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Activin A and Cell-Surface GRP78 Are Novel Targetable RhoA Activators for Diabetic Kidney Disease
Authors:Asfia Soomro  Jackie Trink  Kian O&#x;Neil  Renzhong Li  Safaa Naiel  Bo Gao  Kjetil Ask  Joan C Krepinsky
Affiliation:1.Division of Nephrology, Department of Medicine, McMaster University, Hamilton, ON L8N 4A6, Canada; (A.S.); (J.T.); (K.O.); (R.L.); (B.G.);2.Division of Respirology, Department of Medicine, McMaster University, Hamilton, ON L8N 4A6, Canada; (S.N.); (K.A.)
Abstract:Diabetic kidney disease (DKD) is the leading cause of kidney failure. RhoA/Rho-associated protein kinase (ROCK) signaling is a recognized mediator of its pathogenesis, largely through mediating the profibrotic response. While RhoA activation is not feasible due to the central role it plays in normal physiology, ROCK inhibition has been found to be effective in attenuating DKD in preclinical models. However, this has not been evaluated in clinical studies as of yet. Alternate means of inhibiting RhoA/ROCK signaling involve the identification of disease-specific activators. This report presents evidence showing the activation of RhoA/ROCK signaling both in vitro in glomerular mesangial cells and in vivo in diabetic kidneys by two recently described novel pathogenic mediators of fibrosis in DKD, activins and cell-surface GRP78. Neither are present in normal kidneys. Activin inhibition with follistatin and neutralization of cell-surface GRP78 using a specific antibody blocked RhoA activation in mesangial cells and in diabetic kidneys. These data identify two novel RhoA/ROCK activators in diabetic kidneys that can be evaluated for their efficacy in inhibiting the progression of DKD.
Keywords:diabetic kidney disease  RhoA  Rho-kinase  fibrosis  activins  cell-surface GRP78
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