Our previous studies have provided a causal relationship between inhibition of substrate oxidation and the development of proximal tubule cell death. Peroxisome proliferator activated receptor-alpha (PPARa) is expressed in the kidney and more specifically in the proximal tubule, and stimulates the expression of many genes involved in lipid metabolism, such as, and liver fatty acid binding protein (L-FABP). In our studies we have shown that upregulation of PPARa activity by fibrates prevents the inhibition of fatty acid oxidation, and resulted in significant reduction in proximal tubule cell death and prevention of organ dysfunction, whereas genetic deletion of PPARa increased kidney susceptibility to ischemia reperfusion and cisplatin induced ARF. Our most recent studies using kidney androgen regulated promoter (KAP2)-PPARa transgenic mice that express higher levels of PPARa in the proximal tubule we show that these mice are protected from cisplatin and ischemia/reperfusion induced acute renal failure (ARF), similarly to what we have previously described in wild type mice treated with fibrates. Our first hypothesis is that PPARa activation prevents proximal tubule cell death and ameliorates ARF by increasing FAO in the proximal tubule. Our first specific aim will examine the mechanisms by which PPARa activation prevents proximal tubule cell death including changes in mitochondrial respiratory function, expression of uncoupling proteins, changes in cellular metabolism, and preventing nuclear translocation of Apoptotic inducing factor (AIF). Our second hypothesis is that increased expression of L-FABP is cytoprotective by reducing oxidative stress and accumulation of nonesterified fatty acids.
Our second aim will examine the role of L-FABP in in vivo and in vitro models of acute renal failure. We will examine whether increased expression of L-FABP in the proximal tubule in human L-FABP transgenic mice confers cytoprotection during ARF. Finally we will examine cellular mechanisms by which increased expression of proximal tubule L-FABP is cytoprotective. The protective effect provided by fibrate administration during acute renal failure is very significant, and its use in clinical trials could be considered in future studies, in order to ameliorate acute kidney injury and reduce mortality.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
Project #
Application #
Study Section
Pathobiology of Kidney Disease Study Section (PBKD)
Program Officer
Kimmel, Paul
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Arkansas for Medical Sciences
Internal Medicine/Medicine
Schools of Medicine
Little Rock
United States
Zip Code
Yu, Li-Rong; Sun, Jinchun; Daniels, Jaclyn R et al. (2018) Aptamer-Based Proteomics Identifies Mortality-Associated Serum Biomarkers in Dialysis-Dependent AKI Patients. Kidney Int Rep 3:1202-1213
Xavier, Sandhya; Sahu, Ranjit K; Landes, Susan G et al. (2017) Pericytes and immune cells contribute to complement activation in tubulointerstitial fibrosis. Am J Physiol Renal Physiol 312:F516-F532
Humphreys, Benjamin D; Cantaluppi, Vincenzo; Portilla, Didier et al. (2016) Targeting Endogenous Repair Pathways after AKI. J Am Soc Nephrol 27:990-8
Gomez, Ivan G; MacKenna, Deidre A; Johnson, Bryce G et al. (2015) Anti-microRNA-21 oligonucleotides prevent Alport nephropathy progression by stimulating metabolic pathways. J Clin Invest 125:141-56
Megyesi, Judit; Tarcsafalvi, Adel; Li, Shenyang et al. (2015) Increased expression of p21WAF1/CIP1 in kidney proximal tubules mediates fibrosis. Am J Physiol Renal Physiol 308:F122-30
Charlton, Jennifer R; Portilla, Didier; Okusa, Mark D (2014) A basic science view of acute kidney injury biomarkers. Nephrol Dial Transplant 29:1301-11
Portilla, Didier (2014) Apoptosis, fibrosis and senescence. Nephron Clin Pract 127:65-9
Li, Shenyang; Mariappan, Nithya; Megyesi, Judit et al. (2013) Proximal tubule PPAR? attenuates renal fibrosis and inflammation caused by unilateral ureteral obstruction. Am J Physiol Renal Physiol 305:F618-27
Gomez, Ivan G; Grafals, Monica; Portilla, Didier et al. (2013) MicroRNAs as potential therapeutic targets in kidney disease. J Formos Med Assoc 112:237-43
Goldstein, Stuart L; Jaber, Bertrand L; Faubel, Sarah et al. (2013) AKI transition of care: a potential opportunity to detect and prevent CKD. Clin J Am Soc Nephrol 8:476-83

Showing the most recent 10 out of 22 publications