Calcium oxalate crystals induce renal inflammation by NLRP3-mediated IL-1β secretion

J Clin Invest. 2013 Jan;123(1):236-46. doi: 10.1172/JCI63679. Epub 2012 Dec 10.

Abstract

Nephrocalcinosis, acute calcium oxalate (CaOx) nephropathy, and renal stone disease can lead to inflammation and subsequent renal failure, but the underlying pathological mechanisms remain elusive. Other crystallopathies, such as gout, atherosclerosis, and asbestosis, trigger inflammation and tissue remodeling by inducing IL-1β secretion, leading us to hypothesize that CaOx crystals may induce inflammation in a similar manner. In mice, intrarenal CaOx deposition induced tubular damage, cytokine expression, neutrophil recruitment, and renal failure. We found that CaOx crystals activated murine renal DCs to secrete IL-1β through a pathway that included NLRP3, ASC, and caspase-1. Despite a similar amount of crystal deposits, intrarenal inflammation, tubular damage, and renal dysfunction were abrogated in mice deficient in MyD88; NLRP3, ASC, and caspase-1; IL-1R; or IL-18. Nephropathy was attenuated by DC depletion, ATP depletion, or therapeutic IL-1 antagonism. These data demonstrated that CaOx crystals trigger IL-1β-dependent innate immunity via the NLRP3/ASC/caspase-1 axis in intrarenal mononuclear phagocytes and directly damage tubular cells, leading to the release of the NLRP3 agonist ATP. Furthermore, these results suggest that IL-1β blockade may prevent renal damage in nephrocalcinosis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Apoptosis Regulatory Proteins
  • CARD Signaling Adaptor Proteins
  • Calcium Oxalate / immunology*
  • Calcium Oxalate / metabolism
  • Carrier Proteins / genetics
  • Carrier Proteins / immunology*
  • Carrier Proteins / metabolism
  • Cytoskeletal Proteins / genetics
  • Cytoskeletal Proteins / immunology
  • Cytoskeletal Proteins / metabolism
  • Dendritic Cells / immunology
  • Dendritic Cells / metabolism
  • Immunologic Deficiency Syndromes / genetics
  • Immunologic Deficiency Syndromes / immunology
  • Immunologic Deficiency Syndromes / metabolism
  • Inflammation / genetics
  • Inflammation / immunology
  • Inflammation / metabolism
  • Interleukin-18 / genetics
  • Interleukin-18 / immunology
  • Interleukin-18 / metabolism
  • Interleukin-1beta / genetics
  • Interleukin-1beta / immunology*
  • Interleukin-1beta / metabolism
  • Kidney Tubules / immunology*
  • Kidney Tubules / metabolism
  • Kidney Tubules / pathology
  • Mice
  • Mice, Knockout
  • Myeloid Differentiation Factor 88 / genetics
  • Myeloid Differentiation Factor 88 / immunology
  • Myeloid Differentiation Factor 88 / metabolism
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • Nephrocalcinosis / genetics
  • Nephrocalcinosis / immunology*
  • Nephrocalcinosis / metabolism
  • Nephrocalcinosis / pathology
  • Phagocytosis*
  • Primary Immunodeficiency Diseases
  • Receptors, Interleukin-1 / genetics
  • Receptors, Interleukin-1 / immunology
  • Receptors, Interleukin-1 / metabolism

Substances

  • Apoptosis Regulatory Proteins
  • CARD Signaling Adaptor Proteins
  • Carrier Proteins
  • Cytoskeletal Proteins
  • Interleukin-18
  • Interleukin-1beta
  • Myd88 protein, mouse
  • Myeloid Differentiation Factor 88
  • NLR Family, Pyrin Domain-Containing 3 Protein
  • Nlrp3 protein, mouse
  • Pycard protein, mouse
  • Receptors, Interleukin-1
  • Calcium Oxalate

Supplementary concepts

  • MYD88 Deficiency