Am J Physiol Renal Physiol. 2021 Feb 22.
Aswathy M Cheriyan,
Adaku C Ume,
Cynthia E Francis,
Keyona N King,
Valerie A Linck,
Yun Bai,
Hui Cai,
Robert S Hoover,
Heping P Ma,
Jennifer L Gooch,
Clintoria R Williams.
BACKGROUND: Calcineurin inhibitors (CNIs) are vital immunosuppressive therapies in the management of inflammatory conditions. A long-term consequence is nephrotoxicity. In the kidneys, the primary, catalytic calcineurin (CnA) isoforms are CnAα and CnAβ. While the renal phenotype of CnAα-/- mice substantially mirrors CNI-induced nephrotoxicity, the mechanisms downstream of CnAa are poorly understood.
HYPOTHESIS: Since NADPH oxidase-2 (Nox2)-derived oxidative damage is implicated in CNI-induced nephrotoxicity, we hypothesized that CnAα inhibition drives Nox2 upregulation and promotes oxidative stress.
EXPERIMENTAL DESIGN: To test the hypothesis, Nox2 regulation was investigated in kidneys from CnAα-/-, CnAβ-/- and WT littermate mice. To identify the downstream mediator of CnAα, NFAT and NFκB regulation was examined. To test if Nox2 is transcriptionally regulated via a NFκB pathway, CnAα-/- and WT renal fibroblasts were treated with the NFκB inhibitor, caffeic acid phenethyl ester.
RESULTS: Our findings showed that CsA treatment induced Nox2 upregulation and oxidative stress. Further, Nox2 upregulation and elevated ROS generation occurred only in CnAα-/- mice. In these mice, NFκB but not NFAT activity was increased. In CnAα-/- renal fibroblasts, NFκB inhibition prevented Nox2 upregulation and ROS generation.
CONCLUSIONS: These findings indicate that 1) CnAα loss stimulates Nox2 upregulation, 2) NFκB is a novel CnAα-regulated transcription factor and 3) NFκB mediates CnAα-induced Nox2 and ROS upregulation.
SIGNIFICANCE: Our results demonstrate that CnAα plays a key role in Nox2 and ROS generation. Further, these novel findings provide evidence of divergent CnA isoform signaling pathways. Finally, this study advocates for CnAα-sparing CNIs, ultimately circumventing the CNI nephrotoxicity.
Keywords: NADPH oxidase; NFκB; calcineurin inhibitors; calcineurin isoforms; oxidative stress