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Molecular insights into P2X signalling cascades in acute kidney injury

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Abstract

Acute kidney injury (AKI) is a critical health issue with high mortality and morbidity rates in hospitalized individuals. The complex pathophysiology and underlying health conditions further complicate AKI management. Growing evidence suggests the pivotal role of ion channels in AKI progression, through promoting tubular cell death and altering immune cell functions. Among these channels, P2X purinergic receptors emerge as key players in AKI pathophysiology. P2X receptors gated by adenosine triphosphate (ATP), exhibit increased extracellular levels of ATP during AKI episodes. More importantly, certain P2X receptor subtypes upon activation exacerbate the situation by promoting the release of extracellular ATP. While therapeutic investigations have primarily focused on P2X4 and P2X7 subtypes in the context of AKI, while understanding about other subtypes still remains limited. Whilst some P2X antagonists show promising results against different types of kidney diseases, their role in managing AKI remains unexplored. Henceforth, understanding the intricate interplay between P2X receptors and AKI is crucial for developing targeted interventions. This review elucidates the functional alterations of all P2X receptors during normal kidney function and AKI, offering insights into their involvement in AKI. Notably, we have highlighted the current knowledge of P2X receptor antagonists and the possibilities to use them against AKI in the future. Furthermore, the review delves into the pathways influenced by activated P2X receptors during AKI, presenting potential targets for future therapeutic interventions against this critical condition.

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Acknowledgements

ABG sincerely acknowledges the financial support provided by the Birla Institute of Technology and Science-Pilani, Pilani, for carrying out this work.

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  1. Laboratory of Molecular Pharmacology, Department of Pharmacy, Birla Institute of Technology and Science, Pilani Campus, Pilani, Rajasthan, 333031, India

    Swati Mishra, Vishwadeep Shelke, Neha Dagar & Anil Bhanudas Gaikwad

  2. Division of Nephrology, Department of Medicine IV, LMU University Hospital, Ludwig Maximilians University Munich, 80336, Munich, Germany

    Maciej Lech

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  1. Swati Mishra
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  2. Vishwadeep Shelke
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  3. Neha Dagar
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Contributions

Swati Mishra: conducted literature research and wrote the manuscript. Vishwadeep Shelke: conceptualized, conducted literature research and co-wrote the manuscript. Neha Dagar: conducted literature research and co-wrote the manuscript. Maciej Lech: participated in designing the manuscript, edited, and prepared it for submission. Anil Bhanudas Gaikwad: conceptualized, designed and drafted the manuscript. All authors read and approved the final manuscript.

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Correspondence to Anil Bhanudas Gaikwad.

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Mishra, S., Shelke, V., Dagar, N. et al. Molecular insights into P2X signalling cascades in acute kidney injury. Purinergic Signalling (2024). https://doi.org/10.1007/s11302-024-09987-w

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