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miR-196b-5p-enriched extracellular vesicles from tubular epithelial cells mediated aldosterone-induced renal fibrosis in mice with diabetes
  1. Renzhi Hu1,
  2. Xuan Li1,
  3. Chuan Peng2,
  4. Ruifei Gao3,
  5. Linqiang Ma1,
  6. Jinbo Hu1,
  7. Ting Luo1,
  8. Hua Qing1,
  9. Yue Wang1,
  10. Qian Ge1,
  11. Zhihong Wang1,
  12. Chaodong Wu4,
  13. Xiaoqiu Xiao2,
  14. Jun Yang5,
  15. Morag J Young5,
  16. Qifu Li1,
  17. Shumin Yang1
  1. 1Department of Endocrinology, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
  2. 2The Chongqing Key Laboratory of Translational Medicine in Major Metabolic Diseases, The First Affiliated Hospital of Chongqing Medical University, Chongqing, China
  3. 3School of Public Health and Management, Chongqing Medical University, Chongqing, China
  4. 4Nutrition & Food Sciences, Texas A&M University, College Station, Texas, USA
  5. 5Centre for Endocrinology and Metabolism, Hudson Institute of Medical Research, Clayton, Victoria, Australia
  1. Correspondence to Professor Qifu Li; liqifu{at}; Dr Shumin Yang; 443068494{at}


Introduction Aldosterone is a mediator of progressive renal disease, but the mechanisms for aldosterone-mediated renal impairment in mice with diabetes are not fully defined.

Methods Aldosterone and/or mineralocorticoid receptor antagonist eplerenone were used to treat the db/db mice with diabetes. Proximal tubule epithelial cells (PTECs) and fibroblasts were cultured. Blood and kidney samples from patients with diabetes with or without diabetic kidney disease (DKD) were used to verify the findings from animals and cultured cells.

Results We found that aldosterone promoted proteinuria and tubulointerstitial extracellular matrix (ECM) accumulation in db/db mice with diabetes while eplerenone mitigated the adverse effect of aldosterone. However, coculture of PTECs and fibroblasts found that when PTECs-derived extracellular vesicles (EVs) were taken up by fibroblasts, ECM production increased remarkably. Moreover, C57BL/6 mice injected with EVs from renal cortex of aldosterone-treated db/db mice showed increased ECM accumulation. Function of the ingredients of PTECs-derived EVs were analyzed, and RNAs were identified to be responsible for the EVs-induced fibroblast dysfunction. Furthermore, microRNA (miRNA) array analysis revealed that miR-196b-5p was the most remarkably increased miRNA in PTECs-derived EVs with aldosterone stimulation. Overexpression of miR-196b-5p in fibroblasts increased ECM production, accompanied by inhibition of the SOCS2 expression and enhanced STAT3 phosphorylation. In addition, plasma levels of miR-196b-5p was higher in patients with DKD as compared with patients without DKD and miR-196b-5p levels positively correlated with the albuminuria concentration. In kidney specimens from patients with diabetes, expression of miR-196b-5p, located mainly in PTECs, increased in patients with DKD as compared with the non-DKD.

Conclusion This study demonstrates the involvement of miR-196b-5p-EVs pathway as a novel mechanism in aldosterone-induced renal fibrosis in diabetes. EVs rich in miR-196b-5p mediate the crosstalk between PTECs and fibroblast during the development of renal fibrosis, which might be associated with STAT3/SOCO2 signaling pathway.

  • tubulointerstitial changes
  • fibroblast
  • fibrosis

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  • RH, XL and CP contributed equally.

  • Contributors RH, XL, CP, RG, LM, JH, TL, HQ, YW and QG performed the experiments and analyzed the data. QL and SY conceived the study, and ZW, CW and XX designed the experiments, analyzed the data and wrote the manuscript. JY and MJY provided significant assistance for the cell culture experiments.

  • Funding This work was supported by National Key Research & Development Plan, major project of precision medicine research (2017YFC0909600, sub-project: 2017YFC0909602, 2017YFC0909603); The National Natural Science Foundation of China (81670785, 81870567, 81800731,81770851, 81970720); Chongqing Science and Technology Committee Innovation Project (Technology Development and Application of Precision Medicine, cstc2016shms-ztzx1003).

  • Competing interests None declared.

  • Patient consent for publication Not required.

  • Ethics approval This study was approved by the ethics committee of the First Affiliated Hospital of Chongqing Medical University.

  • Provenance and peer review Not commissioned; externally peer reviewed.

  • Data availability statement Data are available on reasonable request. The dataset generated and analyzed in this study is available from the corresponding author on reasonable request.

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