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Loss of diacylglycerol kinase ε causes thrombotic microangiopathy by impairing endothelial VEGFA signaling
Dingxiao Liu, … , Chou-Long Huang, Massimo Attanasio
Dingxiao Liu, … , Chou-Long Huang, Massimo Attanasio
Published May 10, 2021
Citation Information: JCI Insight. 2021;6(9):e146959. https://doi.org/10.1172/jci.insight.146959.
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Research Article Nephrology

Loss of diacylglycerol kinase ε causes thrombotic microangiopathy by impairing endothelial VEGFA signaling

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Abstract

Loss of function of the lipid kinase diacylglycerol kinase ε (DGKε), encoded by the gene DGKE, causes a form of atypical hemolytic uremic syndrome that is not related to abnormalities of the alternative pathway of the complement, by mechanisms that are not understood. By generating a potentially novel endothelial specific Dgke-knockout mouse, we demonstrate that loss of Dgke in the endothelium results in impaired signaling downstream of VEGFR2 due to cellular shortage of phosphatidylinositol 4,5-biphosphate. Mechanistically, we found that, in the absence of DGKε in the endothelium, Akt fails to be activated upon VEGFR2 stimulation, resulting in defective induction of the enzyme cyclooxygenase 2 and production of prostaglandin E2 (PGE2). Treating the endothelial specific Dgke-knockout mice with a stable PGE2 analog was sufficient to reverse the clinical manifestations of thrombotic microangiopathy and proteinuria, possibly by suppressing the expression of matrix metalloproteinase 2 through PGE2-dependent upregulation of the chemokine receptor CXCR4. Our study reveals a complex array of autocrine signaling events downstream of VEGFR2 that are mediated by PGE2, that control endothelial activation and thrombogenic state, and that result in abnormalities of the glomerular filtration barrier.

Authors

Dingxiao Liu, Qiong Ding, Dao-Fu Dai, Biswajit Padhy, Manasa K. Nayak, Can Li, Madison Purvis, Heng Jin, Chang Shu, Anil K. Chauhan, Chou-Long Huang, Massimo Attanasio

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Figure 2

Endothelial specific Dgke-knockout mice recapitulate the full human phenotype.

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Endothelial specific Dgke-knockout mice recapitulate the full human phen...
(A) Agarose gel of the PCR products of the amplification of genomic DNA from ubiquitously Cre-expressing CMVCreDgkefl/fl mice compared with CMVCreDgke+/fl heterozygotes. Heterozygous mice show a long band of 1201 bp corresponding to the retained exon 2 and a shorter band of 365 bp corresponding to the excised exon 2 (arrowheads). Exon 2 is not retained in the homozygous status. (B) Immunofluorescence microscopy images of glomeruli (dashed lines) from Nphs2CreDgke+/LacZ knockin mice compared with Dgke+/LacZ controls, showing LacZ expression exclusively in glomeruli. Scale bars are 20 μm. (C) RT-PCR on RNA showing a band of 830 bp (arrowhead) in Dgkefl/fl mice and no product in Tie2CreDgkefl/fl mice. Primers were placed in the corresponding exon 1 and 5 in the cDNA of Dgke. (D) Representative bright-field microscopy images of glomeruli of Periodic acid–Schiff–stained (PAS-stained) and (E) H&E-stained sections of Tie2CreDgkefl/fl mouse kidneys showing near-complete occlusion of the capillary tuft. Scale bars are 50 μm. (F) Smears of blood from Tie2CreDgkefl/fl and (G) Dgkefl/fl controls at 6 months of age. Numerous schistocytes (arrows) are present in Tie2CreDgkefl/fl knockouts. Scale bars are 75 μm. (H–K) Serum hemoglobin, circulating platelets (PLT), blood urea nitrogen (BUN), and urine albumin to creatinine ratio (ACR) in Tie2CreDgkefl/fl compared with Dgkefl/fl controls at 2, 3, and 6 months of age. Data are presented as mean ± SD. **: P < 0.01 by Student’s t test. n = 6 mice per group.

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