Journal
KIDNEY INTERNATIONAL
Volume 83, Issue 4, Pages 582-592Publisher
ELSEVIER SCIENCE INC
DOI: 10.1038/ki.2012.448
Keywords
chronic kidney disease; indoxyl sulfate; NADPH oxidase; oxidative stress; p-cresyl sulfate; uremic toxins
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Funding
- Japan Society for the Promotion of Science (JSPS) [23790187]
- Kidney Foundation, Japan
- Grants-in-Aid for Scientific Research [23790187] Funding Source: KAKEN
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The accumulation of p-cresyl sulfate (PCS), a uremic toxin, is associated with the mortality rate of chronic kidney disease patients; however, the biological functions and the mechanism of its action remain largely unknown. Here we determine whether PCS enhances the production of reactive oxygen species (ROS) in renal tubular cells resulting in cytotoxicity. PCS exhibited pro-oxidant properties in human tubular epithelial cells by enhancing NADPH oxidase (nicotinamide adenine dinucleotide phosphate-oxidase) activity. PCS also upregulated mRNA levels of inflammatory cytokines and active TGF-b1 protein secretion associated with renal fibrosis. Knockdown of p22(phox) or Nox4 expression suppressed the effect of PCS, underlining the importance of NADPH oxidase activation on its mechanism of action. PCS also reduced cell viability by increasing ROS production. The toxicity of PCS was largely suppressed in the presence of probenecid, an organic acid transport inhibitor. Administration of PCS for 4 weeks caused significant renal tubular damage in 5/6-nephrectomized rats by enhancing oxidative stress. Thus, the renal toxicity of PCS is attributed to its intracellular accumulation, leading to both increased NADPH oxidase activity and ROS production, which, in turn, triggers induction of inflammatory cytokines involved in renal fibrosis. This mechanism is similar to that for the renal toxicity of indoxyl sulfate. Kidney International (2013) 83, 582-592; doi:10.1038/ki.2012.448; published online 16 January 2013
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