Nlandu Khodo, S. | Search bioRxiv

bioRxiv2026

Keto-gluconeogenic metabolic axis mirrors renal homeostasis and post-injury response in spatial transcriptomics

Metabolic disturbance is a key feature in acute kidney injury (AKI) and chronic kidney disease (CKD). The kidney highly depends on fatty acid metabolism; how renal cells rewire metabolism upon AKI and CKD transition remained unclear. Here, we combine spatial transcriptomics with biochemical analyses to characterize metabolic changes and intercellular interactions during AKI to CKD transition. Using aristolochic acid model of CKD, we spatio-temporally correlated changes in structure and function with metabolic profile during AKI to CKD transition. Surprisingly, keto-gluconeogenic metabolic axis was highly enriched in healthy kidney and paralleled injury phase transitions. Intercellular interaction analysis associated a subtype of macrophage with the drift to chronicity. Online scRNAseq datasets analysis confirmed altered keto-gluconeogenic metabolic pathways in ischemia-reperfusion injured mouse kidneys and AKI and CKD human kidney biopsies compared to healthy controls. This study identifies a metabolic axis transcriptionally mirroring renal homeostasis and injury responses, and tubulo-interstitial interactions that can be targeted to mitigate AKI to CKD transition.

pathology↗

bioRxiv2025

Tissular glucocorticoid reactivating enzyme 11beta-HSD1 drives pathogenic myofibroblast differentiation in chronic kidney disease

Chronic kidney disease (CKD) is a growing public health crisis, affecting over 10% of the global population and significantly increasing mortality and morbidity. Irrespective of its underlying cause, tubulointerstitial fibrosis (TIF) is a hallmark of CKD progression, with myofibroblasts being the primary effectors of renal fibrosis. Here, we show that 11beta-hydroxysteroid dehydrogenase type 1 (11{beta}-HSD1) is a critical driver of pathogenic myofibroblast differentiation and fibrosis in CKD. Using genetic deletion and pharmacological inhibition of 11{beta}-HSD1 in mouse models, we demonstrate a marked reduction in TIF severity and improved renal function, linked to the suppression of a regulatory myofibroblast (Reg-MF) subpopulation. Single-cell and spatial transcriptomics data reveal that 11{beta}-HSD1 is essential for the activation and expansion of Reg-MFs, which is conserved across species and predicts worse outcomes in CKD patients and kidney allograft recipients. These findings establish a direct link between 11{beta}-HSD1 activity and renal fibrogenesis, highlighting its role during the transition from pericytes to pathogenic Reg-MFs. Our results support 11{beta}-HSD1 inhibition as a promising therapeutic strategy to mitigate CKD progression, offering both mechanistic insights and translational potential for improving patient outcomes.

physiology↗