Cyclosporine A impairs nucleotide binding oligomerization domain (Nod1)-mediated innate antibacterial renal defenses in mice and human transplant recipients

PLoS Pathog. 2013 Jan;9(1):e1003152. doi: 10.1371/journal.ppat.1003152. Epub 2013 Jan 31.

Abstract

Acute pyelonephritis (APN), which is mainly caused by uropathogenic Escherichia coli (UPEC), is the most common bacterial complication in renal transplant recipients receiving immunosuppressive treatment. However, it remains unclear how immunosuppressive drugs, such as the calcineurin inhibitor cyclosporine A (CsA), decrease renal resistance to UPEC. Here, we investigated the effects of CsA in host defense against UPEC in an experimental model of APN. We show that CsA-treated mice exhibit impaired production of the chemoattractant chemokines CXCL2 and CXCL1, decreased intrarenal recruitment of neutrophils, and greater susceptibility to UPEC than vehicle-treated mice. Strikingly, renal expression of Toll-like receptor 4 (Tlr4) and nucleotide-binding oligomerization domain 1 (Nod1), neutrophil migration capacity, and phagocytic killing of E. coli were significantly reduced in CsA-treated mice. CsA inhibited lipopolysaccharide (LPS)-induced, Tlr4-mediated production of CXCL2 by epithelial collecting duct cells. In addition, CsA markedly inhibited Nod1 expression in neutrophils, macrophages, and renal dendritic cells. CsA, acting through inhibition of the nuclear factor of activated T-cells (NFATs), also markedly downregulated Nod1 in neutrophils and macrophages. Silencing the NFATc1 isoform mRNA, similar to CsA, downregulated Nod1 expression in macrophages, and administration of the 11R-VIVIT peptide inhibitor of NFATs to mice also reduced neutrophil bacterial phagocytosis and renal resistance to UPEC. Conversely, synthetic Nod1 stimulating agonists given to CsA-treated mice significantly increased renal resistance to UPEC. Renal transplant recipients receiving CsA exhibited similar decrease in NOD1 expression and neutrophil phagocytosis of E. coli. The findings suggest that such mechanism of NFATc1-dependent inhibition of Nod1-mediated innate immune response together with the decrease in Tlr4-mediated production of chemoattractant chemokines caused by CsA may contribute to sensitizing kidney grafts to APN.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Disease
  • Animals
  • Bone Marrow Cells / drug effects
  • Bone Marrow Cells / metabolism
  • Cell Movement / drug effects
  • Chemokines / metabolism*
  • Cyclosporine / adverse effects*
  • Dendritic Cells / drug effects
  • Dendritic Cells / metabolism
  • Disease Models, Animal
  • Female
  • Gene Silencing
  • Humans
  • Immunity, Innate
  • Immunosuppressive Agents / adverse effects*
  • Kidney / drug effects*
  • Kidney / metabolism
  • Kidney / pathology
  • Kidney Transplantation* / immunology
  • Macrophages / drug effects
  • Macrophages / metabolism
  • Mice
  • Mice, Inbred C57BL
  • Mice, Knockout
  • NFATC Transcription Factors / antagonists & inhibitors
  • Neutrophils / drug effects
  • Neutrophils / metabolism
  • Nod1 Signaling Adaptor Protein / metabolism*
  • Organ Culture Techniques
  • Phagocytosis / drug effects
  • Pyelonephritis / chemically induced*

Substances

  • Chemokines
  • Immunosuppressive Agents
  • NFATC Transcription Factors
  • NOD1 protein, human
  • Nod1 Signaling Adaptor Protein
  • Cyclosporine

Grants and funding

AV was in receipt of a Contrat Hospitalier de Recherche Translationnelle (CHRP) INSERM-APHP, 2010. CW salary was funded in part by an ERC grant (PGNfromSHAPEtoVIR 202283, to Ivo Boneca, Institut Pasteur, Paris, France). ET was in receipt of a French Research Ministry thesis grant, and a “Bourse de fin de thèse” FRM grant. The work has been supported by INSERM, and in part by grants from the Agence de la Biomédecine 2007, 2009 (to AV), and from the French National Agency under reference ANR-08-MIE-030 (to AV, ER, and CW). CC is in receipt of a 2011 ATIP-AVENIR grant. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript