Using the global Hipk2-null mice in various models of kidney disease, we previously demonstrated the central role of homeodomain interacting protein kinase 2 (HIPK2) in the development of renal fibrosis. However, whether the renal tubular epithelial cell (RTEC)-specific HIPK2 function significantly contributed to renal fibrogenesis had not been established. Herein, using RTEC-specific HIPK2 null mice and transgenic mice with RTEC-specific overexpression of the wildtype (WT) or kinase-dead (KD) mutant of HIPK2, we now show that the modulation of tubular HIPK2 expression and activity can profoundly affect renal fibrosis development in vivo. The loss of HIPK2 expression in RTECs resulted in a marked diminution of renal fibrosis in mouse models of unilateral obstruction (UUO) and HIV-associated nephropathy (HIVAN) in Tg26 mice, which was associated with the reduction of Smad3 activation and downstream expression of profibrotic markers. Conversely, the overexpression of WT HIPK2 in RTECs accentuated the extent of renal fibrosis in the setting of UUO, HIVAN, and folic acid nephropathy (FAN) in mice. Importantly, the overexpression of HIPK2 KD mutant or administration of BT173, an allosteric inhibitor of HIPK2-Smad3 interaction, markedly attenuated the renal fibrosis in these mouse models of kidney disease, indicating that HIPK2 requires both the kinase activity and its interaction with Smad3 to promote TGF--mediated renal fibrosis. Together, these results establish an important RTEC-specific role of HIPK2 in kidney fibrosis and further substantiates the inhibition of HIPK2 as a therapeutic approach toward renal fibrosis.
Wenzhen Xiao, Jing E, Li Bao, Ying Fan, Yuanmeng Jin, Andrew Wang, David Bauman, Zhengzhe Li, Ya-Li Zheng, Ruijie Liu, Kyung Lee, John Cijiang He
Orphan nuclear receptor estrogen-related receptor (ERR)γ stimulates bile acid production, however, the role and the regulatory mechanism of ERRγ in cholestatic liver disease are largely unknown. This study identifies that Sirt6 is a deacetylase of ERRγ and suggests a novel mechanism by which Sirt6 activation alleviates cholestatic liver damage and fibrosis through regulating ERRγ. We observed that hepatic expression of Sirt6 is repressed while that of ERRγ is upregulated in murine cholestasis models. Hepatocyte-specific Sirt6 knockout mice were more severely injured following a bile duct ligation (BDL) compared to wild-type mice and adenoviral re-expression of Sirt6 reversed liver damage and fibrosis as demonstrated by biochemical and histological analyses. Mechanistically, Sirt6 deacetylated ERRγ, thereby destabilized ERRγ and inhibited its transcriptional activity. Elimination of hepatic ERRγ using Ad-shERRγ abolished the deleterious effects of Sirt6 deficiency, while ERRγ overexpression aggravated cholestatic liver injury. Administration of a Sirt6 deacetylase activator prevented BDL-induced liver damage and fibrosis. In patients with cholestasis, Sirt6 expression was decreased while total- and acetylated-ERRγ levels were increased, confirming negative regulation of ERRγ by Sirt6. Thus, Sirt6 activation represents a new therapeutic strategy for treating cholestatic liver injury.
Lihua Hao, In Hyuk Bang, Jie Wang, Yuancheng Mao, Jae Do Yang, Soon-Young Na, Jeong Kon Seo, Hueng-Sik Choi, Eun Ju Bae, Byung-Hyun Park
Aromatase inhibitors (AIs) reduce breast cancer recurrence and prolong survival, but up to 30% of patients exhibit recurrence. Using a genome-wide association study of patients entered on MA.27, a phase III randomized trial of anastrozole vs exemestane, we identified a SNP in CUB And Sushi Multiple Domains 1 (CSMD1) associated with breast cancer free interval, with the variant allele associated with fewer distant recurrences. Mechanistically, CSMD1 regulates CYP19 expression in a SNP-, and drug-dependent fashion and this regulation is different among three AIs, anastrozole, exemestane, and letrozole. Overexpression of CSMD1 sensitized AI-resistant cells to anastrozole but not to the other two AIs. The SNP in CSMD1 that was associated with increased CSMD1 and CYP19 expression levels increased anastrozole sensitivity, but not letrozole or exemestane sensitivity. Anastrozole degrades estrogen receptor α (ERα), especially in the presence of estradiol (E2). ER positive breast cancer organoids and AI- or fulvestrant-resistant breast cancer cells were more sensitive to anastrozole plus E2 than to AI alone. Our findings suggest that the CSMD1 SNP might help to predict AI response and anastrozole plus E2 serves as a potential new therapeutic strategy for patients with AI- or fulvestrant-resistant breast cancers.
Junmei Cairns, James N. Ingle, Tanda T. M. Dudenkov, Krishna R. Kalari, Erin E. Carlson, Jie Na, Aman U. Buzdar, Mark E. Robson, Matthew J. Ellis, Paul E. Goss, Lois E. Shepherd, Barbara Goodnature, Matthew P. Goetz, Richard M. Weinshilboum, Hu Li, Mehrab Ghanat Bari, Liewei Wang
Nonalcoholic fatty liver disease (NAFLD) is a common comorbidity among people living with HIV with a more aggressive course than in the general population. In a recent randomized placebo-controlled trial, we demonstrated that the growth hormone-releasing hormone analogue tesamorelin reduced liver fat and prevented fibrosis progression in HIV-associated NAFLD over one year. As such, tesamorelin is the first strategy that has shown to be effective against NAFLD among the HIV population. The current study leveraged paired liver biopsy specimens from this trial to identify hepatic gene pathways that are differentially modulated by tesamorelin versus placebo. Using Gene Set Enrichment Analysis (GSEA), we found that tesamorelin increased hepatic expression of hallmark gene sets involved in oxidative phosphorylation and decreased hepatic expression of gene sets contributing to inflammation, tissue repair, and cell division. Tesamorelin also reciprocally up- and downregulated curated gene sets associated with favorable and poor hepatocellular carcinoma prognosis, respectively. Notably, among tesamorelin-treated participants, these changes in hepatic expression correlated with improved fibrosis-related gene score. Our findings inform our knowledge of the biology of growth hormone action on the liver and provide a mechanistic basis for the observed clinical effects of tesamorelin on the liver.
Lindsay T. Fourman, James M. Billingsley, George Agyapong, Shannan J. Ho Sui, Meghan N. Feldpausch, Julia Purdy, Isabel Zheng, Chelsea S. Pan, Kathleen E. Corey, Martin Torriani, David E. Kleiner, Colleen M. Hadigan, Takara L. Stanley, Raymond T. Chung, Steven K. Grinspoon
Current management of childhood leukemia is tailored based on disease risk determined by clinical features at presentation. Whether properties of the host immune response impact disease risk and outcome is not known. Here we combine mass cytometry, single cell genomics and functional studies to characterize the bone marrow immune environment in children with B-cell acute lymphoblastic leukemia, and acute myelogenous leukemia at presentation. T cells in leukemia marrow demonstrate evidence of chronic immune activation and exhaustion/dysfunction, with attrition of naïve T cells and TCF1+ stem-like memory T cells and accumulation of terminally-differentiated effector T cells. Marrow-infiltrating natural killer cells also exhibit evidence of dysfunction, particularly in myeloid leukemia. Properties of immune cells identified distinct immune phenotype-based clusters correlating with disease risk in acute lymphoblastic leukemia. High-risk immune signatures were associated with expression of stem-like genes on tumor cells. These data provide a comprehensive assessment of the immune landscape of childhood leukemias and identify targets potentially amenable to therapeutic intervention. These studies also suggest that properties of the host response with depletion of naïve T cells and accumulation of terminal-effector T cells may contribute to the biologic basis of disease risk. Properties of immune microenvironment identified here may also impact optimal application of immune therapies, including T cell-redirection approaches in childhood leukemia.
Jithendra Kini Bailur, Samuel S. McCachren, Katherine E. Pendleton, Juan C. Vasquez, Hong S. Lim, Alyssa Duffy, Deon Doxie, Akhilesh Kaushal, Connor J.R. Foster, Deborah DeRyckere, Sharon M. Castellino, Melissa L. Kemp, Peng Qiu, Madhav Dhodapkar, Kavita Dhodapkar
COVID-19-associated morbidity and mortality have been attributed to a pathologic host response. Two divergent hypotheses have been proposed: a hyper-inflammatory ‘cytokine-storm’-mediated injury versus failure of host protective immunity resulting in unrestrained viral dissemination and organ injury. A key explanation for the inability to address this controversy has been the lack of diagnostic tools to evaluate immune function in COVID-19 infections. ELISpot, a highly sensitive, functional immunoassay was employed in 27 COVID-19, 51 septic, 18 critically-ill non-septic (CINS), and 27 healthy controls to evaluate adaptive and innate immune status by quantitating T cell IFN-ɣ and monocyte TFN-α production. Circulating T cell subsets were profoundly reduced in COVID-19 patients. Additionally, stimulated blood mononuclear cells produced less than 40% to 50% of the IFN-ɣ and TNF-α observed in septic and CINS patients, consistent with markedly impaired immune effector cell function. Approximately 25% of COVID-19 patients had increased IL-6 levels greater than 1,000 pg/mL that were not associated with elevations in other canonical pro-inflammatory cytokines. Collectively, these findings support the hypothesis that COVID-19 suppresses host functional adaptive and innate immunity. Importantly, Interleukin-7 administered ex vivo restored T cell IFN-ɣ production in COVID-19 patients. Thus, ELISpot may functionally characterize host immunity in COVID-19 and inform prospective therapies.
Kenneth E. Remy, Monty Mazer, David A. Striker, Ali H. Ellebedy, Andrew H. Walton, Jacqueline Unsinger, Teresa M. Blood, Philip A. Mudd, Daehan J. Yi, Daniel A. Mannion, Dale F. Osborne, R. Scott Martin, Nitin J. Anand, James P. Bosanquet, Jane Blood, Anne M. Drewry, Charles C. Caldwell, Isaiah R. Turnbull, Scott C. Brakenridge, Lyle L. Moldawer, Richard S. Hotchkiss
The regulatory mechanisms enabling the intestinal epithelium to maintain a high degree of regenerative capacity during mucosal injury remain unclear. Ex vivo survival and clonogenicity of intestinal stem cells (ISCs) strictly required Cdc42-mediated growth response and Cdc42-deficient enteroids undergo rapid apoptosis. Mechanistically, Cdc42 engaging with EGFR was required for EGF-stimulated receptor-mediated endocytosis and sufficient to promote MAPK signaling. Proteomics and kinase analysis revealed that a physiological, but non-conventionally, spliced Cdc42 variant 2 (V2), exhibited stronger MAPK-activating capability. Human CDC42-V2 is transcriptionally elevated in some colon tumor tissues. Accordingly, mice engineered to overexpress Cdc42-V2 in intestinal epithelium showed elevated MAPK signaling, enhanced regeneration, and reduced mucosal damage in response to irradiation. Overproducing Cdc42-V2 specifically in mouse ISCs enhanced intestinal regeneration following injury. Thus, the intrinsic Cdc42-MAPK program is required for intestinal epithelial regeneration while elevating this signaling cascade is capable of initiating protection from genotoxic injury.
Xiao Zhang, Sheila Bandyopadhyay, Leandro P. Araujo, Kevin Tong, Juan Flores, Daniel Laubitz, Yanlin Zhao, George Yap, Jingren Wang, Qingze Zou, Ronaldo P. Ferraris, Lanjing Zhang, Wenwei Hu, Edward M. Bonder, Pawel R. Kiela, Robert J. Coffey, Michael Verzi, Ivaylo I. Ivanov, Nan Gao
Histone deacetylase (HDAC) enzymes regulate transcription through epigenetic modification of chromatin structure, but their specific functions in the kidney remain elusive. We discovered that the human kidney expresses class I HDACs. Kidney medullary-specific inhibition of class I HDACs in the rat during high salt feeding results in hypertension, polyuria, hypokalemia, and nitric oxide (NO) deficiency. Three new, inducible murine models were used to determine that HDAC1 and HDAC2 in the kidney epithelium are necessary for maintaining epithelial integrity and maintaining fluid-electrolyte balance during increased dietary sodium intake. Moreover, single nucleus RNA sequencing determined that epithelial HDAC1 and HDAC2 are necessary for expression of many sodium or water transporters and channels. In performing a systematic review and meta-analysis of serious adverse events associated with clinical HDAC inhibitor use, we found that HDAC inhibitors increased the odds ratio of experiencing fluid-electrolyte disorders such as hypokalemia. This study provides insight on the mechanisms of potential serious adverse events with HDAC inhibitors, which may be fatal to critically ill patients. In conclusion, kidney tubular HDACs provide a link between the environment, such as consumption of high salt diets, with regulation of homeostatic mechanisms to remain in fluid-electrolyte balance.
Kelly Hyndman, Joshua S. Speed, Luciano D. Mendoza, John Allan, Jackson Colson, Randee Sedaka, Chunhua Jin, Hyun Jun Jung, Samir El-Dahr, David Pollock, Jennifer Pollock.
Over the last years, a number of drugs have been approved for the treatment of cystic fibrosis (CF). Among them, the new Trikafta, a combination of three drugs, holds great promises to radically improve the quality of life for a large part of CF patients carrying one copy of the most frequent CFTR mutation: F508del. Currently available, disease-modifying, CF drugs work by rescuing the function of mutated CFTR (Cystic Fibrosis Transmembrane Conductance Regulator) anion channel. Recent research work shows that membrane lipids, and the cell lipidome in general, play a significant role in the mechanism of CFTR defective trafficking and, on the other hand, in its rescue. In this paper, by using untargeted lipidomics on CFBE41o– cells, we identified distinctive changes in bronchial epithelial cell lipidome associated with treatment with the triple combination VX-661/VX-445/VX-770 (drug name: Trikafta) and other CF drugs. Particularly interesting is the reduction of ceramide levels, known molecular players in the induction of apoptosis, that appears to be associated with a decrease in cell susceptibility to undergo apoptosis. This evidence could account for additional beneficial role of the triple combination on CF phenotypes.
Nara Liessi, Emanuela Pesce, Clarissa Braccia, Sine Mandrup Bertozzi, Alessandro Giraudo, Tiziano Bandiera, Nicoletta Pedemonte, Andrea Armirotti
We identified a novel homozygous duplication involving the promoter region and exons 1-4 of RYR2 that is responsible for highly penetrant, exertion-related sudden deaths/cardiac arrests in the Amish community without an overt phenotype to suggest RYR2-mediated catecholaminergic polymorphic ventricular tachycardia (CPVT). Homozygous RYR2-duplication (RYR2-DUP) induced pluripotent stem cell-cardiomyocytes (iPSC-CMs) were generated from two unrelated patients. There was no difference in baseline Ca2+ handling measurements between WT- and the RYR2-DUP-iPSC-CMs lines. However, compared to WT-iPSC-CMs, both patient lines demonstrated a dramatic reduction in caffeine and isoproterenol (ISO) stimulated Ca2+ transient amplitude, suggesting RyR2 loss-of-function. There was a >50% reduction in RYR2 transcript/RyR2 protein expression in both patient iPSC-CMs compared to WT. Delayed afterdepolarization was observed in the RYR2-DUP-iPSC-CMs but not in the WT-iPSC-CMs. Compared to WT-iPSC-CMs, there was a significantly elevated arrhythmic activity in the RYR2-DUP-iPSC-CMs in response to ISO. Nadolol, propranolol, and flecainide reduced erratic activity by 8.5 fold, 6.8 fold, and 2.4 fold, respectively from ISO challenge. Unlike the gain-of-function mechanism observed in RYR2-mediated CPVT, the homozygous multi-exon duplication precipitates a dramatic reduction in RYR2 transcription and RyR2 protein translation, a loss-of-function in calcium handling, and a calcium-induced calcium release apparatus that is insensitive to catecholamines and caffeine.
David J. Tester, CS John Kim, Samantha K. Hamrick, Dan Ye, Bailey J. O'Hare, Hannah M. Bombei, Kristi K. Fitzgerald, Carla M. Haglund-Turnquist, Dianne L. Atkins, Luis A. Ochoa Nunez, Ian H. Law, Joel D. Temple, Michael J. Ackerman
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