OBESITY IMPAIRS AUTOPHAGY AND PROMOTES MITOCHONDRIAL INJURY, EXACERBATING SEPSIS-INDUCED AKI, WHICH IS ATTENUATED BY BAM15

 

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https://storage.unitedwebnetwork.com/files/1099/1f6279c0fcf670d5e19fe29407195481.pdf
OBESITY IMPAIRS AUTOPHAGY AND PROMOTES MITOCHONDRIAL INJURY, EXACERBATING SEPSIS-INDUCED AKI, WHICH IS ATTENUATED BY BAM15

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Yukihiro
Nakayama
Yukihiro Nakayama y.nkym@hama-med.ac.jp Hamamatsu University School of Medicine First Department of Medicine Hamamatsu Japan *
Naoko Tsuji ntsuji@hama-med.ac.jp Hamamatsu University School of Medicine First Department of Medicine Hamamatsu Japan -
Ryutaro Shida shida831@hama-med.ac.jp Hamamatsu University School of Medicine First Department of Medicine Hamamatsu Japan -
Ema Chiemi em@hama-med.ac.jp Hamamatsu University School of Medicine First Department of Medicine Hamamatsu Japan -
Taro Aoki aoki88@hama-med.ac.jp Hamamatsu University School of Medicine Blood Purification Unit Hamamatsu Japan -
Naoko Katahashi kths@hama-med.ac.jp Hamamatsu University School of Medicine First Department of Medicine Hamamatsu Japan -
Sayaka Ishigaki ishigaki@hama-med.ac.jp Hamamatsu University School of Medicine Blood Purification Unit Hamamatsu Japan -
Takamasa Iwakura tkms0421@hama-med.ac.jp Hamamatsu University School of Medicine First Department of Medicine Hamamatsu Japan -
Shinsuke Isobe isobe58@hama-med.ac.jp Hamamatsu University School of Medicine Blood Purification Unit Hamamatsu Japan -
Tomoyuki Fujikura tfuji@hama-med.ac.jp Hamamatsu University School of Medicine First Department of Medicine Hamamatsu Japan -
Naro Ohasi ohasi-n@hama-med.ac.jp Hamamatsu University School of Medicine First Department of Medicine Hamamatsu Japan -
Hideo Yasuda ysdh@hama-med.ac.jp Hamamatsu University School of Medicine First Department of Medicine Hamamatsu Japan -
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Obesity is a major global health concern and is associated with increased vulnerability to acute kidney injury (AKI). However, the mechanisms by which obesity aggravates sepsis-induced AKI remain unclear. We hypothesized that pre-existing lipid stress in obesity leads to impaired autophagy and renders the kidney more susceptible to mitochondrial injury during sepsis. We further evaluated whether BAM15, a mitochondrial uncoupler, mitigates these pathological processes.

Male C57BL/6J mice were fed either a control diet (CD) or high-fat diet (HFD) for 8 weeks. Cecal ligation and puncture (CLP) was then performed to induce sepsis, with BAM15 administered at the time of CLP in designated groups. Blood and kidneys were collected 6 and 24 h post-CLP. Renal function was assessed by serum creatinine. Transmission electron microscopy (×3000) was used to evaluate mitochondrial morphology, phospholipid accumulation, and autophagy-related organelles in proximal tubular cells.

Sepsis-induced AKI was more severe in obese mice (CD 0.53 ± 0.30 vs. HFD 0.77 ± 0.34 mg/dL, p=0.0148). BAM15 markedly improved renal dysfunction in obese septic mice (HFD-Vehicle 0.72 ± 0.27 vs. HFD-BAM15 0.20 ± 0.08 mg/dL, p<0.0001). Obese mice exhibited baseline phospholipid accumulation, and developed mitochondrial swelling and disrupted cristae architecture after CLP. Autolysosome formation was blunted in obese septic mice, indicating impaired autophagy. BAM15 attenuated mitochondrial injury and partially restored autophagy activity.

Obesity impairs autophagy and predisposes the kidney to mitochondrial injury during sepsis, thereby exacerbating AKI. BAM15 ameliorates this injury, likely by preserving mitochondrial integrity and improving autophagy flux.

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