[HTML][HTML] Absence of PKC-alpha attenuates lithium-induced nephrogenic diabetes insipidus

JH Sim, NJ Himmel, SK Redd, FE Pulous, RT Rogers… - PLoS …, 2014 - journals.plos.org
JH Sim, NJ Himmel, SK Redd, FE Pulous, RT Rogers, LN Black, SM Hong, TN von Bergen…
PLoS One, 2014journals.plos.org
Lithium, an effective antipsychotic, induces nephrogenic diabetes insipidus (NDI) in∼ 40%
of patients. The decreased capacity to concentrate urine is likely due to lithium acutely
disrupting the cAMP pathway and chronically reducing urea transporter (UT-A1) and water
channel (AQP2) expression in the inner medulla. Targeting an alternative signaling
pathway, such as PKC-mediated signaling, may be an effective method of treating lithium-
induced polyuria. PKC-alpha null mice (PKCα KO) and strain-matched wild type (WT) …
Lithium, an effective antipsychotic, induces nephrogenic diabetes insipidus (NDI) in ∼40% of patients. The decreased capacity to concentrate urine is likely due to lithium acutely disrupting the cAMP pathway and chronically reducing urea transporter (UT-A1) and water channel (AQP2) expression in the inner medulla. Targeting an alternative signaling pathway, such as PKC-mediated signaling, may be an effective method of treating lithium-induced polyuria. PKC-alpha null mice (PKCα KO) and strain-matched wild type (WT) controls were treated with lithium for 0, 3 or 5 days. WT mice had increased urine output and lowered urine osmolality after 3 and 5 days of treatment whereas PKCα KO mice had no change in urine output or concentration. Western blot analysis revealed that AQP2 expression in medullary tissues was lowered after 3 and 5 days in WT mice; however, AQP2 was unchanged in PKCα KO. Similar results were observed with UT-A1 expression. Animals were also treated with lithium for 6 weeks. Lithium-treated WT mice had 19-fold increased urine output whereas treated PKCα KO animals had a 4-fold increase in output. AQP2 and UT-A1 expression was lowered in 6 week lithium-treated WT animals whereas in treated PKCα KO mice, AQP2 was only reduced by 2-fold and UT-A1 expression was unaffected. Urinary sodium, potassium and calcium were elevated in lithium-fed WT but not in lithium-fed PKCα KO mice. Our data show that ablation of PKCα preserves AQP2 and UT-A1 protein expression and localization in lithium-induced NDI, and prevents the development of the severe polyuria associated with lithium therapy.
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