Chronic kidney disease (CKD) puts patients at a greatly increased risk of cardiovascular disease, in a condition termed Type 4 Cardiorenal Syndrome (CRS4). While a large amount of clinical data on CKD patients has identified some risk factors, very little is known about the mechanisms by which this condition develops. We have utilized the 5/6 nephrectomy (5/6 NX) model in Sprague Dawley rats to study the development of cardiac dysfunction resulting from declining kidney function in a controlled animal model. The goal of our work is to identifying molecular mechanisms that are mediating dysfunction and target them therapeutically. Small RNA sequencing of left ventricle tissue identified miR-21-5p as a microRNA that is upregulated in response to 5/6 NX. MicroRNAs are a class of several hundred endogenously produced small RNAs that are involved with post-transcriptional regulation of gene expression in the heart and elsewhere. Systemic knockdown of miR-21 prevented cardiac hypertrophy and enhanced cardiac function without improving renal function or reducing blood pressure. This data suggests that suppression of miR-21-5p prevented pathology through pressure independent mechanisms. Subsequent mRNA sequencing identified gene expression changes in pathways relating to fatty acid oxidation, glycolysis, hypertrophic signaling, inflammation, immune function and atherosclerosis in response to miR-21 knockdown, suggesting that miR-21-5p may be targeting peroxisome proliferator-activated receptor alpha (PPAR??. PPAR? is miR-21 target in humans and is involved with regulation of all of the above mentioned pathways. PPAR? is well known to be suppressed with cardiac pathology, however miR-21 targeting of PPARa has not yet been reported in a model of cardiac disease. We hypothesize that miR-21-5p produced by the 5/6Nx remnant kidney supplies the LV with a pathological amount of miR-21-5p, contributing to cardiac remodeling and dysfunction, at least in part, through targeting PPAR?. This proposal will focus understanding the functional and pathological implications of that regulation. We will also locate LV cell types and tissue regions in which miR-21 targeting of PPAR? is occurs and study the gene expression changes that result. A role for the miR-21-5p/PPAR? pathway has not been reported in CRS4, or any other cardiac pathology. The studies outlined in this proposal are designed to characterize the upstream and downstream mechanisms of this pathway in the 5/6Nx model. The discovery of a direct role for circulating miR-21-5p in disease development would be an innovative breakthrough in the field of microRNA research, expanding our understanding of circulating miRNAs from markers of disease to mediators of disease. Further, findings from the proposed study could help elucidate mechanisms that regulate cardiac dysfunction in CRS4 and identify new therapeutic approaches for preventing or improving cardiac dysfunction in CKD patients.

Public Health Relevance

The focus of this proposal is on cardiorenal Syndrome Type 4 (CRS4) is a condition in which chronic kidney disease (CKD) contributes to cardiovascular diseases including enlargement of the heart, poor heart function, and increased risk of heart attack. Cardiovascular disease is the leading cause of death among CKD patients and currently very little is known about how kidney disease can damage the heart. We have identified a regulatory molecule, microRNA miR-21- 5p, as an important contributor to the development of cardiac disease in an animal model of CRS4 impacts the progression of in the disease. High levels of miR-21-5p suppress levels of a beneficial signaling protein called peroxisome proliferator-activated receptor alpha (PPAR?). PPAR? is an involved with processes ranging from control of cellular energy utilization to cell death and proliferation. In this study we will evaluate the significance of miR-21-5p regulation of PPAR? in the development of cardiac disease and try to understand which cell types are impacted. The overall goal of this work is to identifying new preventative and therapeutic treatments for CKD patients at risk for developing CRS4 related pathology.

Agency
National Institute of Health (NIH)
Institute
National Heart, Lung, and Blood Institute (NHLBI)
Type
Research Project (R01)
Project #
5R01HL128332-04
Application #
9688569
Study Section
Cardiac Contractility, Hypertrophy, and Failure Study Section (CCHF)
Program Officer
Sopko, George
Project Start
2016-07-01
Project End
2021-04-30
Budget Start
2019-05-01
Budget End
2020-04-30
Support Year
4
Fiscal Year
2019
Total Cost
Indirect Cost
Name
Medical College of Wisconsin
Department
Physiology
Type
Schools of Medicine
DUNS #
937639060
City
Milwaukee
State
WI
Country
United States
Zip Code
53226
Kriegel, Alison J; Terhune, Scott S; Greene, Andrew S et al. (2018) Isomer-specific effect of microRNA miR-29b on nuclear morphology. J Biol Chem 293:14080-14088
Chuppa, Sandra; Liang, Mingyu; Liu, Pengyuan et al. (2018) MicroRNA-21 regulates peroxisome proliferator-activated receptor alpha, a molecular mechanism of cardiac pathology in Cardiorenal Syndrome Type 4. Kidney Int 93:375-389
Paterson, Mark R; Kriegel, Alison J (2017) MiR-146a/b: a family with shared seeds and different roots. Physiol Genomics 49:243-252