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      cMet agonistic antibody attenuates apoptosis in ischaemia‐reperfusion–induced kidney injury

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          Abstract

          Acute kidney injury (AKI) is a very common complication with high morbidity and mortality rates and no fundamental treatment. In this study, we investigated whether the hepatocyte growth factor (HGF)/cMet pathway is associated with the development of AKI and how the administration of a cMet agonistic antibody (Ab) affects an AKI model. In the analysis using human blood samples, cMet and HGF levels were found to be significantly increased in the AKI group, regardless of underlying renal function. The administration of a cMet agonistic Ab improved the functional and histological changes after bilateral ischaemia‐reperfusion injury. TUNEL‐positive cells and Bax/Bcl‐2 ratio were also reduced by cMet agonistic Ab treatment. In addition, cMet agonistic Ab treatment significantly increased the levels of PI3K, Akt and mTOR. Furthermore, after 24 hours of hypoxia induction in human proximal tubular epithelial cells, treatment with the cMet agonistic Ab also showed dose‐dependent antiapoptotic effects similar to those of the recombinant HGF treatment. Even when the HGF axis was blocked with a HGF‐blocking Ab, the cMet agonistic Ab showed an independent dose‐dependent antiapoptotic effect. In conclusion, cMet expression is associated with the occurrence of AKI. cMet agonistic Ab treatment attenuates the severity of AKI through the PI3K/Akt/mTOR pathway and improves apoptosis. cMet agonistic Ab may have important significance for the treatment of AKI.

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          Acute kidney injury, mortality, length of stay, and costs in hospitalized patients.

          The marginal effects of acute kidney injury on in-hospital mortality, length of stay (LOS), and costs have not been well described. A consecutive sample of 19,982 adults who were admitted to an urban academic medical center, including 9210 who had two or more serum creatinine (SCr) determinations, was evaluated. The presence and degree of acute kidney injury were assessed using absolute and relative increases from baseline to peak SCr concentration during hospitalization. Large increases in SCr concentration were relatively rare (e.g., >or=2.0 mg/dl in 105 [1%] patients), whereas more modest increases in SCr were common (e.g., >or=0.5 mg/dl in 1237 [13%] patients). Modest changes in SCr were significantly associated with mortality, LOS, and costs, even after adjustment for age, gender, admission International Classification of Diseases, Ninth Revision, Clinical Modification diagnosis, severity of illness (diagnosis-related group weight), and chronic kidney disease. For example, an increase in SCr >or=0.5 mg/dl was associated with a 6.5-fold (95% confidence interval 5.0 to 8.5) increase in the odds of death, a 3.5-d increase in LOS, and nearly 7500 dollars in excess hospital costs. Acute kidney injury is associated with significantly increased mortality, LOS, and costs across a broad spectrum of conditions. Moreover, outcomes are related directly to the severity of acute kidney injury, whether characterized by nominal or percentage changes in serum creatinine.
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            A novel mechanism by which hepatocyte growth factor blocks tubular epithelial to mesenchymal transition.

            Hepatocyte growth factor (HGF) is a potent antifibrotic cytokine that blocks tubular epithelial to mesenchymal transition (EMT) induced by TGF-beta1. However, the underlying mechanism remains largely unknown. This study investigated the signaling events that lead to HGF blockade of the TGF-beta1-initiated EMT. Incubation of human kidney epithelial cells HKC with HGF only marginally affected the expression of TGF-beta1 and its type I and type II receptors, suggesting that disruption of TGF-beta1 signaling likely plays a critical role in mediating HGF inhibition of TGF-beta1 action. However, HGF neither affected TGF-beta1-induced Smad-2 phosphorylation and its subsequent nuclear translocation nor influenced the expression of inhibitory Smad-6 and -7 in tubular epithelial cells. HGF specifically induced the expression of Smad transcriptional co-repressor SnoN but not Ski and TG-interacting factor at both mRNA and protein levels in HKC cells. SnoN physically interacted with activated Smad-2 by forming transcriptionally inactive complex and overrode the profibrotic action of TGF-beta1. In vivo, HGF did not affect Smad-2 activation and its nuclear accumulation in tubular epithelium, but it restored SnoN protein abundance in the fibrotic kidney in obstructive nephropathy. Hence, HGF blocks EMT by antagonizing TGF-beta1's action via upregulating Smad transcriptional co-repressor SnoN expression. These findings not only identify a novel mode of interaction between the signals activated by HGF receptor tyrosine kinase and TGF-beta receptor serine/threonine kinases but also illustrate the feasibility of confining Smad activity as an effective strategy for blocking renal fibrosis.
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              Activation of hepatocyte growth factor receptor, c-met, in renal tubules is required for renoprotection after acute kidney injury

              Hepatocyte growth factor is a pleiotrophic protein that promotes injury repair and regeneration in multiple organs. Here, we show that after acute kidney injury (AKI), the HGF receptor, c-met, was induced predominantly in renal tubular epithelium. To investigate the role of tubule-specific induction of c-met in AKI, we generated conditional knockout mice, in which the c-met gene was specifically disrupted in renal tubules. These Ksp-met−/−mice were phenotypically normal and had no appreciable defect in kidney morphology and function. However, in AKI induced by cisplatin or ischemia-reperfusion injury, the loss of tubular c-met substantially aggravated renal injury. Compared with controls, Ksp-met−/−mice displayed higher serum creatinine, more severe morphologic lesions, and increased apoptosis, which was accompanied by an increased expression of Bax and Fas ligand and decreased phosphorylation-activation of Akt. In addition, ablation of c-met in renal tubules promoted chemokine expression and renal inflammation after AKI. Consistently, ectopic expression of hepatocyte growth factor in vivo protected the kidneys against AKI in control mice, but not in Ksp-met−/−counterparts. Thus, our results suggest that tubule-specific c-met signaling is crucial in conferring renal protection after AKI, primarily by its anti-apoptotic and anti-inflammatory mechanisms.
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                Author and article information

                Contributors
                ysh5794@gmail.com
                nephrolee@gmail.com
                Journal
                J Cell Mol Med
                J. Cell. Mol. Med
                10.1111/(ISSN)1582-4934
                JCMM
                Journal of Cellular and Molecular Medicine
                John Wiley and Sons Inc. (Hoboken )
                1582-1838
                1582-4934
                02 April 2020
                May 2020
                : 24
                : 10 ( doiID: 10.1111/jcmm.v24.10 )
                : 5640-5651
                Affiliations
                [ 1 ] Department of Internal Medicine Hallym University Sacred Heart Hospital Anyang Korea
                [ 2 ] Department of Internal Medicine Seoul National University College of Medicine Seoul Korea
                [ 3 ] Department of Intensive Care Unit Yanbian University Hospital Jilin China
                [ 4 ] R&D Center for Innovative Medicines Helixmith Co., Ltd. Seoul Korea
                [ 5 ] Department of Internal Medicine Seoul National University Boramae Medical Center Seoul Korea
                [ 6 ] Department of Internal Medicine Seoul National University Hospital Seoul Korea
                [ 7 ] Kidney Research Institute Seoul National University Seoul Korea
                [ 8 ] Biomedical Research Institute Seoul National University Hospital Seoul Korea
                Author notes
                [*] [* ] Correspondence

                Seung Hee Yang, Kidney Research Institute, Seoul National University, Seoul, Korea and Biomedical Research Institute, Seoul National University Hospital, 101 Daehakro Jongno‐gu, Seoul 03080, Korea.

                Email: ysh5794@ 123456gmail.com

                Jung Pyo Lee, Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea and Seoul National University Boramae Medical Center, 20, Boramae‐ro 5‐gil, Dongjak‐gu, Seoul 07061, Korea.

                Email: nephrolee@ 123456gmail.com

                Author information
                https://orcid.org/0000-0002-8575-6610
                https://orcid.org/0000-0002-4714-1260
                Article
                JCMM15225
                10.1111/jcmm.15225
                7214182
                32239661
                d811decc-9072-42af-9ef5-6ae59fe979ef
                © 2020 The Authors. Journal of Cellular and Molecular Medicine published by Foundation for Cellular and Molecular Medicine and John Wiley & Sons Ltd.

                This is an open access article under the terms of the http://creativecommons.org/licenses/by/4.0/ License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited.

                History
                : 26 October 2019
                : 01 February 2020
                : 10 March 2020
                Page count
                Figures: 6, Tables: 1, Pages: 12, Words: 6304
                Funding
                Funded by: clinical research grant‐in‐aid from the Seoul National University Boramae Medical Center
                Award ID: 03‐2018‐27
                Funded by: Korea Healthcare Technology R&D Project, Ministry for Health and Welfare, Republic of Korea
                Award ID: HI17C1693
                Categories
                Original Article
                Original Articles
                Custom metadata
                2.0
                May 2020
                Converter:WILEY_ML3GV2_TO_JATSPMC version:5.8.1 mode:remove_FC converted:11.05.2020

                Molecular medicine
                acute kidney injury,apoptosis,cmet agonistic antibody,pi3k/akt/mtor pathway
                Molecular medicine
                acute kidney injury, apoptosis, cmet agonistic antibody, pi3k/akt/mtor pathway

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