Single cell profiling in COVID-19 associated acute kidney injury reveals patterns of tubule injury and repair in human

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Abstract

The cellular mechanisms of kidney tubule repair are poorly characterized in human. Here, we applied single-nucleus RNA sequencing to analyze the kidney in the first days after acute injury in 5 critically ill patients with COVID-19. We identified abnormal proximal tubule cell states associated with injury, characterized by altered functional and metabolic profiles and by pro-fibrotic properties. Tubule repair involved the plasticity of mature tubule cells in a process of cell de-differentiation and re-differentiation, which displayed substantial similarities between mouse and man. In addition, in man we identified a peculiar tubule reparative response determining the expansion of progenitor-like cells marked by PROM1 and following a differentiation program characterized by the sequential activation of the WNT, NOTCH and HIPPO signaling pathways. Taken together, our analyses reveal cell state transitions and fundamental cellular hierarchies underlying kidney injury and repair in critically ill patients.

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  1. SciScore for 10.1101/2021.10.05.463150: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    EthicsConsent: The consent was given orally by the next of kin, due to the ban on visits in force in our hospital.
    IACUC: The study was approved by the local ethical committee for human studies of Geneva, Switzerland (CCER 2020-00644, Commission Cantonale d’Ethique de la Recherche) and performed according to the Declaration of Helsinki principles.
    Euthanasia Agents: Briefly, 10- to 12-week-old, 25–28-g, male C57BL6/J or Six2TGC Rosa26rtTA pTREH2-GFP mice were anaesthetized with an intraperitoneal injection of ketamine/xylazine (ketamine, 105 mg kg–1; xylazine, 10 mg kg–1).
    Sex as a biological variableBriefly, 10- to 12-week-old, 25–28-g, male C57BL6/J or Six2TGC Rosa26rtTA pTREH2-GFP mice were anaesthetized with an intraperitoneal injection of ketamine/xylazine (ketamine, 105 mg kg–1; xylazine, 10 mg kg–1).
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.

    Table 2: Resources

    Antibodies
    SentencesResources
    Immunochemistry staining were performed as followed: after antigen retrieval with pressurized heating chamber in citrate buffer pH7 or tris-EDTA pH9, 5 μm tissue sections were incubated with antibodies mouse monoclonal anti-human HAVCR1 (dilution 1:250, clone 219211, RD Systems), rabbit polyclonal anti-human PROM1 (dilution 1:250, Novus biological) and mouse monoclonal anti-human VCAM1 (dilution 1:25, clone 1.4C3, Invitrogen) for 1h at room temperature.
    pH9
    suggested: None
    anti-human HAVCR1
    suggested: (R and D Systems Cat# FAB1750P, RRID:AB_10891505)
    anti-human PROM1
    suggested: None
    anti-human VCAM1
    suggested: None
    Experimental Models: Organisms/Strains
    SentencesResources
    Briefly, 10- to 12-week-old, 25–28-g, male C57BL6/J or Six2TGC Rosa26rtTA pTREH2-GFP mice were anaesthetized with an intraperitoneal injection of ketamine/xylazine (ketamine, 105 mg kg–1; xylazine, 10 mg kg–1).
    C57BL6/J
    suggested: None
    Rosa26rtTA pTREH2-GFP
    suggested: None
    Briefly, bilateral IRI was induced for 18 minutes in C57B6/J 8- to 10-wk-old male mice and body temperature was monitored and maintained at 36.5 to 37.5 °C throughout the procedure.
    C57B6/J
    suggested: RRID:MGI:5818271)
    Recombinant DNA
    SentencesResources
    Briefly, 10- to 12-week-old, 25–28-g, male C57BL6/J or Six2TGC Rosa26rtTA pTREH2-GFP mice were anaesthetized with an intraperitoneal injection of ketamine/xylazine (ketamine, 105 mg kg–1; xylazine, 10 mg kg–1).
    pTREH2-GFP
    suggested: None
    Software and Algorithms
    SentencesResources
    For each pattern cluster, pathway enrichment was performed using hypeR with a hypergeometric test and the REACTOME, KEGG, GOBP, WIKI, BIOCARTA, and HALLMARK databases downloaded from the Molecular Signature Database (https://www.gsea-msigdb.org/gsea/msigdb/) using the msigdb_gsets function.
    KEGG
    suggested: (KEGG, RRID:SCR_012773)
    We finally calculated the Dissimilarity Index, for each pair of pseudotime related fitted gene expression (https://link.springer.com/content/pdf/10.1007/s11634-006-0004-6.pdf) using the TSclust package.
    TSclust
    suggested: None
    For the heatmap comparing pathways activity in the four clusters, we used PROGENY (v 1.12.0) or the score described above with gene sets from the REACTOME database or the proliferation index and the normalized gene expression from the Seurat object as input.
    PROGENY
    suggested: (PROGENY, RRID:SCR_006647)
    REACTOME
    suggested: (Reactome, RRID:SCR_003485)
    The raw counts were first normalized with the TMM method from the EdgeR package and expressed as count per million.
    EdgeR
    suggested: (edgeR, RRID:SCR_012802)
    Public snRNA-Seq dataset integrated: GEO datasets were downloaded from Gene Expression Omnibus (
    Gene Expression Omnibus
    suggested: (Gene Expression Omnibus (GEO, RRID:SCR_005012)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).


    Results from LimitationRecognizer: An explicit section about the limitations of the techniques employed in this study was not found. We encourage authors to address study limitations.

    Results from TrialIdentifier: No clinical trial numbers were referenced.


    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.


    Results from JetFighter: We did not find any issues relating to colormaps.


    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    Results from scite Reference Check: We found no unreliable references.


    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.