The role of renal tubular NFAT5 in aging-associated renal disease

 

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The role of renal tubular NFAT5 in aging-associated renal disease

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Kosuke
Maruyama
Kosuke Maruyama apmaru080@gmail.com Kumamoto University Graduate School of Medical Sciences Department of Nephrology Kumamoto Japan *
Yuichiro Izumi izumi_yu@kumamoto-u.ac.jp Kumamoto University Graduate School of Medical Sciences Department of Nephrology Kumamoto Japan -
Kento Kitada kitada.kento@kagawa-u.ac.jp Faculty of Medicine Kagawa University Department of Pharmacology Kagawa Japan -
Makoto Ono ononoimoko6124@hotmail.co.jp Kumamoto University Graduate School of Medical Sciences Department of Nephrology Kumamoto Japan -
Hiramatu Akiko ran11.akiko@icloud.com Faculty of Medicine Fukuoka University Department of Nephrology and Connective Tissue Diseases Fukuoka Japan -
Yutaka Kakizoe kakizoe@kumamoto-u.ac.jp Kumamoto University Graduate School of Medical Sciences Department of Nephrology Kumamoto Japan -
Takashige Kuwabara ktakasea@kumamoto-u.ac.jp Kumamoto University Graduate School of Medical Sciences Department of Nephrology Kumamoto Japan -
Adachi Masataka m-adachi@gpo.kumamoto-u.ac.jp Kumamoto University Graduate School of Medical Sciences Department of Nephrology Kumamoto Japan -
Masashi Mukoyama mmuko@kumamoto-u.ac.jp Omuta Tenryo Hospital Department of Nephrology Fukuoka Japan -
Hideki Yokoi hyokoi@kumamoto-u.ac.jp Kumamoto University Graduate School of Medical Sciences Department of Nephrology Kumamoto Japan -
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The number of patients with chronic kidney disease (CKD) and hypertension is increased with age; however, it is not clearly defined why and how aging causes renal dysfunction and hypertension. Nuclear factor of activated T-cells 5 (NFAT5) is a transcription factor that is activated upon hypertonic conditions as observed in the renal medulla. Genome-wide association study has suggested that NFAT5 variants are associated with the elevation of blood pressure and serum sodium levels. We have shown that the renal tubular cell-specific NFAT5 conditional knockout (cKO) mice exhibit salt-sensitive hypertension, while the mice exhibit impaired urine concentrating ability and are susceptible to renal fibrosis. These phenotypes resemble aging-associated renal dysfunction, i.e., urine concentrating disorder, salt-sensitive hypertension, and renal fibrosis. We therefore investigated the possible involvement of NFAT5 in aging-related changes of the kidney.

To evaluate age-related changes in NFAT5 activity, we used NFAT5-luciferase transgenic (NFAT5-luc TG) mice, which enable in vivo visualization of NFAT5 activity. Kidneys from wild type (WT) mice at 3, 6, 12, and 18 months of age were analyzed for mRNA expressions of Nfat5, cell senescence markers (p21, p16), senescence-associated secretory phenotype (SASP) factors (Il-6, Mmp3, Icam1, Serpine1), and fibrosis markers (Tgfb1 and Col1a1) by real-time quantitative PCR. Renal function, fibrosis (Azan staining), gene expressions of SASP-related factors, and immunostaining for p21 were compared between WT and cKO mice at 3 and 18 months. 

NFAT5 activity in the kidney significantly increased in 23-month-old NFAT5-luc TG mice compared with 5-month-old mice. In WT mice, mRNA expression of p21, p16, Il-6, Mmp-3, and Serpine1 increased or tended to increase with aging up to 18 months, whereas Icam1, Tgfb1, and Col1a1 showed no clear changes. At 18 months, cKO mice exhibited marked renal atrophy, advanced interstitial fibrosis on Azan staining, and significantly higher serum creatinine levels than age-matched WT mice. The mRNA expressions of p21, p16, Il-6, and Mmp3 tended to be higher in cKO mice than in WT mice at 3 months, and all markers tested were significantly elevated in cKO mice compared with WT at 18 months. Immunostaining for p21 revealed more widespread expression of p21 in tubular cells in cKO mice compared with WT mice at 18 months of age.

Renal tubular NFAT5 deficiency promotes premature renal aging, fibrosis, and functional decline, which is accompanied by upregulation of SASP and profibrotic factors. In contrast, NFAT5 activity increases with normal aging, suggesting that NFAT5 functions as a protective factor maintaining renal homeostasis in the elderly. 

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