Maternal Diabetes Modulates Renal Morphogenesis in Offspring
Stella Tran*,
Yun-Wen Chen*,
Isabelle Chenier*,
John S.D. Chan*,
Susan Quaggin,
Marie-Josée Hébert*,
Julie R. Ingelfinger and
Shao-Ling Zhang*
* University of Montreal, Centre Hospitalier de lUniversité de Montréal–Hôtel-Dieu, Research Centre, Montreal, Quebec, Canada; Samuel Lunenfeld Research Institute, University of Toronto, Toronto, Ontario, Canada; and Pediatric Nephrology Unit, Massachusetts General Hospital, Harvard Medical School, Boston, Massachusetts
Correspondence: Dr. Shao-Ling Zhang University of Montreal, Centre Hospitalier de lUniversité de Montréal–Hôtel-Dieu, Research Centre, Pavillon Masson, 3850 Saint Urbain Street, Montreal, Quebec H2W 1T7, Canada. Phone: 514-890-8000, ext. 15633; Fax: 514-412-7204; E-mail: shao.ling.zhang{at}umontreal.ca
Received for publication August 7, 2007.
Accepted for publication January 10, 2008.
Maternal diabetes leads to an adverse in utero environment,but whether maternal diabetes impairs nephrogenesis is unknown.Diabetes was induced with streptozotocin in pregnant Hoxb7–greenfluorescence protein mice at embryonic day 13, and the offspringwere examined at several time points after birth. Compared withoffspring of nondiabetic controls, offspring of diabetic micehad lower body weight, body size, kidney weight, and nephronnumber. The observed renal dysmorphogenesis may be the resultof increased apoptosis, because immunohistochemical analysisrevealed significantly more apoptotic podocytes as well as increasedactive caspase-3 immunostaining in the renal tubules comparedwith control mice. Regarding potential mediators of these differences,offspring of diabetic mice had increased expression of intrarenalangiotensinogen and renin mRNA, upregulation of NF-B isoformsp50 and p65, and activation of the NF-B pathway. In conclusion,maternal diabetes impairs nephrogenesis, possibly via enhancedintrarenal activation of the renin-angiotensin system and NF-Bsignaling.
Diseases such as maternal diabetes create an adverse in uteroenvironment that may impair the process of embryogenesis, thuspredisposing infants of low birth weight (LBW) to subsequentincreased risk for future disease.1–5 The developing kidneyseems particularly sensitive to a high-glucose milieu, exposureto which may result in congenital renal malformations, suchas renal agenesis, dysplasia, or hypoplasia.6–9
Intrauterine growth retardation, defined as birth weight belowthe 10th percentile for gestational age, is associated witha reduction in nephron number.10 Although the so-called "thriftyphenotype" hypothesis suggests that LBW is linked to perinatalprogramming,10,11 the underlying mechanisms whereby nephronnumber may be affected and/or nephron function altered are notyet completely delineated.
The NF-B pathway has been reported to be a major intracellulartarget in hyperglycemia and oxidative stress,12,13 and its twofunctional pathways (canonical-classical and noncanonical) havebeen studied in the diabetic kidney.14–16 Five membersof the NF-B family have been identified: NF-B1 (p50/p105), NF-B2(p52/p100), RelA (p65), RelB, and c-Rel. It seems that RelA(p65) and p50, in particular, can contribute to p53-, TNF-–,and reactive oxygen species–mediated cell apoptosis.17–21There is a growing consensus that a high-glucose milieu anddiabetes-induced activation of the NF-B pathway have a functionalimpact on the course of diabetic nephropathy15,16,22,23; however,the underlying mechanisms of NF-B signaling in impairing renalmorphogenesis are not well understood.
Deficiency, mutation, or abnormal expression of genes of theintrarenal renin-angiotensin system (RAS) during organogenesisin experimental animal models often leads to abnormal kidneys,12,24–28with a decrease in ultimate nephron numbers.29–36 Studies,including ours, have demonstrated that intrarenal RAS activationplays a key role in the development of hypertension and renalinjury in diabetes.37–40 In a model of experimental diabetesin the rat, Lee et al.23 reported a functional interaction betweenNF-B (in particular, the p65 subunit) and the angiotensin II(AngII) type 1 receptor. Given these data, we hypothesize that,in diabetes, enhanced intrarenal RAS activation and NF-B signalingare two key elements intimately involved in the process of apoptosisin nascent nephrons, ultimately leading to nephron deficiency.
Neonatal Offspring from Control and Diabetic Hoxb7-Green Fluorescence Protein-Transgenic Mothers
The body length of neonatal offspring of streptozotocin (STZ)-induceddiabetic mothers was significantly smaller as compared withthose from control mothers (control versus diabetic neonateoffspring in length 2.54 ± 0.27 versus 2.03 ±0.25 cm), as shown in Figure 1.
Figure 1. Image of representative newborn Hoxb7-GFP mice from nondiabetic and diabetic mothers. The offspring of diabetic mothers are significantly smaller than those of nondiabetic mothers (control).
Biologic Parameters
Offspring from diabetic mice remained significantly smallerand lighter (average 20% less) than control offspring duringthe entire suckling period. Figure 2A shows body weight (BW)for control versus STZ offspring (1.414 ± 0.110 versus1.030 ± 0.070 g [P 0.01] in neonates; 3.744 ±0.900 versus 3.00 ± 1.010 g [P 0.05] in 1-wk-old mice;6.93 ± 1.32 versus 5.71 ± 1.11 [P 0.01] in 2-wk-oldmice; 12.12 ± 1.16 versus 9.79 ± 2.07 [P 0.01]in 3-wk-old mice), and Figure 2B indicates the ratio of kidneyweight to body weight, suggesting that kidneys of diabetic offspringare relatively large for their BW.
Figure 2. Physical parameters in offspring of Hoxb7-GFP-Tg mice. (A) Offspring from diabetic mother had significantly lower body weight (BW; 20% less on average) than control offspring during the entire suckling period (neonate to 3 wk of age). (B) The ratios of kidney weight (KW) to BW in offspring from diabetic mother were also significantly higher than those of control offspring. , control offspring; , offspring from diabetic mother. *P < 0.05; **P < 0.01.
Renal Morphology, Nephron Number, and Glomerular Volume in Neonatal Kidneys
Hematoxylin- and eosin-stained sections of whole-mount neonatalkidneys indicated that offspring from diabetic pregnant micehad smaller kidneys with smaller glomeruli size as comparedwith the kidneys of control offspring (Figure 3A). We foundthat glomerular volume (VG) of young offspring of diabetic mothers(from neonate to 2 wk old) was persistently less than that ofcontrol animals (Figure 3B). By carefully counting the numberof nephrons, we observed that neonatal nephron number in offspringof diabetic dams was significantly lower than in control animals(average 40% less; control versus diabetic neonate offspringin number 3038.00 ± 175.52 [n = 6] versus 1862.00 ±128.74 [n = 5; P 0.001]; Figure 3C).
Figure 3. Renal morphology and VG measurement. (A) hematoxylin and eosin (HE) staining indicates that kidney and glomerular size of neonatal offspring from diabetic mother (right) are smaller as compared with control offspring (left). (B) Quantification of VG value in control and diabetic offspring from neonate to 3 wk of age. The y axis shows the percentage of VG value compared with control animal (100%). Blue bar, control offspring (neonate: n = 9; 1 wk old: n = 12; 2 wk old: n = 9; 3 wk old: n = 8); red bar, diabetic offspring (neonate: n = 8; 1 wk old: n = 8; 2 wk old: n = 7; 3 wk old: n = 8). **P 0.01. (C) Quantification of neonatal nephron number. The y axis shows the percentage of nephron number compared with control animal (100%). Blue bar, control offspring (neonate: n = 6); red bar, diabetic offspring (neonate: n = 5). ***P 0.001.
STZ Toxicity Effect
STZ is an unstable product with a biologic half-life in cellculture medium of approximately 19 min (http://www.sigmaaldrich.com).Because STZ administration does not induce diabetes 100% ofthe time, we had the opportunity to examine nephrogenesis infetuses of STZ-exposed mice with or without diabetes. We performedadditional experiments to determine whether STZ could affectnephrogenesis in Nephrin-Cyan Fluorescence Protein-Transgenic(Nephrin-CFP-Tg) mice in vivo. We observed that renal damage(kidney size and number of glomeruli forming) seemed to dependon the level of maternal hyperglycemia (Figure 4A) but be independentof STZ administration (Figure 4B) or the length of exposureto STZ (from 0 to 5 d; Figure 4C). Thus, we believe that itis unlikely that a small amount of STZ (if it crosses the placenta)exerts toxicity in the fetus in utero in our model.
Figure 4. STZ toxicity studies in Nephrin-CFP-Tg mice. (A) E16 kidney isolated from pregnant mice with three different maternal hyperglycemic levels after 3 d of STZ administration (150 mg/kg, intraperitoneally, at E13): Normal (6.0 mmol), mild (14.3 mmol), and severe (24.9 mmol). (B) E16 kidneys isolated from pregnant mice in normal maternal glucose range with or without administration of STZ at E13. (C) E16 and E18 kidneys isolated from pregnant mice with normal maternal glucose level with STZ administration at E13.
Apoptosis in Kidneys of Offspring of Diabetic Mothers
Terminal transferase-mediated deoxyuridine triphosphate nick-endlabeling (TUNEL) assay revealed that apoptotic cells seem tobe increased in the collapsed nephron region in neonates and1-wk-old offspring of diabetic mothers as compared with controloffspring at the same ages (Figure 5A). Double immunostainingwith anti–Wilms tumor-1 (WT-1) and anti-activecleaved caspase-3 antibody indicated that glomerular podocytesundergo apoptosis, which ultimately results in nephron collapse(Figure 5B). Similarly, we observed augmented cleaved caspase-3immunostaining in renal tubule of offspring of diabetic mothersfrom neonate to 3 wk of age as shown in Figure 6. Taken together,these data suggest that high-glucose milieu creates an adversein utero environment that dynamically triggers nascent nephronapoptosis during nephrogenesis, consequently resulting in dysmorphogenesiswith small kidneys.
Figure 5. Apoptotic assay (TUNEL; A) in kidneys of offspring from nondiabetic and diabetic mothers: Neonate (C0 and D0), offspring at 1 wk of age (C1 and D1), offspring at 2 wk of age (C2 and D2), and offspring at 3 wk of age (C3 and D3). (B) Double immunostaining of WT-1 (a) and active caspase-3 expression (b) as well as a merged image (c) in neonatal kidneys of offspring from nondiabetic and diabetic mothers. Magnification, x60. Pink arrows indicate the apoptotic cells.
Figure 6. Active caspase-3 expression in kidneys of offspring from nondiabetic (control) and diabetic mothers: Neonate (C0 and D0), offspring at 1-wk old (C1 and D1), offspring at 2-wk old (C2 and D2), and offspring at 3 wk-old (C3 and D3). Magnification, x60.
Activation of the Intrarenal RAS and NF-B Pathways in Offspring of Diabetic Mothers
Real-time quantitative PCR (RT-qPCR) assays revealed that high-glucosemilieu in utero is capable of affecting intrarenal RAS geneexpression in kidneys of offspring of diabetic dams; in particular,angiotensinogen and renin mRNA expression was persistently upregulatedfrom the neonatal period to 3 wk of age (Figure 7). Immunohistochemicalexamination of renal sections confirmed that augmented angiotensinogenprotein expression was generally localized to the proximal tubuleregion in kidneys of offspring of diabetic mother (Figure 8),whereas cells positive for renin appeared in a glomerular ortubular position in offspring of diabetic mothers rather thanin the juxtaglomerular apparatus as in normal offspring (Figure 9).Moreover, we observed that the p50 and p65 subunits of NF-Bwere upregulated and translocated from the cytosol to the nucleusin the proximal tubules of offspring from diabetic mothers (Figure 10A).In gel mobility shift assays (GMSA), we found that NF-B activationwas more elevated in the neonatal kidneys of offspring fromdiabetic mothers compared with the offspring of control dams(Figure 10B). Taken together, our data indicate that a hyperglycemicenvironment in utero reduces kidney size and triggers apoptosisof nascent nephrons, possibly via the activation of the intrarenalRAS and NF-B pathways.
Figure 7. Mouse angiotensinogen (mANG) and renin mRNA expression assayed by RT-qPCR. (A and B) Expression levels of ANG (A) and renin (B) mRNA in kidneys of offspring from nondiabetic and diabetic mothers from neonate to 3 wk of age. **P 0.01; ***P 0.001.
Figure 8. ANG protein expression in kidneys of offspring from nondiabetic (control) and diabetic mothers: Neonate (C0 and D0), offspring at 1 wk of age (C1 and D1), offspring at 2 wk of age (C2 and D2), and offspring at 3 wk of age (C3 and D3). Magnification, x60.
Figure 9. Renin protein expression in kidneys of offspring from nondiabetic (control) and diabetic mothers: Neonate (C0 and D0), offspring at 1 wk of age (C1 and D1), offspring at 2 wk of age (C2 and D2), and offspring at 3 wk of age (C3 and D3). Magnification, x60.
Figure 10. NF-B expression and localization as well as activation in neonate kidneys from control and diabetic mothers. (A) Expression and localization of two isoforms of NF-B, p50 and p65, were displayed by immunostaining. (B) GMSA assay. The labeled DNA probe (0.1 pmol) was incubated without (lane 1) or with BSA (10 µg; lane 2) or renal nuclear protein(s) (N.P.; 10 µg each) of neonatal kidney (lanes 3 through 8) in the presence of 0.3 U of poly dI-dC. Renal N.P. from neonatal control (lanes 3, 5, and 7) and diabetic offspring (lanes 4, 6, and 8) is incubated with consensus NF-B DNA cold probe (lanes 3 and 4), consensus NF-B DNA probe (lanes 5 and 6), and mutant NF-B DNA probe (lanes 7 and 8). Magnification x60.
In this work, we aimed to delineate the functional role of maternaldiabetes in modulating renal morphogenesis in their offspringand to study their underlying mechanisms. Our data indicatethat a hyperglycemic environment in utero reduces kidney sizeand triggers nascent nephron apoptosis via intrarenal RAS activationand NF-B signaling.
Maternal diabetes presents an environmental challenge in uteroand may fundamentally and dynamically impair the process ofembryogenesis, thus predisposing to LBW.1–5 By comparingthe global phenotypes displayed in young offspring of controland diabetic mothers, we observed that LBW pups with small kidneyswere frequent in the offspring of diabetic dams. In the kidneys,we observed that glomeruli were smaller and that there werea relatively low number of nephrons; there is evidence of nephroncollapse in these kidneys. These findings may constitute thegenesis of low glomerular endowment.
In the 1980s, Brenner and associates41–44 hypothesizedthat "low glomerular endowment" or "fewer numbers of nephrons"are a risk factor for hypertension and ESRD in adulthood. Inprinciple, decreased nephron number leads to renal hyperfiltration(higher filtration pressure and an increased GFR per glomerulus).Consequently, later in life, pressure natriuresis curves shift,leading to increase in BP, thereby enhancing the risk for injuryas a result of hypertension and ESRD. Although outcomes suchas LBW, small kidneys, and fewer nephron numbers resulting froman adverse intrauterine environment that might predispose tofuture hypertension are known, the mechanisms by which thisoccurs remain incompletely delineated.
Increased apoptosis in the blastocyst and, later, in embryonickidneys has been reported in rodent embryos developing in diabeticdams.45–50 We suggest that apoptosis, in particular differentialapoptosis of specific renal lineages during nephrogenesis, inducedby a high-glucose milieu, is the major mechanism by which renalfunction is ultimately affected in diabetic offspring over time.The activation of intrarenal RAS and NF-B pathways are two keymechanisms that seem critical in the apoptosis induced by anintrauterine high-glucose milieu.
In normal nephrogenesis, apoptotic events occur normally throughoutrenal organogenesis until the formation of the final kidneyis complete. For example, the undifferentiated stromal mesenchymeeither becomes interstitial cells or is destined to undergoapoptosis to make space for the expanding loops of Henle; incontrast, the differentiated metanephric mesenchyme (MM) normallyundergoes epithelialization as a result of mesenchymal-to-epithelialtransformation and becomes the proximal portion of the nephron.51,52Under certain circumstances, however, for example, in maternaldiabetes, if the resultant high-glucose milieu triggers apoptoticevents in cells that do not normally undergo apoptosis (e.g.,differentiated mesenchymal mesenchyme), then nephron formationmay be altered and result in nephron collapse. Indeed, our datasuggest that a high-glucose milieu in utero retards renal morphogenesisby inducing a significantly higher number of apoptotic podocytesin the developing glomeruli and inducing a high level of caspase-3activity in the renal tubule, perhaps via activation of NF-Bpathways and the intrarenal RAS.
On the basis of our observations and those of others, we proposethat high-glucose–induced cell apoptosis resulting innephron collapse in diabetic offspring may be due to severalfactors. First, although the NF-B pathway has been reportedas a major intracellular target in hyperglycemia and oxidativestress,12,13,53 the expression pattern of NF-B in the kidneysof diabetic adults is still controversial.14–16 Regardingthe offspring of diabetic mothers, the functional impact ofNF-B pathways on apoptosis is unknown. We observed that NF-Bpathway was upregulated in kidneys of diabetic offspring. Furthermore,p50 and p65 subunits of NF-B were markedly upregulated, andthese subunits were translocated from the cytosol to the nucleusin proximal tubular cells of diabetic offspring. Linking thisobservation to apoptosis, a first possibility might be thatNF-B activation evokes several pro- and antiapoptotic genes,including Fas (CD95); TRAIL receptors (DR4, 5, and 6); the death-inducingligands FasL, TNF-, and TRAIL; tumor suppressor p53; Bcl-xL;and Bcl-xS,17,19 which could lead to apoptosis of proximal tubularcells, consequently resulting in nephron collapse and, ultimately,in nephron deficiency. Second, the intrarenal RAS, which hasbeen extensively linked to diabetes-induced apoptosis in bothhuman54 and experimental animal models,55 may play a role. Angiotensinogenand renin are major contributors to the production of AngII,the most physiologically active peptide of the RAS. We observedthat the expressions of angiotensinogen and renin were dramaticallyactivated and correlated with apoptotic events in kidneys ofoffspring of diabetic mothers. In addition, the cells that expressrenin, mainly in the renal juxtaglomerular apparatus56–58in the kidneys of the normal offspring, are found in the glomerularor tubular region in kidneys of offspring from diabetic mothers.This shift in renin expression together with increased mouseangiotensinogen expression might be capable of stimulating increasedlocal AngII formation, which could contribute to the observedincrease in glomerular or tubular apoptosis. Finally, the cross-talkbetween NF-B pathways and the intrarenal RAS23,59 may be fundamentallyassociated with nephron deficiency.
In conclusion, our results demonstrate that maternal diabetesimpairs renal development and induces nascent nephron cell apoptosisvia enhanced intrarenal RAS activation and NF-B signaling.
Animals
For these in vivo studies, we used two fertile Tg mouse linesthat have normal phenotype: Hoxb7-Green Fluorescence Protein-Tg(Hoxb7-GFP-Tg) and Nephrin-CFP-Tg. Hoxb7-GFP-Tg mice were providedby Dr. Frank Costantini (Columbia University Medical Center,New York, NY),60,61 which have been used to study ureteral budbranching in nephrogenesis.53 Nephrin-CFP-Tg mice, which haveCFP expression driven by the podocyte-specific nephrin promoterin glomeruli, were obtained from Dr. Susan Quaggin (Universityof Toronto, Toronto, ON, Canada)62; these mice permit us tofollow glomerular development during nephrogenesis.
Animal care in this set of studies met the standards set forthby the Canadian Council on Animal Care, and the procedures usedwere approved by the Institutional Animal Care Committee ofthe Centre Hospitalier de lUniversité de Montréal.Mice were housed under standard humidity and lighting conditions(12-h light-dark cycles) and were allowed free access to standardmouse food and water ad libitum. Timed-pregnant Hoxb7-GFP miceaged 8 to 10 wk were used in all experiments. Vaginal wet mountswere made to determine the estrous cycles of the mice. On theevening before estrus, female mice were housed overnight withmale mice; the presence of spermatozoa in a vaginal smear thenext morning was defined as day 1 of pregnancy.
Animal Model and Experimental Design
On the basis of our previous report63 as well as those of others,64–70maternal diabetes was induced by a single intraperitoneal injectionof STZ (Sigma, St. Louis, MO) at a dosage of 150 mg/kg bodyweight at embryonic day 13 (E13) in Hoxb7-GFP mice. Meanwhile,we performed pilot studies regarding STZ potential toxicityeffect on nephron formation in Nephrin-CFP mice.
Offspring from diabetic Hoxb7-GFP pregnant mice were killedat four time periods after birth (n = 24 at each time point):Neonate, 1 wk, 2 wk, and 3 wk. Offspring from nondiabetic pregnantmice at same time point were used as controls.
Isolation of Metanephroi
Post-STZ embryos were microdissected aseptically from timed-pregnantNephrin-CFP mice (E16 and E18), and the metanephroi were isolatedunder sterile conditions as previously report.53,63 Glomerularimages and quantification in Nephrin-CFP-Tg mice were analyzedby fluorescence microscopy (Nikon Eclipse TE 2000-S Microscope;Nikon, Montreal, QC, Canada).
Biologic Parameters, Renal Morphology Review, and Renal Endowment Measurement
Biologic parameters such as kidney weight, body weight, andbody length were carefully monitored during the entire sucklingperiod. Hematoxylin and eosin staining was used to review renalmorphology.63 We measured glomerular size using an estimateof mean VG and also quantified nephron number. VG was determinedby the method of Weibel71 with the aid of an image analysissoftware system (Motics Images Plus 2.0; Motic, Richmond, BC,Canada). The VG was estimated by the mean glomerular tuft area(AT) derived from the light microscopic measurement of 30 randomsectional profiles of glomeruli from each group (n = 6 animalsper group) using the formula VG = β/k x AT1.5, where β= 1.382 (shape coefficient for spheres) and k = 1.1 (size distributioncoefficient). Quantification of nephron number was adapted fromBertram's72 method using serial sections.
RT-qPCR
RT-qPCR (iQ SYBR Green Supermix Kit and MiniOpticon Real-TimePCR machine; Bio-Rad Laboratories, Mississauga, ON, Canada)was performed as reported previously.36,53 The forward and reverseprimers corresponding to mouse angiotensinogen, mouse renin,and β-actin cDNA36,53 in RT-qPCR assays were as follows:Mouse angiotensinogen forward primer 5'-CCA CGC TCT CTG GATTTA TC-3' and reverse primer 5'-ACA GAC ACC GAG ATG CTG TT-3'(NM_007428), mouse renin forward primer 5'-CTG GCC AAG TTT GACGGT GTT-3' and reverse primer 5'-GTG TCC ACC ACT ACC GCA CAG-3'(BC061053), and β-actin forward primer 5'-CGT GCG TGA CATCAA AGA GAA-3') and reverse primer 5'-GCT CGT TGC CAA TAG TGATGA-3' (NM_007393).
TUNEL Assay
Paraffin-embedded kidney sections (5 µm) fixed in 4% paraformaldehydewere deparaffinized in xylene and rehydrated. Apoptosis wasquantified with a TUNEL kit (La Roche Biochemicals, Laval, QC,Canada) according to the supplier's instructions.
Immunohistochemistry and Immunofluorescence Staining
Paraffin-embedded kidney sections (5 µm) fixed in 4% paraformaldehydewere deparaffinized in xylene and rehydrated. Immunohistochemicalexamination for angiotensinogen, renin, caspase-3, and NF-Bpathway (p50 and p65) was performed by the standard avidin-biotin-peroxidasecomplex method (ABC Staining System; Santa Cruz Biotechnologies,Santa Cruz, CA).39,73 The primary antibodies used included apolyclonal anti-angiotensinogen antibody39,73 (gift from Dr.John S.D. Chan, CHUM-Hôtel Dieu Hospital, Montreal, QC,Canada) in a 1:100 dilution, anti–WT-1 (clone 6F-H2; DakoCytomation, Carpinteria, CA) in 1:100 dilution, anti-cleavedcaspase-3 polyclonal antibody (Cell Signaling Technology, Inc.,Danvers, MA) in a 1:100 dilution, a polyclonal NF-B pathwayantibody (p50/p65; Santa Cruz Biotechnologies) in 1:100 dilution,and a polyclonal anti-renin antibody (cat. no. RDI-rtreninabm;Research Diagnostics, Concord, MA) in a 1:500 dilution.
GMSA
Nuclear protein extracts were prepared from neonatal kidneysof control and diabetic offspring. GMSA were performed as describedpreviously,74,75 using 32P-labeled NF-B probes (NF-B consensusoligonucleotide: C1 [5'-AGT TGA GGG GAC TTT CCC AGG C-3'] andC2 [5'-GCC TGG GAA AGT CCC CTC AAC T-3']; NF-B mutant oligonucleotide:M1 [5'-AGT TGA GGC GAC TTT CCC AGG C-3'] and M2 [5'-GCC TGGGAA AGT CGC CTC AAC T-3']; cat. no. SC-2505 and SC-2511, SantaCruz Biotechnologies).
Statistical Analyses
Statistical significance between experimental groups was analyzedinitially by t test or by one-way ANOVA followed by the Bonferronitest as appropriate. Three to four separate experiments wereperformed for each protocol. Data are expressed as means ±SD. P 0.05 was considered statistically significant.
This research was supported by Kidney Research Scientist CoreEducation and National Training Program (KRESCENT)-CanadianInstitute of Health Research (CIHR) and Kidney Foundation ofCanada and a New Investigator Award (KRESCENT-CIHR scholarship)to S.-L.Z.
We acknowledge the kind gifts of Hoxb7-GFP mice from Dr. FrankCostantini (Columbia University, New York, NY). We also thankDr. Indra R. Gupta (Montreal Children's Hospital, Montreal,QC, Canada), who taught us to count the number of nephrons usingJ.F. Bertram's method in serial sections, and Dr. Maxime Bouchard(McGill Cancer Center, Montreal, QC, Canada), who provided uswith anti–WT-1 antibody. Special thanks to Dr. John S.D.Chan (CHUM-Hôtel-Dieu, Montreal, QC, Canada) and Dr. JulieR. Ingelfinger (Massachusetts General Hospital, Boston, MA)for unconditional support and discussion of this project.
Footnotes
Published online ahead of print. Publication date availableat www.jasn.org.
S.T. and Y.-W.C. contributed equally in this work.
See related editorial, "Perinatal Nephron Programming is notSo Sweet in Maternal Diabetes," on pages 837–839.
Holemans K, Aerts L, Van Assche FA: Fetal growth and long-term consequences in animal models of growth retardation.
Eur J Obstet Gynecol Reprod Biol 81
: 149
–156, 1998[CrossRef][Medline]
Holemans K, Gerber RT, Meurrens K, De Clerck F, Poston L, Van Assche FA: Streptozotocin diabetes in the pregnant rat induces cardiovascular dysfunction in adult offspring.
Diabetologia 42
: 81
–89, 1999[CrossRef][Medline]
Holemans K, Caluwaerts S, Van Assche FA: Unravelling the fetal origins hypothesis.
Lancet 360
: 2073
–2075, 2002[Medline]
Holemans K, Aerts L, Van Assche FA: Fetal growth restriction and consequences for the offspring in animal models.
J Soc Gynecol Investig 10
: 392
–399, 2003[CrossRef][Medline]
Holemans K, Aerts L, Van Assche FA: Lifetime consequences of abnormal fetal pancreatic development.
J Physiol 547
: 11
–20, 2003[Abstract/Free Full Text]
Kitzmiller JL, Gavin LA, Gin GD, Jovanovic-Peterson L, Main EK, Zigrang WD: Preconception care of diabetes: Glycemic control prevents congenital anomalies.
JAMA 265
: 731
–736, 1991[Abstract/Free Full Text]
Lynch SA, Wright C: Sirenomelia, limb reduction defects, cardiovascular malformation, renal agenesis in an infant born to a diabetic mother.
Clin Dysmorphol 6
: 75
–80, 1997[Medline]
Soler NG, Walsh CH, Malins JM: Congenital malformations in infants of diabetic mothers.
Q J Med 45
: 303
–313, 1976[Medline]
Woolf AS: Multiple causes of human kidney malformations.
Arch Intern Med 77
: 471
–473, 1997
Zandi-Nejad K, Luyckx VA, Brenner BM: Adult hypertension and kidney disease: The role of fetal programming.
Hypertension 47
: 502
–508, 2006[Abstract/Free Full Text]
Manning J, Vehaskari VM: Low birth weight-associated adult hypertension in the rat.
Pediatr Nephrol 16
: 417
–422, 2001[CrossRef][Medline]
Mercurio F, Manning AM: NF-kappaB as a primary regulator of the stress response.
Oncogene 18
: 6163
–6171, 1999[CrossRef][Medline]
Mohamed AK, Bierhaus A, Schiekofer S, Tritschler H, Ziegler R, Nawroth PP: The role of oxidative stress and NF-kappaB activation in late diabetic complications.
Biofactors 10
: 157
–167, 1999[Medline]
Flyvbjerg A, Denner L, Schrijvers BF, Tilton RG, Mogensen TH, Paludan SR, Rasch R: Long-term renal effects of a neutralizing RAGE antibody in obese type 2 diabetic mice.
Diabetes 53
: 166
–172, 2004[Abstract/Free Full Text]
Morcos M, Sayed AA, Bierhaus A, Yard B, Waldherr R, Merz W, Kloeting I, Schleicher E, Mentz S, Abd el Baki RF, Tritschler H, Kasper M, Schwenger V, Hamann A, Dugi KA, Schmidt AM, Stern D, Ziegler R, Haering HU, Andrassy M, van der Woude F, Nawroth PP: Activation of tubular epithelial cells in diabetic nephropathy.
Diabetes 51
: 3532
–3544, 2002[Abstract/Free Full Text]
Starkey JM, Haidacher SJ, LeJeune WS, Zhang X, Tieu BC, Choudhary S, Brasier AR, Denner LA, Tilton RG: Diabetes-induced activation of canonical and noncanonical nuclear factor-kappaB pathways in renal cortex.
Diabetes 55
: 1252
–1259, 2006[Abstract/Free Full Text]
Perkins ND, Gilmore TD: Good cop, bad cop: The different faces of NF-kappaB.
Cell Death Differ 13
: 759
–772, 2006[CrossRef][Medline]
Janssen I, Katzmarzyk PT, Boyce WF, King MA, Pickett W: Overweight and obesity in Canadian adolescents and their associations with dietary habits and physical activity patterns.
J Adolesc Health 35
: 360
–367, 2004[Medline]
Dutta J, Fan Y, Gupta N, Fan G, Gelinas C: Current insights into the regulation of programmed cell death by NF-kappaB.
Oncogene 25
: 6800
–6816, 2006[CrossRef][Medline]
Nakano H, Nakajima A, Sakon-Komazawa S, Piao JH, Xue X, Okumura K: Reactive oxygen species mediate crosstalk between NF-kappaB and JNK.
Cell Death Differ 13
: 730
–737, 2006[CrossRef][Medline]
Xue X, Piao JH, Nakajima A, Sakon-Komazawa S, Kojima Y, Mori K, Yagita H, Okumura K, Harding H, Nakano H: Tumor necrosis factor alpha (TNFalpha) induces the unfolded protein response (UPR) in a reactive oxygen species (ROS)-dependent fashion, and the UPR counteracts ROS accumulation by TNFalpha.
J Biol Chem 280
: 33917
–33925, 2005[Abstract/Free Full Text]
Bierhaus A, Schiekofer S, Schwaninger M, Andrassy M, Humpert PM, Chen J, Hong M, Luther T, Henle T, Kloting I, Morcos M, Hofmann M, Tritschler H, Weigle B, Kasper M, Smith M, Perry G, Schmidt AM, Stern DM, Haring HU, Schleicher E, Nawroth PP: Diabetes-associated sustained activation of the transcription factor nuclear factor-kappaB.
Diabetes 50
: 2792
–2808, 2001[Abstract/Free Full Text]
Lee FT, Cao Z, Long DM, Panagiotopoulos S, Jerums G, Cooper ME, Forbes JM: Interactions between angiotensin II and NF-kappaB-dependent pathways in modulating macrophage infiltration in experimental diabetic nephropathy.
J Am Soc Nephrol 15
: 2139
–2151, 2004[Abstract/Free Full Text]
Chen X, Li W, Yoshida H, Tsuchida S, Nishimura H, Takemoto F, Okubo S, Fogo A, Matsusaka T, Ichikawa I: Targeting deletion of angiotensin type 1B receptor gene in the mouse.
Am J Physiol 272
: F299
–F304, 1997[Medline]
Okubo S, Niimura F, Matsusaka T, Fogo A, Hogan BL, Ichikawa I: Angiotensinogen gene null-mutant mice lack homeostatic regulation of glomerular filtration and tubular reabsorption.
Kidney Int 53
: 617
–625, 1998[CrossRef][Medline]
Tsuchida S, Matsusaka T, Chen X, Okubo S, Niimura F, Nishimura H, Fogo A, Utsunomiya H, Inagami T, Ichikawa I: Murine double nullizygotes of the angiotensin type 1A and 1B receptor genes duplicate severe abnormal phenotypes of angiotensinogen nullizygotes.
J Clin Invest 101
: 755
–760, 1998[Medline]
Nishimura H, Yerkes E, Hohenfellner K, Miyazaki Y, Ma J, Hunley TE, Yoshida H, Ichiki T, Threadgill D, Phillips JA III, Hogan BM, Fogo A, Brock JW III, Inagami T, Ichikawa I: Role of the angiotensin type 2 receptor gene in congenital anomalies of the kidney and urinary tract, CAKUT, of mice and men.
Mol Cell 3
: 1
–10, 1999[Medline]
Chen Y, Lasaitiene D, Friberg P: The renin-angiotensin system in kidney development.
Acta Physiol Scand 181
: 529
–535, 2004[CrossRef][Medline]
Ingelfinger JR, Woods LL: Perinatal programming, renal development, and adult renal function.
Am J Hypertens 15
: 46S
–49S, 2002[CrossRef][Medline]
Iosipiv IV, Schroeder M: A role for angiotensin II AT1 receptors in ureteric bud cell branching.
Am J Physiol Renal Physiol 285
: F199
–F207, 2003[Abstract/Free Full Text]
Moritz KM, Dodic M, Wintour EM: Kidney development and the fetal programming of adult disease.
Bioessays 25
: 212
–220, 2003[CrossRef][Medline]
Pan L, Gross KW: Transcriptional regulation of renin: An update.
Hypertension 45
: 3
–8, 2005[Abstract/Free Full Text]
Solhaug MJ, Bolger PM, Jose PA: The developing kidney and environmental toxins.
Pediatrics 113
: 1084
–1091, 2004[Abstract/Free Full Text]
Wolf G: Angiotensin II and tubular development.
Nephrol Dial Transplant 17[Suppl 9]
: 48
–51, 2002
Zhang SL, Moini B, Ingelfinger JR: Angiotensin II increases Pax-2 expression in fetal kidney cells via the AT2 receptor.
J Am Soc Nephrol 15
: 1452
–1465, 2004[Abstract/Free Full Text]
Hsieh TJ, Zhang SL, Filep JG, Tang SS, Ingelfinger JR, Chan JS: High glucose stimulates angiotensinogen gene expression via reactive oxygen species generation in rat kidney proximal tubular cells.
Endocrinology 143
: 2975
–2985, 2002[Abstract/Free Full Text]
Hsieh TJ, Fustier P, Wei CC, Zhang SL, Filep JG, Tang SS, Ingelfinger JR, Fantus IG, Hamet P, Chan JS: Reactive oxygen species blockade and action of insulin on expression of angiotensinogen gene in proximal tubular cells.
J Endocrinol 183
: 535
–550, 2004[Abstract/Free Full Text]
Sachetelli S, Liu Q, Zhang SL, Liu F, Hsieh TJ, Brezniceanu ML, Guo DF, Filep JG, Ingelfinger JR, Sigmund CD, Hamet P, Chan JS: RAS blockade decreases blood pressure and proteinuria in transgenic mice overexpressing rat angiotensinogen gene in the kidney.
Kidney Int 69
: 1016
–1023, 2006[CrossRef][Medline]
Zhang SL, Chen X, Wei CC, Filep JG, Tang SS, Ingelfinger JR, Chan JS: Insulin inhibits dexamethasone effect on angiotensinogen gene expression and induction of hypertrophy in rat kidney proximal tubular cells in high glucose.
Endocrinology 143
: 4627
–4635, 2002[Abstract/Free Full Text]
Brenner BM, Garcia DL, Anderson S: Glomeruli and blood pressure: Less of one, more the other?
Am J Hypertens 1
: 335
–347, 1988[Medline]
Brenner BM, Mackenzie HS: Nephron mass as a risk factor for progression of renal disease.
Kidney Int Suppl 63
: S124
–S127, 1997[Medline]
Mackenzie HS, Brenner BM: Fewer nephrons at birth: A missing link in the etiology of essential hypertension?
Am J Kidney Dis 26
: 91
–98, 1995[Medline]
Mackenzie HS, Lawler EV, Brenner BM: Congenital oligonephropathy: The fetal flaw in essential hypertension?
Kidney Int Suppl 55
: S30
–S34, 1996[Medline]
Chi MM, Pingsterhaus J, Carayannopoulos M, Moley KH: Decreased glucose transporter expression triggers BAX-dependent apoptosis in the murine blastocyst 12.
J Biol Chem 275
: 40252
–40257, 2000[Abstract/Free Full Text]
Keim AL, Chi MM, Moley KH: Hyperglycemia-induced apoptotic cell death in the mouse blastocyst is dependent on expression of p53 10.
Mol Reprod Dev 60
: 214
–224, 2001[CrossRef][Medline]
Leunda-Casi A, Genicot G, Donnay I, Pampfer S, De Hertogh R: Increased cell death in mouse blastocysts exposed to high D-glucose in vitro: implications of an oxidative stress and alterations in glucose metabolism 4.
Diabetologia 45
: 571
–579, 2002[CrossRef][Medline]
Moley KH, Chi MM, Knudson CM, Korsmeyer SJ, Mueckler MM: Hyperglycemia induces apoptosis in pre-implantation embryos through cell death effector pathways 14.
Nat Med 4
: 1421
–1424, 1998[CrossRef][Medline]
Pampfer S, Donnay I: Apoptosis at the time of embryo implantation in mouse and rat 19.
Cell Death Differ 6
: 533
–545, 1999[CrossRef][Medline]
Pampfer S, Cordi S, Vanderheyden I, Van Der Smissen P, Courtoy PJ, Van Cauwenberge A, Alexandre H, Donnay I, De Hertogh R: Expression and role of Bcl-2 in rat blastocysts exposed to high D-glucose 11.
Diabetes 50
: 143
–149, 2001[Medline]
Ekblom P, Miettinen A, Virtanen I, Wahlstrom T, Dawnay A, Saxen L: In vitro segregation of the metanephric nephron 4.
Dev Biol 84
: 88
–95, 1981[CrossRef][Medline]
Piscione TD, Rosenblum ND: The molecular control of renal branching morphogenesis: Current knowledge and emerging insights 3.
Differentiation 70
: 227
–246, 2002[CrossRef][Medline]
Chen YW, Liu F, Tran S, Zhu Y, Hebert MJ, Ingelfinger JR, Zhang SL: Reactive oxygen species and nuclear factor-kappa B pathway mediate high glucose-induced Pax-2 gene expression in mouse embryonic mesenchymal epithelial cells and kidney explants.
Kidney Int 70
: 1607
–1615, 2006[CrossRef][Medline]
Kumar D, Robertson S, Burns KD: Evidence of apoptosis in human diabetic kidney.
Mol Cell Biochem 259
: 67
–70, 2004[CrossRef][Medline]
Brezniceanu ML, Liu F, Wei CC, Tran S, Sachetelli S, Zhang SL, Guo DF, Filep JG, Ingelfinger JR, Chan JS: Catalase overexpression attenuates angiotensinogen expression and apoptosis in diabetic mice.
Kidney Int 71
: 912
–923, 2007[CrossRef][Medline]
Sequeira Lopez ML, Pentz ES, Robert B, Abrahamson DR, Gomez RA: Embryonic origin and lineage of juxtaglomerular cells.
Am J Physiol Renal Physiol 281
: F345
–F356, 2001[Abstract/Free Full Text]
Gomez RA, Tufro-McReddie A, Norwood VF, Harris M, Pentz ES: Renin-angiotensin system: Kidney growth and development.
Exp Nephrol 2
: 130
–1574, 1994[Medline]
Mezzano S, Droguett A, Burgos ME, Ardiles LG, Flores CA, Aros CA, Caorsi I, Vio CP, Ruiz-Ortega M, Egido J: Renin-angiotensin system activation and interstitial inflammation in human diabetic nephropathy.
Kidney Int Suppl S64
–S70, 2003
Srinivas S, Goldberg MR, Watanabe T, D'Agati V, al-Awqati Q, Costantini F: Expression of green fluorescent protein in the ureteric bud of transgenic mice: A new tool for the analysis of ureteric bud morphogenesis.
Dev Genet 24
: 241
–251, 1999[CrossRef][Medline]
Watanabe T, Costantini F: Real-time analysis of ureteric bud branching morphogenesis in vitro.
Dev Biol 271
: 98
–108, 2004[CrossRef][Medline]
Cui S, Li C, Ema M, Weinstein J, Quaggin SE: Rapid isolation of glomeruli coupled with gene expression profiling identifies downstream targets in Pod1 knockout mice.
J Am Soc Nephrol 16
: 3247
–3255, 2005[Abstract/Free Full Text]
Zhang SL, Chen YW, Tran S, Chenier I, Hebert MJ, Ingelfinger JR: Reactive oxygen species in the presence of high glucose alter ureteric bud morphogenesis.
J Am Soc Nephrol 18
: 2105
–2115, 2007[Abstract/Free Full Text]
Cuezva JM, Burkett ES, Kerr DS, Rodman HM, Patel MS: The newborn of diabetic rat. I. Hormonal and metabolic changes in the postnatal period.
Pediatr Res 16
: 632
–637, 1982[Medline]
Kanwar YS, Akagi S, Nayak B, Sun L, Wada J, Xie P, Thakur A, Chugh SS, Danesh FR: Renal-specific oxidoreductase biphasic expression under high glucose ambience during fetal versus neonatal development.
Kidney Int 68
: 1670
–1683, 2005[CrossRef][Medline]
Eriksson U, Andersson A, Efendic S, Elde R, Hellerstrom C: Diabetes in pregnancy: Effects on the foetal and newborn rat with particular regard to body weight, serum insulin concentration and pancreatic contents of insulin, glucagon and somatostatin.
Acta Endocrinol (Copenh) 94
: 354
–364, 1980[Abstract/Free Full Text]
Oh W, Gelardi NL, Cha CJ: Maternal hyperglycemia in pregnant rats: Its effect on growth and carbohydrate metabolism in the offspring.
Metabolism 37
: 1146
–1151, 1988[CrossRef][Medline]
Kervran A, Guillaume M, Jost A: The endocrine pancreas of the fetus from diabetic pregnant rat.
Diabetologia 15
: 387
–393, 1978[CrossRef][Medline]
Aerts L, Sodoyez-Goffaux F, Sodoyez JC, Malaisse WJ, Van Assche FA: The diabetic intrauterine milieu has a long-lasting effect on insulin secretion by B cells and on insulin uptake by target tissues.
Am J Obstet Gynecol 159
: 1287
–1292, 1988[Medline]
Oh W, Gelardi NL, Cha CJ: The cross-generation effect of neonatal macrosomia in rat pups of streptozotocin-induced diabetes.
Pediatr Res 29
: 606
–610, 1991[Medline]
Weibel ER, ed.: Numerical density: Shape and size of particles. In:
Stereological Methods, Vol. 2 Theoretical Foundations, London, Academic Press, 1980
, pp 149
–152
Bertram JF: Counting in the kidney.
Kidney Int 59
: 792
–796, 2001[CrossRef][Medline]
Chen X, Zhang SL, Pang L, Filep JG, Tang SS, Ingelfinger JR, Chan JS: Characterization of a putative insulin-responsive element and its binding protein(s) in rat angiotensinogen gene promoter: Regulation by glucose and insulin.
Endocrinology 142
: 2577
–2585, 2001[Abstract/Free Full Text]
Wei CC, Guo DF, Zhang SL, Ingelfinger JR, Chan JS: Heterogenous nuclear ribonucleoprotein F modulates angiotensinogen gene expression in rat kidney proximal tubular cells.
J Am Soc Nephrol 16
: 616
–628, 2005[Abstract/Free Full Text]
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