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MC1R is dispensable for the proteinuria reducing and glomerular protective effect of melanocortin therapy.

Abstract
Melanocortin therapy by using adrenocorticotropic hormone (ACTH) or non-steroidogenic melanocortin peptides attenuates proteinuria and glomerular injury in experimental glomerular diseases and induces remission of nephrotic syndrome in patients with diverse glomerulopathies, even those resistant to steroids. The underlying mechanism remains elusive, but the role of melanocortin 1 receptor (MC1R) has been implicated and was examined here. Four patients with congenital red hair color and nephrotic syndrome caused by idiopathic membranous nephropathy or focal segmental glomerulosclerosis were confirmed by gene sequencing to bear dominant-negative MC1R mutations. Despite prior corticosteroid resistance, all patients responded to ACTH monotherapy and ultimately achieved clinical remission, inferring a steroidogenic-independent and MC1R-dispensable anti-proteinuric effect of melanocortin signaling. In confirmatory animal studies, the protective effect of [Nle(4), D-Phe(7)]-α-melanocyte stimulating hormone (NDP-MSH), a potent non-steroidogenic pan-melanocortin receptor agonist, on the lipopolysaccharide elicited podocytopathy was completely preserved in MC1R-null mice, marked by reduced albuminuria and diminished histologic signs of podocyte injury. Moreover, in complementary in vitro studies, NDP-MSH attenuated the lipopolysaccharide elicited apoptosis, hypermotility and impairment of filtration barrier function equally in primary podocytes derived from MC1R-null and wild-type mice. Collectively, our findings suggest that melanocortin therapy confers a proteinuria reducing and podoprotective effect in proteinuric glomerulopathies via MC1R-independent mechanisms.
AuthorsYingjin Qiao, Anna-Lena Berg, Pei Wang, Yan Ge, Songxia Quan, Sijie Zhou, Hai Wang, Zhangsuo Liu, Rujun Gong
JournalScientific reports (Sci Rep) Vol. 6 Pg. 27589 (06 08 2016) ISSN: 2045-2322 [Electronic] England
PMID27270328 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Chemical References
  • Melanocortins
  • Receptor, Melanocortin, Type 1
  • alpha-MSH
  • Adrenocorticotropic Hormone
Topics
  • Adrenocorticotropic Hormone (administration & dosage, metabolism)
  • Animals
  • Glomerulosclerosis, Focal Segmental (drug therapy, genetics, pathology)
  • Humans
  • Kidney Glomerulus (drug effects, injuries, pathology)
  • Melanocortins (administration & dosage, genetics)
  • Mice
  • Nephrotic Syndrome (drug therapy, genetics, pathology)
  • Podocytes (drug effects)
  • Proteinuria (drug therapy, genetics, metabolism, pathology)
  • Receptor, Melanocortin, Type 1 (genetics)
  • Signal Transduction (drug effects)
  • alpha-MSH (administration & dosage)

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