Zheng X, Higdon L, Gaudet A, Shah M, Balistieri A, Li C, Nadai P, Palaniappan L, Yang X, Santo B, Ginley B, Wang XX, Myakala K, Nallagatla P, Levi M, Sarder P, Rosenberg A, Maltzman JS, de Freitas Caires N, and Bhalla V
Background: Diabetic kidney disease (DKD) is the most common cause of kidney failure in the world, and novel predictive biomarkers and molecular mechanisms of disease are needed. Endothelial cell-specific molecule-1 (Esm-1) is a secreted proteoglycan that attenuates inflammation. We previously identified that a glomerular deficiency of Esm-1 associates with more pronounced albuminuria and glomerular inflammation in DKD-susceptible relative to DKD-resistant mice, but its contribution to DKD remains unexplored., Methods: Using hydrodynamic tail-vein injection, we overexpress Esm-1 in DKD-susceptible DBA/2 mice and delete Esm-1 in DKD-resistant C57BL/6 mice to study the contribution of Esm-1 to DKD. We analyze clinical indices of DKD, leukocyte infiltration, podocytopenia, and extracellular matrix production. We also study transcriptomic changes to assess potential mechanisms of Esm-1 in glomeruli., Results: In DKD-susceptible mice, Esm-1 inversely correlates with albuminuria and glomerular leukocyte infiltration. We show that overexpression of Esm-1 reduces albuminuria and diabetes-induced podocyte injury, independent of changes in leukocyte infiltration. Using a complementary approach, we find that constitutive deletion of Esm-1 in DKD-resistant mice modestly increases the degree of diabetes-induced albuminuria versus wild-type controls. By glomerular RNAseq, we identify that Esm-1 attenuates expression of kidney disease-promoting and interferon (IFN)-related genes, including Ackr2 and Cxcl11 ., Conclusions: We demonstrate that, in DKD-susceptible mice, Esm-1 protects against diabetes-induced albuminuria and podocytopathy, possibly through select IFN signaling. Companion studies in patients with diabetes suggest a role of Esm-1 in human DKD., Competing Interests: V. Bhalla reports serving on the editorial board of American Journal of Physiology-Renal Physiology (July 2007 to present) and Physiologic Reports (April 2018 to present); having other interests in, or relationships with the American Medical Association (for validated device listing of BP measurement devices), serving in an advisory or leadership role for the American Society of Nephrology (ASN) Kidney Week Education Committee (2020-2021), Hypertension Council of the American Heart Association (as member), and Kidney and Cardiovascular Disease Council of the American Heart Association (as immediate past chair); receiving honoraria from Bayer Pharmaceuticals and CareDx (spouse); having consultancy agreements with Bayer Pharmaceuticals, CareDx, Guidepoint LLC, LEK Consulting, and Reata; receiving research funding from, and serving on a speakers bureau for, CareDx (spouse); serving on the scientific advisory board of CareDx (spouse), Pyrames, and Relypsa; serving as associate editor of European Journal of Clinical Investigation (February 2013 to present); and having ownership interest in Pyrames Health and Viscira LLC. N. de Freitas Caires reports having patents or royalties with Biothelis, and being employed by the Biothelis Society. M. Levi reports receiving research funding from Bayer and Merck. J.S. Maltzman reports serving in an advisory or leadership role for American Society of Nephrology (ASN) Kidney Week Education Committee (ended November 2020), American Society of Transplantation (AST; board of directors; ended June 2021), ASN Qihan (scientific advisory board), AST Research Network (ended June 2021), Federation of Clinical Immunology Societies (as secretary/treasurer), and The Transplantation Society Transplantation Science Committee; receiving research funding and honoraria from One Lambda/Thermo Fisher; and being employed by, and having ownership interest in, Roche/Genentech (spouse). L. Palaniappan reports having consultancy agreements with Amgen (October 2021). A. Rosenberg reports serving in an advisory or leadership role for Escala; receiving honoraria from Georgetown University, Ichilov Hospital (Tel Aviv, Israel), and Stony Brook University; and receiving research funding from National Kidney Foundation and NIH. P. Sarder reports receiving research funding from Clinical and Translational Science Institute at University at Buffalo, Human Biomolecular Atlas Program (NIH Office of the Director), Kidney Precision Medicine Project, National Institute of Diabetes and Digestive and Kidney Diseases, The State University of New York, and University at Buffalo; and serving as an editorial board member of JASN and as associate editor of PLoS One. All remaining authors have nothing to disclose., (Copyright © 2022 by the American Society of Nephrology.)