The mTOR inhibitor Rapamycin protects from premature cellular senescence early after experimental kidney transplantation

PLoS One. 2022 Apr 21;17(4):e0266319. doi: 10.1371/journal.pone.0266319. eCollection 2022.

Abstract

Interstitial fibrosis and tubular atrophy, a major cause of kidney allograft dysfunction, has been linked to premature cellular senescence. The mTOR inhibitor Rapamycin protects from senescence in experimental models, but its antiproliferative properties have raised concern early after transplantation particularly at higher doses. Its effect on senescence has not been studied in kidney transplantation, yet. Rapamycin was applied to a rat kidney transplantation model (3 mg/kg bodyweight loading dose, 1.5 mg/kg bodyweight daily dose) for 7 days. Low Rapamycin trough levels (2.1-6.8 ng/mL) prevented the accumulation of p16INK4a positive cells in tubules, interstitium, and glomerula. Expression of the cytokines MCP-1, IL-1β, and TNF-α, defining the proinflammatory senescence-associated secretory phenotype, was abrogated. Infiltration with monocytes/macrophages and CD8+ T-lymphocytes was reduced and tubular function was preserved by Rapamycin. Inhibition of mTOR was not associated with impaired structural recovery, higher glucose levels, or weight loss. mTOR inhibition with low-dose Rapamycin in the immediate posttransplant period protected from premature cellular senescence without negative effects on structural and functional recovery from preservation/reperfusion damage, glucose homeostasis, and growth in a rat kidney transplantation model. Reduced senescence might maintain the renal regenerative capacity rendering resilience to future injuries resulting in protection from interstitial fibrosis and tubular atrophy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Atrophy / pathology
  • Cellular Senescence
  • Female
  • Fibrosis
  • Glucose / pharmacology
  • Humans
  • Kidney / pathology
  • Kidney Diseases* / pathology
  • Kidney Transplantation* / adverse effects
  • Male
  • Rats
  • Sirolimus / pharmacology
  • TOR Serine-Threonine Kinases / metabolism

Substances

  • MTOR protein, human
  • mTOR protein, rat
  • TOR Serine-Threonine Kinases
  • Glucose
  • Sirolimus

Grants and funding

Duska Dragun received funding for this study from Wyeth Pharma, now Pfizer (https://www.pfizer.com/). Since Duska Dragun passed away in December 2020, she is not listed as an author. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.