Acute Kidney Injury (AKI)1,2, which also can be referred to as acute renal failure, is broadly defined as a sudden impairment in kidney function3. While the level of understanding of this condition has been enhanced remarkably over the years, morbidity and mortality rates have remained high1,2. The current treatment for this condition is mostly supportive, as results from multiple clinical trials of drug therapy have been negative4,5. The kidney is unique in that it has the ability to repair itself. Therefore, supportive therapy after an early diagnosis of AKI is the best way to limit morbidity6. However, it is difficult to detect AKI early, and the mortality rate is a staggering 50-80% for those who require dialysis5. With the ability of the kidneys to repair themselves and the lack of treatment options for this condition, it is important to develop methods to enhance this nephron regeneration process.
There have been many different models used for AKI research that includes different agents of injury and animal models. In terms of agents of kidney damage, the aminoglycoside antibiotic gentamicin has been used as a nephrotoxic agent that leads to AKI7,8. However, several groups have found that gentamicin treatment is lethal to the zebrafish embryo9. It causes tubular damage that is too serious for embryo recovery, making the study of regeneration difficult without some type of intervention. Mammalian models, like the mouse and rat, are also considered valuable, but they face many limitations during the study of AKI. Perhaps the main disadvantage of rodent models is the difficulty in visualizing the rodent kidney and thus determining the precise spatiotemporal processes leading to epithelial death and repair.
Johnson et al. have reported a laser ablation-based technique to induce acute kidney injury in embryonic and larval zebrafish9. They used pulsed laser ablation to damage the kidney after an intramuscular injection with dextran conjugates. The fluorescence from dextran conjugates allows for the visualization of damage and regeneration in the tubule epithelium9. This model overcomes the two limitations mentioned above, but it does not allow for graded levels of injury and is difficult to carry out on large, arbitrary cell groups.
The new laser ablation-based zebrafish model of AKI described here addresses all of the above limitations. The pronephric kidney in larval zebrafish is a mature, functioning organ that contains segments similar to the mammalian nephron, including a glomerulus, proximal and distal tubules, and a collecting duct10. Zebrafish larvae are also optically transparent, making it feasible to observe the kidney through fluorescence techniques. Thus, zebrafish are a valuable in vivo model of AKI, and the larval pronephric kidney (5-12 days-post-fertilization (dpf)) can be used to study the cellular and molecular processes involved in kidney injury and repair.
This paper presents a method through which specific Green Fluorescent Protein (GFP)-expressing nephron segments can be photoablated using a low-energy (compared to a pulsed-laser system) violet laser light (405 nm). The GFP fluorescence allows for the targeting of a group of cells, making the changes that occur visible through the observation of GFP photobleaching. In addition, GFP (by absorbing violet light) serves as an energy sink to potentiate the injury in GFP-expressing kidney cells. Time-lapse microscopy can then be used to study the repair process. Studies have found cell proliferation, cell migration, and cell metaplasia11,12,13 to all be potential processes that may play an important role in kidney repair. However, the relative importance of these processes and the details of their interplay have been difficult to uncover due to the limitations of existing models of AKI. Using this novel approach, it was possible to show that cell migration plays a central role in kidney repair after acute injury14.