The role of AMP-activated protein kinase α1-mediated endoplasmic reticulum stress in alleviating the toxic effect of uremic toxin indoxyl sulfate on vascular endothelial cells by Klotho

J Appl Toxicol. 2021 Sep;41(9):1446-1455. doi: 10.1002/jat.4135. Epub 2021 Jan 17.

Abstract

Recently, the Klotho protein (Klotho) has received substantial attention as protective factor against cardiovascular complications of chronic kidney disease (CKD). However, the direct effect and mechanism of Klotho on endothelial cells injury are not well-known. In this study, we incubated human vein umbilical endothelial cells (HUVECs) with uremic toxin indoxyl sulfate (IS) to mimic CKD internal environment and investigated the direct effect of Klotho on the HUVECs injury induced by IS and to explore the mechanism in this process. We found IS inhibited cell viability, increased endoplasmic reticulum stress, and mediated apoptosis of HUVECs. Treatment with Klotho significantly attenuated IS-induced above effects. Furthermore, Klotho alleviated the IS toxic effect on HUVECs via promoting AMP-activated protein kinase (AMPK) α1 phosphorylation instead of directly upregulating AMPKα1, which could be partly blocked by AMPK pathway inhibitor-Compound C. In addition, Klotho also inhibited intercellular adhesion molecule-1 (ICAM-1) and vascular cell adhesion molecule-1 (VCAM-1) expression induced by IS. Altogether, these results indicated that Klotho can protect HUVECs from IS-induced injury by alleviating AMPKα1-mediated endoplasmic reticulum stress.

Keywords: AMP-activated protein kinase α1; Klotho protein; endoplasmic reticulum stress; indoxyl sulfate; uremic toxin.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • AMP-Activated Protein Kinases / antagonists & inhibitors
  • AMP-Activated Protein Kinases / drug effects*
  • Apoptosis / drug effects
  • Cell Survival / drug effects
  • Endoplasmic Reticulum Chaperone BiP / metabolism
  • Endoplasmic Reticulum Stress / drug effects*
  • Enzyme Inhibitors / pharmacology
  • Human Umbilical Vein Endothelial Cells / drug effects*
  • Humans
  • Indican / toxicity*
  • Intercellular Adhesion Molecule-1 / drug effects
  • Klotho Proteins / metabolism*
  • RNA, Small Interfering / pharmacology
  • Renal Insufficiency, Chronic / metabolism
  • Transcription Factor CHOP / metabolism
  • Uremic Toxins / toxicity*
  • Vascular Cell Adhesion Molecule-1 / drug effects

Substances

  • DDIT3 protein, human
  • Endoplasmic Reticulum Chaperone BiP
  • Enzyme Inhibitors
  • HSPA5 protein, human
  • KLB protein, human
  • RNA, Small Interfering
  • Uremic Toxins
  • Vascular Cell Adhesion Molecule-1
  • Intercellular Adhesion Molecule-1
  • Transcription Factor CHOP
  • AMP-Activated Protein Kinases
  • Klotho Proteins
  • Indican