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Neuronally differentiated macula densa cells regulate tissue remodeling and regeneration in the kidney
Georgina Gyarmati, Urvi Nikhil Shroff, Anne Riquier-Brison, Dorinne Desposito, Wenjun Ju, Sean D. Stocker, Audrey Izuhara, Sachin Deepak, Alejandra Becerra Calderon, James L. Burford, Hiroyuki Kadoya, Ju-Young Moon, Yibu Chen, Markus M. Rinschen, Nariman Ahmadi, Lester Lau, Daniel Biemesderfer, Aaron W. James, Liliana Minichiello, Berislav V. Zlokovic, Inderbir S. Gill, Matthias Kretzler, János Peti-Peterdi
Georgina Gyarmati, Urvi Nikhil Shroff, Anne Riquier-Brison, Dorinne Desposito, Wenjun Ju, Sean D. Stocker, Audrey Izuhara, Sachin Deepak, Alejandra Becerra Calderon, James L. Burford, Hiroyuki Kadoya, Ju-Young Moon, Yibu Chen, Markus M. Rinschen, Nariman Ahmadi, Lester Lau, Daniel Biemesderfer, Aaron W. James, Liliana Minichiello, Berislav V. Zlokovic, Inderbir S. Gill, Matthias Kretzler, János Peti-Peterdi
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Research Article Nephrology

Neuronally differentiated macula densa cells regulate tissue remodeling and regeneration in the kidney

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Abstract

Tissue regeneration is limited in several organs, including the kidney, contributing to the high prevalence of kidney disease globally. However, evolutionary and physiological adaptive responses and the presence of renal progenitor cells suggest an existing remodeling capacity. This study uncovered endogenous tissue remodeling mechanisms in the kidney that were activated by the loss of body fluid and salt and regulated by a unique niche of a minority renal cell type called the macula densa (MD). Here, we identified neuronal differentiation features of MD cells that sense the local and systemic environment and secrete angiogenic, growth, and extracellular matrix remodeling factors, cytokines and chemokines, and control resident progenitor cells. Serial intravital imaging, MD nerve growth factor receptor and Wnt mouse models, and transcriptome analysis revealed cellular and molecular mechanisms of these MD functions. Human and therapeutic translation studies illustrated the clinical potential of MD factors, including CCN1, as a urinary biomarker and therapeutic target in chronic kidney disease. The concept that a neuronally differentiated key sensory and regulatory cell type responding to organ-specific physiological inputs controls local progenitors to remodel or repair tissues may be applicable to other organs and diverse tissue-regenerative therapeutic strategies.

Authors

Georgina Gyarmati, Urvi Nikhil Shroff, Anne Riquier-Brison, Dorinne Desposito, Wenjun Ju, Sean D. Stocker, Audrey Izuhara, Sachin Deepak, Alejandra Becerra Calderon, James L. Burford, Hiroyuki Kadoya, Ju-Young Moon, Yibu Chen, Markus M. Rinschen, Nariman Ahmadi, Lester Lau, Daniel Biemesderfer, Aaron W. James, Liliana Minichiello, Berislav V. Zlokovic, Inderbir S. Gill, Matthias Kretzler, János Peti-Peterdi

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Figure 7

CCN1 expression in the kidney in patients with normal kidney function or CKD.

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CCN1 expression in the kidney in patients with normal kidney function or...
(A) Immunofluorescence labeling (red, left) and quantification (right) of MD cell markers CCN1 (top), NOS1 (center), and COX2 (bottom) in human kidney sections. Note the strong CCN1 expression exclusively in cells of the macula densa (MD; red arrows) in controls and mostly absent labeling in kidney tissue samples from patients with CKD, in contrast to the pattern in NOS1 and COX2 labeling; n = 6 (average of 5 MDs/sample). Nuclei are labeled blue with DAPI; green is tissue autofluorescence. G: glomerulus. Scale bars: 25 μm. (B) Intrarenal CCN1 (CYR61), NOS1, and PTGS2 (COX2) mRNA expression in kidney biopsies (tubulointerstitial compartment) from living donor (LD), tumor nephrectomy (TN), and patients with CKD with various etiologies from the ERCB. LD (n = 31), TN (n = 4), diabetic nephropathy (DN, n = 17), minimal change disease (MCD, n = 14), thin basement membrane disease (TMD, n = 6), arterial hypertension (HTN, n = 20), IgA nephropathy (IgAN, n = 25), focal segmental glomerulosclerosis (FSGS, n = 17), lupus nephritis (SLE, n = 32), membranous glomerulonephropathy (MGN, n = 18), and vasculitis (RPGN, n = 21). Differential expression comparison between LD and each disease subtype was performed using t test. (C) The association of urinary CCN1 levels with kidney function. Comparison of urinary CCN1 in individuals acting as controls (n = 11) and patients with CKD (n = 29) (left) and the positive correlation between urinary CCN1 excretion and eGFR in patients with CKD; n = 18, log2-transformed urinary CCN1/creatinine ratios are shown (right). Data represent mean ± SEM. *P < 0.05, **P < 0.01, ***P < 0.001, ****P < 0.0001 using Student’s t test.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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