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Publication : DNA methyltransferase inhibition restores erythropoietin production in fibrotic murine kidneys.

First Author  Chang YT Year  2016
Journal  J Clin Invest Volume  126
Issue  2 Pages  721-31
PubMed ID  26731474 Mgi Jnum  J:231164
Mgi Id  MGI:5767030 Doi  10.1172/JCI82819
Citation  Chang YT, et al. (2016) DNA methyltransferase inhibition restores erythropoietin production in fibrotic murine kidneys. J Clin Invest 126(2):721-31
abstractText  Renal erythropoietin-producing cells (REPCs) remain in the kidneys of patients with chronic kidney disease, but these cells do not produce sufficient erythropoietin in response to hypoxic stimuli. Treatment with HIF stabilizers rescues erythropoietin production in these cells, but the mechanisms underlying the decreased response of REPCs in fibrotic kidneys to anemic stimulation remain elusive. Here, we show that fibroblast-like FOXD1+ progenitor-derived kidney pericytes, which are characterized by the expression of alpha1 type I collagen and PDGFRbeta, produce erythropoietin through HIF2alpha regulation but that production is repressed when these cells differentiate into myofibroblasts. DNA methyltransferases and erythropoietin hypermethylation are upregulated in myofibroblasts. Exposure of myofibroblasts to nanomolar concentrations of the demethylating agent 5-azacytidine increased basal expression and hypoxic induction of erythropoietin. Mechanistically, the profibrotic factor TGF-beta1 induced hypermethylation and repression of erythropoietin in pericytes; these effects were prevented by 5-azacytidine treatment. These findings shed light on the molecular mechanisms underlying erythropoietin repression in kidney myofibroblasts and demonstrate that clinically relevant, nontoxic doses of 5-azacytidine can restore erythropoietin production and ameliorate anemia in the setting of kidney fibrosis in mice.
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