The hormetic functions of Wnt pathways in tubular injury

Elisabeth F Gröne1, Giuseppina Federico1, Peter J Nelson2

  • 1Department of Cellular and Molecular Pathology, German Cancer Research Center (DKFZ), Im Neuenheimer Feld 280, 69120, Heidelberg, Germany.

Insights

Dickkopf 3 (DKK3) drives chronic kidney disease (CKD) progression by promoting fibrosis. Inhibiting DKK3 improved kidney function and reduced fibrosis, highlighting DKK3 as a potential therapeutic target and urinary biomarker for CKD.

Area of Science:

  • Nephrology
  • Molecular Biology
  • Pathology

Background:

  • Chronic kidney disease (CKD) is characterized by tubulointerstitial damage, tubular atrophy, and fibrosis, which predict disease progression.
  • Wnt signaling pathways are implicated in both the fibrosis of CKD and the regeneration following acute kidney injury.
  • The dual role of Wnt signaling necessitates a deeper understanding of its specific mediators in chronic fibrotic kidney disease.

Purpose of the Study:

  • To investigate the role of Dickkopf 3 (DKK3) in the pathogenesis of chronic kidney disease (CKD).
  • To determine if DKK3 acts as an agonist for Wnt signaling in the context of CKD-associated tubulointerstitial fibrosis.
  • To evaluate the therapeutic potential of inhibiting DKK3 and its utility as a non-invasive biomarker for CKD.

Main Methods:

  • Utilized genetic and antibody-mediated inhibition strategies to block Dickkopf 3 (DKK3) activity in experimental models of CKD.
  • Assessed the impact of DKK3 inhibition on tubular epithelial differentiation and interstitial fibrosis.
  • Analyzed urinary DKK3 levels as a potential non-invasive biomarker for the extent of CKD in human patients.

Main Results:

  • Demonstrated that Dickkopf 3 (DKK3) acts as an agonist for canonical Wnt signaling in chronic kidney disease (CKD).
  • Showed that DKK3 promotes chronic fibrosing inflammation within the tubulointerstitial compartment.
  • Confirmed that genetic and antibody-mediated inhibition of DKK3 significantly improves tubular differentiation and reduces renal fibrosis.
  • Validated urinary DKK3 as a non-invasive biomarker correlating with the extent of CKD in humans.

Conclusions:

  • Dickkopf 3 (DKK3) is a key driver of fibrosing inflammation and tubular atrophy in chronic kidney disease (CKD).
  • Inhibition of DKK3 offers a promising therapeutic strategy for mitigating CKD progression and improving kidney structure.
  • Urinary Dickkopf 3 (DKK3) represents a valuable non-invasive biomarker for assessing CKD severity.

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