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Immune-mediated tubule atrophy promotes acute kidney injury to chronic kidney disease transition

Author

Listed:
  • Leyuan Xu

    (Yale University School of Medicine)

  • Jiankan Guo

    (Yale University School of Medicine)

  • Dennis G. Moledina

    (Yale University School of Medicine)

  • Lloyd G. Cantley

    (Yale University School of Medicine)

Abstract

Incomplete repair after acute kidney injury can lead to development of chronic kidney disease. To define the mechanism of this response, we compared mice subjected to identical unilateral ischemia-reperfusion kidney injury with either contralateral nephrectomy (where tubule repair predominates) or contralateral kidney intact (where tubule atrophy predominates). By day 14, the kidneys undergoing atrophy had more macrophages with higher expression of chemokines, correlating with a second wave of proinflammatory neutrophil and T cell recruitment accompanied by increased expression of tubular injury genes and a decreased proportion of differentiated tubules. Depletion of neutrophils and T cells after day 5 reduced tubular cell loss and associated kidney atrophy. In kidney biopsies from patients with acute kidney injury, T cell and neutrophil numbers negatively correlated with recovery of estimated glomerular filtration rate. Together, our findings demonstrate that macrophage persistence after injury promotes a T cell- and neutrophil-mediated proinflammatory milieu and progressive tubule damage.

Suggested Citation

  • Leyuan Xu & Jiankan Guo & Dennis G. Moledina & Lloyd G. Cantley, 2022. "Immune-mediated tubule atrophy promotes acute kidney injury to chronic kidney disease transition," Nature Communications, Nature, vol. 13(1), pages 1-18, December.
    • Handle: RePEc:nat:natcom:v:13:y:2022:i:1:d:10.1038_s41467-022-32634-0
    DOI: 10.1038/s41467-022-32634-0
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    Cited by:

    1. Li-Kai Chu & Xu Cao & Lin Wan & Qiang Diao & Yu Zhu & Yu Kan & Li-Li Ye & Yi-Ming Mao & Xing-Qiang Dong & Qian-Wei Xiong & Ming-Cui Fu & Ting Zhang & Hui-Ting Zhou & Shi-Zhong Cai & Zhou-Rui Ma & Ssu-, 2023. "Autophagy of OTUD5 destabilizes GPX4 to confer ferroptosis-dependent kidney injury," Nature Communications, Nature, vol. 14(1), pages 1-17, December.
    2. Man Chen & Madhav C. Menon & Wenlin Wang & Jia Fu & Zhengzi Yi & Zeguo Sun & Jessica Liu & Zhengzhe Li & Lingyun Mou & Khadija Banu & Sui-Wan Lee & Ying Dai & Nanditha Anandakrishnan & Evren U. Azelog, 2023. "HCK induces macrophage activation to promote renal inflammation and fibrosis via suppression of autophagy," Nature Communications, Nature, vol. 14(1), pages 1-17, December.
    3. Luca Bordoni & Anders M. Kristensen & Donato Sardella & Hanne Kidmose & Layla Pohl & Søren Rasmus Palmelund Krag & Ina Maria Schiessl, 2023. "Longitudinal tracking of acute kidney injury reveals injury propagation along the nephron," Nature Communications, Nature, vol. 14(1), pages 1-18, December.

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