Podocyte protection by darbepoetin: preservation of the cytoskeleton and nephrin expression.
Podocyte injury is a significant contributor to proteinuria and glomerulosclerosis. Recent studies have shown a renoprotective effect of erythropoietin (EPO) during ischemic kidney disease. In this study, we examine mechanisms by which a long acting recombinant EPO analog, darbepoetin, may confer renoprotection in the puromycin aminonucleoside-induced model of nephrotic syndrome. Darbepoetin decreased the proteinuria of rats treated with puromycin. This protective effect was correlated with the immunohistochemical disappearance of the podocyte injury markers desmin and the immune costimulator molecule B7.1 with the reappearance of nephrin expression in the slit diaphragm. Podocyte foot process retraction and effacement along with actin filament rearrangement, determined by electron microscopy, were all reversed by darbepoetin treatment. The protective effects were confirmed in puromycin-induced nephrotic rats that had been hemodiluted to normal hematocrit levels. Furthermore, puromycin treatment of rat podocytes in culture caused actin cytoskeletal reorganization along with deranged nephrin distribution. All these effects in vitro were reversed by darbepoetin. Our study demonstrates that darbepoetin treatment ameliorates podocyte injury and decreases proteinuria by a direct effect on podocytes. This may be accomplished by maintenance of the actin cytoskeleton and nephrin expression.
Eto
N
N
Division of Nephrology and Endocrinology, University of Tokyo School of Medicine, Tokyo, Japan.
Wada
T
T
Inagi
R
R
Takano
H
H
Shimizu
A
A
Kato
H
H
Kurihara
H
H
Kawachi
H
H
Shankland
S J
SJ
Fujita
T
T
Nangaku
M
M
D000199:Actins / Q000378:metabolism; D000818:Animals; D017209:Apoptosis / Q000187:drug effects; D018122:B7-1 Antigen / Q000378:metabolism; D002478:Cells, Cultured; D003599:Cytoskeleton / Q000187:drug effects* / Q000378:metabolism / Q000473:pathology; D000068256:Darbepoetin alfa; D003893:Desmin / Q000378:metabolism; D004195:Disease Models, Animal; D004305:Dose-Response Relationship, Drug; D004921:Erythropoietin / Q000031:analogs & derivatives* / Q000494:pharmacology / Q000627:therapeutic use; D020287:In Situ Nick-End Labeling; D008297:Male; D008565:Membrane Proteins / Q000378:metabolism*; D009404:Nephrotic Syndrome / Q000139:chemically induced / Q000150:complications / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D050199:Podocytes / Q000187:drug effects* / Q000378:metabolism / Q000648:ultrastructure; D020011:Protective Agents / Q000494:pharmacology* / Q000627:therapeutic use; D011507:Proteinuria / Q000209:etiology / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D011692:Puromycin Aminonucleoside; D012333:RNA, Messenger / Q000378:metabolism; D051381:Rats; D017208:Rats, Wistar; D020794:Receptor Protein-Tyrosine Kinases / Q000378:metabolism; D017467:Receptors, Erythropoietin / Q000235:genetics / Q000378:metabolism; D013997:Time Factors
D000199:Actins; D018122:B7-1 Antigen; D003893:Desmin; D008565:Membrane Proteins; D020011:Protective Agents; D012333:RNA, Messenger; D017467:Receptors, Erythropoietin; C113267:nephrin; D004921:Erythropoietin; D000068256:Darbepoetin alfa; D011692:Puromycin Aminonucleoside; D020794:Receptor Protein-Tyrosine Kinases