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Publication : Mechanism of Fibrosis in <i>HNF1B</i>-Related Autosomal Dominant Tubulointerstitial Kidney Disease.

First Author  Chan SC Year  2018
Journal  J Am Soc Nephrol Volume  29
Issue  10 Pages  2493-2509
PubMed ID  30097458 Mgi Jnum  J:290114
Mgi Id  MGI:6437678 Doi  10.1681/ASN.2018040437
Citation  Chan SC, et al. (2018) Mechanism of Fibrosis in HNF1B-Related Autosomal Dominant Tubulointerstitial Kidney Disease. J Am Soc Nephrol 29(10):2493-2509
abstractText  BACKGROUND: Mutation of HNF1B, the gene encoding transcription factor HNF-1beta, is one cause of autosomal dominant tubulointerstitial kidney disease, a syndrome characterized by tubular cysts, renal fibrosis, and progressive decline in renal function. HNF-1beta has also been implicated in epithelial-mesenchymal transition (EMT) pathways, and sustained EMT is associated with tissue fibrosis. The mechanism whereby mutated HNF1B leads to tubulointerstitial fibrosis is not known. METHODS: To explore the mechanism of fibrosis, we created HNF-1beta-deficient mIMCD3 renal epithelial cells, used RNA-sequencing analysis to reveal differentially expressed genes in wild-type and HNF-1beta-deficient mIMCD3 cells, and performed cell lineage analysis in HNF-1beta mutant mice. RESULTS: The HNF-1beta-deficient cells exhibited properties characteristic of mesenchymal cells such as fibroblasts, including spindle-shaped morphology, loss of contact inhibition, and increased cell migration. These cells also showed upregulation of fibrosis and EMT pathways, including upregulation of Twist2, Snail1, Snail2, and Zeb2, which are key EMT transcription factors. Mechanistically, HNF-1beta directly represses Twist2, and ablation of Twist2 partially rescued the fibroblastic phenotype of HNF-1beta mutant cells. Kidneys from HNF-1beta mutant mice showed increased expression of Twist2 and its downstream target Snai2. Cell lineage analysis indicated that HNF-1beta mutant epithelial cells do not transdifferentiate into kidney myofibroblasts. Rather, HNF-1beta mutant epithelial cells secrete high levels of TGF-beta ligands that activate downstream Smad transcription factors in renal interstitial cells. CONCLUSIONS: Ablation of HNF-1beta in renal epithelial cells leads to the activation of a Twist2-dependent transcriptional network that induces EMT and aberrant TGF-beta signaling, resulting in renal fibrosis through a cell-nonautonomous mechanism.
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