AN ENDOTHELIN-1 MEDIATED AUTOCRINE GROWTH LOOP INVOLVED IN HUMAN RENAL TUBULAR REGENERATION

Renal tubules have the capacity to regenerate following injury. We have investigated the possibility that tubular-derived endothelins, acting as autocrine growth factors, may be involved in this response in human kidney. ET-1 immunoreactivity was demonstrated by immunohistochemical staining in proximal tubules, distal cortical tubules and medullary collecting ducts of human kidney. In cultured human renal proximal tubular cells, RNAase protection assays demonstrated the expression of ET-1 and ET-2 mRNA's, and radioimmunoassay, following separation of conditioned medium by reverse phase HPLC, showed immunoreactive material which co-eluted with ET-1 and ET-2. Competition binding studies revealed the presence of at least two types of endothelin receptor: one with high and one with low affinity for ET-3 relative to ET-1. Analysis of cellular RNA by RT-PCR demonstrated expression of mRNA's for both ET(A) and ET(B) receptor subtypes. Combined blockade of ET(A) and ET(B) receptors (by PD-145065) but not that of ET(A) receptors alone (by BQ-123) blocked the mitogenic effect of exogenous or endogenous ET-1 and also profoundly suppressed endogenous ET-1 synthesis. By contrast, incubation with the ET(B) receptor agonist, BQ-3020, stimulated endogenous ET-1 synthesis. Exposure of the cells to hypoxia (1% O-2 for 16 to 24 hr) resulted in specific up-regulation of ET-1 but not ET-2 gene expression. These findings reveal the existence of a hypoxia-inducible, autocrine growth system in human proximal tubular cells, which is mediated by ET-1 through the ET(B) receptor, and which could function in vivo as an autoregenerative system for restoring tubular integrity after injury. The widespread distribution of ET-1 peptide in different tubular segments suggests that ET-1 mediated tubular regeneration may also occur in other nephron segments.