Ibrutinib does not prevent kidney fibrosis following acute and chronic injury

Sci Rep. 2021 Jun 7;11(1):11985. doi: 10.1038/s41598-021-91491-x.

Abstract

Recent studies suggested that ibrutinib, a Bruton tyrosine kinase (BTK) inhibitor, developed for the treatment of chronic lymphocytic leukemia, may prevent NLRP3 inflammasome activation in macrophages, IL-1β secretion and subsequent development of inflammation and organ fibrosis. The role of NLRP3 has been underlined in the various causes of acute kidney injury (AKI), a pathology characterized by high morbimortality and risk of transition toward chronic kidney disease (CKD). We therefore hypothesized that the BTK-inhibitor ibrutinib could be a candidate drug for AKI treatment. Here, we observed in both an AKI model (glycerol-induced rhabdomyolysis) and a model of rapidly progressive kidney fibrosis (unilateral ureteral obstruction), that ibrutinib did not prevent inflammatory cell recruitment in the kidney and fibrosis. Moreover, ibrutinib pre-exposure led to high mortality rate owing to severer rhabdomyolysis and AKI. In vitro, ibrutinib potentiated or had no effect on the secretion of IL-1β by monocytes exposed to uromodulin or myoglobin, two danger-associated molecule patterns proteins involved in the AKI to CKD transition. According to these results, ibrutinib should not be considered a candidate drug for patients developing AKI.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acute Kidney Injury / chemically induced*
  • Acute Kidney Injury / complications
  • Adenine / analogs & derivatives*
  • Adenine / metabolism
  • Adenine / pharmacology
  • Agammaglobulinaemia Tyrosine Kinase / metabolism
  • Animals
  • Antineoplastic Agents / pharmacology*
  • Blood Specimen Collection
  • Fibrosis / prevention & control*
  • Humans
  • Kidney
  • Leukemia, Lymphocytic, Chronic, B-Cell / drug therapy*
  • Leukocytes, Mononuclear
  • Macrophages
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mortality
  • Myoglobin / metabolism
  • Pharmaceutical Preparations
  • Piperidines / metabolism
  • Piperidines / pharmacology*
  • Protein Kinase Inhibitors / metabolism
  • Rhabdomyolysis / complications

Substances

  • Antineoplastic Agents
  • Myoglobin
  • Pharmaceutical Preparations
  • Piperidines
  • Protein Kinase Inhibitors
  • ibrutinib
  • Agammaglobulinaemia Tyrosine Kinase
  • Adenine