The PI3K/Akt/mTOR pathway in polycystic kidney disease: A complex interaction with polycystins and primary cilium

Jean Piero Margaria1, Carlo Cosimo Campa2, Maria Chiara De Santis1

  • 1Molecular Biotechnology Center, Department of Molecular Biotechnology and Health Sciences, University of Torino, Torino 10126, Italy.

Cellular Signalling
|November 13, 2019
PubMed

Insights

Over-activation of the PI3K/Akt/mTOR pathway drives cell hyper-proliferation in polycystic kidney disease (PKD). Targeting mTOR shows promise, but its complex interactions with polycystins and phosphoinositides are key for effective PKD treatments.

Area of Science:

  • Cell biology
  • Molecular medicine
  • Renal pathophysiology

Background:

  • The PI3K/Akt/mTOR pathway is crucial for cell growth and metabolism.
  • Aberrant activation of this network contributes to hyper-proliferation in diseases like cancer and polycystic kidney disease (PKD).
  • In PKD, mTOR signaling promotes cystogenesis by increasing kidney tubule epithelial cell proliferation, size, and metabolism.

Purpose of the Study:

  • To review recent findings on mTOR activation mechanisms in kidney tubule epithelial cells and cyst formation.
  • To discuss the upstream regulation of mTOR by the PI3K/Akt axis in the context of PKD.
  • To explore the interplay between the PI3K/Akt/mTOR network and cyst formation suppression pathways, including polycystins and phosphoinositides.

Main Methods:

  • Literature review of pre-clinical and clinical studies on mTOR inhibition in PKD.
  • Analysis of molecular mechanisms underlying mTOR activation in kidney tubule cells.
  • Dissection of signaling network interactions, including PI3K/Akt/mTOR, polycystins, and phosphoinositides.

Main Results:

  • mTOR cascade significantly contributes to cyst growth in PKD by enhancing cell proliferation, size, and metabolism.
  • Pre-clinical studies show positive results with mTOR inhibition, while clinical trials have been less conclusive.
  • Complex interactions exist between mTORC1 and polycystins, with reciprocal negative regulation observed.
  • Phosphoinositides, modulated by PI3K, play emerging roles in primary cilium signaling, cell polarization, and cyst formation protection.

Conclusions:

  • The PI3K/Akt/mTOR network's role in PKD extends beyond mitogenic signaling, impacting kidney tubule homeostasis and morphogenesis.
  • Understanding these complex interactions is vital for developing more effective therapeutic strategies for PKD.
  • Targeting the PI3K/Akt/mTOR pathway, considering its intricate connections, holds potential for future PKD clinical trials.

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