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J Am Soc Nephrol 15:299-305, 2004
© 2004 American Society of Nephrology


BASIC SCIENCE

Rescue of Defective Branching Nephrogenesis in Renal-Coloboma Syndrome by the Caspase Inhibitor, Z-VAD-fmk

Patsy Clark*, Alison Dziarmaga*, Michael Eccles{dagger},{ddagger} and Paul Goodyer*,{ddagger}

*Department of Human Genetics, McGill University, Montreal, Quebec, Canada; {dagger}Department of Pathology, University of Otago, Dunedin, New Zealand; {ddagger}Department of Pediatrics, McGill University, Montreal, Quebec, Canada.

Correspondence to Dr. Paul Goodyer, McGill University Montreal Children’s Hospital, 2300 Tupper Street, Room E222A, Montreal, Quebec, Canada H3H 1P3. Phone: 514-412-4400 ext 22584; Fax: 514-412-4359; E-mail: Paul.Goodyer{at}muhc.mcgill.ca


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
ABSTRACT. In renal-coloboma syndrome (RCS), null mutations of the PAX2 gene cause renal hypoplasia due to a congenital deficit of nephrons; affected individuals may develop renal insufficiency in childhood. During normal kidney development, PAX2, is expressed at high levels throughout the arborizing ureteric bud (UB); recent observations suggest that one of its key roles is to suppress apoptosis in this collecting duct lineage. The authors hypothesized that increased UB cell apoptosis due to PAX2 haploinsufficiency must directly influence the rate of branching morphogenesis in developing kidney and the number of nephrons that can be formed before birth, when nephrogenesis in humans comes to an end. If so, the authors reasoned that caspase inhibitors might be used to suppress unwanted UB cell apoptosis during kidney development in Pax21Neu mutant mice and rescue the genetic UB branching defect. E17.5 kidneys from Pax21Neu mutant mice had smaller (-25%) longitudinal cross-sectional area and 3.5-fold increase in collecting duct cell apoptosis versus wild-type littermates; mutant E13.5 kidney explants allowed to arborize for 50 h in vitro had 18% fewer terminal branches than wild-types. However, exposure to the caspase inhibitor, Z-VAD-fmk (25 µM), significantly increased terminal branch number in mutant explants (23%). It also increased branching in wild-type explants, apparently reflecting an effect of Z-VAD-fmk on basal apoptosis induced by ex vivo culture conditions. Similarly, when pregnant mice were injected daily with Z-VAD-fmk (10 µg/g weight from E10.5 to E17.5), apoptosis of Pax21Neu fetal collecting duct cells was suppressed to 40% of untreated mutants; by E14, terminal branch number was increased to 152% that of untreated litters. These studies support the hypothesis that PAX2 normally optimizes the rate of branching morphogenesis in fetal kidney by suppressing UB apoptosis. Furthermore, it suggests that caspase inhibitors can rescue the branching defect caused by PAX2 mutations.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
During normal kidney development, interactions between the arborizing ureteric bud (UB) and the metanephric mesenchyme (MM) generate the nephrons of each kidney. This process begins at 5 to 6 wk fetal age, when the UB emerges from the nephric duct, grows laterally into the undifferentiated mesenchyme, and begins to arborize. Each terminal branch of the UB signals adjacent MM cells to form the proximal portion of a nephron, which then fuses to the common collecting system. By about 1 mo before birth, when nephrogenesis comes to a halt, final nephron number has been determined by how many UB branching events have occurred in the intervening period. This crop of fetal nephrons will constitute the individual’s nephron endowment for life.

Nephron number varies widely from 0.3 to 1.3 million/kidney among normal humans (1,2). Children born at the lower end of this spectrum may have increased risk of hypertension or susceptibility to acquired renal disease later in life (3). In families with the autosomal dominant renal-coloboma syndrome (RCS), more severe renal hypoplasia and ocular colobomas are caused by mutations of a key developmental gene, PAX2 (4). Histopathologic studies of this condition indicate that patients with heterozygous PAX2 mutations have oligomeganephronia—residual nephrons are normally formed and glomeruli exhibit appropriate compensatory hypertrophy, but an absolute nephron deficit causes renal insufficiency (5).

The PAX2 gene encodes a nuclear transcription factor expressed in early stages of nephric duct formation, then in the UB, and finally in proximal elements of the metanephric mesenchyme during renal development. Recent evidence suggests that PAX2 may have multiple functions during renal development. It may determine cell fate during nephric duct formation (6), activate GDNF in metanephric mesenchyme (7), and activate cell adhesion molecules and cytoskeletal elements during conversion of metanephric mesenchyme into epithelial cells of the emerging nephron (8). However, the highest levels of PAX2 expression during renal development are seen in the arborizing UB, and we have recently shown that it appears to suppress programmed cell death pathways in that lineage (8,9). PAX2 strongly suppresses apoptosis in cultured renal cells (8), and we noted a striking increase in apoptotic (TUNEL-positive) UB cells of E15 fetal kidneys of mice heterozygous for the PAX21Neu mutation (9). We have hypothesized (10) that the principal factor causing oligomeganephronia in RCS is loss of PAX2 anti-apoptotic function in the branching UB. If so, we reasoned that it might be possible to rescue defective nephrogenesis in RCS by administration of a caspase inhibitor during renal development.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Genotyping of Pax21Neu Mutant Mice
To genotype 1NEU mice, a method was used that combined the use of polymerase chain reaction (PCR) and digestion by the restriction enzyme, XcmI (New England Biolabs, Beverly, MA). Specially designed primers were used to create a restriction site for XcmI that would not otherwise have been present (Figure 1A). The sense and antisense primers used were 5' GTGTGAACCAGCTCGGGGGTG 3' and 5' GCCCAGGATTTTGCTGACACAGCC 3', respectively. The actual reaction was done using 1x PCR buffer (Life Technologies-BRL, Burlington, ON), 0.7 mM MgCl2 (Life Technologies-BRL), 1 µM each of the sense and antisense primers, 0.06 mM dNTPs, 1 unit Taq polymerase (Life Technologies-BRL), 0.25 to 0.75 µg of DNA and distilled water to reach a final volume of 20 µl. The cycle began with a "hotstart" at 95°C for 3 min, followed by 35 cycles of 10 s at 95°C, 10 s at 61°C, and 20 s at 72°C, ending with an additional 3 min at 72°C and a 4°C soak. Three microliters of each of the amplified samples were digested for 1 h at 37°C with 1 unit XcmI restriction enzyme (New England Biolabs), 2 units NEB2 buffer and distilled water to reach the 20 µl final volume. The digested samples were then run on 10% polyacrylamide gels and visualized by ethidium bromide staining. Wild-type mice displayed one band at 166 bp, and heterozygous 1Neu mice showed two bands, one at 166 bp and another at 151 bp (Figure 1B). Homozygous 1Neu mice, if genotyped, would show one band at 151 bp. All samples of DNA used for genotyping were obtained using the Wizard DNA Purification Kit (Promega, Madison, WI).



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Figure 1. Genotyping Pax21Neu mice. For genotyping of Pax21Neu mice, PCR primers were designed to include a G for T substitution, creating a recognition site for XcmI in the 1Neu mutant but not the wild-type sequence (A). Xcm1 restriction of the resultant PAX2 PCR products from genomic DNA allowed identification of a shorter (151-bp) band in heterozygous mutants versus the 166-bp wild-type product after resolution in polyacrylamide gels. Representative wild-type (166-bp) and Pax21Neu mutant (151-bp) bands are seen (B).

 
Microdissection and Culture of Whole Fetal Kidneys in Presence of Z-VAD-fmk
Once C3H females (Charles River, St. Constant, QC) were impregnated, the litters were allowed to mature to embryonic day 13.5. At that time, the mother was sacrificed, and the embryos were removed for dissection. The embryos were then transported on ice to a sterile tissue culture area, where their kidneys were removed with the aid of a dissecting microscope (Leica, Nussloch, Germany) and fine dissecting instruments. Once microdissected, E13.5 wild-type and Pax21Neu mutant fetal mouse kidneys were cultured at 37°C under 5% Co2/air for 50 h on 0.4-µm floating filters (Millipore, Bedford, MA). All explants were cultured in the presence of DMEM 10% FBS 1% Pen/Strep/Fungizone (Life Technologies BRL). Treated explants were cultured with 25 µM of the apoptosis inhibitor, Z-VAD-fmk (Calbiochem, Darmstadt, Germany).

Administration of Z-VAD-fmk In Vivo
Impregnated females carrying litters of wild-type and Pax21Neu mutant embryos received daily intraperitoneal (IP) injections of Z-VAD-fmk (Calbiochem) (10 µg/g body weight) from E10.5 to E17.5, at which time the mother was sacrificed and the embryos removed. The kidneys of the embryos were isolated by microdissection and immediately fixed with 4% formaldehyde. After approximately 1 h of fixation in 4% formaldehyde, kidneys were transferred to 70% ethanol for longer-term storage.

Dolichos Biflorus Agglutinin Immunostaining
Explants were immediately fixed in 4% formaldehyde. After having been fixed for 1 to 7 d, explants were washed four times for 10 min with PBS 1% Triton X-100 and incubated overnight at 4°C in a 1:100 dilution of Dolichos biflorus agglutinin (Vector Laboratories, Burlingame, CA) in PBS. The following day explants were washed one time for 10 min and allowed to incubate overnight at 4°C in PBS 1% Triton X-100. The kidneys were visualized by fluorescence microscopy.

Quantification of Branching Morphogenesis
Once images were obtained through the use of fluorescence microscopy, the pattern of branching of the collecting duct was traced out and the complexity of branching morphogenesis assessed by counting the terminal ends. The counting of terminal branches was done blindly, without knowledge of the genotypes or treatment status. Significance of the difference in means was determined by the paired t test.

TUNEL Staining
The in situ cell death detection POD kit (Roche Diagnostics, Laval, QC) was used to detect apoptosis by terminal dUTP nick-end labeling (TUNEL) in serial sagittal sections of paraffin-embedded wild-type and Pax21Neu mutant kidneys. Tissue sections were heated to 60°C for 1 h, deparaffinized, and rehydrated. They were then treated with 15 µg/ml proteinase K in 10 mM Tris/HCl pH 7.5 for 20 min at room temperature. Next endogenous peroxidases were blocked by incubating the sections in 2% H2O2 for 20 min at room temperature. The tissue sections were then incubated in labeling solution for 85 min at 37°C and washed three times for 3 min with PBS. The sections were then incubated with the peroxidase converter for 60 min at room temperature. After three washes of 3 min each with PBS, the tissue sections were incubated for 5 min at room temperature with DAB substrate solution (Vector Laboratories), counterstained with methyl green and mounted using Permount (Fisher Scientific, Nepean, ON).

Quantification of Apoptosis
TUNEL-stained sections of fetal mouse kidney were imaged by light microscopy and Spot Advanced digital imaging software. The images obtained were examined at high magnification (x400) to determine the number of TUNEL-positive cells present in the collecting duct of each section of fetal kidney. All quantification of apoptosis was done blindly and without knowledge of the genotypes or treatment status.

Identification of PARP Cleavage by Western Blot Analysis as a Measure of Apoptosis
Fetal explant kidneys were thoroughly lysed using an abrasive Western lysis buffer consisting of 62.5 mM Tris, pH 6.8, 10% Glycerol, 6 M urea, 2% SDS, and 5% {beta}-mercaptoethanol; samples were also sonicated for about 10 s (frequency: 25 W; amplitude: 80). The samples were then heated to 65°C for 15 min and the loading dye (to 1x) added. Once the loading dye had been added, the samples were boiled at 100°C for 5 min, spun down briefly in a microcentrifuge, and loaded on a polyacrylamide gel consisting of two layers; a top (stacking) layer (4%) and a lower (separating) layer (10%). The gel was run at 100 V for approximately 2 h followed by an overnight transfer at 30 V. Once the transfer of protein from gel to membrane was complete, the membrane or "blot" went through a series of steps to tag the protein of interest (PARP). The first step was to block any nonspecific protein by incubating the blot in PBS-T (0.1%) + 5% milk at room temperature for 2 h. The blot was then probed with a primary antibody (1/100 PARP antibody; Oncogene, Hornby, ON) for an additional 2 h at room temperature, followed by 2 washes of 10 min each with PBS-T (0.1%). The blot was then probed with a secondary antibody (1/1000 Anti-Mouse; Amersham Pharmacia Biotech, England) and washed three times for 5 min with PBS-T (0.1%). The final step was to develop the blot by immersing it in a developing solution (ECL; Amersham Pharmacia Biotech) and immediately exposing it to film. PARP in its intact form will appear at 115 kD; once cleaved, PARP will appear as a slightly smaller 85- to 90-kD fragment.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Pax21Neu Mutant Kidneys Compared with Wild-Type Kidneys
Cross-Sectional Surface Area.
Kidneys were microdissected from E17.5 fetal mice, fixed in 4% formaldehyde, and embedded in paraffin. Serial sagittal sections were stained with hematoxylin and eosin. The largest cross-section was identified, and kidney surface area was quantified by Spot Advanced imaging software. The maximal cross-sectional area of Pax21Neu mutant kidneys (0.06 ± 0.003 mm2) was 25% smaller than wild-type kidneys (0.08 ± 0.003 mm2), P = 0.003 (Figure 2C).



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Figure 2. Maximal cross-sectional area of heterozygous Pax21Neu mutant kidneys compared with that of wild-type littermates. Serial sagittal sections of E17.5 Pax21Neu mutant (A) and wild-type (B) fetal mouse kidneys were stained with hematoxylin and eosin. Mean maximal cross-sectional area of Pax21Neu mutant fetal mouse kidneys was 20% smaller than wild-type littermates, P = 0.003 (C). Kidney surface area was calculated by Spot Image Analysis software in the maximal cross-section at x100 magnification.

 
Branching Morphogenesis.
Kidneys were microdissected from E13.5 fetal mice, cultured for 50 h, immunostained with Dolichos biflorus agglutinin, and imaged by fluorescence microscopy. The number of terminal UB branch tips was quantified in each explant. Pax21Neu mutant explants (53 ± 5.5 branch tips/kidney) had 18% fewer branches than their wild-type counterparts (64 ± 4.7 branch tips/kidney), P = 0.04 (Figure 3C).



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Figure 3. Complexity of branching morphogenesis in heterozygous Pax21Neu mutant kidneys compared with that of wild-type littermates. Branching of the ureteric bud (UB) was quantified in Pax21Neu mutant (A) and wild-type (B) E13.5 fetal mouse kidneys stained with fluorescein-labeled Dolichos biflorus agglutinin after 50 h in culture and visualized under ultraviolet light. Pax21Neu mutant kidneys had 18% fewer terminal branches than wild-type kidneys, P = 0.04 (C).

 
UB Apoptosis.
Peroxidase TUNEL immunohistochemistry was used to identify apoptotic cells in E17.5 fetal mouse kidneys (Figure 4, A and B). The number of TUNEL-positive cells in the heterozygous mutant fetal kidneys (741 ± 104 apoptotic cells/mm2) was significantly greater than in wild-type littermates (290 ± 56 apoptotic cells/mm2), P = 0.001 (Figure 4C). However, apoptosis in metanephric blastema and mesenchymal derivatives of the nephron (comma-shaped and S-shaped bodies) was similar in heterozygous mutants and wild-types; increased apoptosis was restricted primarily to the UB. The percent of TUNEL-positive UB cells in mutant kidneys (7 ± 0.02%) was 3.5-fold increased above the apoptotic frequency in UB of E17.5 wild-type littermates (2 ± 0.003%), P = 0.008 (Figure 4D).



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Figure 4. Collecting duct apoptosis in heterozygous Pax21Neu mutant mice. Apoptotic cells in the collecting duct were identified in maximal cross-sections from Pax21Neu (+/-) mutant (A) and wild-type (B) E17.5 fetal mouse kidneys by TUNEL staining. Mutant kidneys had 53% more apoptosis than wild-type counterparts, P = 0.007 (C).

 
Increased Apoptosis Due to In Vitro Culture Conditions
To examine the effect of the Pax21Neu mutation on the rate of UB branching ex vivo, we excised E13.5 mutant and wild-type kidneys and cultured them for 50 h (Figure 5, A and B). To assess basal apoptosis induced by ex vivo culture conditions, we assessed time-dependent appearance of PARP cleavage by Western immunoblotting (Figure 5C). In freshly microdissected E13.5 fetal kidneys (T = 0), 93% of PARP protein appears in the uncleaved form at 115 kD; only 7% appears as cleaved PARP at 85 to 90 kD. In E13.5 kidneys cultured for 50 h, 29% of PARP protein appeared in the cleaved form, indicating a modest basal level of apoptosis ex vivo.



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Figure 5. Branching morphogenesis of wild-type fetal mouse kidneys ex vivo. E13.5 kidneys (A) were cultured on floating filters for 50 h (B). To examine basal apoptosis under ex vivo culture conditions, protein of interest (PARP) cleavage was assessed at 0 and 50 h by Western immunoblotting (C). At T = 0, only 7% of PARP appeared in its cleaved form (85 to 90 kD). At T = 50 h, 29% of PARP protein was cleaved, indicating increased apoptosis. Uncleaved PARP at T = 0 (B1); cleaved PARP at T = 0 (B2); uncleaved PARP at T = 50 h (B3); cleaved PARP at T = 50 h (B4).

 
Rescue of Renal Hypoplasia in Pax21Neu Mutant and Wild-Type Fetal Kidneys Ex Vivo
To assess the effect of caspase inhibition on UB branching ex vivo, Pax21Neu mutant (Figure 6A) and wild-type (Figure 6B) kidneys were cultured for 50 h in the presence or absence of 25 µM Z-VAD-fmk. The explants were then fixed and stained with fluorescence-tagged Dolichos biflorus agglutinin to visualize the branching UB. In Pax21Neu mutant explants, Z-VAD-fmk treatment resulted in a significant increase (23%) in UB branching (65 ± 6.8 terminal branches/kidney) versus untreated mutant explants (53 ± 5.5 terminal branches), P = 0.0003). A significant but lesser effect was observed in treated versus untreated wild-type explants (71 ± 5 versus 64 ± 4.7), P = 0.003 (Figure 6C).



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Figure 6. Rescue of branching morphogenesis in Pax21Neu mutant explants ex vivo. Pax21Neu mutant (A) and wild-type (B) fetal kidney explants were cultured in the presence and absence of Z-VAD-fmk for 50 h, stained with fluorescein-labeled Dolichos biflorus agglutinin, and visualized under ultraviolet light. Treated Pax21Neu mutant kidneys showed an increase in terminal branch number of 25% (P = 0.001). A lesser, but significant increase in terminal branch number (10%) was seen in wild-type kidneys treated with Z-VAD-fmk (P = 0.003) (C).

 
Caspase Inhibition of Pax21Neu Mutant and Wild-Type Mice In Vivo
In view of the results above, we reasoned that it might be possible to reverse the deleterious effect of PAX2 mutations on UB branching in vivo. Pregnant C3H females mated to Pax21Neu mutant males received daily intraperitoneal injections of Z-VAD-fmk (10 µg/g body weight) from day 10.5 of pregnancy through day 17.5. Apoptosis (TUNEL) in maximal cross-sections (Figure 7, A through D) of E17.5 Pax21Neu mutant kidneys (741 ± 104 apoptotic cells/mm2) was significantly reduced (40% of control, P = 0.0004) by Z-VAD-fmk treatment (290 ± 56 apoptotic cells/mm2) (Figure 7E). Again, this effect was largely due to a decrease in TUNEL-positive cells in UB structures: treated (2.0 ± 0.001% of UB cells) versus untreated (7.0 ± 0.02 % of UB cells), P = 0.005 (Figure 7F). Z-VAD-fmk also reduced basal apoptosis in wild-type kidneys (145 ± 24 versus 290 ± 56 apoptotic cells/mm2, P = 0.013 (Figure 7E). No obvious malformations of kidneys or other organs were observed in Z-VAD-fmk-treated pregnancies.



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Figure 7. Inhibition of Pax21Neu mutant collecting duct apoptosis in vivo. Apoptotic cells in the collecting duct of 1Neu (+/-) mutant (A) and wild-type (C) E17.5 fetal mouse kidneys were identified by TUNEL staining. Heterozygous pregnant Pax21Neu mice were injected intraperitoneally daily from E11-E17 with 10 µg/g of Z-VAD-fmk. Pax21Neu (+/-) fetuses had 60% reduction in collecting duct cell apoptosis (P = 0.002) (B). There was a lesser (45% decrease) but significant effect on wild-type E17.5 kidneys as well (P = 0.01) (D and E).

 
Rescue of UB Branching Morphogenesis In Vivo
To determine whether the anti-apoptotic effects of Z-VAD-fmk could rescue the renal branching defect in vivo as it did in vitro, fetal kidneys were excised and stained with tagged Dolichos biflorus agglutinin after treatment from E10 through E14 as above. Following treatment, heterozygous Pax21Neu fetal mouse kidneys exhibited increased (152%) arborization of the UB (79 ± 10 terminal branches/kidney) versus mutants from untreated pregnancies (52 ± 4 terminal branches/kidney), P = 0.014 (Figure 8).



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Figure 8. Rescue of Pax21Neu fetal kidney collecting duct branching in vivo. UB branching morphogenesis was quantified in Pax21Neu (+/-) mutant E14.5 fetal mouse kidneys stained with fluorescein-labeled Dolichos biflorus agglutinin and visualized under ultraviolet light. Kidneys of fetuses from mothers treated with Z-VAD-fmk (10 µg/g body weight) showed a 34% increase in branching morphogenesis (P = 0.01).

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
In previous studies, we have shown that PAX2 haploinsufficiency causes renal hypoplasia associated with reduced nephron number (oligonephronia), detectable in the early stages (E15) of kidney development in the mouse (9). Here, we confirm that heterozygous Pax21Neu fetal (E17.5) mice have a selective increase in apoptosis of UB cells; we also directly demonstrate a significant deficit in arborization of the PAX2 mutant UB. Although the 18% reduction in terminal branches seen in E13.5 kidneys cultured for 50 h is, at first glance, a modest reduction in nephron number unlikely to have clinical consequences, it should be remembered that nephrogenesis appears to proceed in logarithmic (versus linear) fashion during fetal kidney development. A modest decrease in the rate of UB branching from an early stage will be amplified many times over in subsequent generations of nephrons and should substantially reduce final nephron endowment.

Although PAX2 may regulate a variety of developmental genes, we have shown elsewhere that the identical phenotype (pure nephron deficit) can be mimicked by targeting pro-apoptotic genes to the fetal UB and have proposed a model in which stochastic UB apoptosis might account for slowed UB arborization and fewer final nephrons in PAX2 mutant kidneys (10). If this hypothesis is correct, we reasoned that anti-apoptotic agents, such as the caspase inhibitor Z-VAD-fmk, should be able to rescue the UB branching defect in Pax21Neu mice. Indeed, we found in mutant E15 kidney explants allowed to continue branching morphogenesis ex vivo that the caspase inhibitor, Z-VAD-fmk, suppressed apoptosis and produced a 23% increase in terminal branch number within 50 h. Interestingly a significant but smaller effect of Z-VAD-fmk was also seen in wild-type kidneys under the same conditions. Although the frequency of UB cell apoptosis is very low in normal fetal kidney, it was clear from the progressive increase of PARP cleavage that ex vivo culture conditions exert a considerable pro-apoptotic stimulus on the explant. Presumably, this reflects increasingly suboptimal diffusion of oxygen and nutrients to the center of the expanding kidney.

Z-VAD-fmk has been used by others to inhibit caspases in vivo, but no formal studies have been done to demonstrate that the drug can cross the placenta and exert its anti-apoptotic effects on fetal tissue. In preliminary experiments, we injected normal pregnant mice with Z-VAD-fmk, but we were unable to detect the drug by HPLC/mass spectrophotometry in either maternal or fetal tissues. Nevertheless, daily intraperitoneal injections of Z-VAD-fmk (10 µg/g body weight) to pregnant mice during the period of early nephrogenesis (E10.5-E14) were effective in suppressing UB apoptosis and increasing terminal branch number in mutant fetal kidneys. This suggests that the drug can cross the placental barrier and exerts its anti-apoptotic effect on fetal tissue.

Programmed cell death is now thought to be an important normal event during development, necessary for producing luminal cavities, selection of neurons, and sculpting of organs. Nevertheless, we found no obvious teratogenic effects of maternal Z-VAD-fmk in our studies. Other investigators have noted that normal regression of interdigital skin webs can proceed in the presence of Z-VAD-fmk (11). These authors argue that certain apoptotic events during development do not seem to require the Z-VAD-fmk-sensitive caspases (11).

In conclusion, we report that in heterozygous Pax21Neu mutant mouse kidneys with increased UB apoptosis and decreased terminal UB branch number, that the genetically determined defect in branching morphogenesis can be rescued in vitro and in vivo by drugs that restore UB resistance to caspase-mediated programmed cell death. These observations strongly support the hypothesis that loss of the normal anti-apoptotic function of PAX2 during development is the primary cause of nephron deficit in RCS. They also support our proposed model of branching morphogenesis in which optimal rates of arborization require maximal survival of UB cells (10). Conceivably, caspase-inhibitory drugs may be useful for the in utero rescue of congenital abnormalities caused by mutation of other anti-apoptotic genes.


    Acknowledgments
 
This work was supported by an operating grant from the Canadian Institutes of Health Research. Dr. Goodyer was the recipient of a Sessenwein Pediatric Research Award, and Dr. Eccles was a James Cook Fellow of the Royal Society of New Zealand.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

  1. Gundersen HJ, Bagger P, Bendtsen TF, Evans SM, Korbo L, Marcussen N, Moller A, Nielsen K, Nyengaard JR, Pakkenberg B, et al: The new stereological tools: Dissector, fractionator, nucleator and point sampled intercepts and their use in pathological research and diagnosis. APMIS 96: 857–881, 1988[Medline]
  2. Nyengaard JR, Bendtsen TF: Glomerular number and size in relation to age, kidney weight, and body surface in nirmal man. Anat Record 232: 194–201, 1992[CrossRef][Medline]
  3. Keller G, Zimmer G, Mall G, Ritz E, Amann K: Nephron number in patients with hypertension. N Engl J Med 348: 102–108, 2003
  4. Eccles MR, Schimmenti LA: Renal-coloboma syndrome: A multi-system developmental disorder caused by PAX2 mutations. Clin Genet 56: 1–9, 1999[CrossRef][Medline]
  5. Salomon R, Tellier AL, Attie-Bitach T, Amiel J, Vekemans M, Lyonnet S, Dureau P, Niaudet P, Gubler MC, Broyer M: PAX2 mutations in oligomeganephronia. Kidney Int 59: 457–62, 2001[CrossRef][Medline]
  6. Bouchard M, Souabni A, Mandler M, Neubuser A, Busslinger M: Nephric lineage specification by PAX2 and Pax8. Genes Dev 16: 2958–2970, 2002[Abstract/Free Full Text]
  7. Brophy PD, Ostrom L, Lang KM, Dressler GR: Regulation of ureteric bud outgrowth by PAX2-dependent activation of the glial derived neurotrophic factor gene. Development 128: 4747–56, 2001[Abstract/Free Full Text]
  8. Torban E, Eccles MR, Favor J, Goodyer P: PAX2 suppresses apoptosis in renal collecting duct cells. Am J Path 157: 833–842, 2000[Abstract/Free Full Text]
  9. Porteous S, Torban E, Cho NP, Cunliffe H, Chua L, McNoe L, Ward T, Souza C, Gus P, Giugliani R, Sato T, Yun K, Favor J, Sicotte M, Goodyer P, Eccles M: Primary renal hypoplasia in humans and mice with PAX2 mutations: Evidence of increased apoptosis in fetal kidneys of PAX21Neu +/- mutant mice. Hum Mol Gen 9: 1–11, 2000[Abstract/Free Full Text]
  10. Dziarmaga A, Clark P, Stayner C, Julien JP, Torban E, Goodyer P, Eccles M: Ureteric bud apoptosis and renal hypoplasia in transgenic PAX2-Bax fetal mice mimics the renal-coloboma syndrome. J Am Soc Nephrol 14: 2767–2774, 2003[Abstract/Free Full Text]
  11. Jacobsen MD, Weil M, Raff MC: Role of Ced-3/ICE-family proteases in staurosporine-induced programmed cell death. J Cell Biol 133: 1041–1051, 1996[Abstract]
Received for publication May 11, 2003. Accepted for publication October 28, 2003.




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