The actin cytoskeleton is critical to the proper function of cells and its misregulation can lead to human disease states. As a consequence, actin dynamics is tightly controlled. To gain further insight into the mechanisms controlling actin dynamics, my studies have focused on two families of proteins implicated in actin regulation. The Nck proteins act as molecular adaptors in signal propagation by linking upstream mediators, which they recognize through the Nck SH2 domain, to downstream effectors, which bind the Nck SH3 domains. I have found that Nck is required in podocyte cells for proper foot process formation, a process involving actin cytoskeletal reorganization, and therefore for proper kidney function. Furthermore, I show that Nck links the podocyte adhesion protein nephrin to actin polymerization. In cell-based assays, nephrin-induced actin polymerization is dependent on an interaction with functional Nck, which occurs through binding of three phosphorylated tyrosine sites within the cytoplasmic tail of nephrin to the Nck SH2 domain. Finally, I demonstrate that the enteropathogenic E.coli protein Tir reorganizes the cytoskeleton by molecular-mimicry of nephrin-like signaling. The srGAP proteins are GTPase activating proteins that attenuate the activity Rho GTPases, proteins directly involved in actin cytoskeletal control. The regulatory mechanisms that control srGAP activity are unclear. I have found that the srGAP family members srGAP1, srGAP2, and srGAP3 interact, through their carboxy-terminal region with 14-3-3 proteins, and that this interaction is dependent on protein kinase C-induced phosphorylation of srGAP. 14-3-3 binding does not affect the activity of srGAP2, as determined using cell-based GAP assays. Further studies are required to clarify the biological significance of this interaction to srGAP regulation. The data presented in this thesis furthers our understanding of signaling networks that control the actin cytoskeleton, and brings us closer to the goal of fully understanding actin dynamics and cellular signaling.

Introdução: A injúria ao podócito glomerular tem um papel crítico para o surgimento de proteinúria em diferentes glomerulopatias. Neste estudo avaliamos a expressão gênica das proteínas associadas ao podócito em biópsias renais e na urina simultaneamente em pacientes com glomerulopatias proliferativas (GPP) e não proliferativas (GPNP) proteinúricas, assim como a efeito do tratamento imunossupressor sobre a expressão destas moléculas. Material e Métodos: Setenta e cinco pacientes adultos foram incluídos, 35 com diagnóstico de GPNP e 41 casos de GPP. Vinte e um indivíduos sem doença renal foram incluídos como controles. O RNAm foi quantificado no tecido renal (basal) e em células do sedimento urinário (na biópsia, aos 6 e 12 meses) dos genes nefrina, podocina, podocalixina, sinaptopodina e alfa actinina-4 por PCR em tempo real. A expressão gênica foi correlacionada com a proteinúria e a função renal, e a variação do RNAm ao longo do tempo foi comparada entre os grupos pela Equação de Estimativas Generalizadas. Resultados: O RNAm dos genes (exceto da sinaptopodina) no tecido estava significativamente reduzido no grupo GPNP. No grupo GPP, a expressão também foi menor, mas apenas o gene da podocina teve diferença estatística comparado aos controles. Em paralelo, o RNAm dos mesmos genes na urina basal foi mais elevado nos pacientes, e mais marcadamente no grupo GPP. Após seis meses de tratamento imunossupressor associado ou não a inibidores da angiotensina, no grupo GPP houve uma redução significativa da expressão de podocina, podocalixina e alfa actinina-4 aos 6 e 12 meses quando comparando ao nível basal (p<0,001). No grupo GPNP, apenas a alfa actinina-4 diminuiu (p=0,008) com uma tendência de redução da podocalixina (p=0,08). Verificou-se uma forte correlação entre os genes na biópsia (exceto com sinaptopodina), mas na urina esta correlação foi fraca. Houve correlação moderada mas significativa dos genes na urina com a proteinúria basal e dos 6 meses, mas nenhum gene correlacionou-se com a taxa de filtração glomerular. Conclusão: Nestes pacientes com glomerulopatias proteinúricas em fase aguda de doença, a expressão gênica de proteínas associadas ao podócito estava reduzida na biópsia renal concomitante com aumento da excreção urinária, sugerindo a presença de podocitopenia intra-renal e podocitúria, respectivamente. O RNAm destes genes reduziu em paralelo com a proteinúria com o uso de imunossupressores, sugerindo reorganização estrutural dos podócitos. Os resultados deste estudo não são conclusivos sobre diferenças qualitativas da podocitopatia com base em tipos histológicos específicos. / Introduction: Injury to the glomerular podocyte has a critical role in the development of proteinuria in different glomerulopathies. In this study, gene expression of podocyte-associated proteins was evaluated in kidney biopsies and urine simultaneously in patients with proliferative (PGP) and non proliferative (NPGP) glomerulopathies. The effect of immunosuppressive treatment on the expression of these molecules was also studied. Material and Methods: Seventy-five adult patients were included, 35 with NPGP and 41 cases of PGP. Twenty-one individuals without renal disease were included as controls. The mRNA was quantified by real time PCR in renal tissue (baseline) and in urinary sediment cells (at biopsy, at 6 and 12 months) for the following genes: nephrin, podocin, podocalyxin, synaptopodin and alpha actinin-4. Gene expression was correlated with proteinuria and renal function, and variation in mRNA levels over time was compared between groups by Generalized Estimating Equation. Results: The mRNA of all genes (except synaptopodin) in renal tissue was significantly decreased in NPGP group. In the PGP, this expression was also lower, but only podocin had statistical difference as compared to controls in parallel, mRNA of the same genes was increased in baseline urine of the patients, but more markedly in PGP group. After six months of immunosuppressive treatment, with or without angiotensin inhibitors, there was a significative reduction in urinary expression of podocin, podocalyxin and alpha actinin-4 at 6 and 12 months as compared to baseline levels. In the NPGP group, only alpha actinin-4 decreased in the urine (p=0,008) and there was also a trend to reduction of podocalyxin (p=0,08). There was a strong correlation between all genes (except for synaptopodin) in biopsy, but in the urine this correlation was weak. There was also a moderate but significative correlation between urinary genes and baseline and six-month proteinuria, but no gene correlated with glomerular filtration rate. Conclusion: In these patients with proteinuric glomerulopathies in the acute phase of disease, gene expression of podocyte-associated proteins was decreased in kidney biopsy concurrent with increased levels in the urine, suggesting the presence of intra-renal podocytopenia and podocyturia respectively. The mRNA of these genes decreased in parallel with proteinuria along with immunosuppressive treatment, suggesting structural reorganization of podocytes. The findings of this study cannot be conclusive about qualitative differences of the podocytopathy based on specific histologic types.

Introdução: A injúria ao podócito glomerular tem um papel crítico para o surgimento de proteinúria em diferentes glomerulopatias. Neste estudo avaliamos a expressão gênica das proteínas associadas ao podócito em biópsias renais e na urina simultaneamente em pacientes com glomerulopatias proliferativas (GPP) e não proliferativas (GPNP) proteinúricas, assim como a efeito do tratamento imunossupressor sobre a expressão destas moléculas. Material e Métodos: Setenta e cinco pacientes adultos foram incluídos, 35 com diagnóstico de GPNP e 41 casos de GPP. Vinte e um indivíduos sem doença renal foram incluídos como controles. O RNAm foi quantificado no tecido renal (basal) e em células do sedimento urinário (na biópsia, aos 6 e 12 meses) dos genes nefrina, podocina, podocalixina, sinaptopodina e alfa actinina-4 por PCR em tempo real. A expressão gênica foi correlacionada com a proteinúria e a função renal, e a variação do RNAm ao longo do tempo foi comparada entre os grupos pela Equação de Estimativas Generalizadas. Resultados: O RNAm dos genes (exceto da sinaptopodina) no tecido estava significativamente reduzido no grupo GPNP. No grupo GPP, a expressão também foi menor, mas apenas o gene da podocina teve diferença estatística comparado aos controles. Em paralelo, o RNAm dos mesmos genes na urina basal foi mais elevado nos pacientes, e mais marcadamente no grupo GPP. Após seis meses de tratamento imunossupressor associado ou não a inibidores da angiotensina, no grupo GPP houve uma redução significativa da expressão de podocina, podocalixina e alfa actinina-4 aos 6 e 12 meses quando comparando ao nível basal (p<0,001). No grupo GPNP, apenas a alfa actinina-4 diminuiu (p=0,008) com uma tendência de redução da podocalixina (p=0,08). Verificou-se uma forte correlação entre os genes na biópsia (exceto com sinaptopodina), mas na urina esta correlação foi fraca. Houve correlação moderada mas significativa dos genes na urina com a proteinúria basal e dos 6 meses, mas nenhum gene correlacionou-se com a taxa de filtração glomerular. Conclusão: Nestes pacientes com glomerulopatias proteinúricas em fase aguda de doença, a expressão gênica de proteínas associadas ao podócito estava reduzida na biópsia renal concomitante com aumento da excreção urinária, sugerindo a presença de podocitopenia intra-renal e podocitúria, respectivamente. O RNAm destes genes reduziu em paralelo com a proteinúria com o uso de imunossupressores, sugerindo reorganização estrutural dos podócitos. Os resultados deste estudo não são conclusivos sobre diferenças qualitativas da podocitopatia com base em tipos histológicos específicos. / Introduction: Injury to the glomerular podocyte has a critical role in the development of proteinuria in different glomerulopathies. In this study, gene expression of podocyte-associated proteins was evaluated in kidney biopsies and urine simultaneously in patients with proliferative (PGP) and non proliferative (NPGP) glomerulopathies. The effect of immunosuppressive treatment on the expression of these molecules was also studied. Material and Methods: Seventy-five adult patients were included, 35 with NPGP and 41 cases of PGP. Twenty-one individuals without renal disease were included as controls. The mRNA was quantified by real time PCR in renal tissue (baseline) and in urinary sediment cells (at biopsy, at 6 and 12 months) for the following genes: nephrin, podocin, podocalyxin, synaptopodin and alpha actinin-4. Gene expression was correlated with proteinuria and renal function, and variation in mRNA levels over time was compared between groups by Generalized Estimating Equation. Results: The mRNA of all genes (except synaptopodin) in renal tissue was significantly decreased in NPGP group. In the PGP, this expression was also lower, but only podocin had statistical difference as compared to controls in parallel, mRNA of the same genes was increased in baseline urine of the patients, but more markedly in PGP group. After six months of immunosuppressive treatment, with or without angiotensin inhibitors, there was a significative reduction in urinary expression of podocin, podocalyxin and alpha actinin-4 at 6 and 12 months as compared to baseline levels. In the NPGP group, only alpha actinin-4 decreased in the urine (p=0,008) and there was also a trend to reduction of podocalyxin (p=0,08). There was a strong correlation between all genes (except for synaptopodin) in biopsy, but in the urine this correlation was weak. There was also a moderate but significative correlation between urinary genes and baseline and six-month proteinuria, but no gene correlated with glomerular filtration rate. Conclusion: In these patients with proteinuric glomerulopathies in the acute phase of disease, gene expression of podocyte-associated proteins was decreased in kidney biopsy concurrent with increased levels in the urine, suggesting the presence of intra-renal podocytopenia and podocyturia respectively. The mRNA of these genes decreased in parallel with proteinuria along with immunosuppressive treatment, suggesting structural reorganization of podocytes. The findings of this study cannot be conclusive about qualitative differences of the podocytopathy based on specific histologic types.

Introdução: A injúria ao podócito glomerular tem um papel crítico para o surgimento de proteinúria em diferentes glomerulopatias. Neste estudo avaliamos a expressão gênica das proteínas associadas ao podócito em biópsias renais e na urina simultaneamente em pacientes com glomerulopatias proliferativas (GPP) e não proliferativas (GPNP) proteinúricas, assim como a efeito do tratamento imunossupressor sobre a expressão destas moléculas. Material e Métodos: Setenta e cinco pacientes adultos foram incluídos, 35 com diagnóstico de GPNP e 41 casos de GPP. Vinte e um indivíduos sem doença renal foram incluídos como controles. O RNAm foi quantificado no tecido renal (basal) e em células do sedimento urinário (na biópsia, aos 6 e 12 meses) dos genes nefrina, podocina, podocalixina, sinaptopodina e alfa actinina-4 por PCR em tempo real. A expressão gênica foi correlacionada com a proteinúria e a função renal, e a variação do RNAm ao longo do tempo foi comparada entre os grupos pela Equação de Estimativas Generalizadas. Resultados: O RNAm dos genes (exceto da sinaptopodina) no tecido estava significativamente reduzido no grupo GPNP. No grupo GPP, a expressão também foi menor, mas apenas o gene da podocina teve diferença estatística comparado aos controles. Em paralelo, o RNAm dos mesmos genes na urina basal foi mais elevado nos pacientes, e mais marcadamente no grupo GPP. Após seis meses de tratamento imunossupressor associado ou não a inibidores da angiotensina, no grupo GPP houve uma redução significativa da expressão de podocina, podocalixina e alfa actinina-4 aos 6 e 12 meses quando comparando ao nível basal (p<0,001). No grupo GPNP, apenas a alfa actinina-4 diminuiu (p=0,008) com uma tendência de redução da podocalixina (p=0,08). Verificou-se uma forte correlação entre os genes na biópsia (exceto com sinaptopodina), mas na urina esta correlação foi fraca. Houve correlação moderada mas significativa dos genes na urina com a proteinúria basal e dos 6 meses, mas nenhum gene correlacionou-se com a taxa de filtração glomerular. Conclusão: Nestes pacientes com glomerulopatias proteinúricas em fase aguda de doença, a expressão gênica de proteínas associadas ao podócito estava reduzida na biópsia renal concomitante com aumento da excreção urinária, sugerindo a presença de podocitopenia intra-renal e podocitúria, respectivamente. O RNAm destes genes reduziu em paralelo com a proteinúria com o uso de imunossupressores, sugerindo reorganização estrutural dos podócitos. Os resultados deste estudo não são conclusivos sobre diferenças qualitativas da podocitopatia com base em tipos histológicos específicos. / Introduction: Injury to the glomerular podocyte has a critical role in the development of proteinuria in different glomerulopathies. In this study, gene expression of podocyte-associated proteins was evaluated in kidney biopsies and urine simultaneously in patients with proliferative (PGP) and non proliferative (NPGP) glomerulopathies. The effect of immunosuppressive treatment on the expression of these molecules was also studied. Material and Methods: Seventy-five adult patients were included, 35 with NPGP and 41 cases of PGP. Twenty-one individuals without renal disease were included as controls. The mRNA was quantified by real time PCR in renal tissue (baseline) and in urinary sediment cells (at biopsy, at 6 and 12 months) for the following genes: nephrin, podocin, podocalyxin, synaptopodin and alpha actinin-4. Gene expression was correlated with proteinuria and renal function, and variation in mRNA levels over time was compared between groups by Generalized Estimating Equation. Results: The mRNA of all genes (except synaptopodin) in renal tissue was significantly decreased in NPGP group. In the PGP, this expression was also lower, but only podocin had statistical difference as compared to controls in parallel, mRNA of the same genes was increased in baseline urine of the patients, but more markedly in PGP group. After six months of immunosuppressive treatment, with or without angiotensin inhibitors, there was a significative reduction in urinary expression of podocin, podocalyxin and alpha actinin-4 at 6 and 12 months as compared to baseline levels. In the NPGP group, only alpha actinin-4 decreased in the urine (p=0,008) and there was also a trend to reduction of podocalyxin (p=0,08). There was a strong correlation between all genes (except for synaptopodin) in biopsy, but in the urine this correlation was weak. There was also a moderate but significative correlation between urinary genes and baseline and six-month proteinuria, but no gene correlated with glomerular filtration rate. Conclusion: In these patients with proteinuric glomerulopathies in the acute phase of disease, gene expression of podocyte-associated proteins was decreased in kidney biopsy concurrent with increased levels in the urine, suggesting the presence of intra-renal podocytopenia and podocyturia respectively. The mRNA of these genes decreased in parallel with proteinuria along with immunosuppressive treatment, suggesting structural reorganization of podocytes. The findings of this study cannot be conclusive about qualitative differences of the podocytopathy based on specific histologic types.

京都大学 / 新制・課程博士 / 博士(医学) / 甲第23462号 / 医博第4769号 / 新制||医||1053(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 長船 健二, 教授 渡邊 直樹, 教授 羽賀 博典 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DGAM

Abnormal kidney development is a relatively prevalent health issue; however, the genetic basis is mostly unknown. The aim of this thesis is to identify genes important in kidney development and disease and to study their molecular functions. We hypothesized that human diseases associated with kidney anomalies can uncover novel genes important in kidney development and disease. The thesis is divided into three independent projects that examined three genes (i.e. Zeb2, Ilk, Robo2) at three stages of mouse kidney development: nephrogenesis, glomerular podocyte, and early ureteric bud outgrowth. In the first project, we identified Zeb2, a gene encoding the zinc finger E-box binding homeobox 2 transcription factor that is mutated in the Mowat Wilson syndrome, as a novel gene important in nephrogenesis. Zeb2 conditional knockout mice (Zeb2 cKO) develop glomerulocystic kidney disease with many atubular glomeruli and decreased expression of proximal tubular markers before cyst formation. These data suggest that abnormal nephrogenesis leads to the congenital atubular glomeruli and primary glomerular cysts in the Zeb2 cKO mice. This study implies that ZEB2 is a novel candidate gene for glomerular cystic disease in patients. Additionally we found that Pkd1, the gene mutated in autosomal dominant polycystic kidney disease, is upregulated in non-cystic glomeruli and knockout of one copy of the Pkd1 gene exacerbates the cystic phenotype of the Zeb2 cKO mice. These findings suggest a genetic interaction between Zeb2 and Pkd1 and that Zeb2 might be a novel PKD1 modifier. In the second project, we studied the roles of integrin-linked kinase (ILK) and roundabout 2 (ROBO2) in glomerular podocytes. We found that ILK and ROBO2 form a protein complex, and that loss of Robo2 improves survival and alleviates the podocyte and basement membrane abnormalities seen in Ilk knockout mice. In the third project, using microarray gene expression analysis, we found lower gene expression levels of extracellular matrix proteins during early ureteric bud outgrowth in the Robo2 homozygous knockout embryos as compared to wild type controls. These findings suggest that ROBO2 may regulate extracellular matrix components in the kidney. In conclusion, we found a new role for Zeb2 in nephrogenesis, and identified a novel function of Robo2 in regulating extracellular matrix gene expression in podocytes and during early kidney development. / 2017-11-03T00:00:00Z

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13206号 / 論医博第2160号 / 新制||医||1031(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 木村 剛, 教授 岩田 想, 教授 秋山 芳展 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 0048 / 新制・論文博士 / 博士(医学) / 乙第13234号 / 論医博第2174号 / 新制||医||1036(附属図書館) / 京都大学大学院医学研究科内科系専攻 / (主査)教授 長船 健二, 教授 瀬原 淳子, 教授 小川 修 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

The increased prevalence of chronic kidney disease (CKD) has become a major global health burden. This increase in CKD burden parallels the increase in hypertension prevalence. In addition, increasing evidence suggest that genetics play a strong role in the susceptibility for renal disease. Inbred mouse strains C57BL/6 and 129S6SvEv differ in their susceptibility to kidney disease when subjected to hypertension using the DOCA/salt uninephrectomy model of hypertension. Similar to others, we found the 129S6SvEv mice to be susceptible to develop severe glomerulosclerosis, whereas the C57BL/6 mice are comparatively resistant. To identify new candidate genes that are involved in the pathogenesis of glomerular disease, we used microarray technology to compare the glomerular transcriptome of both strains and determine changes in glomerular gene expression when subjected to the DOCA/salt uninephrectomy model of systemic hypertension. This approach was accompanied with ultrastructural analysis and glomerular stiffness measurements to identify corresponding structural changes. Here, we have identified novel genes associated with strain differences and hypertension, and we used immunohistochemistry to validate their expression in podocytes and glomerular arterioles in murine and human kidneys. The increased understanding of the molecular mechanisms underlying hypertension-associated podocyte injury and glomerular damage which will result from these studies, will ultimately lead to identification of novel pharmacologic targets or therapeutic strategies for patients with hypertension and renal disease. / 2017-11-02T00:00:00Z

Résumé de la thèse:Le syndrome néphrotique idiopathique (SNI) est la forme la plus fréquente de néphropathies glomérulaires et résulte d'altérations touchant les podocytes. La progression de la maladie est associée à une déplétion podocytaire et l'apparition de glomérulosclérose. Malgré de nombreuses études moléculaires et des avancées scientifiques indiscutables sur les formes génétiques, la pathogénie du SNI reste une énigme.Nous avons trouvé que la protéine c-mip est spécifiquement induite dans les podocytes des patients atteints de SNI.Nous avons montré que les souris transgéniques c-mip développent une protéinurie néphrotique qui n'est associée ni à des lésions inflammatoires glomérulaires ou interstitielles, ni à des dépôts de complexes immuns circulants ou de complément. Les études in vitro et in vivo ont démontré que c-mip se lie à Fyn et bloque la liaison de Fyn avec la néphrine et N WASP. Il en résulte une inhibition de la voie de signalisation de la néphrine et l'incapacité de N-WASP à recruter Nck, ce qui altère l'organisation du cytosquelette podocytaire et contribue au développement de la protéinurie masssive.D'autre part, nous avons montré que Wt1 se lie au promoteur de c-mip et bloque sa transactivation. Au cours du SNI acquis, les résultats obtenus in vitro et dans les souris transgéniques suggèrent que c-mip inhibe la transcription du gène de Wt1 médiée par NF-κB, interagit avec Wt1 via son domaine LRR et favorise la dégradation de Wt1 par le protéasome.Nous avons également trouvé que c-mip interfère avec l'activation de la voie NF-κB en destabilisant la sous-unité RelA, tandis que la sous-unité p50 est préservée. Les résultats in vitro et dans le modèle murin suggèrent que c-mip est dotée de propriétés pro-apoptotiques.Ces travaux montrent que la protéine c-mip joue un rôle crucial dans la physiopathologie du SNI et constitue une cible thérapeutique de choix. / SummaryPodocyte damages are the initiating event in the pathogenesis of idiopathic nephrotic syndrome (INS). Progression of podocyte disease is associated with cellular depletion and appearance of glomerulosclerosis. The molecular pathophysiology of this disease remains an enigma.We showed that c-mip (c-maf inducing protein) is up-regulated in podocytes during the active phase of INS.We generated c-mip transgenic mice overexpressing c-mip specifically in podocytes. These mice developed morphological and biochemical alterations similar to INS. We demonstrated that c-mip switches off podocyte proximal signaling by preventing the interaction between Fyn and nephrin, resulting in the inhibition of nephrin phosphorylation in vitro and in vivo. Moreover, we found that the in vivo interactions of Fyn with Nck and N WASP are inhibited, which may account for disorganization of the cytoskeleton and the effacement of foot processes.We showed that, under physiological conditions, Wt1 inhibits the transcriptional induction of c-mip. Conversely, we demonstrated that, under pathological conditions, c-mip inhibits NF κB mediated-Wt-1 transcription, interacts in vitro and in vivo with Wt1 via its LRR domain, and targets Wt1 to proteasome degradation.We also observed that the induction of c-mip in patients with INS is correlated with a downregulation of RelA in podocytes. We showed that c-mip alters NF-κB signaling by destabilizing the RelA protein, while p50 is preserved. Morever, the results established in stably transfected podocytes and in transgenic mice suggest that c-mip is a proapoptotic protein.Collectively, these data postulate that c-mip functions as a negative regulator and plays a central role in podocytes disorders during INS.