ASN's Mission

To create a world without kidney diseases, the ASN Alliance for Kidney Health elevates care by educating and informing, driving breakthroughs and innovation, and advocating for policies that create transformative changes in kidney medicine throughout the world.

learn more

Contact ASN

1401 H St, NW, Ste 900, Washington, DC 20005

email@asn-online.org

202-640-4660

The Latest on X

Kidney Week

Abstract: TH-OR136

A Small Molecule Inhibitor of ASK1 Modulates Biomarkers and Pathways Associated with Diabetic Kidney Disease (DKD)

Session Information

Category: Diabetes

  • 501 Diabetes Mellitus and Obesity: Basic - Experimental

Authors

  • Badal, Shawn S., Gilead Sciences, Foster City, California, United States
  • Yang, Haichun, Vanderbilt University , Nashville, Tennessee, United States
  • Li, Li, Gilead Sciences, Foster City, California, United States
  • Liu, Henry, Gilead Sciences, Foster City, California, United States
  • Fogo, Agnes B., Vanderbilt University , Nashville, Tennessee, United States
  • Breckenridge, David G., Gilead Sciences, Foster City, California, United States
  • Liles, John T., Gilead Sciences, Foster City, California, United States
Background

Apoptosis signal-regulating kinase 1 (ASK1) promotes inflammation, apoptosis, and fibrosis via activation of MAPK kinases p38 and c-Jun N terminal kinase (JNK). ASK1 pathway activation has been demonstrated in human DKD biopsies and in kidneys of db/db eNOS-/- mice. Clinically relevant urinary biomarkers associated with kidney damage and GFR decline in DKD patients have not been investigated in this animal model. This study evaluated effects of a selective, small molecule ASK1 inhibitor on urinary biomarkers and expression of DKD-related genes in db/db eNOS-/- mice.

Methods

db/db eNOS-/- mice were treated with a structural analog of the ASK1 inhibitor, Selonsertib, (GS-444217, 0.3% in chow) or vehicle for 8 weeks, starting at 10 weeks of age (baseline) (n=8-10 mice/group). At 18 weeks of age EGF, KIM-1 and TIMP1 levels in urine were quantified at end of study by ELISA and values normalized to urine creatinine levels. GFR was measured by FITC-inulin clearance. Kidney cortex mRNA was isolated and gene expression analyzed by qPCR and RNA-Seq.

Results

At 18 weeks, vehicle-treated mice had significant reductions in GFR (212± 21 vs 296±27 ml/min, p=0.0265) and uEGF levels (1.38 ± 0.11 vs 2.17± 0.27 μg/mg, p=0.0067) compared to baseline. ASK1 inhibition halted GFR decline (365± 31 vs 212± 21 ml/min, p=0.0007), prevented decreases in uEGF (2.51± 0.23 μg/mg vs 1.38±0.11, p=0.0003) and preserved kidney Egf mRNA levels. ASK1 inhibition reduced urinary TIMP1 (481.5± 96.3 vs 903.4± 158.8 pg/mg, p=0.0473) and Timp1 mRNA, compared to vehicle. Additionally, urinary KIM-1 as well as Havcr1 (KIM-1), Lcn2 (NGAL), Mcp1, and Tnf mRNA were all significantly reduced by ASK1 inhibition. Gene set enrichment analysis (GSEA) of RNA-Seq data revealed that TNFα signaling and inflammatory response pathways were enriched in db/db eNOS-/- mice and down-regulated by treatment with an ASK1 inhibitor.

Conclusion

Biomarkers related to kidney injury, inflammation, fibrosis and GFR decline in DKD patients are dysregulated in db/db eNOS-/- mice. The administration of an ASK1 inhibitor improved these biomarker levels and kidney function. These data establish db/db eNOS-/- mice as a relevant model to evaluate drug effects on biomarkers associated with GFR decline.

Funding

  • Commercial Support –