title: The protective effect of neutralizing high-mobility group box1 against chronic cyclosporine nephrotoxicity in mice.
abstract: BACKGROUND
  High-mobility group box1 (HMGB1) is known to be involved in innate immune response through interaction with receptor for advanced glycation end products (RAGE) and toll-like receptors (TLRs), besides its proper role within the nucleus. Immunological pathways, including TLR signaling, are also involved in chronic cyclosporine (CsA) nephrotoxicity. This study was designed to determine whether neutralizing HMGB1 prevents chronic CsA nephrotoxicity.
  
  
  METHODS
  Chronic CsA nephrotoxicity was induced by CsA subcutaneous injection daily for 4weeks under salt-depletion in mice. Anti-HMGB1 neutralizing antibody for HMGB1 blockade (600mcg/mouse) was administered weekly to mice in the anti-HMGB1 treatment group. The effects of HMGB1 neutralization were evaluated in terms of renal function as well as histological and immunopathological examination.
  
  
  RESULTS
  Anti-HMGB1 administration prevented the increases in serum creatinine and 24h albuminuria and the decrease in creatinine clearance associated with CsA treatment. Increased tubulointerstitial fibrosis and transforming growth factor (TGF)-β immunohistochemical staining associated with CsA treatment were also prevented by anti-HMGB1 administration. Anti-HMGB1 administration prevented the activation of the TLR4 signaling pathway, which resulted in the reduction of nuclear factor kappa B (NF-κB) expression. In cultured tubular cells, anti-HMGB1 pretreatment also prevented the increases in fibronectin and collagen IV levels associated with CsA treatment.
  
  
  CONCLUSIONS
  Neutralizing HMGB1 with an anti-HMGB1 antibody ameliorated chronic CsA nephrotoxicity via inhibition of the TLR4 signaling pathway. Our study suggests that HMGB1 blockade can be beneficial for increasing allograft survival in renal transplant recipients by protecting against calcineurin inhibitor-induced nephrotoxicity.
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Hoon Suk
authors.initials: HS
authors.lastname: Park
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Eun Nim
authors.initials: EN
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Min Young
authors.initials: MY
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Ji Hee
authors.initials: JH
authors.lastname: Lim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Hyung Wook
authors.initials: HW
authors.lastname: Kim
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Cheol Whee
authors.initials: CW
authors.lastname: Park
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Chul Woo
authors.initials: CW
authors.lastname: Yang
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea.
authors.forename: Dong Chan
authors.initials: DC
authors.lastname: Jin
authors.affiliation: Division of Nephrology, Department of Internal Medicine, The Catholic University of Korea, Seoul, Republic of Korea. Electronic address: sooncb@catholic.ac.kr.
authors.forename: Bum Soon
authors.initials: BS
authors.lastname: Choi
mesh_terms: D000818:Animals; D019138:Antibodies, Blocking / Q000008:administration & dosage / Q000276:immunology; D065095:Calcineurin Inhibitors / Q000009:adverse effects*; D002478:Cells, Cultured; D003404:Creatinine / Q000097:blood; D016572:Cyclosporine / Q000008:administration & dosage / Q000009:adverse effects*; D005355:Fibrosis; D006084:Graft Rejection; D006085:Graft Survival; D024243:HMGB1 Protein / Q000037:antagonists & inhibitors* / Q000276:immunology; D007113:Immunity, Innate; D007166:Immunosuppressive Agents / Q000009:adverse effects*; D016030:Kidney Transplantation; D007684:Kidney Tubules / Q000187:drug effects* / Q000473:pathology*; D008297:Male; D051379:Mice; D008813:Mice, Inbred ICR; D016328:NF-kappa B / Q000235:genetics / Q000378:metabolism; D009395:Nephritis, Interstitial / Q000139:chemically induced* / Q000517:prevention & control*; D051197:Toll-Like Receptor 4 / Q000378:metabolism; D016212:Transforming Growth Factor beta / Q000235:genetics / Q000378:metabolism
chemical_list: D019138:Antibodies, Blocking; D065095:Calcineurin Inhibitors; D024243:HMGB1 Protein; D007166:Immunosuppressive Agents; D016328:NF-kappa B; D051197:Toll-Like Receptor 4; D016212:Transforming Growth Factor beta; D016572:Cyclosporine; D003404:Creatinine
keywords: Cyclosporine; HMGB1; Nephrotoxicity; TLR4