Tamm-Horsfall Protein Regulates Mononuclear Phagocytes in the Kidney

J Am Soc Nephrol. 2018 Mar;29(3):841-856. doi: 10.1681/ASN.2017040409. Epub 2017 Nov 27.


Tamm-Horsfall protein (THP), also known as uromodulin, is a kidney-specific protein produced by cells of the thick ascending limb of the loop of Henle. Although predominantly secreted apically into the urine, where it becomes highly polymerized, THP is also released basolaterally, toward the interstitium and circulation, to inhibit tubular inflammatory signaling. Whether, through this latter route, THP can also regulate the function of renal interstitial mononuclear phagocytes (MPCs) remains unclear, however. Here, we show that THP is primarily in a monomeric form in human serum. Compared with wild-type mice, THP-/- mice had markedly fewer MPCs in the kidney. A nonpolymerizing, truncated form of THP stimulated the proliferation of human macrophage cells in culture and partially restored the number of kidney MPCs when administered to THP-/- mice. Furthermore, resident renal MPCs had impaired phagocytic activity in the absence of THP. After ischemia-reperfusion injury, THP-/- mice, compared with wild-type mice, exhibited aggravated injury and an impaired transition of renal macrophages toward an M2 healing phenotype. However, treatment of THP-/- mice with truncated THP after ischemia-reperfusion injury mitigated the worsening of AKI. Taken together, our data suggest that interstitial THP positively regulates mononuclear phagocyte number, plasticity, and phagocytic activity. In addition to the effect of THP on the epithelium and granulopoiesis, this new immunomodulatory role could explain the protection conferred by THP during AKI.

Keywords: acute renal failure; ischemia-reperfusion; macrophages.

Publication types

  • Research Support, N.I.H., Extramural

MeSH terms

  • Acute Kidney Injury / drug therapy*
  • Acute Kidney Injury / etiology
  • Acute Kidney Injury / pathology*
  • Animals
  • Cell Plasticity / genetics
  • Cell Proliferation / drug effects
  • Enzyme Activation
  • Humans
  • Kidney / pathology
  • Mice
  • Phagocytes / drug effects*
  • Phagocytes / physiology*
  • Phenotype
  • Proto-Oncogene Proteins c-akt / metabolism
  • Reperfusion Injury / complications
  • Uromodulin / chemistry
  • Uromodulin / genetics*
  • Uromodulin / metabolism*
  • Uromodulin / pharmacology
  • Uromodulin / therapeutic use


  • UMOD protein, human
  • Umod protein, mouse
  • Uromodulin
  • Proto-Oncogene Proteins c-akt