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1 Indiana Center for Biological Microscopy, Department of Medicine, Division of Nephrology, Indiana University, Indianapolis, Indiana, USA
* To whom correspondence should be addressed. E-mail: pdaghe2{at}iupui.edu.
Toll-like receptors (TLRs) are now recognized as the major receptors for microbial pathogens on cells of the innate immune system. Recently, TLRs were also identified in many organs including the kidney. However, the cellular distribution and role of these renal TLRs remain largely unknown. In this paper, we investigated the expression of TLR4 in a cecal ligation and puncture (CLP) model of sepsis in Sprague-Dawley rats utilizing fluorescence microscopy. In sham animals, TLR4 was expressed predominantly in Tamm-Horsfall protein (THP) positive tubules. In CLP animals, TLR4 expression increased markedly in all tubules (proximal and distal), glomeruli and the renal vasculature. The staining showed a strong apical distribution in all tubules. A moderately less intense cellular signal co-localized partially with the Golgi apparatus. In addition, kidneys from septic rats showed increased expression of CD14 and THP. They each co-localized strongly with TLR4, albeit in different tubular segments. We also imaged the kidneys of live septic animals with 2-photon microscopy after fluorescent lipopolysaccharide (LPS) injection. Within 10 minutes, LPS was seen at the brush border of some proximal tubules. Within 60 minutes, LPS was fully cytoplasmic in proximal tubules. Conversely, distal tubules showed no LPS uptake. We conclude that TLR4, CD14 and THP have specific renal cellular and tubular expression patterns that are markedly affected by sepsis. Systemic endotoxin can freely access the tubular and cellular sites where these proteins are present. Therefore, locally expressed TLRs and other interacting proteins could potentially modulate the renal response to systemic sepsis.
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