INTRODUCTION: This study was designed to investigate whether renal ��-klotho levels are associated with renal pathology. This is the first report on patients with chronic kidney disease (CKD). METHODS: We conducted a retrospective observational study. A total of 65 CKD patients were enrolled. Serum and renal biopsy samples were collected. Estimated glomerular filtration rate (eGFR) was examined by biochemical test. And ��-klotho expressions were assessed by RT-PCR and immunohistochemistry. In addition, detailed microscopic findings were reviewed. RESULTS: Renal ��-klotho levels are associated positively with eGFR, and negatively with renal pathology, including interstitial fibrosis, inflammatory cell infiltration, and tubular atrophy. CONCLUSIONS: The renal ��-klotho is related to renal pathology.
Kuroo M, Matsumura Y, Aizawa H, Kawaguchi H, Suga T, Utsugi T, et al. Mutation of the mouse klotho gene leads to a syndrome resembling ageing. Nature. 1997;390:45���51.
Ohyama Y, Kurabayashi M, Masuda H, Nakamura T, Aihara Y, Kaname T, et al. Molecular cloning of rat klotho cDNA: markedly decreased expression of klotho by acute inflammatory stress. Biochem Biophys Res Commun. 1998;251:920���925.
Haruna Y, Kashihara N, Satoh M, Tomita N, Namikoshi T, Sasaki T, et al. Amelioration of progressive renal injury by genetic manipulation of klotho gene. Proc Natl Acad Sci USA. 2007;104:2331���2336.
Sakan H, Nakatani K, Asai O, Imura A, Tanaka T, Yoshimoto S, et al. Reduced renal �����klotho expression in CKD patients and its effect on renal phosphate handling and vitamin D metabolism. PLoS One. 2014;9:e86301.
Doi S, Zou Y, Togao O, Pastor JV, John GB, Wang L, et al. Klotho inhibits transforming growth factor���beta1 (TGF���beta1) signaling and suppresses renal fibrosis and cancer metastasis in mice. J Biol Chem. 2011;286:8655���8665.
Liu QF, Ye JM, Deng ZY, Yu LX, Sun Q, Li SS. Ameliorating effect of klotho on endoplasmic reticulum stress and renal fibrosis induced by unilateral ureteral obstruction. Iran J Kidney Dis. 2015;9:291���297.
Wu YL, Xie J, An SW, Oliver N, Barrezueta NX, Lin MH, et al. Inhibition of TRPC6 channels ameliorates renal fibrosis and contributes to renal protection by soluble klotho. Kidney Int. 2017;91:830���841.
Zhou L, Mo H, Miao J, Zhou D, Tan RJ, Hou FF, et al. Klotho ameliorates kidney injury and fibrosis and normalizes blood pressure by targeting the renin���angiotensin system. Am J Pathol. 2015;185:3211���3223.
Levey AS, Coresh J, Greene T, Stevens LA, Zhang YL, Hendriksen S, et al. Using standardized serum creatinine values in the modification of diet in renal disease study equation for estimating glomerular filtration rate. Ann Intern Med. 2006;145:247���254.
Chen J, Zhang X, Zhang H, Lin J, Zhang C, Wu Q, et al. Elevated klotho promoter methylation is associated with severity of chronic kidney disease. PLoS One. 2013;8:e79856.
Lindberg K, Amin R, Moe OW, Hu MC, Erben RG, ��stman Wernerson A, et al. The kidney is the principal organ mediating klotho effects. J Am Soc Nephrol. 2014;25:2169���2175.
Mart��n���V��rgala J, Fern��ndez���Villabrille S, Mart��n���Carro B, Tamargo���G��mez I, Navarro���Gonz��lez JF, Mora���Fern��ndez C, et al. Serum and urinary soluble �����klotho as markers of kidney and vascular impairment. Nutrients. 2023;15:1470.
Chang JR, Guo J, Wang Y, Hou YL, Lu WW, Zhang JS, et al. Intermedin1���53 attenuates vascular calcification in rats with chronic kidney disease by upregulation of �����klotho. Kidney Int. 2016;89:586���600.
Mytych J, Romerowicz���Misielak M, Koziorowski M. Klotho protects human monocytes from LPS���induced immune impairment associated with immunosenescent���like phenotype. Mol Cell Endocrinol. 2018;470:1���13.
Zhao Y, Banerjee S, Dey N, LeJeune WS, Sarkar PS, Brobey R, et al. Klotho depletion contributes to increased inflammation in kidney of the db/db mouse model of diabetes via RelA (serine)536 phosphorylation. Diabetes. 2011;60:1907���1916.
Liu F, Wu S, Ren H, Gu J. Klotho suppresses RIG���I���mediated senescence���associated inflammation. Nat Cell Biol. 2011;13:254���262.
Typiak M, Piwkowska A. Antiinflammatory actions of klotho: implications for therapy of diabetic nephropathy. Int J Mol Sci. 2021;22:956.
Grants
LY15H050006/Natural Science Foundation of Zhejiang Province
20160533B62/Hangzhou Science and Technology Bureau
81803911/National Natural Science Foundation of China