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Human liver-kidney model elucidates the mechanisms of aristolochic acid nephrotoxicity
Shih-Yu Chang, Elijah J. Weber, Viktoriya S. Sidorenko, Alenka Chapron, Catherine K. Yeung, Chunying Gao, Qingcheng Mao, Danny Shen, Joanne Wang, Thomas A. Rosenquist, Kathleen G. Dickman, Thomas Neumann, Arthur P. Grollman, Edward J. Kelly, Jonathan Himmelfarb, David L. Eaton
Shih-Yu Chang, Elijah J. Weber, Viktoriya S. Sidorenko, Alenka Chapron, Catherine K. Yeung, Chunying Gao, Qingcheng Mao, Danny Shen, Joanne Wang, Thomas A. Rosenquist, Kathleen G. Dickman, Thomas Neumann, Arthur P. Grollman, Edward J. Kelly, Jonathan Himmelfarb, David L. Eaton
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Research Article Cell biology Nephrology

Human liver-kidney model elucidates the mechanisms of aristolochic acid nephrotoxicity

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Abstract

Environmental exposures pose a significant threat to human health. However, it is often difficult to study toxicological mechanisms in human subjects due to ethical concerns. Plant-derived aristolochic acids are among the most potent nephrotoxins and carcinogens discovered to date, yet the mechanism of bioactivation in humans remains poorly understood. Microphysiological systems (organs-on-chips) provide an approach to examining the complex, species-specific toxicological effects of pharmaceutical and environmental chemicals using human cells. We microfluidically linked a kidney-on-a-chip with a liver-on-a-chip to determine the mechanisms of bioactivation and transport of aristolochic acid I (AA-I), an established nephrotoxin and human carcinogen. We demonstrate that human hepatocyte-specific metabolism of AA-I substantially increases its cytotoxicity toward human kidney proximal tubular epithelial cells, including formation of aristolactam adducts and release of kidney injury biomarkers. Hepatic biotransformation of AA-I to a nephrotoxic metabolite involves nitroreduction, followed by sulfate conjugation. Here, we identify, in a human tissue-based system, that the sulfate conjugate of the hepatic NQO1-generated aristolactam product of AA-I (AL-I-NOSO3) is the nephrotoxic form of AA-I. This conjugate can be transported out of liver via MRP membrane transporters and then actively transported into kidney tissue via one or more organic anionic membrane transporters. This integrated microphysiological system provides an ex vivo approach for investigating organ-organ interactions, whereby the metabolism of a drug or other xenobiotic by one tissue may influence its toxicity toward another, and represents an experimental approach for studying chemical toxicity related to environmental and other toxic exposures.

Authors

Shih-Yu Chang, Elijah J. Weber, Viktoriya S. Sidorenko, Alenka Chapron, Catherine K. Yeung, Chunying Gao, Qingcheng Mao, Danny Shen, Joanne Wang, Thomas A. Rosenquist, Kathleen G. Dickman, Thomas Neumann, Arthur P. Grollman, Edward J. Kelly, Jonathan Himmelfarb, David L. Eaton

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Figure 5

Inhibition of AL-I-NOSO3 nephrotoxicity by probenecid (OAT inhibitor).

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Inhibition of AL-I-NOSO3 nephrotoxicity by probenecid (OAT inhibitor).
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(A) Representative LIVE/DEAD staining of human proximal tubular epithelial cells cultured in MPS after probenecid (Pro, 2 mM) and AL-I-NOSO3 (25 μM) cotreatment for 24 hours. Scale bars: 150 μm. (B) Quantitative nephrotoxicity of images in A. n = 5–6 per treatment. (C) Uptake of 0.5 μM AL-I-NOSO3 in OAT4-transfected COS7 cells versus mock transfection in the presence of 2 mM probenecid. n = 4–5. (D) Uptake of 0.5 μM AL-I-NOSO3 in OAT1 or OAT3-transfected HEK cells versus mock transfection in the presence of 2 mM probenecid. n = 3. Statistical significance was calculated using t test. *P < 0.05, **P < 0.01, ***P < 0.001. Quantitative results are presented as average ± SD.

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