Scaffold Attachment Factor A reprograms splicing and translation to drive podocyte cytoskeletal injury and proteinuria in diabetic kidney disease

 

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Scaffold Attachment Factor A reprograms splicing and translation to drive podocyte cytoskeletal injury and proteinuria in diabetic kidney disease

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jia guo guo.jia0209@outlook.com The first affiliated hospital of zhengzhou university Nephrology zhengzhou China *
Chaojie Zhang g4chaochao@163.com The first affiliated hospital of zhengzhou university Nephrology zhengzhou China -
 
 
 
 
 
 
 
 
 
 
 
 
 

Diabetic kidney disease (DKD) is characterized by podocyte injury and proteinuria, yet the upstream RNA regulatory mechanisms remain poorly defined. We investigated the role of the RNA-binding protein Scaffold Attachment Factor A (SAF-A/hnRNP U) in podocyte pathogenesis in DKD.


We employed a systematic integrative approach, including single-cell RNA sequencing and MARVEL-based splicing analysis of human DKD kidneys. Functional validation was performed through podocyte-specific SAF-A knockdown in db/db mice and overexpression studies in cultured podocytes under diabetic conditions, complemented by RNA-seq, RIP-seq, and ribosome profiling.

DKD kidneys exhibited widespread alternative splicing across cell types, with marked upregulation and perinuclear-to-nuclear relocalization of SAF-A in podocytes. SAF-A levels were elevated in serum and urine and correlated with serum creatinine and eGFR. Podocyte-specific SAF-A knockdown in db/db mice attenuated proteinuria and preserved foot process ultrastructure. Conversely, SAF-A overexpression in cultured podocytes induced injury phenotypes—F-actin disassembly, slit diaphragm disruption, desmin induction, and abnormal nuclear division—alongside altered cytoskeletal and cell cycle protein expression. Mechanistically, SAF-A orchestrates a dual-layer regulatory program: at the pre-mRNA level, it directs alternative splicing of cytoskeletal and cell cycle genes, including the actomyosin regulator Myl12a and microtubule-stabilizing factor Tacc3; at the translational level, it enhances synthesis of Nek2, Ccnd1, Ccnb1, and Tacc3 while repressing Myl12a, collectively disrupting actomyosin and microtubule networks and promoting foot process effacement.

SAF-A is a central mechanistic regulator of podocyte injury in DKD, acting through coordinated splicing and translational control. These findings identify circulating and urinary SAF-A as promising biomarkers and candidate therapeutic targets in DKD.

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