Aberrant adaptation of the inner medullary collecting ducts results in sodium retention and hypernatremia in a thick ascending limb specific Myh9 and Myh10 conditional knockout mouse model
Authors: Otterpohl Karla , Busselman Brook , Zimmerman Jenna , Mukherjee Malini , Surendran Kameswaran , Chandrasekar Indra 
Published: May 2023

Sodium reabsorption in the thick ascending limb (TAL) epithelium is essential to generate and sustain the interstitial osmotic gradient, which facilitates water reabsorption in the adjacent collecting duct system. Impaired TAL function can compromise this gradient and lead to electrolyte imbalance. Our previous work demonstrated that pan renal tubular conditional genetic inactivation of nonmuscle myosin II genes Myh9&10 in adult mice results in progressive kidney disease of TAL origin with aberrant regulation of TAL proteins U MOD and NKCC2 (Otterpohl et al; 2020). To confirm the cell-autonomous role for NM2 proteins in adult TAL epithelial cells, we generated a TAL-specific conditional knockout mouse model of Myh9&10 using the UMOD->CreERT2 mouse line (cKO). Genetic inactivation of Myh9&10 in the TAL was induced at 5 weeks of age with tamoxifen injections. Age matched control and cKO littermates were part of every cohort. Mice underwent metabolic, histologic, immunohistochemical, and biochemical analyses at varying time points until moribund. Development of progressive kidney disease in cKO mice was indicated by increasing levels of blood urea nitrogen, serum creatinine, and the tubular injury marker NGAL. Our results show that cKO females experience significant loss of weight at 12 weeks of age and are moribund between 13 – 14 weeks, while cKO males survive up to 25 weeks. Interestingly, female cKO mice exhibit hypernatremia at 12 weeks of age and male cKO mice between 16 - 20 weeks of age. We analyzed NKCC2 protein levels in whole kidney lysates and a drastic reduction was evident in both female and male cKO mice by 9 weeks of age, therefore hypernatremia was unexpected. We examined if the hypernatremia in TAL-Myh9&10 cKO mice is due to tubular adaptation in the distal nephron and/or the collecting duct segments. Systematic analysis of sodium cotransporters and channels in the distal nephron and collecting duct segments revealed an increase in NCC/pNCC levels in males and a decrease in females when compared with age matched control littermates. No apparent volume loss (increased urine output) has been observed in the female mice. Additionally, immunostaining experiments showed aberrant increase in expression of ENaC gamma in the inner medullary collecting duct cells in female and not male mice by 9-weeks of age. ENaC expression is limited to cortical collecting duct and the connecting segment under normal conditions in the mouse kidney. Consistent with this, our control mice do not have ENaC gamma expression in the inner medullary collecting ducts. Further experiments are underway to determine the cellular state/identity of these ENaC expressing inner medullary collect duct cells. These experiments confirm the critical role for Myh9&10 proteins in TAL tubule NKCC2 transport, and reveal novel, sex specific, adaptive mechanisms in distal nephron and collecting ducts in response to compromised NKCC2 transport within the TAL. NIDDK RO1 DK131020-01A1 This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.