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Clinical Research
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GSTM1 Deletion Exaggerates Kidney Injury in Experimental Mouse Models and Confers the Protective Effect of Cruciferous Vegetables in Mice and Humans

Joseph C. Gigliotti, Adrienne Tin, Shirin Pourafshar, Sylvia Cechova, Yves T. Wang, Sun-sang J. Sung, Gabor Bodonyi-Kovacs, Janet V. Cross, Guang Yang, Nhu Nguyen, Fang Chan, Casey Rebholz, Bing Yu, Megan L. Grove, Morgan E. Grams, Anna Köttgen, Robert Scharpf, Phillip Ruiz, Eric Boerwinkle, Josef Coresh and Thu H. Le
JASN November 2019, ASN.2019050449; DOI: https://doi.org/10.1681/ASN.2019050449
Joseph C. Gigliotti
Division of Nephrology, Department of Medicine and
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Adrienne Tin
Department of Epidemiology andWelch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland;
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Shirin Pourafshar
Division of Nephrology, Department of Medicine and
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Sylvia Cechova
Division of Nephrology, Department of Medicine and
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Yves T. Wang
Division of Nephrology, Department of Medicine, University of Rochester School of Medicine, Rochester, New York;
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Sun-sang J. Sung
Division of Nephrology, Department of Medicine and
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Gabor Bodonyi-Kovacs
Division of Nephrology, Department of Medicine and
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Janet V. Cross
Department of Pathology, University of Virginia School of Medicine, Charlottesville, Virginia;
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Guang Yang
Division of Nephrology, Heinrich-Heine University of Dusseldorf, Dusseldorf, Germany;
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Nhu Nguyen
Department of Biomedical Sciences, Grand Valley State University, Allendale, Michigan;
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Fang Chan
Division of Nephrology, Department of Medicine and
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Casey Rebholz
Department of Epidemiology andWelch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland;
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Bing Yu
Department of Epidemiology, Human Genetics and Environmental Sciences, School of Public Health and
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Megan L. Grove
Human Genetics Center, University of Texas Health Science Center at Houston, Houston, Texas;
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Morgan E. Grams
Welch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland;Department of Medicine and
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Anna Köttgen
Department of Epidemiology andInstitute of Genetic Epidemiology, Faculty of Medicine and Medical Center, University of Freiburg, Freiburg, Germany; and
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Robert Scharpf
Department of Biostatistics, Johns Hopkins Bloomberg School of Public Heath, Baltimore, Maryland;Division of Oncology, Johns Hopkins School of Medicine, Baltimore, Maryland;
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Phillip Ruiz
Department of Pathology, University of Miami, Miami, Florida
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Eric Boerwinkle
Human Genetics Center, University of Texas Health Science Center at Houston, Houston, Texas;
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Josef Coresh
Department of Epidemiology andWelch Center for Prevention, Epidemiology and Clinical Research, Baltimore, Maryland;
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Thu H. Le
Division of Nephrology, Department of Medicine andDepartment of Biostatistics, Johns Hopkins Bloomberg School of Public Heath, Baltimore, Maryland;
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    Figure 1.

    Gstm1 KO mice have higher BP and renal oxidative stress at baseline. (A) SBP measured by radiotelemetry was significantly higher in Gstm1 KO mice: WT 129.0±4.9 versus KO 135.6±2.7 mm Hg; P=0.02; n=6 each. (B) Urinary ACR was not different between groups: WT 27.3±7.2 versus KO 29.1±10.1 µg/mg; P=0.73; n=6 each. (C) Twenty four hour excretion of urinary 8-isoprostane was elevated in Gstm1 KO mice: WT 6.6±1.2 versus KO 14.2±3.1 ng/100 mg body wt/24 h; P=0.001; n=5/6. All comparisons by t test. *P<0.05; **P<0.01.

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    Figure 2.

    Deletion of Gstm1 in the Nx CDK model results in poor survival and exaggerated HTN and kidney injury. (A) Survival curve showing significant mortality in Gstm1 KO mice after Nx; P=0.01 versus WT; n=8 each. Time of censoring for mice that were used for terminal experiments are marked by ×. (B) SBP measured by radiotelemetry was significantly higher in Gstm1 KO mice: WT 135.0±8.4 versus KO 150.6±13.7 mm Hg; P=0.04; n=4/7. (C) Renal superoxide levels measured by lucigenin luminescence and normalized to dry tissue weight were higher in Gstm1 KO mice: WT 74.5±36.1 versus KO 250.4±153.6; P=0.04; n=6 each. (D) Urinary ACR was higher in Gstm1 KO mice: WT 235.1±60.3 versus KO 748.4±460.4 µg/mg; P=0.04; n=6 each. (E) Kidney pathology scores were greater in Gstm1 KO mice for all compartments (total: WT 8.3±2.3 versus KO 18.7±3.6; P<0.001) and in most individual compartments (glomeruli: WT 6.5±1.2 versus KO 14.5±2.7; P<0.001; tubules: WT 1.0±0.0 versus KO 1.5±0.8; P=0.20; interstitium: WT 0.8±1.2 versus KO 2.7±0.8; P=0.01), n=6 each. (F) Area fractions were greater in Gstm1 KO mice for glomerular to total noninfarcted kidney (G/T, left: WT 2.3±0.7 versus KO 3.3±0.7; P=0.03) and mesangial to glomerular (M/G, right: WT 23.7±6.1 versus KO 35.7±5.5; P=0.005), n=6 each. (G) Percent of scratched area that remained uncovered after 14 hours was reduced in Gstm1 KO mice: WT 69.3±11.5 versus KO 54.2±8.6; P=0.007; n=9 each. All comparisons by t test. *P<0.05; **P<0.01; ***P<0.001.

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    Figure 3.

    Deletion of Gstm1 in the AngII HTN model results in exaggerated oxidative stress and kidney injury that is ameliorated by Tempol. (A) SBP measured by radiotelemetry was significantly higher in Gstm1 KO mice treated with Tempol (KO+T): WT 157.8±6.7 versus KO 163.7±14.1 versus KO+T 195.6±13.2 mm Hg; P=0.001; n=5/6/4. (B) Urinary ACR was not significantly different: WT 5108.2±1302.9 versus KO 4657.9±1262.2 µg/mg; P=0.62; n=5/4. (C) Renal superoxide levels measured by lucigenin luminescence and normalized to dry tissue weight were higher in Gstm1 KO mice: WT 41.6±20.8 versus KO 128.25±30.5 versus KO+T 53.8±18.4; P<0.001; n=6/6/4. (D) Kidney pathology scores were greater in Gstm1 KO mice for all compartments (total: WT 8.8±6.1 versus KO 19.8±4.1 versus KO+T 7.3±3.8; P=0.002) and in individual compartments (glomeruli: WT 7.7±4.2 versus KO 15.2±2.7 versus KO+T 7.0±3.6; P=0.003; tubules: WT 0.8±1.3 versus KO 2.3±0.8 versus KO+T 0.3±0.5; P=0.01; interstitium: WT 0.3±0.8 versus KO 2.3±1.5 versus KO+T 0.0±0.0; P=0.006), n=6/6/4. (E) Renal mRNA levels of genes involved in inflammation normalized to Hprt in WT mice at baseline (WTBL) and with HTN (WT), n=6/5 and KO mice at baseline (KOBL), with HTN (KO) and with HTN treated with Tempol (KO+T), n=6/6/4. Expression levels were elevated in the KO mice for MCP-1 (KOBL 0.0054±0.0050 versus KO 0.048±0.016 versus KO+T 0.019±0.0068; P<0.001) and CXCL-1 (KOBL 0.0071±0.0027 versus KO 0.068±0.028 versus KO+T 0.012±0.0051; P<0.001). WT comparisons in (E) by t test. Comparisons in other panels and KO comparisons in (E) by one-way ANOVA. *P<0.05; **P<0.01; ***P<0.001; ****P<0.001.

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    Figure 4.

    Gstm1 KO mice in the AngII HTN model have increased renal inflammation associated with the deletion of Gstm1 in the parenchyma. (A) Flow cytometry data of renal leukocytes normalized to WT counts showed Gstm1 KO mice have increased populations (P values: CD4+T=0.04; CD8+T=0.05; B=0.16; PMN=0.007; F4/80High=0.004), n=3/4. Comparisons by one-way ANOVA. *P<0.05; **P<0.01. (B) Flow cytometry data of renal leukocytes for BM chimeras generated from BM crosstransplantation (genotypes listed as donor-recipient) normalized to WT-WT showed recipient genotype was the statistically significant factor (donor P values: CD4+T=0.82; CD8+T=0.95; B=0.87; PMN=0.70; F4/80High=0.31; recipient P values: CD4+T=5.9×10−5; CD8+T=0.30; B=1.1×10−5; PMN=1.5×10−6; F4/80High=5.0×10−7), n=4/5/5/4. Comparisons by two-way ANOVA.

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    Figure 5.

    Treatment with SRBP ameliorated kidney injury only in Gstm1 KO mice. In all panels, WT and KO mice are the same as those in Figure 3, with the data reproduced here for ease of comparison. (A) SBP measured by radiotelemetry was elevated in WT mice fed SRBP (WT+SRBP 176.9±5.9 mm Hg; P=0.001; n=6) but not in Gstm1 KO mice fed SRBP (KO+SRBP 168.9±3.5 mm Hg; P=0.24; n=6). (B) Renal superoxide levels measured by lucigenin luminescence and normalized to dry tissue weight were not affected by SRBP in WT mice (WT+SRBP 57.7±31.5 counts/min per milligram dry tissue; P=0.02; n=6) but were reduced in Gstm1 KO mice (KO+SRBP 50.4±33.9 counts/min per milligram dry tissue; post hoc versus KO P=0.004; n=5). (C) Urinary ACR was reduced by SRBP in Gstm1 KO mice (KO+SRBP 1671.5±683.6 µg/mg; post hoc versus KO P=0.05; n=5), but not WT mice (WT+SRBP 4314.4±2155.3 µg/mg; P=0.47; n=6). (D) Kidney pathology scores were unaffected by SRBP in WT mice (total: 5.4±1.5; P=0.24; glomeruli: 4.4±0.5; P=0.11; tubules: 1.0±1.0; P=0.82; interstitium: 0.0±0.0; P=0.36; n=5) but were reduced in Gstm1 KO mice (total: 4.6±1.7; post hoc versus KO P=2.0×10−6; glomeruli: 3.6±0.9; post hoc versus KO P=2.4×10−7; tubules: 1.0±1.0; post hoc versus KO P=0.10; interstitium: 0.0±0.0; P=0.004; n=5). Comparisons between WT and WT+SRBP by t test. Comparisons between WT+SRBP, KO, and KO+SRBP by one-way ANOVA. *P<0.05; **P<0.01; ***P<0.001; ****P<0.001.

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    Figure 6.

    Humans with GSTM1(0/0) have reduced incidence of kidney failure with higher cruciferous vegetable intake. Kaplan–Meier plots of kidney failure by cruciferous vegetable intake category within those (A) with and (B) without GSTM1 homozygous deletion showed a significant benefit only in those with the homozygous deletion. See Table 2 for statistical analysis.

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    Table 1.

    Baseline population characteristics by cruciferous vegetable intake category (n=10, 155)

    CharacteristicLow IntakeMedium IntakeHigh IntakeP Value
    N201756802458
    Age, yr, mean (SD)54.4 (5.8)54.6 (5.7)54.4 (5.6)0.29
    Men, n (%)1150 (57.0)2512 (44.2)801 (32.6)<0.001
    Black, n (%)700 (34.7)1582 (27.9)431 (17.5)<0.001
    Body mass index, kg/m2, mean (SD)27.57 (5.28)27.78 (5.3)27.65 (5.48)0.25
    Smoking, n (%)<0.001
     Current smoker623 (30.9)1412 (24.9)548 (22.3)
     Former smoker670 (33.2)1856 (32.7)806 (32.8)
     Never smoked724 (35.9)2412 (42.5)1104 (44.9)
    Diabetes, n (%)222 (11)645 (11.4)258 (10.5)0.52
    HTN, n (%)741 (36.7)1990 (35)762 (31)<0.001
    Coronary heart disease, n (%)114 (5.7)282 (5)105 (4.3)0.10
    eGFR, ml/min per 1.73 m2, mean (SD)103.31 (16.38)102.75 (15.51)102.25 (14.19)0.07
    Education, n (%)<0.001
     Less than high school595 (29.5)1154 (20.3)360 (14.6)
     Some college817 (40.5)2358 (41.5)1015 (41.3)
     Graduate education605 (30)2168 (38.2)1083 (44.1)
    Physical activity score, median (25 percentile, 75 percentile)2.2 (1.8, 2.5)2.2 (2, 2.8)2.5 (2.2, 2.8)<0.001
    Total calorie intake, median (25 percentile, 75 percentile)1475 (1133, 1913)1511 (1177, 1918)1633 (1283, 2056)<0.001
    • Intake categories: low intake, three or more times per month; medium, more than three times per month but less than once per week; high intake, at least once per week. P values for baseline characteristics of participants by three levels of cruciferous vegetable intake were obtained using t tests for nonskewed continuous variables, Wilcoxon tests for skewed continuous variables, and chi-squared tests for categorical variables.

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    Table 2.

    Association between cruciferous vegetable intake and kidney failure stratified by GSTM1

    HR (95% CI)
    Low IntakeMedium IntakeHigh IntakeP-Trend
    Model 1
     GSTM1 (0/0)Reference0.58 (0.41 to 0.82)0.41 (0.25 to 0.68)<0.001
     GSTM1 (0/1 or 1/1)Reference0.73 (0.53 to 1.01)0.88 (0.59 to 1.33)0.45
    Model 2
     GSTM1 (0/0)Reference0.68 (0.48 to 0.98)0.49 (0.29 to 0.83)0.005
     GSTM1 (0/1 or 1/1)Reference0.68 (0.49 to 0.94)0.89 (0.59 to 1.36)0.46
    • n (event). GSTM1(0/0), 4601 (159); GSTM1(0/1 or 1/1), 5554 (211).

    • Model 1 covariates: age, sex, race, center, genetic principal components. Model 2 covariates: model 1 plus eGFR, prevalent diabetes, HTN, coronary heart disease, smoking status, body mass index, leisure physical activity, education levels, and total calorie intake. P-trend was obtained by using cruciferous vegetable intake as a continuous variable in Cox regression. P value for GSTM1 and cruciferous vegetable intake interaction: model 1=0.02; model 2=0.03.

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Journal of the American Society of Nephrology: 30 (12)
Journal of the American Society of Nephrology
Vol. 30, Issue 12
December 2019
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GSTM1 Deletion Exaggerates Kidney Injury in Experimental Mouse Models and Confers the Protective Effect of Cruciferous Vegetables in Mice and Humans
Joseph C. Gigliotti, Adrienne Tin, Shirin Pourafshar, Sylvia Cechova, Yves T. Wang, Sun-sang J. Sung, Gabor Bodonyi-Kovacs, Janet V. Cross, Guang Yang, Nhu Nguyen, Fang Chan, Casey Rebholz, Bing Yu, Megan L. Grove, Morgan E. Grams, Anna Köttgen, Robert Scharpf, Phillip Ruiz, Eric Boerwinkle, Josef Coresh, Thu H. Le
JASN Nov 2019, ASN.2019050449; DOI: 10.1681/ASN.2019050449

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GSTM1 Deletion Exaggerates Kidney Injury in Experimental Mouse Models and Confers the Protective Effect of Cruciferous Vegetables in Mice and Humans
Joseph C. Gigliotti, Adrienne Tin, Shirin Pourafshar, Sylvia Cechova, Yves T. Wang, Sun-sang J. Sung, Gabor Bodonyi-Kovacs, Janet V. Cross, Guang Yang, Nhu Nguyen, Fang Chan, Casey Rebholz, Bing Yu, Megan L. Grove, Morgan E. Grams, Anna Köttgen, Robert Scharpf, Phillip Ruiz, Eric Boerwinkle, Josef Coresh, Thu H. Le
JASN Nov 2019, ASN.2019050449; DOI: 10.1681/ASN.2019050449
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Keywords

  • genetic renal disease
  • oxidative stress
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  • inflammation
  • glutathione S-transferase
  • chronic kidney disease

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