Hirschberg, Raimund

Renal interstitial fibrosis is a major determinant of renal failure in the majority of chronic renal diseases. Transforming growth factor-β (TGF-β) is the single most important cytokine promoting renal fibrogenesis. Recent in vitro studies identified novel non-smad TGF-β targets including p21-activated kinase-2 (PAK2), the abelson nonreceptor tyrosine kinase (c-Abl), and the mammalian target of rapamycin (mTOR) that are activated by TGF-β in mesenchymal cells, specifically in fibroblasts but less in epithelial cells. In the present studies, we show that non-smad effectors of TGF-β including PAK2, c-Abl, Akt, tuberin (TSC2), and mTOR are activated in experimental unilateral obstructive nephropathy in rats. Treatment with c-Abl or mTOR inhibitors, imatinib mesylate and rapamycin, respectively, each blocks noncanonical (non-smad) TGF-β pathways in the kidney in vivo and diminishes the number of interstitial fibroblasts and myofibroblasts as well as the interstitial accumulation of extracellular matrix proteins. These findings indicate that noncanonical TGF-β pathways are activated during the early and rapid renal fibrogenesis of obstructive nephropathy. Moreover, the current findings suggest that combined inhibition of key regulators of these non-smad TGF-β pathways even in dose-sparing protocols are effective treatments in renal fibrogenesis.

ABSTRACT Transforming growth factor‐β (TGF‐β) is the single most important cytokine promoting renal fibrogenesis. p21‐activated kinase‐2 (PAK2) and activa‐ tion of abelson nonreceptor tyrosine kinase (c‐abl) have been shown recently to be smad‐independent, fibro‐ blast‐specific targets downstream of the activated TGF‐β receptor. In the current study we show that in cultured NRK49F‐renal fibroblasts (but not in tubular or mesangial cells) TGF‐β similarly activates PAK2 as well as c‐abl and induces cell proliferation. Inhibition of the c‐abl kinase with imatinib mesylate prevents increased proliferation after TGF‐β addition without affecting PAK2. These in vitro findings were extended to rats with unilateral obstructive nephropathy, a dis‐ ease model of TGF‐β‐driven renal fibrogenesis. In obstructed kidneys, PAK2 and c‐abl activity were in‐ creased but only c‐abl activation was blocked by ima‐ tinib. Treatment with imatinib did not prevent renal interstitial infiltration of macrophages or phosphoryla‐ tion and nuclear translocation of smad2/3 in ob‐ structed kidneys. In contrast, imatinib substantially inhibited an increase in the number of interstitial fibroblasts and myofibroblasts and reduced the expres‐ sion and interstitial accumulation of collagen type III, collagen type IV and fibronectin. These findings indi‐ cate that TGF‐β‐induced activation of the nonreceptor c‐abl tyrosine kinase regulates fibroblast proliferation and, by this means, is a costimulatory signal in TGF‐β‐ dependent renal fibrogenesis. Inhibition of c‐abl activ‐ ity with imatinib mesylate ameliorates experimental renal fibrosis in rats.—Wang, S., Wilkes, M. C., Leof, L. B., Hirschberg, R. Imatinib mesylate blocks a non‐ Smad TGF‐β pathway and reduces renal fibrogenesis in vivo. FASEB J. 19, 1‐11 (2005)