Defective glucose metabolism in polycystic kidney disease identifies a new therapeutic strategy

Isaline Rowe, Marco Chiaravalli, Valeria Mannella, Valeria Ulisse, Giacomo Quilici, Monika Pema, Xuewen W. Song, Hangxue Xu, Silvia Mari, Feng Qian, York Pei, Giovanna Musco, Alessandra Boletta

Research output: Contribution to journalArticle

150 Citations (Scopus)

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is a common genetic disorder characterized by bilateral renal cyst formation. Recent identification of signaling cascades deregulated in ADPKD has led to the initiation of several clinical trials, but an approved therapy is still lacking. Using a metabolomic approach, we identify a pathogenic pathway in this disease that can be safely targeted for therapy. We show that mutation of PKD1 results in enhanced glycolysis in cells in a mouse model of PKD and in kidneys from humans with ADPKD. Glucose deprivation resulted in lower proliferation and higher apoptotic rates in PKD1-mutant cells than in nondeprived cells. Notably, two distinct PKD mouse models treated with 2-deoxyglucose (2DG), to inhibit glycolysis, had lower kidney weight, volume, cystic index and proliferation rates as compared to nontreated mice. These metabolic alterations depend on the extracellular signal-related kinase (ERK) pathway acting in a dual manner by inhibiting the liver kinase B1 (LKB1)-AMP-activated protein kinase (AMPK) axis on the one hand while activating the mTOR complex 1 (mTORC1)-glycolytic cascade on the other. Enhanced metabolic rates further inhibit AMPK. Forced activation of AMPK acts in a negative feedback loop, restoring normal ERK activity. Taken together, these data indicate that defective glucose metabolism is intimately involved in the pathobiology of ADPKD. Our findings provide a strong rationale for a new therapeutic strategy using existing drugs, either individually or in combination.

Original languageEnglish
Pages (from-to)488-493
Number of pages6
JournalNature Medicine
Volume19
Issue number4
DOIs
Publication statusPublished - Apr 2013

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Autosomal Dominant Polycystic Kidney
Polycystic Kidney Diseases
Metabolism
AMP-Activated Protein Kinases
Glucose
Glycolysis
Kidney
Phosphotransferases
Inborn Genetic Diseases
Metabolomics
Deoxyglucose
Therapeutics
Cysts
Liver
Clinical Trials
Weights and Measures
Mutation
Chemical activation
Feedback
Pharmaceutical Preparations

ASJC Scopus subject areas

  • Biochemistry, Genetics and Molecular Biology(all)
  • Medicine(all)

Cite this

Defective glucose metabolism in polycystic kidney disease identifies a new therapeutic strategy. / Rowe, Isaline; Chiaravalli, Marco; Mannella, Valeria; Ulisse, Valeria; Quilici, Giacomo; Pema, Monika; Song, Xuewen W.; Xu, Hangxue; Mari, Silvia; Qian, Feng; Pei, York; Musco, Giovanna; Boletta, Alessandra.

In: Nature Medicine, Vol. 19, No. 4, 04.2013, p. 488-493.

Research output: Contribution to journalArticle

Rowe, I, Chiaravalli, M, Mannella, V, Ulisse, V, Quilici, G, Pema, M, Song, XW, Xu, H, Mari, S, Qian, F, Pei, Y, Musco, G & Boletta, A 2013, 'Defective glucose metabolism in polycystic kidney disease identifies a new therapeutic strategy', Nature Medicine, vol. 19, no. 4, pp. 488-493. https://doi.org/10.1038/nm.3092
Rowe I, Chiaravalli M, Mannella V, Ulisse V, Quilici G, Pema M et al. Defective glucose metabolism in polycystic kidney disease identifies a new therapeutic strategy. Nature Medicine. 2013 Apr;19(4):488-493. https://doi.org/10.1038/nm.3092
Rowe, Isaline ; Chiaravalli, Marco ; Mannella, Valeria ; Ulisse, Valeria ; Quilici, Giacomo ; Pema, Monika ; Song, Xuewen W. ; Xu, Hangxue ; Mari, Silvia ; Qian, Feng ; Pei, York ; Musco, Giovanna ; Boletta, Alessandra. / Defective glucose metabolism in polycystic kidney disease identifies a new therapeutic strategy. In: Nature Medicine. 2013 ; Vol. 19, No. 4. pp. 488-493.
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