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Proximal tubule ACE2 mediates early responses to hypertension by regulating intrarenal RAS and sodium homeostasis
Jacqueline M. Emathinger, Zhidan Xiang, Jonathan W. Nelson, Matthew W. Hagen, Nakyung Kim, David I. Ortiz-Melo, Natalie Mattocks, Jorge F. Giani, Dexter L. Lee, Hannah Hartman-Houstman, Donna L. Ralph, Alicia A. McDonough, Brianna Chen, Stan G. Louie, Thomas M. Coffman, Susan B. Gurley
Jacqueline M. Emathinger, Zhidan Xiang, Jonathan W. Nelson, Matthew W. Hagen, Nakyung Kim, David I. Ortiz-Melo, Natalie Mattocks, Jorge F. Giani, Dexter L. Lee, Hannah Hartman-Houstman, Donna L. Ralph, Alicia A. McDonough, Brianna Chen, Stan G. Louie, Thomas M. Coffman, Susan B. Gurley
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Research Article Cardiology Nephrology

Proximal tubule ACE2 mediates early responses to hypertension by regulating intrarenal RAS and sodium homeostasis

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Abstract

ACE2 is a membrane-bound monocarboxypeptidase strongly expressed in the renal proximal tubule (PT) with high affinity to degrade the vasopressor angiotensin II (AngII). We employed a mouse model of PT-specific ACE2 deletion (PT ACE2–KO) to demonstrate that the renal PT is a critical site for ACE2 regulation of blood pressure (BP) via modulation of the intrarenal renin-angiotensin system (RAS). While deletion of ACE2 from the PT had a minimal effect on baseline physiology, PT ACE2–KO mice were more susceptible to AngII hypertension than control mice. At day 5 of AngII infusion, the enhanced BP response was associated with cardiac hypertrophy, increased renal AngII levels, failure to suppress epithelial sodium channel (ENaC) γ cleavage, and increased sodium pump activity in PT ACE2–KO mice. Control mice instead increased renal ACE2 expression to reduce renal AngII accumulation and suppress intrarenal RAS activation, which offered protection from hypertension and complications. Transcriptional analysis corroborated changes in intrarenal RAS components and revealed alterations in distinct physiological pathways during AngII hypertension in PT ACE2–KO mice. Our studies provide evidence for alterations in ENaC regulation to contribute to the development of AngII hypertension and support PT-derived ACE2 as an integral member of the intrarenal RAS.

Authors

Jacqueline M. Emathinger, Zhidan Xiang, Jonathan W. Nelson, Matthew W. Hagen, Nakyung Kim, David I. Ortiz-Melo, Natalie Mattocks, Jorge F. Giani, Dexter L. Lee, Hannah Hartman-Houstman, Donna L. Ralph, Alicia A. McDonough, Brianna Chen, Stan G. Louie, Thomas M. Coffman, Susan B. Gurley

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Figure 1

Proximal tubule-specific deletion of ACE2.

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Proximal tubule-specific deletion of ACE2.
(A) PT ACE2–KO mice were gene...
(A) PT ACE2–KO mice were generated by crossing mice expressing Cre-recombinase downstream of the PEPCK promoter with ACE2-floxed mice. (B–D) Ace2 mRNA expression, ACE2 protein abundance and Coomassie brilliant blue loading control, and ACE2 activity in kidney cortex and medulla of PT ACE2–KO and Control mice. (E) IHC for ACE2 in the proximal tubule in Control kidneys. (F) ACE2 expression is decreased in PT ACE2–KO mice (representative images; n = 3 mice per group). (G) ACE2 is absent in Global KO mice. Hoechst DNA stain in blue, Lotus Tetragonolobus Lectin (LTL) proximal tubule marker in green, and ACE2 in magenta. Scale bar: 200 μm. Numeric data expressed as mean ± SEM and analyzed as a 2-way ANOVA with Šídák’s multiple-comparison post hoc analysis. n = 3 mice per group, **P < 0.01, ****P < 0.0001.

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