Scientists identify drug target for kidney disease affecting millions
Researchers have pinpointed a molecular pathway that drives focal segmental glomerulosclerosis, a progressive kidney disease with no cure. The discovery of endothelin signaling as a key driver opens a route for drug development, potentially offering treatment options for patients who currently face transplant or dialysis.
Originaltitel: Podocyte-derived endothelin-1 and endothelial cell endothelin A receptors are essential for glomerular injury in mouse models of focal segmental glomerulosclerosis
Introduction: Increased endothelin-1 (ET1) and endothelin receptor A (ETA) signaling have been implicated in the pathogenesis of focal segmental glomerulosclerosis (FSGS). Previous studies have suggested that crosstalk between activated podocytes and glomerular endothelial cells (GECs) could contribute to the pathogenesis of FSGS. Methods: To examine this, we developed mouse lines with endothelial cell-targeted and conditional deletion of ETA using the Cre-LoxP system (Scl:Cre-ETAfl/fl), as well as targeted deletion of ET1 in podocytes (Nphs2:Cre-ET1fl/fl). Results: The absence of endothelial ETA in mice was protective in adriamycin-induced glomerular injury, as evidenced by decreased albuminuria and reduced podocyte depletion. RNA-seq of ET1-treated mouse glomerular endothelial cells showed activation of cellular signaling pathways and alteration of matrix component deposition programs via ETA. Endothelin-1 expression was detected in glomerular cells in patient biopsy samples and mice with FSGS. Compared to adriamycin-treated mice, podocytespecific ET1 knockout mice treated with adriamycin had reduced glomerular injury, albuminuria, and podocyte depletion. Furthermore, canonical transforming growth factor (TGF)I3 signaling mediates ET1 release by podocytes, and Edn1 knockout in podocytes with inducible TGFI3 receptor-1 signaling (Nphs2:Cre-ET1-Nphs1:TgfbrI) abrogated glomerular injury and albuminuria upon TGFI3 receptor-1 activation. Ultrastructural changes and podocyte depletion were completely prevented in these mice, and there was no increase in GEC-associated ETA expression. Mathematical modelling supports rapid bidirectional diffusion of ET1 across the glomerular basement membrane. Conclusions: Our studies provide in vivo evidence that crosstalk of podocyte-derived ET1 with activation of GEC ETA contributes to glomerular injury in FSGS.