Research ArticleInfectious diseases

Restoring glucose uptake rescues neutrophil dysfunction and protects against systemic fungal infection in mouse models of kidney disease

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Science Translational Medicine  17 Jun 2020:
Vol. 12, Issue 548, eaay5691
DOI: 10.1126/scitranslmed.aay5691

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Uremia undermines antifungal immunity

Systemic fungal infections are more prevalent and difficult to treat in patients with kidney disease. Jawale et al. set out to discern the mechanisms responsible for this enhanced risk and identify a way to mitigate disseminated fungal infections in kidney disease. Using multiple mouse models of kidney disease, they observed that uremia specifically conferred enhanced susceptibility to Candida albicans, which is typically controlled by neutrophils. Uremia blunted reactive oxygen species generation by neutrophils through glucose uptake perturbation. Accordingly, neutrophils isolated from patients with kidney disease were more capable of controlling fungal growth in vitro after dialysis. GSK3β inhibition restored the defect in mice or in human neutrophils and represents a potential intervention for patients with chronic kidney disease.

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