RIPK3 promotes sepsis-induced acute kidney injury via mitochondrial dysfunction.

TitleRIPK3 promotes sepsis-induced acute kidney injury via mitochondrial dysfunction.
Publication TypeJournal Article
Year of Publication2018
AuthorsSureshbabu A, Patino E, Ma KC, Laursen K, Finkelsztein EJ, Akchurin O, Muthukumar T, Ryter SW, Gudas L, Choi AMK, Choi ME
JournalJCI Insight
Volume3
Issue11
Date Published2018 06 07
ISSN2379-3708
KeywordsAcute Kidney Injury, Adult, Aged, Aged, 80 and over, Animals, Apoptosis, Biomarkers, Cell Line, Epithelial Cells, Female, Humans, Kidney Tubules, Male, Mice, Mice, Inbred C57BL, Mice, Knockout, Microscopy, Electron, Transmission, Middle Aged, Mitochondria, NADPH Oxidase 4, Necrosis, Oxidative Stress, Primary Cell Culture, Receptor-Interacting Protein Serine-Threonine Kinases, RNA, Small Interfering, Shock, Septic, Up-Regulation, Young Adult
Abstract

Sepsis causes acute kidney injury (AKI) in critically ill patients, although the pathophysiology remains unclear. The receptor-interacting protein kinase-3 (RIPK3), a cardinal regulator of necroptosis, has recently been implicated in the pathogenesis of human disease. In mice subjected to polymicrobial sepsis, we demonstrate that RIPK3 promotes sepsis-induced AKI. Utilizing genetic deletion and biochemical approaches in vitro and in vivo, we identify a potentially novel pathway by which RIPK3 aggravates kidney tubular injury independently of the classical mixed lineage kinase domain-like protein-dependent (MLKL-dependent) necroptosis pathway. In kidney tubular epithelial cells, we show that RIPK3 promotes oxidative stress and mitochondrial dysfunction involving upregulation of NADPH oxidase-4 (NOX4) and inhibition of mitochondrial complex I and -III, and that RIPK3 and NOX4 are critical for kidney tubular injury in vivo. Furthermore, we demonstrate that RIPK3 is required for increased mitochondrial translocation of NOX4 in response to proinflammatory stimuli, by a mechanism involving protein-protein interactions. Finally, we observed elevated urinary and plasma RIPK3 levels in human patients with sepsis-induced AKI, representing potential markers of this condition. In conclusion, we identify a pathway by which RIPK3 promotes kidney tubular injury via mitochondrial dysfunction, independently of MLKL, which may represent a promising therapeutic target in sepsis-induced AKI.

DOI10.1172/jci.insight.98411
Alternate JournalJCI Insight
PubMed ID29875323
PubMed Central IDPMC6124406
Grant ListR01 DK113088 / DK / NIDDK NIH HHS / United States
R01 HL133801 / HL / NHLBI NIH HHS / United States
R01 HL132198 / HL / NHLBI NIH HHS / United States
R01 HL055330 / HL / NHLBI NIH HHS / United States
R01 HL060234 / HL / NHLBI NIH HHS / United States