# Targeting ferroptosis in renal tubular epithelial cells to improve outcomes of lupus nephritis

> **NIH NIH R01** · UNIVERSITY OF FLORIDA · 2024 · $447,463

## Abstract

PROJECT SUMMARY/ABSTRACT
 Lupus nephritis is one of the most severe end-organ manifestations of systemic lupus erythematosus.
Immunosuppression, the cornerstone for treating this disease, is complicated by many adverse effects. Although
traditionally considered as a glomerular disease, up to 80% of lupus nephritis patients present with tubular injury,
and tubular injury is a better predictor of progression to end stage kidney disease than glomerular injury. This
identifies the renal tubules as a therapeutic target in lupus nephritis. The complex biological mechanisms that
underlie tubular epithelial cell injury in lupus nephritis remain, for the most part, obscure. We propose to provide
such a mechanistic understanding by leveraging our key novel findings.
 We have shown that iron accumulates in the tubular compartment of the lupus nephritis kidneys but not
in the glomeruli. Most of the iron recycling in the kidney is performed by proximal tubular epithelial cells, and
excess iron induces ferroptosis -- an inflammatory form of cell death characterized by high levels of lipid
peroxidation. Ferroptosis is mostly observed in the tubular segments of human and murine lupus nephritis
kidneys. We have found that the enzyme Acyl-CoA synthetase long-chain family member 4 (ACSL4), a
ferroptosis promoter, was increased whereas SLC7A11, a ferroptosis inhibitor, was decreased in lupus nephritis.
Additionally, human lupus nephritis serum induced ferroptosis in proximal tubular epithelial cells and this was
associated with inflammation and injury. Liproxstain-2, a novel ferroptosis inhibitor, blocked these outcomes.
 These data led us to hypothesize that iron accumulation in proximal tubular epithelial cells promotes
ferroptosis, propagates tubulointerstitial inflammation and worsens outcomes of lupus nephritis. We aim to test
this hypothesis using congenic mice deficient for ACSL4 (Acsl4PTEC-/-) and SCL7A11 (Slc7a11PTEC-/-) only in their
proximal tubular epithelial cells (PTEC). We will first investigate the resistance of Acsl4PTEC-/- and susceptibility of
Slc7a11PTEC-/- mice to ferroptosis using an inducible and a spontaneous mouse model of immune complex
glomerulonephritis, identify the downstream molecular pathways that block or lead to ferroptosis and follow the
outcomes of kidney injury. Using lupus nephritis patients and healthy controls, we will dissect the ferroptosis
inducing ability of whole and immunoglobin depleted serum on proximal tubular epithelial cells as well as test
novel ACSL4 inhibitors. Using purified cells from the same cohort of patients and controls we will block known
repressors of SLC7A11 and evaluate outcomes of ferroptosis and tubular pathology. Finally, we will evaluate the
in vivo therapeutic efficacy of Liproxstain-2 in two spontaneous murine models of lupus nephritis with existing
renal injury. These studies will identify novel mechanisms of proximal tubular epithelial cell injury in lupus
nephritis and support use of ferroptos...

## Key facts

- **NIH application ID:** 10817055
- **Project number:** 5R01DK136011-02
- **Recipient organization:** UNIVERSITY OF FLORIDA
- **Principal Investigator:** Laurence Morel
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $447,463
- **Award type:** 5
- **Project period:** 2023-04-01 → 2028-01-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10817055

## Citation

> US National Institutes of Health, RePORTER application 10817055, Targeting ferroptosis in renal tubular epithelial cells to improve outcomes of lupus nephritis (5R01DK136011-02). Retrieved via AI Analytics 2026-05-24 from https://api.ai-analytics.org/grant/nih/10817055. Licensed CC0.

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