The Contribution of Bone Marrow‐Derived Cells to the Development of Renal Interstitial Fibrosis

Recent evidence suggests that bone marrow (BM)‐derived cells may integrate into the kidney, giving rise to functional renal cell types, including endothelial and epithelial cells and myofibroblasts. BM‐derived cells can contribute to repair of the renal peritubular capillary (PTC) network following acute ischemic injury. However, the cell fate and regulation of BM‐derived cells during the progression of chronic renal disease remains unclear. Using chimeric mice transplanted with enhanced green fluorescent protein (EGFP)‐expressing BM, we demonstrate that the number of BM‐derived myofibroblasts coincided with the development of fibrosis in a mouse adriamycin (ADR)‐induced nephrosis model of chronic, progressive renal fibrosis. Four weeks after ADR injection, increased numbers of BM‐derived myofibroblasts were observed in the interstitium of ADR‐injected mice. Six weeks after ADR injection, more than 30% of renal α‐smooth muscle actin (+) (α‐SMA+) interstitial myofibroblasts were derived from the BM. In addition, BM‐derived cells were observed to express the endothelial cell marker CD31 and the myofibroblast marker α‐SMA. Blockade of p38 mitogen‐activated protein kinase (MAPK) and transforming growth factor (TGF)‐β1/Smad2 signaling was found to protect BM‐derived PTC endothelial cells and inhibit the number of BM‐derived von Willebrand factor (vWF)(+)/EGFP(+)/α‐SMA(+) cells, EGFP(+)/α‐SMA(+) cells, and total α‐SMA(+) cells in ADR‐injected mice. Inhibition of the p38 MAPK and TGF‐β1/Smad signaling pathways enhanced PTC repair by decreasing endothelial‐myofibroblast transformation, leading to structural and functional renal recovery and the attenuation of renal interstitial fibrosis. Investigation of the signaling pathways that regulate the differentiation and survival of BM‐derived cells in a progressive disease setting is vital for the successful development of cell‐based therapies for renal repair.

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