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p-Cresyl sulfate promotes insulin resistance associated with CKD.

Journal of the American Society of Nephrology : JASN (2013-01-01)
Laetitia Koppe, Nicolas J Pillon, Roxane E Vella, Marine L Croze, Caroline C Pelletier, Stéphane Chambert, Ziad Massy, Griet Glorieux, Raymond Vanholder, Yann Dugenet, Hédi A Soula, Denis Fouque, Christophe O Soulage
ABSTRACT

The mechanisms underlying the insulin resistance that frequently accompanies CKD are poorly understood, but the retention of renally excreted compounds may play a role. One such compound is p-cresyl sulfate (PCS), a protein-bound uremic toxin that originates from tyrosine metabolism by intestinal microbes. Here, we sought to determine whether PCS contributes to CKD-associated insulin resistance. Administering PCS to mice with normal kidney function for 4 weeks triggered insulin resistance, loss of fat mass, and ectopic redistribution of lipid in muscle and liver, mimicking features associated with CKD. Mice treated with PCS exhibited altered insulin signaling in skeletal muscle through ERK1/2 activation. In addition, exposing C2C12 myotubes to concentrations of PCS observed in CKD caused insulin resistance through direct activation of ERK1/2. Subtotal nephrectomy led to insulin resistance and dyslipidemia in mice, and treatment with the prebiotic arabino-xylo-oligosaccharide, which reduced serum PCS by decreasing intestinal production of p-cresol, prevented these metabolic derangements. Taken together, these data suggest that PCS contributes to insulin resistance and that targeting PCS may be a therapeutic strategy in CKD.

MATERIALS
Product Number
Brand
Product Description

Sigma-Aldrich
p-Cresol, 99%
Supelco
4-Methylphenol solution, certified reference material, 5000 μg/mL in methanol
Sigma-Aldrich
p-Cresol, ≥99%, FG
Supelco
p-Cresol, analytical standard