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Updated: Jun 20, 2026

Modeling Hypoxia/Reoxygenation Injury in Proximal Tubular Epithelial Cells
Published on: November 21, 2025
Variable effects of the mitoK(ATP) channel modulators diazoxide and 5-HD in ATP-depleted renal epithelial cells
Vani Nilakantan1, Huanling Liang, Jordan Mortensen
1Division of Transplant Surgery, Medical College of Wisconsin, Milwaukee, WI 53226, USA. vnilakan@mcw.edu
Abstract:
The role of mitochondrial K(ATP) (mitoK(ATP)) channels in renal ischemia-reperfusion injury is controversial with studies showing both protective and deleterious effects. In this study, we compared the effects of the putative mitoK(ATP) opener, diazoxide, and the mitoK(ATP) blocker, 5-hydroxydecanoate (5-HD) on cytotoxicity and apoptosis in tubular epithelial cells derived from rat (NRK-52E) and pig (LLC-PK1) following in vitro ischemic injury. Following ATP depletion-recovery, there was a significant increase in cytotoxicity in both NRK cells and LLC-PK1 cells although NRK cells were more sensitive to the injury. Diazoxide treatment attenuated cytotoxicity in both cell types and 5-HD treatment-increased cytotoxicity in the sensitive NRK cells in a superoxide-dependant manner. The protective effect of diazoxide was also reversed in the presence of 5-HD in ATP-depleted NRK cells. The ATP depletion-mediated increase in superoxide was enhanced by both diazoxide and 5-HD with the effect being more pronounced in the cells undergoing 5-HD treatment. Further, ATP depletion-induced activation of caspase-3 was decreased by diazoxide in NRK cells. In order to determine the signaling pathways involved in apoptosis, we examined the activation of Erk and JNK in ATP-depleted NRK cells. Diazoxide-activated Erk in ATP-depleted cells, but did not have any effect on JNK activation. In contrast, 5-HD did not impact Erk levels but increased JNK activation even under controlled conditions. Further, the use of a JNK inhibitor with 5-HD reversed the deleterious effects of 5-HD. This study demonstrates that in cells that are sensitive to ATP depletion-recovery, mitoK(ATP) channels protect against ATP depletion-mediated cytotoxicity and apoptosis through Erk- and JNK-dependant mechanisms.
Insights
Mitochondrial K(ATP) channels play a protective role in kidney injury. Opening these channels with diazoxide reduced cell damage, while blocking them with 5-hydroxydecanoate worsened it, involving specific cell signaling pathways.
Area of Science:
- Cell Biology
- Renal Physiology
- Mitochondrial Medicine
Background:
- The role of mitochondrial K(ATP) (mitoK(ATP)) channels in renal ischemia-reperfusion injury remains debated, with conflicting evidence on their protective or detrimental effects.
- Understanding these effects is crucial for developing targeted therapies for kidney injury.
Purpose of the Study:
- To investigate the specific roles of mitoK(ATP) channel openers (diazoxide) and blockers (5-hydroxydecanoate) in cellular response to in vitro ischemic injury.
- To elucidate the underlying mechanisms, including cytotoxicity, apoptosis, and key signaling pathways (Erk, JNK).
Main Methods:
- Utilized rat (NRK-52E) and pig (LLC-PK1) tubular epithelial cells subjected to in vitro ischemic injury via ATP depletion-recovery.
- Administered diazoxide (mitoK(ATP) opener) and 5-hydroxydecanoate (5-HD, mitoK(ATP) blocker) to assess effects on cytotoxicity, apoptosis, superoxide production, and signaling pathways (caspase-3, Erk, JNK).
Main Results:
- Diazoxide attenuated cytotoxicity and decreased caspase-3 activation in sensitive NRK cells, while 5-HD exacerbated cytotoxicity in a superoxide-dependent manner.
- Diazoxide activated Erk signaling, whereas 5-HD increased JNK activation, and inhibiting JNK reversed 5-HD's detrimental effects.
- Both agents increased superoxide production during ATP depletion, with a more pronounced effect observed with 5-HD.
Conclusions:
- MitoK(ATP) channels exert a protective effect against ATP depletion-mediated cytotoxicity and apoptosis in sensitive renal tubular cells.
- The protective mechanisms involve modulation of Erk and JNK signaling pathways, highlighting their therapeutic potential in renal injury.
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