Annexin A1 tripeptide mimetic increases sirtuin-3 to augment mitochondrial function and limit ischemic kidney injury

Abstract

BackgroundAcute kidney injury (AKI) is one of the most common organ failures following surgery. We have developed a tripeptide mimetic (ANXA1sp) of the parent annexin A1 molecule that shows promise as an organ protectant limiting cellular stress; however, its potential as a kidney protective agent remains unexplored, and its mechanism of action is poorly understood. Our hypothesis was that ANXA1sp would limit kidney injury and improve mitochondrial function following surgical ischemic kidney injury. MethodsIn blinded fashion, wildtype mice were assigned to receive vehicle control or experimental drug (ANXA1sp) 1 hour prior to and 1 hour after kidney vascular clamping. Our primary outcome was assessment of kidney injury and function by measurement of serum creatinine and blood urea nitrogen (BUN) and histologic injury scoring of kidney tissue sections. Immunofluorescence microscopy, real-time PCR and western blot were used to assess cell death, oxidative stress, and mitochondrial biomarkers. An in vitro model of oxygen-glucose deprivation in immortalized kidney tubule cells was used. ResultsANXA1sp given prior to and after ischemic kidney injury abrogated ischemic AKI. ANXA1sp further limited kidney cell death and oxidative stress following ischemia. ANXA1sp significantly improved markers associated with mitochondrial DNA repair and mitochondrial biogenesis. ANXA1sp upregulated expression of the mitochondrial protectant sirtuin-3 (SIRT3) in the mitochondria of kidney tubular cells. Silencing of SIRT3 limited ANXA1sp-mediated protection against hypoxic cell death. ConclusionsANXA1sp limits kidney injury through upregulation of SIRT3 and consequent preservation of mitochondrial function. ANXA1sp holds considerable promise as a perioperative kidney protectant prior to ischemia inducing surgery and/or kidney transplantation.