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Functionally active (conformational) autoantibodies directed against the β1-adrenergic receptor (β1-AR) are supposed to have a pathogenic relevance in human heart failure, particularly in idiopathic dilated cardiomyopathy (DCM). Prevalence of anti-β1-autoantibodies (anti-β1-aabs) in the healthy population is almost negligible, whereas it amounts to up to 30% in heart failure patients with idiopathic DCM. As β1-ARs are not restricted to the heart and are also highly expressed in particular segments of the nephron, it is conceivable that such autoantibodies might also affect kidney function to some extent through the activation of renal β1-ARs.
In the kidney, β1-ARs are highly abundant in the juxtaglomerular apparatus, the distal convoluted tubules, the collecting duct, and the renal arteries. However, the functional significance of β1-ARs at these particular sites along the nephron is poorly understood, as are the effects of conformational stimulating anti-β1-aabs on renal β1-ARs. From the available literature, it is well known that the β1-adrenergic system is involved in, e.g., the regulation of renin-secretion from juxtaglomerular cells. In addition, the β1-adrenergic system is thought to be involved in the regulation of the urine pH via type B-intercalated cells in the collecting duct. In contrast, the regulation of salt- and fluid-secretion in the medullary collecting duct appears to occur independently from the SNS.
As a consequence, the present work aimed to unravel the potential pathophysiological links between renal function, alterations in the cardiovascular system, and circulating agonist-like anti- β1-abs. We analyzed possible renal effects of anti-β1-abs in a human-analogous rat model. After immunization with a GST-fusion protein containing the second extracellular loop (β1-ECII) of the human β1-AR, Lewis-rats develop functionally active, stimulating, conformational anti-β1-ECII-abs. Within the first 6 months, anti-β1-ECII-ab-positive animals develop a hypertensive phenotype, which after 9 months evolves into a DCM phenotype.
In n=40 GST/ β1-ECII-immunized Lewis rats and n=40 age-matched, 0.9% NaCl-injected control animals, we sequentially (i.e. at months 1, 2, 3, 6, 9, 12, 15, and 18 after start of immunization) analyzed the changes in renal function on a molecular, functional, and structural level. We could show that the presence of stimulating anti-β1-ECII-abs – even though having detrimental effects on the heart – has only a minor impact on kidney function and structure. Within the first 3 months after induction of anti-β1-ECII-abs, the levels and activity of renin were significantly increased in immunized compared to corresponding control animals, which was confirmed by experiments on isolated perfused kidneys, in which anti-β1-ECII-abs were able to directly induce the liberation of renin. However, within several weeks the initial anti-β1-ECII-ab-mediated RAAS activation was counter-regulated by auto-regulatory mechanisms activated in the kidney. Similarly, glomerular filtration rate (GFR) and renal blood flow (RBF) were initially decreased in the presence of the stimulating anti-β1-ECII-abs, but returned to control values within 3 months after immunization of the animals. Although expression of several pro-fibrotic markers was significantly up-regulated in anti-β1-ECII-ab-positive rats, no significant differences were noted on a histomorphological level with regard to the occurrence of renal fibrosis, glomerular damage, tubular damage, and perivascular fibrosis. Only a mild decrease in glomerular filtration function was observed in the kidneys of anti-β1-ECII-ab-positive animals from immunization-month 12 on, apparent by increased levels of urinary protein.
Even though anti-β1-ECII-abs were able to induce mild changes in renal function, their effects were not strong enough to critically damage the kidneys in our rat-model. Differences between immunized anti-β1-ECII-ab-positive and corresponding control rats at later time-points (that is, from immunization-month 12 on) are most likely secondary to the progressive heart failure phenotype that immunized animals develop in the course of the experiment.
The present study is the first to focus on the effects of stimulating anti-β1-ECII-abs on the kidney, and on the prevalence of these effects for the heart (referred to as cardio-renal crosstalk). Although our results were obtained in a rat model, they might contribute to better understand the situation in anti-β1-AR-aab-positive human patients. Following the results of our experiments, treatment of such patients should focus on direct and specific neutralization/elimination of stimulating anti-β1-ECII-aab or at least comprise therapeutic strategies that counteract the anti-β1-ECII-aab-effects on the heart by standard treatment for heart failure (i.e. ACE inhibitors, AT1-receptor blockers, and β-blockers) according to current guidelines.
Virulent Agrobacterium tumefaciens strains transfer and integrate a DNA region of the tumor-inducing (Ti) plasmid, the T-DNA, into the plant genome and thereby cause crown gall disease. The most essential genes required for crown gall development are the T-DNA-encoded oncogenes, IaaH (indole-3-acetamide hydrolase), IaaM (tryptophan monooxygenase) for auxin, and Ipt (isopentenyl transferase) for cytokinin biosynthesis. When these oncogenes are expressed in the host cell, the levels of auxin and cytokinin increase and cause cell proliferation. The aim of this study was to unravel the molecular mechanisms, which regulate expression of the agrobacterial oncogenes in plant cells. Transcripts of the three oncogenes were expressed in Arabidopsis thaliana crown galls induced by A. tumefaciens strain C58 and the intergenic regions (IGRs) between their coding sequences (CDS) were proven to have promoter activity in plant cells. These promoters possess eukaryotic sequence structures and contain cis-regulatory elements for the binding of plant transcription factors. The high-throughput protoplast transactivation (PTA) system was used and identified the Arabidopsis thaliana transcription factors WRKY18, WRKY40, WRKY60 and ARF5 to activate the Ipt oncogene promoter. No transcription factor promoted the activity of the IaaH and IaaM promoters, despite the fact that the sequences contained binding elements for type B ARR transcription factors. Likewise, the treatment of Arabidopsis mesophyll protoplasts with cytokinin (trans-zeatin) and auxin (1-NAA) exerted no positive effect on IaaH and IaaM promoter activity. In contrast, the Ipt promoter strongly responded to a treatment with auxin and only modestly to cytokinin. The three Arabidopsis WRKYs play a role in crown gall development as the wrky mutants developed smaller crown galls than wild-type plants. The WRKY40 and WRKY60 genes responded very quickly to pathogen infection, two and four hours post infection, respectively. Transcription of the WRKY18 gene was induced upon buffer infiltration, which implicates a response to wounding. The three WRKY proteins interacted with ARF5 and with each other in the plant nucleus, but only WRKY40 together with ARF5 increased activation of the Ipt promoter. Moreover, ARF5 activated the Ipt promoter in an auxin-dependent manner. The severe developmental phenotype of the arf5 mutant prevented studies on crown gall development, nevertheless, the reduced crown gall growth on the transport inhibitor response 1 (TIR1) tir1 mutant, lacking the auxin sensor, suggested that auxin signaling is required for optimal crown gall development. In conclusion, A. tumefaciens recruits the pathogen defense related WRKY40 pathway to activate Ipt expression in T-DNA-transformed plant cells. IaaH and IaaM gene expression seems not to be controlled by transcriptional activators, but the increasing auxin levels are signaled via ARF5. The auxin-depended activation of ARF5 boosts expression of the Ipt gene in combination with WRKY40 to increase cytokinin levels and induce crown gall development.