Abstract |
Kidney hypoperfusion during episodes of systemic hypotension or after surgical procurement for transplantation can lead to tubular cell death via necrosis and apoptosis, which trigger a series of responses that promote repair. The factors that contribute to the repair phase after kidney injury are not well understood. Using a urine proteomic screen in mice, we identified the macrophage-secreted chitinase-like protein Brp-39, the murine protein product of the chitinase 3-like 1 gene, as a critical component of this reparative response that serves to limit tubular cell apoptotic death via activation of Akt, improving animal survival after kidney ischemia/reperfusion. Examination of graded times of renal ischemia revealed a direct correlation between the degree of kidney injury and both Chi3l1/Brp-39 expression in the kidney and its levels in the urine. In samples collected from patients undergoing deceased-donor kidney transplantation, we found higher levels of the orthologous human protein, YKL-40, in urine and blood from allografts subjected to sufficient peri-transplant ischemia to cause delayed graft function than from allografts with slow or immediate graft function. Urinary levels of YKL-40 obtained within hours of transplant predicted the need for subsequent dialysis in these patients. In summary, these data suggest that Brp-39/YKL-40 is a sensor of the degree of injury, a critical mediator of the reparative response, and a possible biomarker to identify patients at greatest risk of sustained renal failure after transplantation.
|
Authors | Insa M Schmidt, Isaac E Hall, Sujata Kale, Sik Lee, Chuan-Hua He, Yashang Lee, Geoffrey L Chupp, Gilbert W Moeckel, Chun Geun Lee, Jack A Elias, Chirag R Parikh, Lloyd G Cantley |
Journal | Journal of the American Society of Nephrology : JASN
(J Am Soc Nephrol)
Vol. 24
Issue 2
Pg. 309-19
(Feb 2013)
ISSN: 1533-3450 [Electronic] United States |
PMID | 23291472
(Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
|
Chemical References |
- Adipokines
- Biomarkers
- CHI3L1 protein, human
- Chil1 protein, mouse
- Chitinase-3-Like Protein 1
- Glycoproteins
- Lectins
- AKT1 protein, human
- Akt1 protein, mouse
- Proto-Oncogene Proteins c-akt
|
Topics |
- Adipokines
(genetics, metabolism)
- Animals
- Apoptosis
(physiology)
- Biomarkers
(blood, urine)
- Cells, Cultured
- Chitinase-3-Like Protein 1
- Delayed Graft Function
(metabolism, mortality, physiopathology)
- Disease Models, Animal
- Epithelial Cells
(cytology)
- Glycoproteins
(genetics, metabolism)
- Humans
- Kidney
(cytology)
- Kidney Transplantation
- Lectins
(genetics, metabolism)
- Macrophages
(metabolism)
- Male
- Mice
- Mice, Inbred C57BL
- Phosphatidylinositol 3-Kinases
(metabolism)
- Predictive Value of Tests
- Proto-Oncogene Proteins c-akt
(metabolism)
- Reperfusion Injury
(metabolism, mortality, physiopathology)
- Signal Transduction
(physiology)
- Transplantation, Homologous
|