Absence of PKC-alpha attenuates lithium-induced nephrogenic diabetes insipidus

PLoS One. 2014 Jul 9;9(7):e101753. doi: 10.1371/journal.pone.0101753. eCollection 2014.

Abstract

Lithium, an effective antipsychotic, induces nephrogenic diabetes insipidus (NDI) in ∼40% of patients. The decreased capacity to concentrate urine is likely due to lithium acutely disrupting the cAMP pathway and chronically reducing urea transporter (UT-A1) and water channel (AQP2) expression in the inner medulla. Targeting an alternative signaling pathway, such as PKC-mediated signaling, may be an effective method of treating lithium-induced polyuria. PKC-alpha null mice (PKCα KO) and strain-matched wild type (WT) controls were treated with lithium for 0, 3 or 5 days. WT mice had increased urine output and lowered urine osmolality after 3 and 5 days of treatment whereas PKCα KO mice had no change in urine output or concentration. Western blot analysis revealed that AQP2 expression in medullary tissues was lowered after 3 and 5 days in WT mice; however, AQP2 was unchanged in PKCα KO. Similar results were observed with UT-A1 expression. Animals were also treated with lithium for 6 weeks. Lithium-treated WT mice had 19-fold increased urine output whereas treated PKCα KO animals had a 4-fold increase in output. AQP2 and UT-A1 expression was lowered in 6 week lithium-treated WT animals whereas in treated PKCα KO mice, AQP2 was only reduced by 2-fold and UT-A1 expression was unaffected. Urinary sodium, potassium and calcium were elevated in lithium-fed WT but not in lithium-fed PKCα KO mice. Our data show that ablation of PKCα preserves AQP2 and UT-A1 protein expression and localization in lithium-induced NDI, and prevents the development of the severe polyuria associated with lithium therapy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Aquaporin 2 / metabolism
  • Diabetes Insipidus, Nephrogenic / chemically induced
  • Diabetes Insipidus, Nephrogenic / enzymology*
  • Homeostasis
  • Kidney / metabolism
  • Kidney / pathology
  • Lithium
  • Male
  • Membrane Transport Proteins / metabolism
  • Mice, Knockout
  • Protein Kinase C-alpha / genetics*
  • Protein Kinase C-alpha / metabolism
  • Protein Transport
  • Urea Transporters

Substances

  • Aqp2 protein, mouse
  • Aquaporin 2
  • Membrane Transport Proteins
  • Lithium
  • Protein Kinase C-alpha