#5645 SHORT-CHAIN FATTY ACIDS, PROPIONATE AND BUTYRATE, RESEMBLE THE BENEFICIAL EFFECTS OF VITAMIN D DURING ACUTE KIDNEY DAMAGE
Authors: Corte-Iglesias Viviana , Saiz Maria Laura , Bernet Cristian Ruiz , Diaz-Bulnes Paula , Florez Aida Bernardo , Martin Cristina Martin , Lopez-Larrea Carlos , Suarez-Alvarez Beatriz 
Published: June 2023

Abstract

Background and Aims
The vitamin D receptor (VDR) is a nuclear receptor that acts as a ligand-induced transcription factor regulating the renal expression of numerous genes with anti-inflammatory and anti-fibrotic effects, among others. For that, VDR requires the binding of its ligand, 1,25 (OH)2D3, to further heterodimerize with its co-activator, RXR, and translocate into the nucleus. Vitamin D deficiency in patients with renal disease leads to a decrease in VDR-mediated signaling and, consequently, of its beneficial functions. Additionally, these patients have intestinal dysbiosis, which leads to alterations in the production of microbial metabolites. Short-chain fatty acids (SCFAs) are metabolites with a clear anti-inflammatory and immunoregulatory role. Until now, some studies have studied their role as regulators of the inflammation and oxidative stress during the renal damage.1,2 However, their role in the VDR-mediated signaling in the kidney and the potential consequences to prevent the progression of the disease have not yet been explored in detail.

Method
The tubular epithelial cell line, HK2, was used to analyze the effect of the SCFAs, Propionate (Prop,1-15mM) and Butyrate (But, 0.5-3 mM), in the VDR expression and their target-genes. In vitro treatment with histone deacetylases (HDACs) inhibitors and specific HDAC1 and HDAC3 siRNAs were used to determine the role of both SCFAs as epigenetic remodelers. The binding of VDR to HDAC1/3 and RXR was determined by ChIP and co-immunoprecipitation assays. The in vivo effect of these SCFAs was evaluated in an acute kidney injury mice model induced by folic acid (250 mg/kg) and administration of Prop (200mg/kg) or But (500mg/kg) at different time points. The expression of VDR and its target genes, inflammatory cell infiltration, renal damage markers and renal function parameters were evaluated at shorter (24h) and longer times (40 days).

Results
Treatment of tubular cells with Prop and But induces, in a dose-dependent manner, the VDR gene transcription. This effect is similar to the one obtained by using specific inhibitors and siRNA treatments against HDAC1/3. We determine using ChIP assay, that HDAC1/3 are recruited to the promoter regions of the VDR gene, blocking its expression. In presence of Prop and But, these HDACs are displaced, increasing the acetylation levels and VDR transcription. Moreover, Prop and But prevent the degradation of VDR by the proteasome, increasing its stability and enhancing VDR protein levels. In the presence of both SCFAs, VDR dimerizes with RXR initiating its translocation to the nucleus and allowing the transcription of its dependent genes, such as Cyp24a1 and E-cadherin. Of note, VDR activation by Prop and But is additive to the effect achieved by the vitamin D alone. In vivo studies reported that administration of Prop or But prevents the loss of VDR expression 24h after induction of the damage, leading to its activation and to the expression of its target genes. Additionally, a decrease in the recruitment of neutrophils to the kidney was observed associated to a reduced expression of IL-6. These changes are accompanied by a decrease of the kidney damage markers (KIM-1 and NGAL) and a significant reduction of the creatinine and blood urea nitrogen serum levels. In a second model of AKI-to CKD transition, administration of both SCFAs shows a decrease in the inflammatory (Ccl20, Ccl2, Lif, Ltb, Csf2SF2, Il18, Ccl5, Tnf-α) and pro-fibrotic markers (Fsp1, α-Sma, Col1a1, Fn1) and a partial recovery of the glomerular filtration rate at long term.

Conclusion
Propionate and Butyrate, not only induce the VDR gene transcription in renal tubular cells but are also able to stabilize and activate the VDR protein. Accordingly, both metabolites are able to restore the loosed expression and activation of VDR due to induced renal damage, reduce the infiltration of immune cells, and partially recover the renal function. Thus, strategies aimed to increase the propionate and butyrate levels with postbiotics could be useful to ameliorate the AKI renal damage and CKD transition.