Background and purpose: Hyperuricemia is an essential risk factor in
chronic kidney disease (CKD), while urate-lowering therapy to prevent or
delay CKD progression is controversial. Alternatively activated
macrophages in response to local microenvironment play diverse roles in
kidney injury, repair, and fibrosis. Here, we aim to investigate whether
and how macrophage ITGAM contributes to hyperuricemia-related CKD.
Experimental approach: In vivo, we explored dynamic characteristics of
renal tissue in hyperuricemia-related CKD. By incorporating mRNA and
protein sequencing data, we analyzed gene expression profile, hub genes
and potential pathways responsible for disease development, which was
further confirmed using qPCR, western blotting, and immunofluorescent
stainings. In vitro, we validated bioinformatic findings under different
conditions of macrophages with interventions corresponding to core nodes
in pathway. Key Results: Hyperuricemia-related CKD was characterized by
the rise in serum uric acid, decline in renal function, macrophage
alternative (M2) polarization, and kidney fibrosis. Integrated
bioinformatic analyses revealed ITGAM as the potential core gene
mediating disease progression which was associated with
FAK/Akt1/β-catenin signaling. Notably, we confirmed the upregulated
macrophage ITGAM, activated pathway, and macrophage M2 polarization in
injured kidneys and macrophages. In vitro, we verified
ITGAM/FAK/Akt1/β-catenin pathway participated in promoting macrophage M2
polarization through silencing Itgam and inhibiting FAK or Akt1
phosphorylation, where the expression of M2 phenotype macrophage markers
and downstream molecules in pathway were down-regulated. Conclusion and
implications: In hyperuricemia-related CKD, ITGAM promotes macrophage M2
polarization contributing to renal fibrosis through FAK/Akt1/β-catenin
pathway. Targeting macrophage ITGAM might be a promising therapeutic
approach for preventing or delaying CKD.