Our Lab Focus: Dietary protein load, immune response and kidney cyst progression

See a complete list of published works here.

Current Research Projects in the Saigusa Lab

Unilateral nephrectomy increases macrophage-driven inflammation and accelerates kidney cyst growth in polycystic kidney disease (PKD) mice

Adult conditional, global Pkd1 knockout (Pkd1KO) mice exhibit slow kidney cyst growth, however environmental factors can hasten kidney cyst expansion. Bell PD et. al. first demonstrated that inducing injury via unilateral nephrectomy (removing one kidney) accelerates cystogenesis in conditional Ift88KO mice https://doi.org/10.1681%2FASN.2010050526. We similarly observed this phenomenon in Pkd1KO mice. Fitzgibbon WR et al. https://doi.org/10.1152/ajprenal.00389.2017

Accelerated kidney cyst growth is associated with increased numbers of tissue resident macrophages (MФ), pro-inflammatory cytokines, and inflammation in early stages of PKD. Interferon regulatory factor 5 (IRF5),  a MФ transcription factor that induces a pro-inflammatory state, was increased in nephrectomized Pkd1KO mice compared to non-nephrectomized counterparts. Antisense oligonucleotides that inhibit Irf5 expression reduced kidney tissue resident MФ Irf5 and Il6 expression, Stat3 abundance, and cyst growth. This indicates that tissue resident MФs and pro-inflammatory cytokines accelerate cystogenesis in response to unilateral nephrectomy. Zimmerman KA et al. https://doi.org/10.34067/KID.0001052019


High dietary protein intake increases inflammation and cystogenesis in PKD

A high protein diet is another well-known environmental factor that can increase renal blood flow and stimulate kidney and cyst growth in PKD. Similar to the unilateral nephrectomy model, high protein (casein) intake increases MФ -driven inflammation and cyst expansion. In very early stages of dietary protein load, kidney cyst growth precedes the increase in MФ numbers or pro-inflammatory cytokines. High protein diet elevated the expression of glutamine transporter Snat3 and gluconeogenesis marker Pepck1 alongside increases in urinary ammonia in Pkd1KO mice. This indicates that glutamine, the most abundant amino acid in high protein diet, is an early stimulator of cyst growth in PKD. Sedaka R et al. https://doi.org/10.3389/fmed.2023.1173674

When Pkd1KO mice are fed a plant-based (wheat-gluten) high protein diet in lieu of the typical animal-based (casein) high protein diet, it mitigates the kidney immune response and slows the rate of cyst growth. Sedaka R et al. Unpublished. Our current research is focused on determining whether specific amino acids in these dietary proteins may be responsible for kidney cyst growth and to explore the underlying mechanism.  


Intestinal epithelial integrity declines during late-stage PKD

Despite its role as the body’s largest inflammatory cell reservoir, the potential contribution of the intestines to PKD development has yet to be elucidated. Utilizing Pkd1KO mice, we uncovered that the intestinal barrier is less permeable in early PKD while cyst growth initiates but becomes leakier as kidney disease progresses and cysts are enlarged. Sedaka R et al. Unpublished. Our current research is focused on the physiological implications of these findings and expanding upon the PKD intestinal phenotype.