Cytochrome P450 2E1 (
CYP2E1) induction and oxidative metabolism of
ethanol in hepatocytes inflame and damage liver. Chronic
ethanol ingestion also induces kidney dysfunction, which is associated with mortality from
alcoholic hepatitis. Whether the kidney is directly affected by
ethanol or is secondary to liver damage is not established. We found that
CYP2E1 was induced in kidney tubules of mice chronically ingesting a modified Lieber-deCarli liquid
ethanol diet.
Phospholipids of kidney tubules were oxidized and fragmented in
ethanol-fed mice with accumulation of azelaoyl
phosphatidylcholine (Az-PC), a nonbiosynthetic product formed only by oxidative truncation of
polyunsaturated phosphatidylcholine. Az-PC stimulates the inflammatory PAF receptor (PTAFR) abundantly expressed by neutrophils and kidney tubules, and inflammatory cells and
myeloperoxidase-containing neutrophils accumulated in the kidneys of
ethanol-fed mice after significant hysteresis. Decreased kidney filtration and induction of the
acute kidney injury biomarker KIM-1 in tubules temporally correlated with leukocyte infiltration. Genetic ablation of PTAFR reduced accumulation of PTAFR
ligands and reduced leukocyte infiltration into kidneys. Loss of this receptor in PTAFR(-/-) mice also suppressed oxidative damage and kidney dysfunction without affecting
CYP2E1 induction. Neutrophilic
inflammation was responsible for
ethanol-induced kidney damage, because loss of neutrophil
myeloperoxidase in MPO(-/-) mice was similarly protective. We conclude that
ethanol catabolism in renal tubules results in a self-perpetuating cycle of
CYP2E1 induction, local PTAFR
ligand formation, and neutrophil infiltration and activation that leads to
myeloperoxidase-dependent oxidation and damage to kidney function. Hepatocytes do not express PTAFR, so this oxidative cycle is a local response to
ethanol catabolism in the kidney.