kint.2020.03.036. Epub 2020 Apr 26.
Transforming growth factor-β (TGF-β) is a central mediator of diabetic nephropathy. The effect of TGF-β, mediated by the type I TGF-β receptor, ALK5, and subsequent Smad2/3 activation results in podocyte apoptosis and loss. Previously, we demonstrated that the genetic deletion of the BMP and Activin Membrane-Bound Inhibitor (BAMBI), a negative modulator TGF-β signaling, accelerates diabetic nephropathy in mice. This was associated with heightened ALK1-mediated activation of Smad1/5 in the glomerular endothelial cells (ECs). Therefore, to evaluate the glomerular cell-specific effects of TGF-β in diabetic nephropathy we examined the effects of the podocyte- or EC-specific loss of Bambi (Pod-Bambi-/- or EC-Bambi-/-) in streptozotocin-induced diabetic mice with endothelial nitric oxide synthase deficiency. Interestingly, although hyperglycemia and body weight loss were similar in all groups of diabetic mice, significant hypertension was present only in the diabetic EC-Bambi-/- mice. While the podocyte or EC-specific loss of BAMBI both accelerated the progression of diabetic nephropathy, the worsened podocyte injury and loss observed in the diabetic Pod-Bambi-/- mice were associated with enhanced Smad3 activation. Increased Smad1/5 activation and EC proliferation were apparent only in the glomeruli of diabetic EC-Bambi-/- mice. The enhanced Smad1/5 activation in diabetic EC-Bambi-/- mice was associated with increased glomerular expression of plasmalemma vesicle-associated protein, pointing to the involvement of immature or dedifferentiated glomerular ECs in diabetic nephropathy. Notably, diabetic EC-Bambi-/- mice displayed podocyte injury and loss that were comparable to diabetic Pod-Bambi-/- mice. Thus, our results highlight the glomerular cell-specific contribution of TGF-β signaling and the intricate cross-talk between injured glomerular cells in the progression of diabetic nephropathy.
转化生长因子-β(TGF-β)是糖尿病肾病的关键介质。由I型TGF-β受体ALK5介导的TGF-β效应以及随后的Smad2/3激活会导致足细胞凋亡和丢失。此前,我们证明了骨形态发生蛋白和激活素膜结合抑制剂(BAMBI)(一种TGF-β信号的负调节因子)的基因缺失会加速小鼠糖尿病肾病的发展。这与肾小球内皮细胞(ECs)中ALK1介导的Smad1/5激活增强有关。因此,为了评估TGF-β在糖尿病肾病中对肾小球细胞的特异性作用,我们研究了在链脲佐菌素诱导的内皮型一氧化氮合酶缺乏的糖尿病小鼠中,足细胞或内皮细胞特异性缺失Bambi(Pod-Bambi-/-或EC-Bambi-/-)的影响。有趣的是,尽管所有糖尿病小鼠组的高血糖和体重减轻情况相似,但只有糖尿病EC-Bambi-/-小鼠出现了明显的高血压。虽然足细胞或内皮细胞特异性缺失BAMBI均加速了糖尿病肾病的进展,但在糖尿病Pod-Bambi-/-小鼠中观察到的足细胞损伤和丢失加重与Smad3激活增强有关。Smad1/5激活增加和内皮细胞增殖仅在糖尿病EC-Bambi-/-小鼠的肾小球中明显。糖尿病EC-Bambi-/-小鼠中Smad1/5激活增强与质膜囊泡相关蛋白的肾小球表达增加有关,这表明未成熟或去分化的肾小球内皮细胞参与了糖尿病肾病。值得注意的是,糖尿病EC-Bambi-/-小鼠表现出的足细胞损伤和丢失与糖尿病Pod-Bambi-/-小鼠相当。因此,我们的结果突出了TGF-β信号在肾小球细胞中的特异性作用以及在糖尿病肾病进展过程中受损肾小球细胞之间复杂的相互作用。