Cyst growth in ADPKD is prevented by pharmacological and genetic inhibition of TMEM16A in vivo

Nat Commun. 2020 Aug 28;11(1):4320. doi: 10.1038/s41467-020-18104-5.


In autosomal dominant polycystic kidney disease (ADPKD) multiple bilateral renal cysts gradually enlarge, leading to a decline in renal function. Transepithelial chloride secretion through cystic fibrosis transmembrane conductance regulator (CFTR) and TMEM16A (anoctamin 1) are known to drive cyst enlargement. Here we demonstrate that loss of Pkd1 increased expression of TMEM16A and CFTR and Cl- secretion in murine kidneys, with TMEM16A essentially contributing to cyst growth. Upregulated TMEM16A enhanced intracellular Ca2+ signaling and proliferation of Pkd1-deficient renal epithelial cells. In contrast, increase in Ca2+ signaling, cell proliferation and CFTR expression was not observed in Pkd1/Tmem16a double knockout mice. Knockout of Tmem16a or inhibition of TMEM16A in vivo by the FDA-approved drugs niclosamide and benzbromarone, as well as the TMEM16A-specific inhibitor Ani9 largely reduced cyst enlargement and abnormal cyst cell proliferation. The present data establish a therapeutic concept for the treatment of ADPKD.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Anoctamin-1 / drug effects
  • Anoctamin-1 / genetics*
  • Anoctamin-1 / metabolism*
  • Benzbromarone / pharmacology
  • Calcium Channels
  • Cell Proliferation
  • Chlorides / metabolism
  • Cystic Fibrosis Transmembrane Conductance Regulator
  • Cysts / drug therapy
  • Cysts / genetics
  • Cysts / metabolism*
  • Disease Models, Animal
  • Dogs
  • Epithelial Cells / metabolism
  • Humans
  • Kidney / metabolism
  • Kidney / pathology
  • Madin Darby Canine Kidney Cells
  • Mice
  • Mice, Knockout
  • Nephrons / metabolism
  • Niclosamide / pharmacology
  • Polycystic Kidney, Autosomal Dominant / drug therapy
  • Polycystic Kidney, Autosomal Dominant / genetics
  • Polycystic Kidney, Autosomal Dominant / metabolism*
  • TRPP Cation Channels / genetics*
  • TRPP Cation Channels / metabolism*


  • ANO1 protein, mouse
  • Anoctamin-1
  • CFTR protein, human
  • Calcium Channels
  • Chlorides
  • TRPP Cation Channels
  • polycystic kidney disease 1 protein
  • Cystic Fibrosis Transmembrane Conductance Regulator
  • Benzbromarone
  • Niclosamide