Glomerular Function and Structural Integrity Depend on Hyaluronan Synthesis by Glomerular Endothelium

Bernard M. van den Berg, Gangqi Wang, Margien G. S. Boels, M. Cristina Avramut, Erik Jansen, Wendy M. P. J. Sol, Franck Lebrin, Anton Jan van Zonneveld, Eelco J. P. de Koning, Hans Vink, Hermann-Josef Groene, Peter Carmeliet, Johan van der Vlag, Ton J. Rabelink*

*Corresponding author for this work

Research output: Contribution to journalArticleAcademicpeer-review


Background A glycocalyx envelope consisting of proteoglycans and adhering proteins covers endothelial cells, both the luminal and abluminal surface. We previously demonstrated that short-term loss of integrity of the luminal glycocalyx layer resulted in perturbed glomerular filtration barrier function.

Methods To explore the role of the glycocalyx layer of the endothelial extracellular matrix in renal function, we generated mice with an endothelium-specific and inducible deletion of hyaluronan synthase 2 (Has2), the enzyme that produces hyaluronan, the main structural component of the endothelial glycocalyx layer. We also investigated the presence of endothelial hyaluronan in human kidney tissue from patients with varying degrees of diabetic nephropathy.

Results Endothelial deletion of Has2 in adult mice led to substantial loss of the glycocalyx structure, and analysis of their kidneys and kidney function showed vascular destabilization, characterized by mesangiolysis, capillary ballooning, and albuminuria. This process develops over time into glomerular capillary rarefaction and glomerulosclerosis, recapitulating the phenotype of progressive human diabetic nephropathy. Using a hyaluronan-specific probe, we found loss of glomerular endothelial hyaluronan in association with lesion formation in tissue from patients with diabetic nephropathy. We also demonstrated that loss of hyaluronan, which harbors a specific binding site for angiopoietin and a key regulator of endothelial quiescence and maintenance of EC barrier function results in disturbed angiopoietin 1 Tie2.

Conclusions Endothelial loss of hyaluronan results in disturbed glomerular endothelial stabilization. Glomerular endothelial hyaluronan is a previously unrecognized key component of the extracelluar matrixthat is required for glomerular structure and function and lost in diabetic nephropathy.

Original languageEnglish
Pages (from-to)1886-1897
Number of pages12
JournalJournal of the American Society of Nephrology
Issue number10
Publication statusPublished - Oct 2019


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