Endothelial cell dysfunction (ECD) is the harbinger of majority of cardiovascular disease and is especially prevalent in patients with chronic kidney disease (CKD). During the past 2 cycles of this study we obtained and verified genetic and proteomic signatures of ECD. In the process we established a model of pre-clinical "early" ECD using chronically non-pressor doses of L-NMMA. Renal microvasculature of these mice revealed depletion of 2 key mitochondrial enzymes - enoyl- CoA-hydratase-1 (ECHS-1) and aconitase-2 (Aco-2). Consequently, TCA cycle was inhibited, mitochondrial biogenesis suppressed, and normoxic glycolysis prevailed resulting in the increase of lactate production - a metabolic profile which is a hallmark of Warburg effect. Present application is based on a hypothesis that this metabolic profile of ECD may explain some abnormalities in the pathways of mitochondrial and cytosolic glucose-lipid metabolism. A therapeutic corollary of these findings predicts the possibility of correcting "truncated" TCA cycle by introducing an intermediate bypassing the enzymatic block potentially resulting in alleviation of ECD. Another major goal consists in obtaining the metabolic signatures of advanced ECD accompanied by hypoxic glycolysis (Pasteur effect). We hypothesize that it is responsible for the induction of HIFs, VEGF, and an increase in vascular permeability.
Four Specific Aims are proposed: 1) profiling glucose metabolism of dysfunctional endothelium: links to redox, lipid metabolism, and glyceroneogenesis;2) metabolic consequences of Pasteur effect (hypoxic glycolysis) in advanced ECD: induction of HIFs, VEGF and increased vascular permeability;3) glutamine bypasses mitochondrial enzymatic blockade in endothelial dysfunction: metabolic and functional consequences;culminating in 4) a proof of principal clinical trial of glutamine supplementation in patients with CKD 3-4. Results of these investigations should offer a detailed picture of metabolic disturbances associated with ECD in vitro and in vivo, have a potential to disclose a mechanistically rational therapeutic intervention to restore metabolism and alleviate manifestations of ECD, and finally test these findings on glutamine supplementation and vascular functions in a pilot clinical trial of a select patient population with CKD 3-4.

Public Health Relevance

Studies proposed in this grant application should shed light on two concepts: 1) incompetence of stem/progenitor cells in Chronic Kidney Disease (CKD) contributes to the insufficient regenerative processes thus accounting in part for progression of disease and 2) stem cell incompetence is reversible and can be pharmacologically corrected thus resulting in reduction of the rate of progression or even regression of disease. Among the potential causes of stem cell incompetence in CKD we shall focus on a) stem cell-related factors and b) stem cell niche-related factors, as well as attempt pharmacologic correction of stem cell incompetence. These studies should supplement the search for mechanisms of progression of CKD by exploring the regenerative potential and its failure in these morbid states and offering alternative therapeutic strategies.

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Research Project (R01)
Project #
5R01DK045462-16
Application #
8517645
Study Section
Pathobiology of Kidney Disease Study Section (PBKD)
Program Officer
Rys-Sikora, Krystyna E
Project Start
1995-09-01
Project End
2015-04-30
Budget Start
2013-05-01
Budget End
2014-04-30
Support Year
16
Fiscal Year
2013
Total Cost
$346,263
Indirect Cost
$120,728
Name
New York Medical College
Department
Internal Medicine/Medicine
Type
Schools of Medicine
DUNS #
041907486
City
Valhalla
State
NY
Country
United States
Zip Code
10595
Rabadi, May M; Xavier, Sandhya; Vasko, Radovan et al. (2015) High-mobility group box 1 is a novel deacetylation target of Sirtuin1. Kidney Int 87:95-108
Lin, Chi Hua Sarah; Chen, Jun; Ziman, Bruce et al. (2014) Endostatin and kidney fibrosis in aging: a case for antagonistic pleiotropy? Am J Physiol Heart Circ Physiol 306:H1692-9
Vasko, Radovan; Xavier, Sandhya; Chen, Jun et al. (2014) Endothelial sirtuin 1 deficiency perpetrates nephrosclerosis through downregulation of matrix metalloproteinase-14: relevance to fibrosis of vascular senescence. J Am Soc Nephrol 25:276-91
Goligorsky, Michael S (2014) Endothelial progenitor cells: from senescence to rejuvenation. Semin Nephrol 34:365-73
Goligorsky, Michael S; Salven, Petri (2013) Concise review: endothelial stem and progenitor cells and their habitats. Stem Cells Transl Med 2:499-504
Ratliff, Brian B; Rabadi, May M; Vasko, Radovan et al. (2013) Messengers without borders: mediators of systemic inflammatory response in AKI. J Am Soc Nephrol 24:529-36
Goligorsky, Michael S (2013) Restitutio ad integrum: a dream or a real possibility? Nephrol Dial Transplant 28:2682-7
Addabbo, Francesco; Chen, Qiuying; Patel, Dhara P et al. (2013) Glutamine supplementation alleviates vasculopathy and corrects metabolic profile in an in vivo model of endothelial cell dysfunction. PLoS One 8:e65458
Yasuda, Kaoru; Vasko, Radovan; Hayek, Peter et al. (2012) Functional consequences of inhibiting exocytosis of Weibel-Palade bodies in acute renal ischemia. Am J Physiol Renal Physiol 302:F713-21
Chen, Jun; Xavier, Sandhya; Moskowitz-Kassai, Eliza et al. (2012) Cathepsin cleavage of sirtuin 1 in endothelial progenitor cells mediates stress-induced premature senescence. Am J Pathol 180:973-83

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