Repository logo
 

Ischemia-reperfusion injury in renal transplantation: 3 key signaling pathways in tubular epithelial cells.

Published version
Peer-reviewed

Type

Article

Change log

Authors

Smith, Stephanie F 
Hosgood, Sarah A 
Nicholson, Michael L 

Abstract

Renal ischemia-reperfusion injury (IRI) is a significant clinical challenge faced by clinicians perioperatively in kidney transplantation. Recent work has demonstrated the key importance of transmembrane receptors in the injured tubular epithelial cell, most notably Toll-like receptors, activated by exogenous and endogenous ligands in response to external and internal stresses. Through sequential protein-protein interactions, the signal is relayed deep into the core physiological machinery of the cell, having numerous effects from upregulation of pro-inflammatory gene products through to modulating mitochondrial respiration. Inter-pathway cross talk facilitates a co-ordinated response at an individual cellular level, as well as modulating the surrounding tissue's microenvironment through close interactions with the endothelium and circulating leukocytes. Defining the underlying cellular cascades involved in IRI will assist the identification of novel interventional targets to attenuate IRI with the potential to improve transplantation outcomes. We present a focused review of 3 key cellular signalling pathways in the injured tubular epithelial cell that have been the focus of much research over the past 2 decades: toll-like receptors, sphingosine-1-phosphate receptors and hypoxia inducible factors. We provide a unique perspective on the potential clinical translations of this recent work in the transplant setting. This is particularly timely with the recent completion of phase I and ongoing phase 2 clinical trials of inhibitors targeting specific components of these signaling cascades.

Description

Keywords

ischemia-reperfusion injury, tubular epithelial cells, Allografts, Basic Helix-Loop-Helix Transcription Factors, Clinical Trials, Phase II as Topic, Epithelial Cells, Humans, Hypoxia-Inducible Factor 1, Kidney Failure, Chronic, Kidney Transplantation, Kidney Tubules, Receptors, Lysosphingolipid, Reperfusion Injury, Signal Transduction, Toll-Like Receptors

Journal Title

Kidney Int

Conference Name

Journal ISSN

0085-2538
1523-1755

Volume Title

95

Publisher

Elsevier BV