The role of Vpr-mediated cell cycle dysregulation in HIV-associated kidney disease

项目总结 随着联合抗逆转录病毒药物的广泛使用，HIV相关性肾病的发病率 (HIVAN)在最近几年急剧下降。然而，慢性肾脏疾病(CKD)的患病率 艾滋病毒携带者患终末期肾病的比例仍然很高，这表明艾滋病毒容易患上 患者患慢性肾脏疾病的风险增加。事实上，最近有几行证据表明 流行病学和动物模型研究表明，同时感染艾滋病毒和与年龄有关的共病， 如糖尿病，对慢性肾脏疾病的发病率有协同作用，从而 有必要对HIV感染的机制进行检查，即使在低病毒负荷下也是如此 慢性肾脏病的进展。在HIV-1病毒蛋白中，我们先前发现HIV病毒蛋白R(VPR)可以 诱导肾小管细胞周期紊乱、细胞凋亡和多倍体。然而，重要性和 VPR介导的细胞周期停滞和多倍体的后果在 肾脏疾病。在这项提案中，我们将进一步剖析决定VPR细胞命运的机制- 用体外方法表达肾小管(目标1)。同样，使用表达VPR的转基因小鼠在 肾小管上皮细胞，我们将在单细胞上表征细胞周期失调和基因表达 水平，并确定细胞周期失调的药物干预是否可以减弱 该模型中的肾脏疾病进展，以及HIVAN小鼠模型TG26(目标2)。为了补充 在目标1和目标2中，我们将评估肾脏活检中基因和细胞周期调节因子的表达。 HIV+CKD患者样本(目标3)。我们还将执行转录特征分析以进行比较分析 在小鼠肾脏上的发现。我们的结果将提供对潜在分子的更好的理解 慢性HIV感染加速慢性肾脏病进展的机制和概念验证 HIV患者慢性肾脏病的新靶向治疗。

PROJECT SUMMARY With the widespread use of combination antiretroviral agents, the incidence of HIV-associated nephropathy (HIVAN) has dramatically decreased in the recent years. Yet, the prevalence of chronic kidney disease (CKD) and end-stage kidney disease in patients living with HIV remains high, suggesting that HIV predisposes patients to increased risk for chronic kidney disease. Indeed, several lines of evidence from recent epidemiological and animal model studies indicate that concurrent HIV infection and age-related comorbidities, such as diabetes mellitus, have a synergistic effect on the incidence of chronic kidney disease, thereby necessitating an examination of mechanisms by which HIV infection even at low viral load accelerates the progression of CKD. Among the HIV-1 viral proteins, we previously showed that HIV viral protein R (Vpr) can induce cell cycle dysregulation, apoptosis, and polyploidy in renal tubular cells. However, the importance and consequences of Vpr-mediated cell cycle arrest and polyploidy has not been fully explored in the setting of kidney disease. In this proposal, we will further dissect the mechanisms dictating the cell fates of Vpr- expressing renal tubular using in vitro approaches (Aim 1). Similarly, using transgenic mice expressing Vpr in renal tubular epithelial cells, we will characterize the cell cycle dysregulation and gene expression at single-cell levels, and determine whether the pharmacological intervention of cell cycle dysregulation can attenuate kidney disease progression in this model, as well as in HIVAN mouse model, Tg26 (Aim 2). To complement the findings in Aims 1 and 2, we will assess the expression of genes and cell cycle regulators in kidney biopsy samples of HIV+ CKD patients (Aim 3). We will also perform transcriptomic profiling for comparative analyses with findings in murine kidneys. Our results will provide a better understanding of the underlying molecular mechanisms by which chronic HIV infection accelerates the progression of CKD and a proof-of-concept for novel target treatment for CKD in HIV patients.