Abstract Body: Introduction: Nicotine consumption through vaping, cigarettes, or nicotine replacement therapy poses major risks for renal health, especially in individuals with hypertension or kidney disease. Nicotine induces oxidative stress and nitric oxide synthase (NOS) remodeling in endothelial cells, but a gap in knowledge persists regarding its impact on glomerular epithelial cells, particularly podocytes. We hypothesize that nicotine promotes nitrosative stress in podocytes, generating peroxynitrite (ONOO^-), causing mitochondrial damage, and glomerular impairment.

Methods: We performed confocal imaging on human cultured podocytes to detect ONOO^-, Ca²⁺, and nitric oxide (NO) in response to nicotine. We used Seahorse assay (Agilent XFe24) to test mitochondrial respiration. Nicotine was then chronically infused in Dahl SS rats (0.2 mg/kg/day s.c., 0.4% NaCl diet) for 21 days, and recorded blood pressure with telemetry. Glomerular damage was evaluated, and electron microscopy was employed to assess mitochondrial ultrastructure. Electron paramagnetic resonance (EPR) spectroscopy was used to access the NO levels in cultured podocytes and in vivo. OriginPro was used for statistical analysis.

Results: Acute application of nicotine promoted intracellular Ca²⁺ and ONOO^- transients in podocytes. The ONOO^- response was blocked in the presence of SOD, indicating that ONOO^- production requires superoxide. The application of specific α7, α4β2, α2β4, α4β4, and α3β4 nicotinic acetylcholine receptor (nAChR) agonists elicited Ca²⁺ transients but did not produce ONOO^-, suggesting that nitrosative stress occurs independently from nAChR activation. Incubation with nicotine (12 hrs) resulted in a decrease in podocytes’ mitochondrial respiration (two-sample t-test, p<0.05). In vivo, nicotine infusion did not affect blood pressure but promoted mitochondrial damage in podocytes, which exhibited swelling, loss of cristae, and mitophagy (t-test, p<0.05). Histopathological assessment showed higher glomerular damage in nicotine-exposed rats (t-test, p<0.05). Both EPR and confocal approaches demonstrated nicotine-mediated changes in NO bioavailability and an increase in NOS2 activity (t-test, p<0.05).

Conclusion: Nicotine products promote NOS uncoupling in podocytes, leading to ONOO^- formation, redox stress, mitochondrial impairment, and glomerular damage. Understanding nicotine's impact on podocytes is crucial for preventing or developing therapies against smoking and vaping-related pathologies.