Klotho的研究进展

Klotho是新发现的一种抗衰老基因,其表达受多种因素的调控,如活性肽降钙素基因相关肽、成纤维细胞生长因子2等可以上调Klotho表达,而肾素-血管紧张素、尿毒素、炎症反应与氧化应激则可下调Klotho表达。Klotho蛋白有膜结合型和分泌型两种形式。现有研究表明,Klotho参与了多种疾病的发生发展,包括血管钙化、动脉粥样硬化、高血压、肾病损伤、甲状旁腺功能亢进、糖尿病及肿瘤等。本文就Klotho的表达调控及其与疾病的关系简要作一综述。     

亚硒酸钠对糖尿病肾病大鼠肾脏Nephrin表达的影响与意义

探讨亚硒酸钠对糖尿病肾病大鼠肾脏Nephrin表达的影响及二者间的关系,从而研究亚硒酸钠和Nephrin在糖尿病肾病中的作用机制.通过链脲佐菌素法及给予高脂饮食诱导模拟大鼠糖尿病肾病模型,实验设空白对照组、糖尿病肾病对照组、亚硒酸钠干预组,亚硒酸钠干预组每日给予亚硒酸钠溶液灌胃,其它组给予等量生理盐水灌胃.灌胃10周后处死大鼠,取血、尿标本测相关生化指标.取肾脏组织戊二醛固定制作切片电镜下观察超微结构改变,取肾脏组织多聚甲醛固定制石蜡切片光镜下观察病理改变和免疫组化定位蛋白表达.取肾脏组织RT-PCR检测Nephrin的mRNA表达、Western Blotting检测nephrin的蛋白表达,分析各组数据的统计差异.结果发现亚硒酸钠干预组大鼠基本状况和生化指标较糖尿病肾病对照组明显改善,光镜和电镜下观察病理改变和超微结构病变较糖尿病肾病对照组明显减轻.免疫组化nephrin蛋白表达着色糖尿病肾病对照组较空白对照组减少,亚硒酸钠干预组较糖尿病肾病对照组着色明显增多.Nephrin mRNA和蛋白表达糖尿病肾病对照组较空白对照组明显降低,而亚硒酸钠干预组较糖尿病肾病对照组升高,但低于空白对照组,差异均有统计学意义（P〈0．05）．亚硒酸钠明显促进肾脏Nephrin表达,改善了糖尿病肾病,表明亚硒酸钠和Nephrin在防治和延缓糖尿病肾病的发生发展中可能起重要作用．     

血管生成素样蛋白2在糖尿病肾病小鼠肾脏中的表达研究

利用半定量RT-PCR和免疫组化的方法同时从mRNA水平和蛋白质水平对血管生成素样蛋白2在不同病理阶段的2型糖尿病肾病模型小鼠--db/db小鼠肾脏中的表达情况进行了较为系统的分析.结果发现:a.在糖尿病前的db/db小鼠(4周龄的db/db小鼠),血管生成素样蛋白2与作为正常对照的db/m小鼠相比,差异不是很大,随着肥胖的加剧,高血糖、蛋白尿的出现,血管生成素样蛋白2在db/db小鼠肾脏中的表达无论从mRNA水平还是从蛋白质水平均显著升高.b.从免疫组化的分析结果来看,血管生成素样蛋白2主要分布于小鼠肾脏的肾小球部分,主要是沿毛细血管袢呈线性分布,其位置与足细胞的位置重叠,足细胞是小鼠肾脏中血管生成素样蛋白2的主要分泌细胞.c.小鼠肾脏血管生成素样蛋白2的表达水平似乎还与鼠龄相关:虽然变化幅度不是很大,但在周龄较大的小鼠(如20周龄以上),其表达水平相对较高.上述工作不仅印证了先前对2型糖尿病肾病患者肾小球基因表达谱的分析结果,更加明确了血管生成素样蛋白2与糖尿病肾病的相关性,同时揭示了血管生成素样蛋白2在正常小鼠和糖尿病肾病小鼠肾脏中的表达、分布和变化规律,有利于进一步揭示血管生成素样蛋白2的功能及其在糖尿病肾病发生、发展过程中的可能作用,探讨糖尿病肾病的分子机制.     

miRNA-9-5p与NF-κB信号通路在2型糖尿病肾病发病中的作用机制

目的:探讨mi RNA-9-5p与NF-κB信号通路在2型糖尿病肾病发病中的作用机制。方法:将80只db/db小鼠随机分为糖尿病肾病组、糖尿病肾病+罗格列酮组、糖尿病肾病+mi RNA-9-5p组、糖尿病肾病+阴性对照组,每组20只,分别给予生理盐水、噻唑烷二酮类抗糖尿病药马来酸罗格列酮、mi RNA-9-5p、mi RNA-9-5p阴性对照核酸,10μg/d腹腔注射。另将20只健康db/m小鼠作为对照组。观察各组空腹血糖(FBG)、餐后血糖(PBG)、肾脏指数、24h尿量、肾脏组织变化,检测血清NF-κB信号通路关键因子单核细胞趋化因子蛋白-1(MCP-1)、肿瘤坏死因子-α(TNF-α)和白细胞介素-6(IL-6),及肾脏组织NF-κB m RNA、NF-κB p65蛋白水平。结果:糖尿病肾病组FBG、PBG、24 h尿量均高于对照组,肾脏指数低于对照组(P0.05)。糖尿病肾病+罗格列酮组和糖尿病肾病+mi RNA-9-5p组小鼠FBG、PBG、24 h尿量低于糖尿病肾病组,肾脏指数高于糖尿病肾病组(P0.05)。糖尿病肾病组小鼠血清MCP-1、TNF-α、IL-6水平,肾脏组织NF-κB m RNA、NF-κB p65蛋白水平均高于对照组(P0.05)。糖尿病肾病+罗格列酮组和糖尿病肾病+mi RNA-9-5p组血清MCP-1、TNF-α、IL-6水平,肾脏组织NF-κB m RNA、NF-κB p65蛋白水平低于糖尿病肾病组(P0.05)。结论:NF-κB在糖尿病肾病发病中起到重要作用,mi RNA-9-5p可以阻断NF-κB信号通路,下调MCP-1、TNF-α、IL-6的表达,抑制糖尿病肾病的发生和发展。     

Klotho与肾损伤及修复的研究进展

Klotho蛋白在肾脏高表达,可溶型Klotho广泛分布于血液、尿液和脑脊液中,在体内发挥重要内分泌样功能。Klotho在肾损伤中的作用日益受到重视,已有研究表明Klotho在急性肾损伤(acute kidney injury, AKI)中呈暂时性,而在慢性肾脏病中呈持续性肾脏局部和系统性缺陷。Klotho可望成为肾损伤的生物标志物,有利于AKI早期诊断及反映其向慢性肾损伤的进展,并有潜在的治疗价值。然而,对Klotho如何影响AKI修复的研究有限。本综述着重讨论Klotho在AKI及修复中的作用,特别是Klotho与细胞命运(坏死/凋亡/自噬)、修复/再生、Wnt/β-catenin和促红细胞生成素受体(Klotho的效应因子之一)的关系。     

黄芪调节自发糖尿病肾病鼠层粘连蛋白表达的实验研究

目的:观察黄芪对自发糖尿病肾病大鼠肾小球层粘连蛋白表达的影响.方法:将实验用6月龄SPF级GK大鼠和Wistar大鼠随机分为正常对照组、糖尿病组、黄芪治疗组.治疗16周,观察治疗后大鼠的尿素氮、血肌苷,内生肌苷清除率、24小时尿蛋白排泄率,免疫组化检测肾组织层粘连蛋白表达.结果:造模组大鼠均出现肾脏功能有损害.黄芪能改善自发糖尿病肾病大鼠基本状况,降低糖尿病大鼠的尿素氮、血肌苷、24h尿白蛋白排泄率,增加内生肌苷清除率,层粘连蛋白表达显著下调.结论:黄芪可通过降低层粘连蛋白的表达,对肾脏起保护作用.     

Klotho对CsA慢性肾毒性大鼠肾脏内质网应激相关凋亡的影响

24只雄性SD(Sprague dawley)大鼠在低盐饮食的基础上,随机分为3组:对照组、模型组、治疗组。模型组给予环孢素A(Cyclosporin A,Cs A)30 mg/kg/d腹腔注射共28 d建立慢性肾毒性大鼠模型;治疗组在给予等量Cs A的基础上腹腔注射给予重组可溶性Klotho蛋白(0.02 mg/kg/d腹腔注射,隔日一次)。28 d后处死大鼠,收集肾组织标本;行Masson染色观察肾脏病理损害;TUNEL(Td T-mediated d UTP nick end labeling)染色观察细胞凋亡情况;Western-blot检测肾组织内质网应激标志物兔抗葡萄糖调节蛋白78(glucose regulated protein78,GRP78)及CCAAT/增强子结合蛋白同源蛋白(pro-apoptotic protein CCAAT/enhancer binding protein homologous protein,CHOP)的表达情况。分析发现,模型组大鼠肾脏病理损害明显加重,肾小管上皮细胞大量凋亡,GRP78及CHOP表达显著上调,而Klotho治疗组大鼠肾脏病理损害明显减轻,细胞凋亡减少,GRP78及CHOP的表达明显降低。表明Klotho蛋白可通过抑制内质网应激诱导的凋亡缓解Cs A慢性肾毒性的发生。     

匹伐他汀对Klotho基因敲除杂合子小鼠血管新生的促进作用

目的：探讨匹伐他汀对Klotho基因敲除杂合子小鼠血管新生的促进作用及其作用机制。方法：建立Klotho基因敲除杂合子小鼠（hetero kl＋／-）和同窝出生野生型小鼠（wild kl＋／＋）下肢缺血模型并分为4组：①hetero正常组;②hetero匹伐他汀组;③wild正常组;④wild匹伐他汀组。使用激光多普勒血流测定仪测定klotho（kl＋／-,kl＋／＋）小鼠投药前、下肢缺血手术后双下肢血流。免疫荧光组化SP法计数Klotho（kl＋／-,kl＋／＋）小鼠缺血肢毛细血管数。免疫酶组化直接法计数Klotho（kl＋／-,kl＋／＋）小鼠缺血肢磷酸化Akt阳性细胞数。蛋白印迹杂交方法检测Klotho（kl＋／-）小鼠缺血肢VEGF蛋白表达。结果：匹伐他汀使Klotho（kl＋／-,kl＋／＋）小鼠术后缺血肢血流恢复明显,缺血肢与非缺血肢血流面积比明显增加;匹伐他汀使Klotho（kl＋／-、kl＋／＋）小鼠缺血肢毛细血管密度增加、p-Akt阳性细胞数明显增加;匹伐他汀使Klotho（kl＋／-）缺血肢VEGF蛋白表达增强。结论：匹伐他汀有促进Klotho基因敲除杂合子小鼠血管新生的作用。其作用机制可能是通过VEGF—p—Akt—NO径路实现的。     

化瘀通络中药不同配伍对糖尿病肾病大鼠肾脏保护作用及对肾小球P-cadherin表达的影响

为观察化瘀通络中药不同配伍对糖尿病肾病大鼠肾脏的保护作用及对肾小球足细胞裂孔膜蛋白P-cadherin表达的影响,将70只雄性SD大鼠随机分为正常组和模型组、化瘀通络组、厄贝沙坦组、化瘀组和通络组,灌胃干预16周。检测大鼠的体重、肾重、肾脏指数、24 h尿蛋白定量,分别采用实时定量PCR和蛋白印迹法检测P-cadherin的表达。结果显示,与模型组比较,化瘀通络组大鼠的肾脏指数、24 h尿蛋白定量明显下降(P0.01),体重增加、P-cadherin mRNA和蛋白表达明显上调(P0.01)。提示化瘀通络中药可能通过上调P-cadherin mRNA和蛋白的表达,减少尿蛋白,延缓糖尿病肾病病程进展。     

中草药干预糖尿病肾病炎症的作用

随着糖尿病发病率逐年升高,糖尿病肾病成为导致慢性肾脏疾病和终末期肾脏疾病的主要原因。而目前控制血糖及抑制肾素-血管紧张素系统的药物治疗,并不能有效防止糖尿病肾病进展。近年来发现,慢性低水平炎症和免疫系统激活在糖尿病性肾病的发生及发展中起着至关重要的作用。明确糖尿病肾病进展中的炎症机制将有助于确定新的潜在靶点及研发抗炎治疗策略。越来越多的证据表明,中药治疗可以有效改善糖尿病性肾病的高血糖和蛋白尿,并能延缓其进展成为终末期肾病。糖尿病肾病动物实验和体外研究证实中药复方、中草药提取物和中药单体具有调节炎症介质的作用。本文旨在归纳总结文献中与糖尿病肾病肾损伤相关的炎症分子和途径,并探讨中草药靶向抗炎治疗糖尿病肾病的作用。     

P2X<Subscript>7</Subscript> receptor and klotho expressions in diabetic nephropathy progression

Diabetes mellitus is characterized by increased levels of reactive oxygen species (ROS), leading to high levels of adenosine triphosphate (ATP) and the activation of purinergic receptors (P2X₇), which results in cell death. Klotho was recently described as a modulator of oxidative stress and as having anti-apoptotic properties, among others. However, the roles of P2X₇ and klotho in the progression of diabetic nephropathy are still unclear. In this context, the aim of the present study was to characterize P2X₇ and klotho in several stages of diabetes in rats. Diabetes was induced in Wistar rats by streptozotocin, while the control group rats received the drug vehicle. From the 1st to 8th weeks after the diabetes induction, the animals were placed in metabolic cages on the 1st day of each week for 24 h to analyze metabolic parameters and for the urine collection. Then, blood samples and the kidneys were collected for biochemical analysis, including Western blotting and qPCR for P2X₇ and klotho. Diabetic rats presented a progressive loss of renal function, with reduced nitric oxide and increased lipid peroxidation. The P2X₇ and klotho expressions were similar up to the 4th week; then, P2X₇ expression increased in diabetes mellitus (DM), but klotho expression presented an opposite behavior, until the 8th week. Our data show an inverse correlation between P2X₇ and klotho expressions through the development of DM, which suggests that the management of these molecules could be useful for controlling the progression of this disease and diabetic nephropathy.     

P2X7 siRNA targeted to the kidneys increases klotho and delays the progression of experimental diabetic nephropathy

Previous studies in our laboratory have suggested that P2X7 could contribute to the progression of diabetic nephropathy and modulated klotho expression. The aim of this study was to investigate if P2X7 receptor is related to the expression of klotho in the onset of diabetic nephropathy in rats. Seven-week-old male Wistar rats weighing 210 g were all uninephrectomized; two-third of the animals were induced to diabetes with 60 mg/kg streptozotocin i.v., and one-third received its vehicle (control rats). At 4th day of the fifth week of the protocol, half of the diabetic rats received a small interfering RNA targeting for P2X7 mRNA, and the other half received its vehicle. Euthanasia was made at the eighth week. Diabetic animals reproduced all classic symptoms of the disease; besides, they showed reduced renal function and low NO bioavailability; also, SOD1, SOD2, and catalase were increased, probably due to the oxidative stress which was elevated in this situation. Metabolic data of diabetic rats did not change by silencing P2X7 receptor. For the other hand, silencing P2X7 was able to contribute to balance oxidative and nitrosative profile, ultimately improving the renal function and increasing plasma and membrane forms of klotho. These findings suggest that the management of P2X7 receptor can benefit the kidneys with diabetic nephropathy. Further studies are needed to show the therapeutic potential of this receptor inhibition to provide a better quality of life for the diabetic patient.

     

Klotho attenuates diabetic nephropathy in db/db mice and ameliorates high glucose-induced injury of human renal glomerular endothelial cells

Glomerular endothelial cell injury plays an important role in the development and progression of diabetic nephropathy (DN). The expression and function of klotho in glomerular endothelial cells remain unclear. Thus, this study aimed to investigate the expression and the functional role of klotho in DN progression in mice and in high glucose (HG)-induced cell injury of human renal glomerular endothelial cells (HRGECs) and the underlying mechanism. In this study, HRGECs were cultured with media containing HG to induce endothelial cell injury and db/db mice were used as DN model mice. Klotho was overexpressed or knocked down in HRECs to evaluate its role in HG-induced HRGECs injury. klotho-overexpressing adenovirus (rAAV-klotho) was injected into db/db mice via the tail vein to further validate the protective effect of klotho in DN. Decreased klotho expression was observed in DN patients, DN mice, and HG-exposed HRGECs. Furthermore, klotho overexpression significantly abolished the HG-induced HRGECs injury and activation of Wnt/β-catenin pathway and RAAS. In contrast, klotho knockdown exerted the opposite effects. Moreover, klotho attenuated diabetic nephropathy in db/db mice, which was also associated with inhibition of the Wnt/β-catenin pathway and RAAS. In conclusion, klotho attenuates DN in db/db mice and ameliorates HG-induced injury of HRGECs.     

Klotho as a regulator of oxidative stress and senescence

The klotho gene functions as an aging-suppressor gene that extends life span when overexpressed and accelerates aging-like phenotypes when disrupted in mice. The klotho gene encodes a single-pass transmembrane protein that binds to multiple fibroblast growth factor (FGF) receptors and functions as a co-receptor for FGF23, a bone-derived hormone that suppresses phosphate reabsorption and vitamin D biosynthesis in the kidney. In addition, the extracellular domain of Klotho protein is shed and secreted, potentially functioning as a humoral factor. The secreted Klotho protein can regulate multiple growth factor signaling pathways, including insulin/IGF-1 and Wnt, and the activity of multiple ion channels. Klotho protein also protects cells and tissues from oxidative stress, yet the precise mechanism underlying these activities remains to be determined. Thus, understanding of Klotho protein function is expected to provide new insights into the molecular basis for aging, phosphate/vitamin D metabolism, cancer and stem cell biology.     

Resveratrol protects diabetic kidney by attenuating hyperglycemia-mediated oxidative stress and renal inflammatory cytokines via Nrf2-Keap1 signaling

Hyperglycemia-mediated oxidative stress plays a crucial role in the progression of diabetic nephropathy. Hence, the present study was hypothesized to explore the renoprotective nature of resveratrol by assessing markers of oxidative stress, proinflammatory cytokines and antioxidant competence in streptozotocin-nicotinamide-induced diabetic rats. Oral administration of resveratrol to diabetic rats showed a significant normalization on the levels of creatinine clearance, plasma adiponectin, C-peptide and renal superoxide anion, hydroxyl radical, nitric oxide, TNF-α, IL-1β, IL-6 and NF-κB p65 subunit and activities of renal aspartate transaminase, alanine transaminase and alkaline phosphatase in comparison with diabetic rats. The altered activities of renal aldose reductase, sorbitol dehydrogenase and glyoxalase-I and elevated level of serum advanced glycation end products in diabetic rats were also reverted back to near normalcy. Further, resveratrol treatment revealed a significant improvement in superoxide dismutase, catalase, glutathione peroxidase, glutathione-S-transferase and glutathione reductase activities and vitamins C and E, and reduced glutathione levels, with a significant decline in lipid peroxides, hydroperoxides and protein carbonyls levels in diabetic kidneys. Similarly, mRNA and protein analyses substantiated that resveratrol treatment notably normalizes the renal expression of Nrf2/Keap1and its downstream regulatory proteins in the diabetic group of rats. Histological and ultrastructural observations also evidenced that resveratrol effectively protects the kidneys from hyperglycemia-mediated oxidative damage. These findings demonstrated the renoprotective nature of resveratrol by attenuating markers of oxidative stress in renal tissues of diabetic rats.     

Klotho protects the heart from hyperglycemia-induced injury by inactivating ROS and NF-κB-mediated inflammation both in vitro and in vivo

Cardiac inflammation and oxidative stress play a key role in the pathogenesis of diabetic cardiomyopathy (DCM). The anti-aging protein Klotho has been found to protect cells from inflammation and oxidative stress. The current study aimed to explore the cardioprotective effects of Klotho on DCM and the underlying mechanisms. H9c2 cells and neonatal cardiomyocytes were incubated with 33 mM glucose in the presence or absence of Klotho. Klotho pretreatment effectively inhibited high glucose-induced inflammation, ROS generation, apoptosis, mitochondrial dysfunction, fibrosis and hypertrophy in both H9c2 cells and neonatal cardiomyocytes. In STZ-induced type 1 diabetic mice, intraperitoneal injection of Klotho at 0.01 mg/kg per 48 h for 3 months completely suppressed cardiac inflammatory cytokines and oxidative stress and prevented cardiac cell death and remodeling, which subsequently improved cardiac dysfunction without affecting hyperglycemia. This study revealed that Klotho may exert its protective effects by augmenting nuclear factor erythroid 2-related factor 2 (Nrf2) expression and inactivating nuclear factor κB (NF-κB) activation both in vitro and in vivo. Thus, this work demonstrated for the first time that the anti-aging protein Klotho may be a potential therapeutic agent to treat DCM by inhibiting oxidative stress and inflammation. We also demonstrated the critical roles of the Nrf2 and NF-κB pathways in diabetes-stimulated cardiac injuries and indicated that they may be key therapeutic targets for diabetic complications.     

Reduced Klotho expression level in kidney aggravates renal interstitial fibrosis

Renal expression of the klotho gene is markedly suppressed in chronic kidney disease (CKD). Since renal fibrosis is the final common pathology of CKD, we tested whether decreased Klotho expression is a cause and/or a result of renal fibrosis in mice and cultured renal cell lines. We induced renal fibrosis by unilateral ureteral obstruction (UUO) in mice with reduced Klotho expression (kl/+ mice) and compared them with wild-type mice. The UUO kidneys from kl/+ mice expressed significantly higher levels of fibrosis markers such as α-smooth muscle actin (α-SMA), fibronectin, and transforming growth factor-β(1) (TGF-β(1)) than those from wild-type mice. In addition, in cultured renal fibroblast cells (NRK49F), the levels of α-SMA and PAI1 expression were significantly suppressed by addition of recombinant Klotho protein to the medium. The similar effects were observed by a TGF-β(1) receptor inhibitor (ALK5 inhibitor). These observations suggest that low renal Klotho expression enhances TGF-β(1) activity and is a cause of renal fibrosis. On the other hand, TGF-β(1) reduced Klotho expression in renal cultured epithelial cells (inner medullary collecting duct and human renal proximal tubular epithelium), suggesting that low renal Klotho expression is a result of renal fibrosis. Taken together, renal fibrosis can trigger a deterioration spiral of Klotho expression, which may be involved in the pathophysiology of CKD progression.