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

Please note that you are viewing an archived section from 2022 and some content may be unavailable. To unlock all content for 2022, please visit the archives.

Abstract: FR-PO695

Therapeutic Blockade of the SLIT/ROBO Signaling Pathway Alleviates Podocytopathy Defects in Integrin-Linked Kinase Podocyte-Specific Knockout Mice

Session Information

Category: Glomerular Diseases

  • 1304 Glomerular Diseases: Podocyte Biology

Authors

  • Kumar, Sudhir, Boston University, Boston, Massachusetts, United States
  • Fan, Xueping, Boston University, Boston, Massachusetts, United States
  • Zaltz, Emily, Boston University, Boston, Massachusetts, United States
  • Chen, Hui, Boston Medical Center, Boston, Massachusetts, United States
  • Henderson, Joel M., Boston University, Boston, Massachusetts, United States
  • Salant, David J., Boston University, Boston, Massachusetts, United States
  • Yang, Hongying, Pfizer Inc, Cambridge, Massachusetts, United States
  • Berasi, Stephen, Pfizer Inc, Cambridge, Massachusetts, United States
  • Lu, Weining, Boston University, Boston, Massachusetts, United States
Background

The SLIT/ROBO signaling pathway negatively regulates podocyte adhesion and actin polymerization. Podocyte-specific deletion of integrin-linked kinase (ILK) in mice (ILK cKO) causes a podocytopathy reflecting FSGS with severe proteinuria, podocyte loss, and renal failure. We hypothesized that therapeutically blocking the SLIT/ROBO pathway with a ROBO2-IgG-Fc fusion protein would improve the podocytopathy phenotype in adult ILK cKO mice.

Methods

Seven-week-old ILK cKO homozygous mice were generated and treated with the ROBO2-IgG-Fc fusion protein or control IgG at 25 mg/kg every 2-3 days for 16 weeks. The survival probability of ILK cKO mice was calculated using the Kaplan Meier estimator. Urine samples were collected every two days to measure the urine albumin-to-creatinine ratio (UACR). Renal function (BUN measurement), kidney histology (PAS staining), podocyte number (P57 staining), podocyte foot process width (FPW), and slit diaphragm (SD) density of ILK cKO mice were assessed after three weeks of the treatment.

Results

Median survival was significantly longer in ROBO2-IgG-Fc treated than control IgG treated ILK cKO mice (105 days versus 52 days). After 3-weeks of treatment, significant mean UACR reductions were observed on day 18 (46%) and day 21 (50%) in ROBO2-IgG-Fc treated ILK cKO mice compared to control IgG treated mice. In addition, BUN was considerably lower in ILK cKO mice treated with the ROBO2-IgG-Fc (88 mg/dL) than the control IgG (124 mg/dL). Finally, podocyte loss, podocyte FPW, SD density, and renal tubular injury in ILK cKO mice were significantly improved by the ROBO2- IgG-Fc treatment compared to control IgG.

Conclusion

Therapeutic inhibition of the SLIT/ROBO signaling pathway ameliorates the podocytopathy phenotype and significantly extends the life span of adult ILK podocyte-specific knockout mice via preventing podocyte loss, reducing albuminuria, and improving renal function. Our studies provide additional confidence in rationale for blocking the ROBO/SLIT signaling pathway for treating podocytopathies and proteinuric kidney diseases. A phase 2 (NCT03448692) clinical trial testing the efficacy of a ROBO2-Fc fusion protein (PF-06730512) in FSGS patients is ongoing.

Funding

  • NIDDK Support –