Volume 19 Supplement 1

35th International Symposium on Intensive Care and Emergency Medicine

Open Access

Is acute kidney injury in the early phase of sepsis a sign of metabolic downregulation in tubular epithelial cells?

  • K Jin1,
  • H Li1,
  • J Volpe1,
  • D Emlet1,
  • N Pastor-Soler1,
  • MR Pinsky1,
  • BS Zuckerbraun1,
  • K Hallows1,
  • JA Kellum1 and
  • H Gomez1
Critical Care201519(Suppl 1):P286


Published: 16 March 2015


This study tested the hypothesis that the cellular response in the kidney to sepsis is characterized by early activation of AMP activated protein kinase (AMPK), and that such activation is temporally associated with downregulation of the epithelial sodium channel (B-ENaC).


Fifteen C57BL/6 wildtype (WT) mice were subjected to cecal ligation and puncture (CLP), and sacrificed at 2, 6, 18, 24, or 48 hours. In addition, we pretreated three WT and three AMPK Beta 1 knockout mice with the AMPK activator AICAR (100 mg/kg intraperitoneal, 24 hours before CLP), and sacrificed 24 hours after CLP. Blood and tissue samples were collected for all animals. AMPK activation (pThr172), B-ENaC, and mitophagy (LC3 II/I) were examined by western blot of kidney lysates. Plasma creatinine (Scr) was assessed using ELISA.


The acute response to sepsis was characterized by early activation of AMPK which increased from 6 to 18 hours, peaked at 24 hours, and decreased by 48 hours (Figure 1A). This activation was associated with a consistent decrease in B-ENaC expression. In AICAR pretreated animals, AMPK was only activated in WT mice, which was associated with a decrease in the expression of B-ENaC as compared with AMPK KO mice (Figure 1B).
Figure 1

(A) AMPK activation (p-Thr172) and Beta-ENAC expression during early CLP. (B) Difference in Beta-ENAC expression between AICAR pretreated WT versus KO at 24 hours after CLP.


AMPK was activated early after induction of sepsis, and was associated with a consistent decrease in Beta-ENaC expression in the apical membrane of tubular epithelial cells. In addition, absence of AMPK activation in KO animals was associated with increased expression of Beta-ENaC at 24 hours after CLP. These data support the hypothesis that early activation of AMPK decreases energy consumption through ion channel downregulation.

Authors’ Affiliations

University of Pittsburgh


© Jin et al.; licensee BioMed Central Ltd. 2015

This article is published under license to BioMed Central Ltd. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated.