Indoxyl sulfate exacerbates alveolar bone loss in chronic kidney disease through ferroptosis

Author:

Chen Huiwen12ORCID,Zhou Yining12,Liu Yingli3,Zhou Wei24,Xu Lina12,Shang Dihua12,Ni Jing12,Song Zhongchen12

Affiliation:

1. Department of Periodontology, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai China

2. College of Stomatology Shanghai Jiao Tong University National Center for Stomatology National Clinical Research Center for Oral Diseases Shanghai Key Laboratory of Stomatology Shanghai Research Institute of Stomatology Shanghai China

3. Department of Nephrology, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai China

4. Laboratory of Oral Microbiota and Systemic Diseases, Shanghai Ninth People's Hospital Shanghai Jiao Tong University School of Medicine Shanghai China

Abstract

AbstractObjectivesThe purpose of this study was to determine whether indoxyl sulfate (IS) is involved in alveolar bone deterioration and to elucidate the mechanism underlying alveolar bone loss in chronic kidney disease (CKD) patients.Materials and MethodsMice were divided into the control group, CP group (ligature‐induced periodontitis), CKD group (5/6 nephrectomy), and CKD + CP group. The concentration of IS in the gingival crevicular fluid (GCF) was determined by HPLC. The bone microarchitecture was evaluated by micro‐CT. MC3T3‐E1 cells were stimulated with IS, and changes in mitochondrial morphology and ferroptosis‐related factors were detected. RT‐PCR, western blotting, alkaline phosphatase activity assays, and alizarin red S staining were utilized to assess how IS affects osteogenic differentiation.ResultsCompared with that in the other groups, alveolar bone destruction in the CKD + CP group was more severe. IS accumulated in the GCF of mice with CKD. IS activated the aryl hydrocarbon receptor (AhR) in vitro, inhibited MC3T3‐E1 cell osteogenic differentiation, caused changes in mitochondrial morphology, and activated the SLC7A11/GPX4 signaling pathway. An AhR inhibitor attenuated the aforementioned changes induced by IS.ConclusionsIS activated the AhR/SLC7A11/GPX4 signaling pathway, inhibited osteogenesis in MC3T3‐E1 cells, and participated in alveolar bone resorption in CKD model mice through ferroptosis.

Publisher

Wiley

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