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: SA-PO0495

Role of GDF15 in Lithium-Induced Tubulointerstitial Remodeling

Session Information

Category: Fluid, Electrolytes, and Acid-Base Disorders

  • 1101 Fluid, Electrolyte, and Acid-Base Disorders: Basic

Authors

  • Zerarga, Lucie, Centre de Recherche des Cordeliers, Paris, Île-de-France, France
  • Cheval, Lydie, Centre de Recherche des Cordeliers, Paris, Île-de-France, France
  • Billiet, Justine, Centre de Recherche des Cordeliers, Paris, Île-de-France, France
  • Morla, Luciana, Centre de Recherche des Cordeliers, Paris, Île-de-France, France
  • Try, Mélanie, Centre de Recherche des Cordeliers, Paris, Île-de-France, France
  • Himbert, Marie, Centre de Recherche des Cordeliers, Paris, Île-de-France, France
  • Vidal-Petiot, Emmanuelle, Hopital Bichat - Claude-Bernard, Paris, Île-de-France, France
  • Flamant, Martin, Hopital Bichat - Claude-Bernard, Paris, Île-de-France, France
  • Vrtovsnik, Francois, Hopital Bichat - Claude-Bernard, Paris, Île-de-France, France
  • Crambert, Gilles, Centre de Recherche des Cordeliers, Paris, Île-de-France, France
  • Tabibzadeh, Nahid, Centre de Recherche des Cordeliers, Paris, Île-de-France, France

Group or Team Name

  • Team Renal Physiology and Tubulopathy, Cordeliers Research Center.
Background

Lithium salts are the first-line treatment for bipolar disorder, a common and severe psychiatric condition. However, long-term use can cause two renal side effects: nephrogenic diabetes insipidus (NDI) and chronic microcystic tubulointerstitial nephropathy. The latter involves collecting duct remodeling, with increased cell proliferation and expansion of type A intercalated cells (A-ICs). GDF15 (Growth Differentiation Factor 15) is induced by vasopressin (AVP) and promotes A-IC proliferation in acidosis. We hypothesized that GDF15 may link lithium-induced NDI and nephropathy.

Methods

In wild-type mice, we compared lithium chloride (LiCl)-treated and control groups. We measured GDF15 levels in plasma and urine (ELISA), and renal expression (qPCR). We assessed the correlation between GDF15 levels and renal phenotype, defined by polyuria and collecting duct remodeling. Remodeling was assessed by histology and machine learning analysis. We then studied the effect of GDF15 knockout on renal phenotype in a lithium-exposed mouse model. We also tested whether blocking the AVP V2 receptor (V2R) reduces LiCl-induced GDF15 expression and tubular remodeling. In parallel, we analyzed data from 200 lithium-treated patients, correlating urinary GDF15 with renal phenotype.

Results

LiCl increased GDF15 levels in blood, urine, and kidney (Fig1). GDF15 levels correlated with polyuria and tubular changes. GDF15 knockout protected against both (Fig2). The effect of V2R inhibition on GDF15 and remodeling is under investigation. In patients, urinary GDF15 also correlated with renal phenotype.

Conclusion

These findings support a potential contributory role of GDF15 in lithium-induced nephropathy. Ongoing spatial transcriptomic analysis in a lithium-exposed mouse model will help refine our understanding of the underlying mechanisms.

Funding

  • Government Support – Non-U.S.

Digital Object Identifier (DOI)