AI Article Synopsis

  • Familial hyperkalemic hypertension (FHHt), also known as Gordon syndrome, results from abnormal WNK4 accumulation that activates the NaCl cotransporter (NCC) in the kidneys, primarily affecting the distal convoluted tubule (DCT).
  • Mutations in the cullin 3 (CUL3) gene disrupt its interaction with the COP9 signalosome, leading to WNK4 accumulation and potential kidney injury, but short-term experiments show no significant plasma electrolyte changes in DCT-specific knockout mice.
  • Long-term DCT-specific deletion of CUL3 causes kidney injury and atrophy, indicating that CUL3's role in degrading WNK4 is crucial for preventing FHHt, highlighting how the

Article Abstract

The disease familial hyperkalemic hypertension (FHHt; also known as Gordon syndrome) is caused by aberrant accumulation of with-no-lysine kinase (WNK4) activating the NaCl cotransporter (NCC) in the distal convoluted tubule (DCT) of the kidney. Mutations in cullin 3 (CUL3) cause FHHt by disrupting interaction with the deneddylase COP9 signalosome (CSN). Deletion of or (the catalytically active CSN subunit) along the entire nephron causes a partial FHHt phenotype with activation of the WNK4-STE20/SPS1-related proline/alanine-rich kinase (SPAK)-NCC pathway. However, progressive kidney injury likely prevents hypertension, hyperkalemia, and hyperchloremic metabolic acidosis associated with FHHt. We hypothesized that DCT-specific deletion would more closely model the disease. We used -Cre-ERT2 mice to delete (DCT-) or (DCT-) only in the DCT and examined the mice after short- and long-term deletion. Short-term DCT-specific knockout of both and mice caused elevated WNK4, pSPAK, and pNCC abundance. However, neither model demonstrated changes in plasma K, Cl, or total CO, even though no injury was present. Long-term DCT- mice showed significantly lower NCC and parvalbumin abundance and a higher abundance of kidney injury molecule-1, a marker of proximal tubule injury. No injury or reduction in NCC or parvalbumin was observed in long-term DCT- mice. In summary, the prevention of injury outside the DCT did not lead to a complete FHHt phenotype despite activation of the WNK4-SPAK-NCC pathway, possibly due to insufficient NCC activation. Chronically, only DCT- mice developed tubule injury and atrophy of the DCT, suggesting a direct JAB1 effect or dysregulation of other cullins as mechanisms for injury. CUL3 degrades WNK4, which prevents activation of NCC in the DCT. CSN regulation of CUL3 is impaired in the disease FHHt, causing accumulation of WNK4. Short-term DCT-specific disruption of CUL3 or the CSN in mice resulted in activation of the WNK4-SPAK-NCC pathway but not hyperkalemic metabolic acidosis found in FHHt. Tubule injury was observed only after long-term CSN disruption. The data suggest that disruption of other cullins may be the cause for the injury.

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http://www.ncbi.nlm.nih.gov/pmc/articles/PMC11483082PMC
http://dx.doi.org/10.1152/ajprenal.00138.2024DOI Listing

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