#1400 Acidosis-induced inflammatory response in tubule cells and fibroblasts is amplified by tubule-fibroblast crosstalk and mediated via p38 signaling
Authors: Schulz Marie-Christin , Wolff Nathalie , Kopf Michael , Gekle Michael 
Published: May 2024

Abstract

Background and Aims
Tubulointerstitial kidney disease, associated with micromilieu changes such as acidification and inflammation, impacts tubule cells and fibroblasts. Micromilieu homeostasis influences intracellular signaling and intercellular crosstalk.
Furthermore, cell-cell communication modulates the interstitial microenvironment. In the early stages of kidney failure, fibroblasts undergo a transition to an inflammatory phenotype driven by rapid and long-lasting p38 or CREB (cAMP response element-binding protein) signaling. This phenotypic shift involves an increased secretion of cytokines such as IL-6, TNF, or COX-2 metabolites, thereby changing the microenvironment. Additionally, the phenotype switch is characterized by remodelling of the cytoskeleton and alterations in cell-cell contacts.
The objective of our study was to evaluate the impact of acidosis on inflammatory responses in proximal tubule cells and fibroblasts in the context of cellular crosstalk. Furthermore, we aimed to investigate the involvement of p38 and CREB signaling.

Method
HK-2 (human proximal tubule) and CCD-1092Sk (human fibroblasts), in mono and coculture, were exposed to acidic or control media for 3 or 48 h. Protein expression levels of inflammation markers (IL-6, TNF, TGF-ß, and COX-2), dedifferentiation markers (N-cadherin, vinculin, ß-catenin, and vimentin), as well as phospho- and total p38 and CREB, were determined through western blot analysis. The impact of p38 activation was assessed using pharmacological interventions. Furthermore, the influence of IL-6 incubation on the expression of phospho-p38 was investigated

Results
In tubule cells acidosis led, independent of culture conditions, to an increase of IL-6 after 3h and a decrease of vimentin and COX-2 after 48h. Moreover, acidosis caused an increase of TNF solely in coculture after 3h. Only in monoculture, ß-Catenin expression decreased in tubule cells during acidosis. In fibroblasts acidosis led to an increase of TNF, COX-2, vimentin, vinculin, N-cadherin and a decrease of TGF-ß expression exclusively in co-culture after 48 h. Independent of incubation or culture conditions acidosis induced a strong increase of IL-6 protein expression in fibroblasts.
In co-culture, acidosis enhanced phosphorylation of p38 phosphorylation only after 3 h and that of CREB appeared after 3h and was persistent after 48h. In fibroblasts, acidosis enhanced phosphorylation of p38 in a sustained and very strong manner. Moreover, acidosis caused an increased phosphorylation of CREB independent of culture conditions and incubation time. Inhibition of p38 under co-culture conditions reduced acidosis-induced changes in fibroblasts significantly. In monoculture, incubation with IL-6 under acidic conditions caused an increase in p38 phosphorylation after 3 hours in tubule cells and after 48 hours in fibroblasts.

Conclusion
Our data indicate that acidosis-induced pathophysiological changes are significantly amplified by tubule-fibroblast crosstalk. The synergy between cellular crosstalk and acidosis triggers the activation of the p38, CREB, and IL-6 signaling pathways, leading to a phenotype switch in fibroblasts that promotes inflammation and fibrosis. If these findings hold true in vivo, the synergistic interplay between tubule-fibroblast crosstalk and acidosis emerges as a crucial factor in the development of kidney failure.