马兜铃酸诱导大鼠肾小管上皮细胞表型转化和胶原累积及垂盆草提取物的作用

 目的：研究垂盆草（SSB）提取物对马兜铃酸（AA）诱导的肾小管上皮细胞表型转化和胶原累积的作用,并初步探讨可能的分子机制。方法：将体外培养的大鼠肾小管上皮细胞（NRK-52E）分为：(1) 溶剂对照组：未加入SSB和AA;(2) AA损伤组：只加AA,浓度为1~100 mg/L;(3) SSB提取物干预组：在加入10 mg/L AA基础上,同时加入SSB提取物（10~2 000 mg/L）。细胞培养24 h后,酶联免疫吸附试验检测转化生长因子β1(TGF-β1)含量;细胞免疫荧光染色检测肌成纤维细胞标志物α-平滑肌肌动蛋白（α-SMA）、上皮细胞标志物E-cadherin和基质成分III型胶原的表达;实时荧光定量PCR检测α-SMA、E-cadherin、骨形成蛋白7（BMP-7）和I型胶原mRNA的表达。结果：AA可诱导NRK-52E细胞呈现纤维化样改变;1 mg/L和10 mg/L AA不仅可增加基质成分I型和III型胶原的表达量,同时也可促进α-SMA表达,抑制E-cadherin的表达。用SSB提取物干预后,AA所致的纤维化改变明显减轻;SSB提取物下调了α-SMA、I型和III型胶原的表达,并且促进E-cadherin和BMP-7的表达。此外,SSB提取物也抑制TGF-β1的分泌,并呈浓度依赖性。结论：应用SSB提取物干预可明显降低AA所致的肾纤维化效应,可能的机制为SSB提取物降低TGF-β1的表达,抑制小管上皮细胞的表型转化,进而抑制胶原的累积。     

Loss of osteopontin perturbs the epithelial-mesenchymal transition in an injured mouse lens epithelium

We previously reported that osteopontin (OPN), a matrix structural glycophosphoprotein, is upregulated in the injured mouse lens prior to the epithelial-mesenchymal transition (EMT). Here, we investigated the role of this protein in EMT of the lens epithelium during wound healing. The crystalline lens was injured by needle puncture in OPN-null (KO, n=40) and wild-type (WT, n=40) mice. The animals were killed at day 1, 2, 5, and 10 postinjury. Immunohistochemistry was employed to detect alpha-smooth muscle action (alphaSMA), a marker of EMT, collagen type I, transforming growth factor beta1 (TGFbeta1), TGFbeta2, and phospho-Smad2/3. Cell proliferation was assayed by examining uptake of bromodeoxyuridine (BrdU). The results showed that injury-induced EMT of mouse lens epithelium, as evaluated by histology, expression pattern of alphaSMA and collagen I, was altered in the absence of OPN with reduced phospho-Smad2/3 signaling. Upregulation of TGFbeta1 and TGFbeta2 in the epithelium was also inhibited. Cell proliferation was more active in KO mice as compared with WT mice at day 1 and 2, but not at day 5 and 10. An in vitro experiment shows OPN facilitates cell adhesion of lens epithelial cell line. OPN is required for activation of Smad2/3 signal in an injured lens epithelium and lens cell EMT.     

氧化苦参碱抑制高糖诱导的大鼠肾小管上皮-间充质转化及其机制研究

 目的：探讨氧化苦参碱(OM)对高糖诱导的大鼠肾小管上皮-间充质转化（EMT）的抑制作用及其可能机制。方法：体外培养大鼠近端肾小管上皮NRK52E细胞,随机分为：对照组、高糖组、高糖+OM不同浓度组和高糖+0.50 g/L OM动态观察组。采用real-time PCR和Western blotting方法检测转化生长因子β1（TGF-β1）、Smad7、α-平滑肌肌动蛋白（α-SMA）、E-钙黏素（E-cadherin）mRNA和蛋白的表达。结果：（1）与对照组相比,高糖组TGF-β1、α-SMA mRNA和蛋白表达水平均进行性增高,Smad7蛋白表达进行性降低,E-cadherin mRNA和蛋白表达进行性降低,呈时间依赖性（P＜0.05）,而Smad7 mRNA表达进行性增高（P＜0.05）;（2）与高糖组相比,高糖+ OM不同浓度组随OM剂量增加,TGF-β1、α-SMA mRNA和蛋白表达均逐渐降低,Smad7蛋白表达水平逐渐增高,E-cadherin mRNA和蛋白表达水平逐渐增高,且呈剂量依赖性（P＜0.05）,而Smad7 mRNA表达无明显差异;（3）与高糖组相比,高糖+0.50 g/L OM动态观察组TGF-β1、α-SMA mRNA和蛋白表达持续降低,Smad7蛋白表达持续增高,E-cadherin mRNA和蛋白表达持续增高（P＜0.05）,而Smad7 mRNA表达无明显差异。结论：OM可抑制高糖诱导的NRK52E细胞发生EMT,其机制可能与OM下调TGF-β1表达及上调Smad7蛋白表达,进而抑制TGF-β1/Smads信号通路的致纤维化效应有关。     

Dissection of key events in tubular epithelial to myofibroblast transition and its implications in renal interstitial fibrosis

Myofibroblast activation is a key event playing a critical role in the progression of chronic renal disease. Emerging evidence suggests that myofibroblasts can derive from tubular epithelial cells by an epithelial to mesenchymal transition (EMT); however, the details regarding the conversion between these two cell types are poorly understood. Here we dissect the key events during the process of EMT induced by transforming growth factor-beta1. Incubation of human tubular epithelial cells with transforming growth factor-beta1 induced de novo expression of alpha-smooth muscle actin, loss of epithelial marker E-cadherin, transformation of myofibroblastic morphology, and production of interstitial matrix. Time-course studies revealed that loss of E-cadherin was an early event that preceded other alterations during EMT. The transformed cells secreted a large amount of matrix metalloproteinase-2 that specifically degraded tubular basement membrane. They also exhibited an enhanced motility and invasive capacity. These alterations in epithelial phenotypes in vitro were essentially recapitulated in a mouse model of renal fibrosis induced by unilateral ureteral obstruction. Hence, these results indicate that tubular epithelial to myofibroblast transition is an orchestrated, highly regulated process involving four key steps including: 1) loss of epithelial cell adhesion, 2) de novo alpha-smooth muscle actin expression and actin reorganization, 3) disruption of tubular basement membrane, and 4) enhanced cell migration and invasion.     

The differential expression of TGF-β1, ILK and wnt signaling inducing epithelial to mesenchymal transition in human renal fibrogenesis: an immunohistochemical study

Epithelial-to-mesenchymal transition (EMT) is a process for fully differentiated epithelial cells to undergo a phenotypic change to fibroblasts via diverse intracellular signaling pathways. While the pivotal role of fibroblasts in renal fibrosis is widely accepted, their origin remains undefined. In addition, although a large number of studies have provided evidence of EMT in human kidney diseases, specific signaling pathways leading to EMT have not yet been discovered in humans. To evaluate the origin of interstitial fibroblasts and signaling pathways involved in the EMT process, we analyzed the differential expression of EMT-related molecules in paraffin-fixed sections from 19 human fibrotic kidneys and 4 control kidneys. In human fibrotic kidneys, tubular epithelial cells (TECs) with intact tubular basement membrane (TBM) showed loss or down-regulation of an epithelial marker (E-cadherin), de novo expression of mesenchymal markers (vimentin and fibronectin), and significant up-regulation of inducers and mediators controlling the EMT process (transforming growth factor-β1 (TGF-β1), p-Smad2/3, β1-integrin, p38 mitogen-activated protein kinase (MAPK), WNT5B and β-catenin) in the areas of interstitial inflammation and fibrosis, compared with their expression in control kidneys. In conclusion, the type II EMT process in humans is thought to be an adaptive response of TECs to chronic injury and is regulated by interconnections of TGF-β/Smad, integrin/integrin-linked kinase (ILK) and wnt/β-catenin signaling pathways.     

环杷明对马兜铃酸诱导的肾上皮细胞表型转化及Hedgehog通路的影响

目的:探讨环杷明干预Hedgehog(HH)信号对马兜铃酸(AA)致肾小管上皮细胞表型转化和基质累积的影响。方法:根据干预措施将体外培养的大鼠肾小管上皮细胞NRK-52E分为溶剂对照组、AA损伤组(分别用终浓度为1、5和10 mg/L的AA处理细胞)和环杷明干预组(10 mg/L AA基础上加入1、5和10μmol/L环杷明)。细胞培养24 h后,用real-time PCR检测HH信号关键分子Ptch1和Smo、表型转化相关分子α-SMA和E-cadherin、ZO-1、BMP-7和基质成分I型和III型胶原mRNA的表达;ELISA法检测Shh和TGF-β1的含量;细胞免疫荧光染色检测Ptch1、Smo、E-cadherin、α-SMA和III型胶原蛋白表达。结果:AA不仅增加了TGF-β1、α-SMA和III型胶原的表达,降低了E-cadherin和ZO-1的表达,而且诱导了Shh和Smo mRNA表达的升高和Ptch1 mRNA表达的下降,提示AA促进小管上皮细胞表型转化和胶原累积,同时也激活了HH信号通路。环杷明干预AA作用后,Smo mRNA或蛋白表达下调,Ptch1 mRNA表达升高,这说明环杷明抑制了AA诱导的HH信号通路的活化。此外,环杷明也降低TGF-β1、α-SMA、I型和III型胶原的表达,提高BMP-7、ZO-1和E-cadherin的表达,这提示环杷明抑制了AA所致的上皮细胞的表型转化和基质累积。结论:环杷明可抑制AA所致的肾小管上皮细胞表型转化和基质累积,可能是通过靶向抑制HH信号的活化来实现的。     

WT1 and Pax2 re-expression is required for epithelial-mesenchymal transition in 5/6 nephrectomized rats and cultured kidney tubular epithelial cells

Mature tubular epithelial cells in the adult kidney can undergo epithelial-mesenchymal transition (EMT), a phenotypic change that is linked to the pathogenesis of renal interstitial fibrosis. EMT may be considered the reverse of mesenchymal-epithelial transition, which occurs during normal kidney development. The Wilms' tumor suppressor gene WT1 and the paired box 2 gene Pax2 are needed to induce mesenchymal-epithelial transition and play key roles in the progression of nephrogenesis. However, until now, WT1 and Pax2 have not been tested for their direct involvement in the process of renal tubular EMT. In this study, we explored the potential roles of WT1 and Pax2 in EMT that is induced in the remnant kidney of rats following 5/6 nephrectomy. We also examined WT1 and Pax2 in cultured renal tubular epithelial (NRK52E) cells treated with interleukin-1α and investigated the effects of blocking EMT using RNA interference. We showed that WT1 and Pax2 were re-expressed in the EMT models, and these were accompanied by decreased expression of E-cadherin and increased expression of vimentin, Snail and α-smooth muscle actin. Silencing WT1 and Pax2 by RNA interference blocked the interleukin-1α-induced EMT in the NRK52E cells, as reflected in the suppression of α-SMA and Snail expression, the restoration of E-cadherin expression and normal cell morphology. Our experiments suggested that the re-expression of WT1 and Pax2 in the tubular epithelial cells plays important roles in the promotion of EMT, and there may be therapeutic value in silencing Pax2 and WT1 to prevent or reverse renal fibrosis.     

AGEs对肾小管上皮细胞转分化、1型胶原合成及smad信号通路的影响

目的:观察终末期糖基化终产物(AGEs)对正常大鼠近端肾小管上皮细胞（NRK52E ）转分化、collagenⅠ合成及Smads信号通路的影响。 方法:应用自制的AGEs（AGE-BSA）刺激NRK52E细胞，采用免疫细胞化学方法检测pmad2/3核表达情况；ELISA方法检测细胞培养上清TGF-β₁的浓度；RT-PCR检测TGF-β₁、Smad2、Smad3和Smad7 mRNA的表达；Western印迹检测α-平滑肌肌动蛋白（SMA）、E-钙粘着糖蛋白（cadherin）和1型胶原（collagenⅠ）蛋白的表达。 结果: AGE-BSA刺激15 min后pSmad2/3核表达明显增加，于30 min（68%）和24 h（76%）出现两个高峰，与刺激前及时间匹配的BSA对照组比较均有显著差异（P<0.05）；AGE-BSA以时间依赖方式上调TGF-β₁、Smad2、Smad3和Smad7 mRNA的表达；NRK52E细胞α-SMA和collagenⅠ蛋白表达高于对照组（P<0.01），E-cadherin蛋白表达低于对照组（P<0.01），细胞上清液TGF-β₁的浓度高于对照组（P<0.01）。 结论:AGEs可诱导肾小管上皮细胞Smads信号通路活化，促进肾小管上皮细胞转分化和细胞外基质collagenⅠ的合成。     

肾小管上皮间充质转化与肾脏纤维化

 [摘要] 在肾脏损伤过程中,多种因子可诱导上皮细胞转化为成纤维细胞/肌成纤维细胞,引起肾小管缺失与细胞外基质蛋白沉积,这一过程被称为上皮间充质转化(epithelial-mesenchymal transition, EMT)。在肾脏损伤或应激时,肾小管上皮细胞发生EMT,对肾脏纤维化具有重要作用。肾小管上皮细胞微环境存在多种调节因子,调控EMT相关信号如TGF-β/Smad、Wnt/β-catenin等的表达与传导。本文就近年来肾小管上皮细胞EMT在肾脏纤维化的作用及机制研究进展进行综述。     

Transforming growth factor-beta-induced epithelial-mesenchymal transition in the lens: a model for cataract formation

The vertebrate lens has a distinct polarity and structure that are regulated by growth factors resident in the ocular media. Fibroblast growth factors, in concert with other growth factors, are key regulators of lens fiber cell differentiation. While members of the transforming growth factor (TGFbeta) superfamily have also been implicated to play a role in lens fiber differentiation, inappropriate TGFbeta signaling in the anterior lens epithelial cells results in an epithelial-mesenchymal transition (EMT) that bears morphological and molecular resemblance to forms of human cataract, including anterior subcapsular (ASC) and posterior capsule opacification (PCO; also known as secondary cataract or after-cataract), which occurs after cataract surgery. Numerous in vitro and in vivo studies indicate that this TGFbeta-induced EMT is part of a wound healing response in lens epithelial cells and is characterized by induced expression of numerous extracellular matrix proteins (laminin, collagens I, III, tenascin, fibronectin, proteoglycans), intermediate filaments (desmin, alpha-smooth muscle actin) and various integrins (alpha2, alpha5, alpha7B), as well as the loss of epithelial genes [Pax6, Cx43, CP49, alpha-crystallin, E-cadherin, zonula occludens-1 protein (ZO-1)]. The signaling pathways involved in initiating the EMT seem to primarily involve the Smad-dependent pathway, whereby TGFbeta binding to specific high affinity cell surface receptors activates the receptor-Smad/Smad4 complex. Recent studies implicate other factors [such as fibroblast growth factor (FGFs), hepatocyte growth factor, integrins], present in the lens and ocular environment, in the pathogenesis of ASC and PCO. For example, FGF signaling can augment many of the effects of TGFbeta, and integrin signaling, possibly via ILK, appears to mediate some of the morphological features of EMT initiated by TGFbeta. Increasing attention is now being directed at the network of signaling pathways that effect the EMT in lens epithelial cells, with the aim of identifying potential therapeutic targets to inhibit cataract, particularly PCO, which remains a significant clinical problem in ophthalmology.     

Transforming growth factor-beta stimulates epithelial-mesenchymal transformation in the proepicardium.

The proepicardium (PE) migrates over the heart and forms the epicardium. A subset of these PE-derived cells undergoes epithelial-mesenchymal transformation (EMT) and gives rise to cardiac fibroblasts and components of the coronary vasculature. We report that transforming growth factor-beta (TGFbeta) 1 and TGFbeta2 increase EMT in PE explants as measured by invasion into a collagen gel, loss of cytokeratin expression, and redistribution of ZO1. The type I TGFbeta receptors ALK2 and ALK5 are both expressed in the PE. However, only constitutively active (ca) ALK2 stimulates PE-derived epithelial cell activation, the first step in transformation, whereas caALK5 stimulates neither activation nor transformation in PE explants. Overexpression of Smad6, an inhibitor of ALK2 signaling, inhibits epithelial cell activation, whereas BMP7, a known ligand for ALK2, has no effect. These data demonstrate that TGFbeta stimulates transformation in the PE and suggest that ALK2 partially mediates this effect.     

Transient adenoviral gene transfer of Smad7 prevents injury-induced epithelial-mesenchymal transition of lens epithelium in mice

We examined the effect of adenovirus-mediated transient expression of Smad7, an inhibitory Smad in TGFbeta/activin signaling, on injury-induced epithelial-mesenchymal transition (EMT) of lens epithelium in mice. A volume of 3 microl of adenoviral solution was injected into the right lens of adult male C57BL/6 mice (n=56) at the time of capsular injury made using a hypodermic needle under general anesthesia. A mixture of recombinant adenovirus carrying CAG promoter-driven Cre (Cre adv) and mouse Smad7 complementary DNA (Smad7 adv) was administered to induce Smad7 expression, while control lenses were treated with Cre adv alone. After healing intervals of 2, 3, 5, and 10 days, animals were killed 2 h after labeling with bromodeoxyuridine (BrdU) and eyes were processed for histology. During healing, marked expression of Smad7 was observed in lens epithelial cells in the Smad7 adv group with loss of nuclear translocation of Smads2/3, while little Smad7 and abundant nuclear Smads2/3 were seen in cells in the Cre adv group. Lens epithelial cells in the Cre adv control group exhibited a fibroblastic appearance at days 5 and 10 and the capsular break was sealed with fibrous tissue, while Smad7 adv-treated cells around the capsular break retained their epithelial morphology and the break was not sealed. Expression of snail mRNA, and alpha-smooth muscle actin, lumican, and collagen VI proteins, markers of EMT, was observed in control-treated eyes, but not in cells of the Smad7 adv group at day 5 with minimal expression at day 10. Additionally, cell proliferation increased in epithelium infected with Smad7 adv consistent with suppression of injury-induced upregulation of TGFbeta1 in epithelium. We conclude that gene transfer of Smad7 in mice prevents injury-induced EMT of lens epithelial cells and sealing of the capsular break with fibrous tissue.     

Epithelial-mesenchymal transition contributes to portal tract fibrogenesis during human chronic liver disease

The relationship between bile duct damage and portal fibrosis in chronic liver diseases remains unclear. This study was designed to show whether human intrahepatic biliary epithelial cells can undergo epithelial-mesenchymal cell transition, thereby directly contributing to fibrogenesis. Primary human cholangiocytes were stimulated with transforming growth factor-beta (TGFbeta) or TGFbeta-presenting T cells and examined for evidence of transition to a mesenchymal phenotype. Liver sections were labelled to detect antigens associated with biliary epithelial cells (cytokeratin 7 and 19 and E-cadherin), T cells (CD8), epithelial-mesenchymal transition (S100A4, vimentin and matrix metalloproteinase-2 (MMP-2)), myofibroblasts (alpha-smooth muscle actin) and intracellular signal-transduction mediated by phosphorylated (p)Smad 2/3; in situ hybridisation was performed to detect mRNA encoding TGFbeta and S100A4. Stimulation of cultured cells with TGFbeta induced the expression of pSmad2/3, S100A4 and alpha-smooth muscle actin; these cells became highly motile. Although normal bile ducts expressed ALK5 (TGFbeta RI), low levels of TGFbeta mRNA and nuclear pSmad2/3, they did not express S100A4, vimentin or MMP-2. However, TGFbeta mRNA and nuclear pSmad2/3 were strongly expressed in damaged ducts, which also expressed S100A4, vimentin and MMP-2. Fibroblast-like cells which expressed S100A4 were present around many damaged bile ducts. Cells in the 'ductular reaction' expressed both epithelial and mesenchymal markers together with high levels of TGFbeta mRNA and pSmad2/3. In conclusion, the cells forming small- and medium-sized bile ducts and the ductular reaction undergo EMT during chronic liver diseases, resulting in the formation of invasive fibroblasts; this process may be driven by a response to local TGFbeta, possibly presented by infiltrating T cells.     

The roles of Arkadia in renal tubular epithelial to mesenchymal transition

The ubiquitin-proteasome pathway (UPP) can regulate the stability of proteins, which is regarded as an important mechanism in controlling various biological processes. In the pathway, E3 ubiquitin ligases play critical roles in the recognition of target proteins and degradation by 26S proteasomes. Arkadia is one of the E3 ubiquitin ligases, and recent research has shown that Arkadia amplifies TGF-beta signalling through degradation of Smad7. The cellular level of Smad7 plays an important role in the regulation of Smad-mediated TGF-beta signalling during progression of organ fibrosis. Studies indicate that the level of Smad7 protein expression is decreased in progression of tubulointerstitial fibrosis. Moreover, growing evidence suggests renal tubular epithelial to mesenchymal transition (EMT) plays a key role in renal tubulointerstitial fibrosis and transforming growth factor-beta(1) (TGF-beta(1)) is the most potent inducer that is capable of initiating and completing the entire EMT course. Therefore, the activation of Smad signalling induced by TGF-beta(1) plays a key role in the mechanism of renal tubular EMT, and in this process, Arkadia may has an important influence on the mechanism above mentioned through degradation of Smad7.     

Transforming growth factor-beta induces loss of epithelial character and smooth muscle cell differentiation in epicardial cells.

During embryogenesis, epicardial cells undergo epithelial-mesenchymal transformation (EMT), invade the myocardium, and differentiate into components of the coronary vasculature, including smooth muscle cells. We tested the hypothesis that transforming growth factor-beta (TGFbeta) stimulates EMT and smooth muscle differentiation of epicardial cells. In epicardial explants, TGFbeta1 and TGFbeta2 induce loss of epithelial morphology, cytokeratin, and membrane-associated Zonula Occludens-1 and increase the smooth muscle markers calponin and caldesmon. Inhibition of activin receptor-like kinase (ALK) 5 blocks these effects, whereas constitutively active (ca) ALK5 increases cell invasion by 42%. Overexpression of Smad 3 did not mimic the effects of caALK5. Inhibition of p160 rho kinase or p38 MAP kinase prevented the loss of epithelial morphology in response to TGFbeta, whereas only inhibition of p160 rho kinase blocked TGFbeta-stimulated caldesmon expression. These data demonstrate that TGFbeta stimulates loss of epithelial character and smooth muscle differentiation in epicardial cells by means of a mechanism that requires ALK5 and p160 rho kinase.     

AMPKα2 reduces renal epithelial transdifferentiation and inflammation after injury through interaction with CK2β

TGFβ1/Smad, Wnt/β‐catenin and snail1 are preferentially activated in renal tubular epithelia after injury, leading to epithelial–mesenchymal transition (EMT). The stress response is coupled to EMT and kidney injury; however, the underlying mechanism of the stress response in EMT remains elusive. AMP‐activated protein kinase (AMPK) signalling is responsive to stress and regulates cell energy balance and differentiation. We found that knockdown of AMPKα, especially AMPKα2, enhanced EMT by up‐regulating β‐catenin and Smad3 in vitro. AMPKα2 deficiency enhanced EMT and fibrosis in a murine unilateral ureteral obstruction (UUO) model. AMPKα2 deficiency also increased the expression of chemokines KC and MCP‐1, along with enhanced infiltration of inflammatory cells into the kidney after UUO. CK2β interacted physically with AMPKα and enhanced AMPKα Thr172 phosphorylation and its catalytic activity. Thus, activated AMPKα signalling suppresses EMT and secretion of chemokines in renal tubular epithelia through interaction with CK2β to attenuate renal injury. Copyright © 2015 Pathological Society of Great Britain and Ireland. Published by John Wiley & Sons, Ltd.     

Dog as model for down-expression of E-cadherin and β-catenin in tubular epithelial cells in renal fibrosis

Mechanism of renal fibrosis leading to end stage kidney remains still a challenge of interest in humans. The pathogenesis of chronic kidney disease is characterized by progressive loss of kidney function and fibrosis. The mechanism of epithelial–mesenchymal transition (EMT) has been predominantly studied in in vitro studies, and we previously demonstrated the EMT of tubular epithelial cells in dogs. In this study, we examined and quantified the modifications of cadherin–catenin complex by immunohistochemistry of E-cadherin and β-catenin and the mesenchymal marker vimentin in 25 dogs with three different spontaneous inflammatory renal diseases. Results showed a significant down-expression of levels of E-cadherin and β-catenin directly correlated with the tubular–interstitial damage (TID). In TID grades 2 and 3, E-cadherin expression was significantly reduced (p < 0.001). β-catenin expression was overall similar to E-cadherin. The mesenchymal-associated protein, vimentin, was de novo identified in tubules within areas of inflammation. In this work, we identified the loss of cadherin or catenin expression as a progressive mechanism in tubulo-interstitial fibrosis, which allows dissociation of structural integrity of renal epithelia and loss of epithelial polarity. The dog might result more significant as model for new therapies.