Title | RIPK3 promotes sepsis-induced acute kidney injury via mitochondrial dysfunction. |
Publication Type | Journal Article |
Year of Publication | 2018 |
Authors | Sureshbabu A, Patino E, Ma KC, Laursen K, Finkelsztein EJ, Akchurin O, Muthukumar T, Ryter SW, Gudas L, Choi AMK, Choi ME |
Journal | JCI Insight |
Volume | 3 |
Issue | 11 |
Date Published | 2018 06 07 |
ISSN | 2379-3708 |
Keywords | Acute 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. |
DOI | 10.1172/jci.insight.98411 |
Alternate Journal | JCI Insight |
PubMed ID | 29875323 |
PubMed Central ID | PMC6124406 |
Grant List | R01 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 |