Deciphering the role of the blood-brain barrier in uremic toxins-induced neuropathies

ended

Chronic kidney disease (CKD) is estimated to affect more than 840 million people worldwide constituting a major global health crisis. Clinically, the number of CKD patients will continue to rise mostly because of the ageing population and the increased prevalence of comorbidities such as diabetes and hypertension. In Europe, around 100,000 million people are affected by it. According to the gloomy predictions, Europe is at risk of a dismal increase of CKD patients as well as costs to healthcare systems. Patients with advanced CKD display a loss of kidney function leading to a blood accumulation of, a.o. protein-bound uremic toxins (PBUTs) that are poorly eliminated by renal replacement therapies. This systemic retention known as the uremic syndrome affects other organs. Indeed, neurologic complications such as blood-brain barrier (BBB) disruption have been reported in CKD patients. The BBB guarantees the exchange between the blood and the brain through a complex cellular organization and a diverse range of transport proteins mediates the movement of endo/exogenous compounds. I hypothesize that impairment of kidney tubular functionality in CKD causes an alteration of BBB integrity and function. This results in an aberrant BBB pass-through of PBUTs as well as impacts BBB vectorial transport capabilities. This fellowship aims to develop an appropriate multi-organs-on-chip device to accurately describe (i) the impact of PBUTs on BBB integrity and functionality, and (ii) the involvement of kidney-brain axis dysfunction in PBUTs-driven BBB disruption. We will develop a bioprinting-based microfluidic BBB-on-chip to accurately study BBB permeability, architecture, and transport function. This device will be connected to our established proximal tubule-on-chip to form a robust (kidney-brain) multi-organs-on-chip system. This project will pave the way toward the establishment of new and effective CKD therapies, and an expert system for pharmacology studies in a near future.