# Role of Amphiregulin in kidney fibrosis

> **NIH NIH R01** · WASHINGTON UNIVERSITY · 2022 · $393,693

## Abstract

PROJECT SUMMARY ABSTRACT
The overall goal of our research is to develop novel therapeutic and detection/monitoring strategies to prevent
progression of chronic kidney disease (CKD) and fibrosis. Acute kidney injury (AKI) due to ischemia reperfusion
injury (IRI) or unilateral ureteral obstruction (UUO) in mice induces sustained EGFR activation and kidney fibrosis
which is prevented by EGFR chemical inhibition or its genetic deletion in proximal tubule cells (PTCs). The
specific EGFR ligand(s) involved remain unknown. We showed that A-disintegrin-and-metalloprotease-17
(ADAM17) proximal tubule knockout protects against injury-induced fibrosis, identifying the source of pro-fibrotic
EGFR ligands to PTCs. In the injured mouse kidney, the EGFR ligand pro-Amphiregulin (pro-AREG) was very
strongly upregulated and in humans sAREG was very significantly elevated in the urine of AKI and CKD patients,
as well as fibrotic CKD kidney biopsies. In vitro, in human proximal tubule cells (HPTCs), sAREG induced
sustained EGFR activation and pro-fibrotic targets. (Kefalogianni JCI Insight 2016). The objective of this
application is to determine the role of sAREG in early vs. late injury-repair stages after AKI and to firmly link
sAREG in human patient samples to kidney fibrosis and to CKD progression. Our central hypothesis is that
Amphiregulin (sAREG) is the key epidermal growth factor receptor (EGFR) ligand that is responsible for inducing
and amplifying pro-fibrotic EGFR signals in kidney injury. We base this on preliminary data including: (1) sAREG
is sufficient and necessary to induce fibrosis after kidney injury in mice, based on sAREG injection and PTC-KO
studies in mice (2) sAREG is significantly elevated in serum samples of a nephrectomy cohort of patients with
CKD and its levels correlate negatively with kidney function parameters. The rationale for this project is that
completion will identify sAREG as a novel therapeutic target and biomarker in CKD/fibrosis, and identify
molecular mechanisms involved. We plan to test our central hypothesis with two specific aims: AIM1: Determine
whether AREG is necessary for early renal recovery and/or the development of kidney fibrosis after IRI injury.
AIM2: To link sAREG to degree of kidney fibrosis and stage of CKD in humans in the Boston Kidney Biopsy
Cohort (BKBC, n=770) and to CKD progression in the Chronic-Renal-Insufficiency-Cohort (CRIC, n=3889). Here
we will correlate sAREG serum/urine levels to kidney fibrosis on biopsy and CKD progression, and compare this
to correlation with currently used kidney biomarkers (Creatinine, proteinuria). As outcomes, we expect that AREG
proximal tubule knockout protects against injury-induced fibrosis and that sAREG levels correlate with CKD
outcomes and perform better than current biomarkers (creatinine, proteinuria). This contribution is significant
because it is expected to have impact on CKD/fibrosis detection, prevention and treatment. Our research is
innovative, in our o...

## Key facts

- **NIH application ID:** 10470729
- **Project number:** 5R01DK121200-04
- **Recipient organization:** WASHINGTON UNIVERSITY
- **Principal Investigator:** Andreas Herrlich
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2022
- **Award amount:** $393,693
- **Award type:** 5
- **Project period:** 2019-09-15 → 2024-08-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10470729

## Citation

> US National Institutes of Health, RePORTER application 10470729, Role of Amphiregulin in kidney fibrosis (5R01DK121200-04). Retrieved via AI Analytics 2026-05-23 from https://api.ai-analytics.org/grant/nih/10470729. Licensed CC0.

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