Renal fibrosis is an unavoidable end result of all forms of progressive chronic kidney diseases(CKD).Discovery of efficacious drugs against renal fibrosis is in crucial need.In a preliminary study we found that a derivative of artemisinin,dihydroartemisinin(DHA),exerted strong renoprotection,and reversed renal fibrosis in adenine-induced CKD mouse model.In this study we investigated the anti-fibrotic mechanisms of DHA,particularly its specific target in renal cells.Renal fibrosis was induced in mice by unilateral ureteral obstruction(UUO)or oral administration of adenine(80 mg·kg-1),the mice received DHA(30 mg·kg-1·d-1,i.g.)for 14 or 21 days,respectively.We showed that DHA administration markedly attenuated the inflammation and fibrotic responses in the kidneys and significantly improved the renal function in both the renal fibrosis mouse models.In adenine-treated mice,DHA was more effective than 5-azacytidine against renal fibrosis.The anti-fibrotic effects of DHA were also observed in TGF-β1-treated HK-2 cells.In order to determine the target protein of DHA,we conducted pull-down technology coupled with shotgun proteomics using a small-molecule probe based on the structure of DHA(biotin-DHA).As a results,DNA methyltransferase 1(DNMT1)was identified as the anti-fibrotic target of DHA in 3 different types of renal cell lines(HK-2,HEK293 and 3T3).We demonstrated that DHA directly bound to Asn 1529 and Thr 1528 of DNMT1 with a Kd value of 8.18 μM.In primary mouse renal tubular cells,we showed that DHA(10 μM)promoted DNMT1 degradation via the ubiquitin-proteasome pathway.DHA-reduced DNMT1 expression effectively reversed Klotho promoter hypermethylation,which led to the reversal of Klotho protein loss in the kidney of UUO mice.This subsequently resulted in inhibition of the Wnt/β-catenin and TGF-β/Smad signaling pathways and consequently conferred renoprotection in the animals.Knockdown of Klotho abolished the renoprotective effect of DHA in UUO mice.Our study reveals a novel pharmacological activity for DHA,i.e.,renoprotection.DHA exhibits this effect by targeting DNMT1 to reverse Klotho repression.This study provides an evidence for the possible clinical application of DHA in the treatment of renal fibrosis.

Wei Zhou;Min-min Chen;Hui-ling Liu;Zi-lin Si;Wen-hui Wu;Hong Jiang;Lin-xiao Wang;Nosratola D.Vaziri;Xiao-fei An;Ke Su;Cheng Chen;Ning-hua Tan;Zhi-hao Zhang

State Key Laboratory of Natural Medicines,Department of TCMs Pharmaceuticals,School of Traditional Chinese Pharmacy,China Pharmaceutical University,Nanjing 210009,China;Division of Nephrology and Hypertension,School of Medicine,University of California Irvine,Irvine,CA,USA;Affiliated Hospital of Nanjing University of Chinese Medicine,Nanjing 210023,China;Department of Nephrology,Renmin Hospital of Wuhan University,Wuhan 430060,China

中国药理学报（英文版）

[1]Wei Zhou;Min-min Chen;Hui-ling Liu;Zi-lin Si;Wen-hui Wu;Hong Jiang;Lin-xiao Wang;Nosratola D.Vaziri;Xiao-fei An;Ke Su;Cheng Chen;Ning-hua Tan;Zhi-hao Zhang-.Dihydroartemisinin suppresses renal fibrosis in mice by inhibiting DNA-methyltransferase 1 and increasing Klotho)[J].中国药理学报（英文版）,2022(10):2609-2623

renoprotection,renoprotective

Dihydroartemisinin,suppresses,renal,fibrosis,mice,by,inhibiting,methyltransferase,increasing,Klotho,Renal,unavoidable,end,forms,progressive,chronic,diseases,CKD,Discovery,efficacious,drugs,against,crucial,need,In,preliminary,study,found,that,derivative,dihydroartemisinin,DHA,exerted,strong,reversed,adenine,induced,mouse,this,investigated,anti,fibrotic,mechanisms,particularly,specific,cells,was,unilateral,ureteral,obstruction,UUO,oral,administration,received,days,respectively,We,showed,markedly,attenuated,inflammation,responses,kidneys,significantly,improved,function,both,models,treated,more,than,azacytidine,effects,were,also,observed,TGF,HK,order,determine,protein,conducted,pull,technology,coupled,shotgun,proteomics,using,small,molecule,probe,structure,biotin,results,DNMT1,identified,different,types,lines,HEK293,3T3,demonstrated,directly,bound,Asn,Thr,Kd,value,primary,tubular,promoted,degradation,via,ubiquitin,proteasome,reduced,expression,effectively,promoter,hypermethylation,which,reversal,loss,This,subsequently,resulted,inhibition,Wnt,catenin,Smad,signaling,pathways,consequently,conferred,animals,Knockdown,abolished,Our,reveals,novel,pharmacological,activity,exhibits,targeting,repression,provides,evidence,possible,clinical,application,treatment

0.504321