Acute podocyte vascular endothelial growth factor (VEGF-A) knockdown disrupts alpha_vbeta₃ integrin signaling in the glomerulus

Podocyte or endothelial cell VEGF-A knockout causes thrombotic microangiopathy in adult mice. To study the mechanism involved in acute and local injury caused by low podocyte VEGF-A we developed an inducible, podocyte-specific VEGF-A knockdown mouse, and we generated an immortalized podocyte cell line (VEGF^KD) that downregulates VEGF-A upon doxycycline exposure. Tet-O-siVEGF:podocin-rtTA mice express VEGF shRNA in podocytes in a doxycycline-regulated manner, decreasing VEGF-A mRNA and VEGF-A protein levels in isolated glomeruli to ~20% of non-induced controls and urine VEGF-A to ~30% of control values a week after doxycycline induction. Induced tet-O-siVEGF:podocin-rtTA mice developed acute renal failure and proteinuria, associated with mesangiolysis and microaneurisms. Glomerular ultrastructure revealed endothelial cell swelling, GBM lamination and podocyte effacement. VEGF knockdown decreased podocyte fibronectin and glomerular endothelial alpha_Vbeta₃ integrin in vivo. VEGF receptor-2 (VEGFR2) interacts with beta₃ integrin and neuropilin-1 in the kidney in vivo and in VEGF^KD podocytes. Podocyte VEGF knockdown disrupts alpha_Vbeta₃ integrin activation in glomeruli, detected by WOW1-Fab. VEGF silencing in cultured VEGF^KD podocytes downregulates fibronectin and disrupts alpha_Vbeta₃ integrin activation cell-autonomously. Collectively, these studies indicate that podocyte VEGF-A regulates alpha_Vbeta₃ integrin signaling in the glomerulus, and that podocyte VEGF knockdown disrupts alpha_Vbeta₃ integrin activity via decreased VEGFR2 signaling, thereby damaging the three layers of the glomerular filtration barrier, causing proteinuria and acute renal failure.