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Repetitive ischemic injuries to the kidneys result in lymph node fibrosis and impaired healing
Omar H. Maarouf, Mayuko Uehara, Vivek Kasinath, Zhabiz Solhjou, Naima Banouni, Baharak Bahmani, Liwei Jiang, Osman A. Yilmam, Indira Guleria, Scott B. Lovitch, Jane L. Grogan, Paolo Fiorina, Peter T. Sage, Jonathan S. Bromberg, Martina M. McGrath, Reza Abdi
Omar H. Maarouf, Mayuko Uehara, Vivek Kasinath, Zhabiz Solhjou, Naima Banouni, Baharak Bahmani, Liwei Jiang, Osman A. Yilmam, Indira Guleria, Scott B. Lovitch, Jane L. Grogan, Paolo Fiorina, Peter T. Sage, Jonathan S. Bromberg, Martina M. McGrath, Reza Abdi
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Research Article Nephrology

Repetitive ischemic injuries to the kidneys result in lymph node fibrosis and impaired healing

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Abstract

The contribution of the kidney-draining lymph node (KLN) to the pathogenesis of ischemia-reperfusion injury (IRI) of the kidney and its subsequent recovery has not been explored in depth. In addition, the mechanism by which repetitive IRI contributes to renal fibrosis remains poorly understood. Herein, we have found that IRI of the kidney is associated with expansion of high endothelial venules (HEVs) and activation of fibroblastic reticular cells (FRCs) in the KLN, as demonstrated by significant expansion in the extracellular matrix. The lymphotoxin α signaling pathway mediates activation of FRCs, and chronic treatment with lymphotoxin β receptor–immunoglobulin fusion protein (LTβr-Ig) resulted in marked alteration of the KLN as well as augmentation of renal fibrosis. Depletion of FRCs reduced T cell activation in the KLN and ameliorated renal injury in acute IRI. Repetitive renal IRI was associated with senescence of FRCs, fibrosis of the KLN, and renal scarring, which were ameliorated by FRC administration. Therefore, our study emphasizes the critical role of FRCs in both the initiation and repair phases of injury following IRI of the kidney.

Authors

Omar H. Maarouf, Mayuko Uehara, Vivek Kasinath, Zhabiz Solhjou, Naima Banouni, Baharak Bahmani, Liwei Jiang, Osman A. Yilmam, Indira Guleria, Scott B. Lovitch, Jane L. Grogan, Paolo Fiorina, Peter T. Sage, Jonathan S. Bromberg, Martina M. McGrath, Reza Abdi

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Figure 4

LTβ receptor–immunoglobulin (LTβr-Ig) treatment enhances renal fibrosis following IRI.

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LTβ receptor–immunoglobulin (LTβr-Ig) treatment enhances renal fibrosis ...
(A) Ischemic kidney from mouse treated with LTβr-Ig fails to recover histologically (H&E) 30 days following IRI and shows tissue fibrosis (Masson T), in comparison with the kidney from mouse treated with control IgG. Thirty days following IRI, the ischemic kidney from mouse treated with LTβr-Ig shows increased staining of αSMA, fibronectin, and F4/80, as compared with the kidney from mouse treated with control IgG. Scale bars: 75 μm. (B) Thirty days following IRI, KLN from mouse treated with LTβr-Ig shows marked increase in fibronectin staining, as compared with KLN from mouse treated with control IgG. Scale bar: 200 μm. (C) Thirty days following IRI, BUN is significantly higher in mouse receiving LTβr-Ig, as compared with mouse treated with control IgG (n = 5–6/group, mean ± SEM). *P < 0.05 by Student’s t test.

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