title: Tubular nuclear accumulation of Snail and epithelial phenotypic changes in human myeloma cast nephropathy.
abstract: The transcription factor Snail is an important repressor of E-cadherin gene expression. It plays a key role in the induction of epithelial-mesenchymal transition, an essential process important not only in embryonic development and tumor progression but also in organ fibrogenesis. We studied the expression of Snail by immunohistochemistry, along with several epithelial phenotypic changes suggestive of epithelial-mesenchymal transition, in 14 patients with multiple myeloma cast nephropathy. This nephropathy is characterized by a rapid progression toward fibrosis. As controls, we used normal kidneys and kidneys from patients displaying an idiopathic nephrotic syndrome, a syndrome unassociated with renal fibrosis. We discovered that, in all patients with multiple myeloma nephropathy, a drastic accumulation of Snail is seen in the nuclei from tubular epithelial cells showing epithelial phenotypic changes. In contrast, normal and idiopathic nephrotic syndrome kidneys did not exhibit either of these markers. Snail, a major player in the process of epithelial-to-mesenchymal transition, is highly expressed by tubular epithelial cells during multiple myeloma nephropathy. It is, therefore, a potential target to prevent multiple myeloma kidneys from fibrosing. Intranuclear accumulation of Snail is a characteristic in phenotypically altered tubular cells from multiple myeloma kidneys. The epithelial-mesenchymal transition pathway could, therefore, be involved in the rapid renal fibrogenesis observed in this setting.
authors.affiliation: AP-HP, Hôpital Tenon, Urgences Néphrologiques & Transplantation Rénale, F-75020 Paris, France.
authors.forename: Alexandre
authors.initials: A
authors.lastname: Hertig
authors.forename: Guillaume
authors.initials: G
authors.lastname: Bonnard
authors.forename: Tim
authors.initials: T
authors.lastname: Ulinski
authors.forename: Magali
authors.initials: M
authors.lastname: Colombat
authors.forename: Chantal
authors.initials: C
authors.lastname: Jouanneau
authors.forename: Edith
authors.initials: E
authors.lastname: Baugey
authors.forename: Albert
authors.initials: A
authors.lastname: Bensman
authors.forename: Pierre
authors.initials: P
authors.lastname: Ronco
authors.forename: Eric
authors.initials: E
authors.lastname: Rondeau
authors.forename: Yi-Chun
authors.initials: YC
authors.lastname: Xu-Dubois
mesh_terms: D058186:Acute Kidney Injury / Q000378:metabolism / Q000473:pathology*; D015415:Biomarkers / Q000378:metabolism; D002467:Cell Nucleus / Q000378:metabolism* / Q000473:pathology; D004847:Epithelial Cells / Q000378:metabolism / Q000473:pathology*; D006801:Humans; D007668:Kidney / Q000473:pathology; D007684:Kidney Tubules / Q000378:metabolism* / Q000473:pathology; D008875:Middle Aged; D009101:Multiple Myeloma / Q000378:metabolism / Q000473:pathology*; D010641:Phenotype; D000071250:Snail Family Transcription Factors; D014157:Transcription Factors / Q000378:metabolism*
chemical_list: D015415:Biomarkers; D000071250:Snail Family Transcription Factors; D014157:Transcription Factors