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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 3

A PTEN inhibitor rescues the phenotype of endothelial-specific Dgke-knockout mice.

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A PTEN inhibitor rescues the phenotype of endothelial-specific Dgke-knoc...
(A) Western blot showing impaired Akt activation (phosphorylation of threonine 308 and serine 473) in kidney cortex extracts of Tie2CreDgkefl/fl mice compared with controls. Akt activation was partially rescued in VO-OHpic–treated Tie2CreDgkefl/fl littermates. (B) Western blot showing increased protein levels of COX2 in kidney cortex extracts of VO-OHpic–treated Tie2CreDgkefl/fl mice compared with Tie2CreDgkefl/fl littermates. (C) Representative bright-field microscopy images of glomeruli of PAS-stained Tie2CreDgkefl/fl mouse kidneys and (D) Tie2CreDgkefl/fl littermates’ kidneys after 4 weeks of treatment with the PTEN inhibitor VO-OHpic. The occlusion of the glomerular capillaries is rescued after VO-OHpic treatment. Scale bars are 50 μm. (E) Smears of blood from Tie2CreDgkefl/fl mice and (F) Tie2CreDgkefl/fl littermates after VO-OHpic treatment at 3 months of age. Schistocytes are found in Tie2CreDgkefl/fl mice (arrowheads) but not in VO-OHpic–treated mice. Scale bars are 50 μm. (G–J) Serum hemoglobin, circulating PLT, BUN, and urine ACR in Tie2CreDgkefl/fl mice compared with VO-OHpic–treated Tie2CreDgkefl/fl littermates at 8, 10, and 12 weeks of age. Data are presented as mean ± SD. *: P < 0.05, **: P < 0.01 by Student’s t test. n = 6 mice per group.

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