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?Klotho deficiency in acute kidney injury contributes to lung damage #MMPMID26718784
Ravikumar P; Li L; Ye J; Shi M; Taniguchi M; Zhang J; Kuro-o M; Hu MC; Moe OW; Hsia CCW
J Appl Physiol (1985) 2016[Apr]; 120 (7): 723-32 PMID26718784show ga
?Klotho is a circulating protein that originates predominantly from the kidney and exerts cytoprotective effects in distant sites. We previously showed in rodents that the lung is particularly vulnerable to ?Klotho deficiency. Because acute lung injury is a common and serious complication of acute kidney injury (AKI), we hypothesized that ?Klotho deficiency in AKI contributes to lung injury. To test the hypothesis, we created AKI by renal artery ischemia-reperfusion in rats and observed the development of alveolar interstitial edema and increased pulmonary oxidative damage to DNA, protein, and lipids. Administration of ?Klotho-containing conditioned media 6 h post-AKI did not alter plasma creatinine but improved recovery of endogenous ?Klotho production 3 days post-AKI, reduced lung edema and oxidative damage, and increased endogenous antioxidative capacity in the lung. Intravenously injected ?Klotho rapidly exits alveolar capillaries as a macromolecule, suggesting transcytosis and direct access to the epithelium. To explore the epithelial action of ?Klotho, we simulated oxidative stress in vitro by adding hydrogen peroxide to cultured A549 lung epithelial cells. Purified recombinant ?Klotho directly protected cells at 20 pM with half-maximal effects at 40-50 pM, which is compatible with circulating ?Klotho levels. Addition of recombinant ?Klotho activated an antioxidant response element reporter and increased the levels of target proteins of the nuclear factor erythroid-derived 2 related factor system. In summary, ?Klotho deficiency in AKI contributes to acute lung injury by reducing endogenous antioxidative capacity and increasing oxidative damage in the lung. ?Klotho replacement partially reversed these abnormalities and mitigated pulmonary complications in AKI.