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Publication : Mapping cardiac remodeling in chronic kidney disease.

First Author  Kaesler N Year  2023
Journal  Sci Adv Volume  9
Issue  47 Pages  eadj4846
PubMed ID  38000021 Mgi Jnum  J:343311
Mgi Id  MGI:7563537 Doi  10.1126/sciadv.adj4846
Citation  Kaesler N, et al. (2023) Mapping cardiac remodeling in chronic kidney disease. Sci Adv 9(47):eadj4846
abstractText  Patients with advanced chronic kidney disease (CKD) mostly die from sudden cardiac death and recurrent heart failure. The mechanisms of cardiac remodeling are largely unclear. To dissect molecular and cellular mechanisms of cardiac remodeling in CKD in an unbiased fashion, we performed left ventricular single-nuclear RNA sequencing in two mouse models of CKD. Our data showed a hypertrophic response trajectory of cardiomyocytes with stress signaling and metabolic changes driven by soluble uremia-related factors. We mapped fibroblast to myofibroblast differentiation in this process and identified notable changes in the cardiac vasculature, suggesting inflammation and dysfunction. An integrated analysis of cardiac cellular responses to uremic toxins pointed toward endothelin-1 and methylglyoxal being involved in capillary dysfunction and TNFalpha driving cardiomyocyte hypertrophy in CKD, which was validated in vitro and in vivo. TNFalpha inhibition in vivo ameliorated the cardiac phenotype in CKD. Thus, interventional approaches directed against uremic toxins, such as TNFalpha, hold promise to ameliorate cardiac remodeling in CKD.
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