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: SA-PO647

An Epigenetically Driven Mechanism Triggered by Viral and Bacterial RNA Regulates the IL-6 Levels in IgA Nephropathy

Session Information

Category: Glomerular Diseases

  • 1302 Glomerular Diseases: Immunology and Inflammation

Authors

  • Sallustio, Fabio, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy
  • Curci, Claudia, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy
  • Cimmarusti, Maria Teresa, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy
  • Picerno, Angela, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy
  • Stasi, Alessandra, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy
  • Pesce, Francesco, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy
  • Di leo, Vincenzo, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy
  • Gesualdo, Loreto, Universita degli Studi di Bari Aldo Moro, Bari, Puglia, Italy

Group or Team Name

  • Loreto Gesualdo's research Group
Background

Recently, the role of IL-6 in IgAN pathogenesis is becoming increasingly important. A possible hypothesis emerges from our recent work on genome-wide DNA methylation screening in patients with IgAN, which identified, among other findings, a hypermethylated region comprising Vault 2-1 RNA (VTRNA2-1), a non-RNA coding also known as a precursor of miR-886 (pre-mi-RNA). Consistently, VTRNA2-1 expression was found downregulated in IgAN patients.

Methods

Total RNA were isolated from PBMCs of IgAN patients, transplanted IgAN patients (TP-IgAN), non-IgAN transplanted patients (TP) and healthy subjects (HS). VTRNA2-1, CREB, PKR and IL-6 were evaluated by RT-PCR and by ELISA. Poly (I:C) and Pfizer-BioNTech COVID-19 COMIRNATY vaccine were used to transfect patient PBMCs. PKR inhibitor imoxin (C16) 1 µM was used to stimulate patient PBMCs.

Results

Here we confirm that VTRNA2-1 is low expressed in IgAN subjects compared to HS and we found that also in TP-IgAN, compared to TP, the VTRNA2-1 transcript was expressed at level very low. We found that in IgAN patients with downregulated VTRNA2-1, PKR is overactivated, coherently with the role of the VTRNA2-1 that binds to PKR and inhibits its phosphorylation. The loss of the VTRNA2-1 natural restrain caused the activation of CREB by PKR, a classical cAMP-inducible CRE-binding factor interacting with a region of the IL-6 promoter and leading to IL-6 production. We found higher CREB phosphorylation levels and IL-6 levels both in IgAN and in TP-IgAN patients. Since PKR is normally activated by bacterial and viral RNA, we hypothesized that these microorganisms can further activate the PKR/CREB/IL-6 pathway leading to an excess of IL-6 production, explaining both the high levels of IL-6, both infection involvement in the disease, both cases of IgAN associated with COVID-19 infection and with COVID-19 RNA-vaccination. Both the RNA poly(I:C) and the COVID-19 RNA-vaccine stimulation significantly increase the IL-6 levels in IgAN patient PBMCs.

Conclusion

In conclusion, the discovery of the upregulated VTRNA2-1/PKR/CREB/IL-6 pathway in IgAN patients may provide a new pathogenic mechanism in IgAN and may be useful for the development of novel therapeutic approaches, likely by modulating the VTRNA2-1 methylation level in IgAN patients.

Funding

  • Government Support – Non-U.S.