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In contrast to type II cells, type I cells are highly efficient at maintaining cell volume, preventing sodium reabsorption, and pumping potassium out of the cell. Sodium reabsorption in the kidney is highly dependent on the epithelial sodium channel (ENaC), which is activated by the sodium-hydrogen exchanger (NHE3). The Na,K-ATPase is the main ATP-dependent sodium pump in the kidney. These three proteins (ENaC, NHE3, and the Na,K-ATPase) form a functional unit called the apical sodium pump that, when activated, increases the concentration of sodium (Na+) on the apical side of the epithelium, which subsequently increases the driving force for sodium reabsorption (Bilousova, 2001; Kramer and Aronson, 2006). There is strong evidence of impaired Na,K-ATPase activity in diabetic nephropathy (Bilousova et al., 2004). This can lead to sodium accumulation and osmotic swelling of the tubular epithelium and the interstitium (Kramer and Aronson, 2006; Bilousova, 2001; Kramer and Aronson, 2006; Pieperhoff, 2015). In fact, the Na,K-ATPase has been suggested as a therapeutic target for the treatment of diabetic nephropathy (Kramer and Aronson, 2006).
Finally, to evaluate the relevance of renal PAR2 expression in vivo, we treated wild-type C57BL/6J and PAR2 knockout mice with the inducing peptide, 2F, and evaluated TF expression in the kidney. We found a significant (p < 0.05) increase in TF expression in the kidneys of the knockout mice (Figure 3C). This result was not observed in the wild-type mice. These data provide evidence that PAR2-mediated TF production is physiologically relevant in the kidneys, and suggests that PAR2 activation, directly or indirectly, may be an important factor in mediating thrombotic injury to the kidney and renal tissue.
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