title: Transcription factor Nrf2 hyperactivation in early-phase renal ischemia-reperfusion injury prevents tubular damage progression.
abstract: Acute kidney injury is a devastating disease with high morbidity in hospitalized patients and contributes to the pathogenesis of chronic kidney disease. An underlying mechanism of acute kidney injury involves ischemia-reperfusion injury which, in turn, induces oxidative stress and provokes organ damage. Nrf2 is a master transcription factor that regulates the cellular response to oxidative stress. Here, we examined the role of Nrf2 in the progression of ischemia-reperfusion injury-induced kidney damage in mice using genetic and pharmacological approaches. Both global and tubular-specific Nrf2 activation enhanced gene expression of antioxidant and NADPH synthesis enzymes, including glucose-6-phosphate dehydrogenase, and ameliorated both the initiation of injury in the outer medulla and the progression of tubular damage in the cortex. Myeloid-specific Nrf2 activation was ineffective. Short-term administration of the Nrf2 inducer CDDO during the initial phase of injury ameliorated the late phase of tubular damage. This inducer effectively protected the human proximal tubular cell line HK-2 from oxidative stress-mediated cell death while glucose-6-phosphate dehydrogenase knockdown increased intracellular reactive oxygen species. These findings demonstrate that tubular hyperactivation of Nrf2 in the initial phase of injury prevents the progression of reactive oxygen species-mediated tubular damage by inducing antioxidant enzymes and NADPH synthesis. Thus, Nrf2 may be a promising therapeutic target for preventing acute kidney injury to chronic kidney disease transition.
authors: Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan; Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Division of Oxygen Biology, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Masahiro
authors: M
authors: Nezu
authors: Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan; Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan; Division of Oxygen Biology, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Tomokazu
authors: T
authors: Souma
authors: Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Lei
authors: L
authors: Yu
authors: Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Takafumi
authors: T
authors: Suzuki
authors: Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Daisuke
authors: D
authors: Saigusa
authors: Division of Nephrology, Endocrinology, and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
authors: Sadayoshi
authors: S
authors: Ito
authors: Division of Oxygen Biology, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: sunorio@med.tohoku.ac.jp.
authors: Norio
authors: N
authors: Suzuki
authors: Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan; Department of Integrative Genomics, Tohoku Medical Megabank Organization, Tohoku University Graduate School of Medicine, Sendai, Japan. Electronic address: masiyamamoto@med.tohoku.ac.jp.
authors: Masayuki
authors: M
authors: Yamamoto
mesh_terms: D000818:Animals; D000975:Antioxidants / Q000378:metabolism; D002460:Cell Line; D004195:Disease Models, Animal; D018450:Disease Progression; D015971:Gene Expression Regulation, Enzymologic; D005838:Genotype; D005954:Glucosephosphate Dehydrogenase / Q000235:genetics / Q000378:metabolism; D005978:Glutathione / Q000378:metabolism; D006801:Humans; D000072019:Kelch-Like ECH-Associated Protein 1 / Q000235:genetics / Q000378:metabolism; D007683:Kidney Tubular Necrosis, Acute / Q000235:genetics / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D007684:Kidney Tubules / Q000378:metabolism* / Q000473:pathology; D018345:Mice, Knockout; D009249:NADP / Q000378:metabolism; D051267:NF-E2-Related Factor 2 / Q000172:deficiency / Q000235:genetics / Q000378:metabolism*; D018384:Oxidative Stress; D010641:Phenotype; D034622:RNA Interference; D017382:Reactive Oxygen Species / Q000378:metabolism; D015427:Reperfusion Injury / Q000235:genetics / Q000378:metabolism / Q000473:pathology / Q000517:prevention & control*; D015398:Signal Transduction; D013997:Time Factors; D014162:Transfection
chemical_list: D000975:Antioxidants; C117301:Keap1 protein, mouse; D000072019:Kelch-Like ECH-Associated Protein 1; D051267:NF-E2-Related Factor 2; C495636:Nfe2l2 protein, mouse; D017382:Reactive Oxygen Species; D009249:NADP; D005954:Glucosephosphate Dehydrogenase; D005978:Glutathione
keywords: acute kidney injury; chronic kidney disease; ischemia reperfusion; oxidative stress; transcription regulation