Abstract Body: Background: We showed previously that global knockout (KO) of microRNA miR-204 attenuated hypertension but exacerbated renal injury including albuminuria in 14 days in C57BL/6J mice treated with uninephrectomy, angiotensin II, and a high-salt diet (Unx/AngII/salt). This suggests cell type-specific roles of miR-204. We hypothesize that miR-204 in podocytes protects against renal injury, specifically albuminuria via podocyte damage, in hypertension.

Methods: We generated podocyte-specific miR-204 KO mice. Blood pressure and albuminuria were measured. RNA-seq in isolated miR-204 wild-type (WT) and KO mouse glomeruli, approximately 20% of which are podocytes, was performed. Human induced pluripotent stem cell-derived podocytes (iPSC-podocytes) were utilized to model and characterize podocyte injury.

Results: Podocyte-specific miR-204 KO mice and WT littermates developed hypertension similarly following Unx/AngII/salt, but albuminuria was substantially exacerbated in miR-204 KO male mice (n=12, 8, 10 for WT, miR-204^+/- and miR-204^-/-, respectively; P<0.05, one-way ANOVA followed by Holm–Šidák test). RNA-seq analysis showed significant upregulation of Sox4, a target of miR-204 and a transcription factor promoting apoptotic p53, in the glomeruli of podocyte-specific miR-204 KO mice (P<0.05). A miR-204 KO iPSC line was generated by CRISPR/Cas9 and clonal expansion. Podocytes differentiated from miR-204 WT and KO iPSCs displayed arborized cell body, foot process-like structures, and significantly higher levels of podocyte markers Nphs1 and Nphs2. When apoptosis was induced via 24-hour AngII treatment, miR-204 KO iPSC-podocytes displayed upregulation of Sox4 (0.67±0.32 and 1.55±0.87, fold for WT and KO iPSC-podocytes compared to their control, n = 4, 4) and p53 (1.56±0.15 and 3.70±1.56, fold for WT and KO iPSC-podocytes compared to their control, n = 4, 4), and exacerbated AngII-induced apoptosis. Sox4 knockdown in miR-204 KO iPSC-podocytes mitigated the p53 upregulation (1.49±0.29 and 1.53±0.16, fold for WT and KO iPSC-podocytes compared to their control, n = 4, 4) and apoptosis.

Conclusions: Our findings suggested that miR-204 in podocytes protect against AngII-induced apoptosis by suppressing Sox4, which in turn suppresses p53. Targeting the miR-204/Sox4 axis may hold therapeutic potential in attenuating podocyte injury and preserving renal function in hypertension patients.