Medical College of Wisconsin
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Smac-mimetic-induced epithelial cell death reduces the growth of renal cysts. J Am Soc Nephrol 2013 Dec;24(12):2010-22

Date

08/31/2013

Pubmed ID

23990677

Pubmed Central ID

PMC3839552

DOI

10.1681/ASN.2013020176

Scopus ID

2-s2.0-84889004022 (requires institutional sign-in at Scopus site)   43 Citations

Abstract

Past efforts to pharmacologically disrupt the development and growth of renal cystic lesions focused primarily on normalizing the activity of a specific signaling molecule, but the effects of stimulating apoptosis in the proliferating epithelial cells have not been well studied. Although benign, ADPKD renal cysts created by the sustained proliferation of epithelial cells resemble tumors, and malignant cell death can be achieved by cotreatment with TNF-α and a mimetic of second mitochondria-derived activator of caspase (Smac). Notably, TNF-α accumulates to high levels in ADPKD cyst fluid. Here, we report that an Smac-mimetic selectively induces TNF-α-dependent cystic renal epithelial cell death, leading to the removal of cystic epithelial cells from renal tissues and delaying cyst formation. In vitro, a Smac-mimetic (GT13072) induced the degradation of cIAP1 that is required but not sufficient for cell death. Cotreatment with TNF-α augmented the formation and activation of the RIPK1-dependent death complex and the degradation and cleavage of FLIP, an inhibitor of caspase-8, in renal cystic epithelial cells. This approach produced death specifically in Pkd1 mutant epithelial cells, with no effect on normal renal epithelial cells. Moreover, treatment with the Smac-mimetic slowed cyst and kidney enlargement and preserved renal function in two genetic strains of mice with Pkd1 mutations. Thus, our mechanistic data characterize an apoptotic pathway, activated by the selective synergy of an Smac-mimetic and TNF-α in renal cyst fluid, that attenuates cyst development, providing an innovative translational platform for the rational development of novel therapeutics for ADPKD.

Author List

Fan LX, Zhou X, Sweeney WE Jr, Wallace DP, Avner ED, Grantham JJ, Li X

Author

Ellis D. Avner MD Professor in the Pediatrics department at Medical College of Wisconsin




MESH terms used to index this publication - Major topics in bold

Animals
Apoptosis
Apoptosis Regulatory Proteins
Carrier Proteins
Cells, Cultured
Dipeptides
Epithelial Cells
Female
Humans
Indoles
Intracellular Signaling Peptides and Proteins
Kidney Tubules, Proximal
Mice
Mice, Mutant Strains
Mitochondrial Proteins
NF-kappa B
Polycystic Kidney, Autosomal Dominant
Pregnancy
TRPP Cation Channels
Tumor Necrosis Factor-alpha