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Updated: Oct 15, 2025

Mechanism of Kemeng Fang's Inhibition of Podocyte Apoptosis in Rats with Membranous Nephropathy through the PI3K/AKT Signaling Pathway
Published on: August 23, 2024
Rapamycin attenuates PLA2R activation-mediated podocyte apoptosis via the PI3K/AKT/mTOR pathway
Terry Ting-Yu Chiou1, You-Ying Chau2, Jin-Bor Chen3
1Division of Nephrology, Department of Internal Medicine, Kaohsiung Chang Gung Memorial Hospital and Chang Gung University College of Medicine, Kaohsiung 83301, Taiwan; School of Medicine, Chung Shan Medical University, Taichung 40201, Taiwan.
Abstract:
Membranous nephropathy (MN) is the most common cause of nephrotic syndrome in adults without diabetes. Primary MN has been associated with circulating antibodies against native podocyte antigens, including phospholipase A2 receptor (PLA2R); however, precision therapy targeting the signaling cascade of PLA2R activation is lacking. Both PLA2R and the mammalian target of rapamycin (mTOR) exist in podocytes, but the interplay between these two proteins and their roles in MN warrants further exploration. This study aimed to investigate the crosstalk between PLA2R activation and mTOR signaling in a human podocyte cell line. We demonstrated that podocyte apoptosis was induced by Group IB secretory phospholipase A2 (sPLA2IB) in a concentration- and time-dependent manner via upregulation of phosphoinositide 3-kinase (PI3K), protein kinase B (AKT), and mTOR, and inhibited by rapamycin or LY294002. Furthermore, aberrant activation of the PI3K/AKT/mTOR pathway triggers both extrinsic (caspase-8 and caspase-3) and intrinsic (Bcl-2-associated X protein [BAX], B-cell lymphoma 2 [BCL-2], cytochrome c, caspase-9, and caspase-3) apoptotic cascades in podocytes. The therapeutic implications of our findings are that strategies to reduce PLA2R activation and PI3K/AKT/mTOR pathway inhibition in PLA2R-activated podocytes help protect podocytes from apoptosis. The therapeutic potential of rapamycin shown in this study provides cellular evidence supporting the repurposing of rapamycin for MN treatment.
Insights
Group IB secretory phospholipase A2 (sPLA2IB) triggers podocyte apoptosis via the PI3K/AKT/mTOR pathway in membranous nephropathy (MN). Rapamycin inhibits this pathway, offering potential therapeutic benefits for MN.
Area of Science:
- Nephrology
- Cell Biology
- Molecular Medicine
Background:
- Membranous nephropathy (MN) is a leading cause of nephrotic syndrome in adults, often linked to antibodies against phospholipase A2 receptor (PLA2R).
- The precise signaling pathways involved in PLA2R-mediated podocyte injury and potential therapeutic targets remain incompletely understood.
- The mammalian target of rapamycin (mTOR) pathway's role in podocyte function and its interplay with PLA2R signaling in MN require further investigation.
Purpose of the Study:
- To elucidate the crosstalk between phospholipase A2 receptor (PLA2R) activation and mammalian target of rapamycin (mTOR) signaling in human podocytes.
- To investigate the role of Group IB secretory phospholipase A2 (sPLA2IB) in podocyte apoptosis and its association with the phosphoinositide 3-kinase (PI3K)/protein kinase B (AKT)/mTOR pathway.
- To evaluate the potential of rapamycin and LY294002 in mitigating sPLA2IB-induced podocyte apoptosis.
Main Methods:
- Utilized a human podocyte cell line exposed to Group IB secretory phospholipase A2 (sPLA2IB).
- Assessed podocyte apoptosis and the activation status of the PI3K/AKT/mTOR pathway.
- Investigated the effects of pharmacological inhibitors, including rapamycin and LY294002, on sPLA2IB-induced cellular changes.
- Analyzed the expression of key proteins involved in both extrinsic and intrinsic apoptotic cascades.
Main Results:
- sPLA2IB induced podocyte apoptosis in a concentration- and time-dependent manner.
- sPLA2IB-induced apoptosis was mediated by the upregulation of the PI3K/AKT/mTOR pathway.
- Inhibition of the PI3K/AKT/mTOR pathway by rapamycin or LY294002 significantly reduced sPLA2IB-induced podocyte apoptosis.
- Aberrant PI3K/AKT/mTOR activation was found to trigger both extrinsic (caspase-8, caspase-3) and intrinsic (BAX, BCL-2, cytochrome c, caspase-9, caspase-3) apoptotic pathways.
Conclusions:
- PLA2R activation by sPLA2IB promotes podocyte apoptosis through the PI3K/AKT/mTOR signaling cascade.
- Inhibiting the PI3K/AKT/mTOR pathway offers a protective effect against podocyte apoptosis in the context of PLA2R activation.
- Rapamycin demonstrates therapeutic potential for membranous nephropathy by protecting podocytes from apoptosis, supporting its repurposing for MN treatment.
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