MO067: Role of ANT2 in the Development of Obesity-Induced Chronic Kidney Disease
Authors: Permyakova Anna , Hamad Sharleen , Yosef Omri , Kogot-Levin Aviram , Leibowitz Gil , Berger Michael , Tam Joseph 
Published: May 2022

Abstract

BACKGROUND AND AIMS
Obesity, a widespread condition with an ever-increasing prevalence, imposes a great medical concern since it serves as a risk factor for a wide range of conditions, including the development of chronic kidney disease (CKD). Lipid accumulation and impaired fatty acid β-oxidation in the renal proximal tubular cells (RPTCs) as well as an overall mitochondrial dysfunction have been shown to induce kidney injury, inflammation and fibrosis, leading to the development of CKD. However, the molecular mechanisms linking mitochondrial dysfunction in RPTCs to obesity-induced CKD are not fully understood and require further examination. Adenine nucleotide translocases (ANTs), which transport ADP and ATP through the mitochondrial inner membrane, play an essential role in energy metabolism of eukaryotic cells. ANT2 (Slc25a5) mediates fatty acid-induced uncoupled respiration, and its complete deletion is embryonic lethal. Here we explore its specific role in RPTCs in the development of obesity-induced CKD.

METHOD
ANT2 protein levels were measured using western blot and immunohistochemistry analyses. RPTC-ANT2-/- animals were generated using the Cre/loxP system. The null mice and their wild-type littermate controls were fed with either a high-fat diet (HFD) or a standard diet (STD) for 24 weeks. Kidney function and lipid content were assessed by biochemical analysis. Histological techniques were used to visualize the morphological changes in the kidney as well as fibrogenesis. Kidney injury and inflammatory markers were measured via qPCR and ELISAs. Mitochondrial function was tested in primary mouse RPTCs extracted from the null and WT animals by measuring oxygen consumption rate via Seahorse as well as reactive oxygen species (ROS) production by DCFDA staining.

RESULTS
As evident from the double-stained immunofluorescence staining of mouse kidney, high levels of ANT2 were found in RPTCs. Interestingly, its protein expression was downregulated in HFD-fed WT mice. Nullification of ANT2 specifically in RPTCs prevented the obesity-induced kidney dysfunction as reflected by lowered albumin-to-creatinine ratio. This was associated with the improved renal morphology in HFD-fed RPTC-ANT2-/- mice, evident by the reduction in obesity-related increased glomerular and Bowman's space areas and mesangial expansion. Compared with their littermate controls, obese RPTC-ANT2-/- mice showed reduced renal KIM-1 and NGAL protein levels and downregulation in the expression levels of Mcp1 and Lcn2, markers of renal injury and inflammation, respectively. The null mice were also protected from obesity-induced fibrosis, measured by trichrome staining, as well as accumulation of triglycerides and cholesterol in the kidney. In addition, preserved mitochondrial function was found in primary mouse RPTCs lacking ANT2, measured by increased spare respiratory capacity and decreased ROS production. Lastly, downregulated Hif1α gene and protein expression levels were found in RPTCs and kidney tissue lacking ANT2.

CONCLUSION
Our findings introduce ANT2 in the RPTCs as a key player in the development of obesity-induced CKD. Deletion of RPTC-ANT2 protects the kidney from the deleterious effects of lipotoxicity. Therefore, targeted manipulation of renal mitochondrial metabolism, particularly via inhibiting ANT2, may represent a novel approach for the treatment of obesity-induced CKD.