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The secreted micropeptide C4orf48 enhances renal fibrosis via an RNA-binding mechanism
Jiayi Yang, … , David J. Nikolic-Paterson, Xueqing Yu
Jiayi Yang, … , David J. Nikolic-Paterson, Xueqing Yu
Published April 16, 2024
Citation Information: J Clin Invest. 2024;134(10):e178392. https://doi.org/10.1172/JCI178392.
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Research Article Nephrology

The secreted micropeptide C4orf48 enhances renal fibrosis via an RNA-binding mechanism

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Abstract

Renal interstitial fibrosis is an important mechanism in the progression of chronic kidney disease (CKD) to end-stage kidney disease. However, we lack specific treatments to slow or halt renal fibrosis. Ribosome profiling identified upregulation of a secreted micropeptide, C4orf48 (Cf48), in mouse diabetic nephropathy. Cf48 RNA and protein levels were upregulated in tubular epithelial cells in human and experimental CKD. Serum Cf48 levels were increased in human CKD and correlated with loss of kidney function, increasing CKD stage, and the degree of active interstitial fibrosis. Cf48 overexpression in mice accelerated renal fibrosis, while Cf48 gene deletion or knockdown by antisense oligonucleotides significantly reduced renal fibrosis in CKD models. In vitro, recombinant Cf48 (rCf48) enhanced TGF-β1–induced fibrotic responses in renal fibroblasts and epithelial cells independently of Smad3 phosphorylation. Cellular uptake of Cf48 and its profibrotic response in fibroblasts operated via the transferrin receptor. RNA immunoprecipitation–sequencing identified Cf48 binding to mRNA of genes involved in the fibrotic response, including Serpine1, Acta2, Ccn2, and Col4a1. rCf48 binds to the 3′UTR of Serpine1 and increases mRNA half-life. We identify the secreted Cf48 micropeptide as a potential enhancer of renal fibrosis that operates as an RNA-binding peptide to promote the production of extracellular matrix.

Authors

Jiayi Yang, Hongjie Zhuang, Jinhua Li, Ana B. Nunez-Nescolarde, Ning Luo, Huiting Chen, Andy Li, Xinli Qu, Qing Wang, Jinjin Fan, Xiaoyan Bai, Zhiming Ye, Bing Gu, Yue Meng, Xingyuan Zhang, Di Wu, Youyang Sia, Xiaoyun Jiang, Wei Chen, Alexander N. Combes, David J. Nikolic-Paterson, Xueqing Yu

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Figure 2

Cf48 expression in human kidney disease.

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Cf48 expression in human kidney disease.
(A–C) In situ hybridization sho...
(A–C) In situ hybridization shows a lack of Cf48 RNA expression in normal control kidney (A), and upregulation of Cf48 RNA in the tubulointerstitium in diabetic nephropathy (DN) (B), but it is virtually absent in the glomerular compartment in DN (C). (D and E) Confocal microscopy staining of Cf48 (green), Acta2 (red), PECAM-1 (CD31, yellow), and DAPI (blue) in normal control kidney (D) and DN (E). (F) Quantitation of the Cf48 staining area (%) in the tubulointerstitium in normal control (CTL) and DN. **P < 0.01 by 2-tailed Student’s t test. (G–I) Confocal microscopy staining of Cf48 (green), Acta2 (red), and DAPI (blue) in minimal change disease (MCD) (G), lupus nephritis (LN) (H), and IgA nephropathy (IgAN) (I). (J) Serum Cf48 levels in normal healthy controls (CTL), diabetes mellitus without kidney disease (DM), DN, IgAN, and LN. Data are expressed as mean ± SD. ****P < 0.0001 by 1-way ANOVA with Tukey’s multiple-comparison test. NS, not significant. (K) Spearman’s correlation between serum Cf48 levels and estimated glomerular filtration rate (eGFR) in DN, LN, and IgAN groups. (L) Spearman’s correlation between serum Cf48 levels and CKD stage in DN, LN, and IgAN groups. Scale bars: 50 μm.

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