Abstract:
Background: Acute kidney injury (AKI) is a life-threatening condition with no effective treatment currently available. This study investigates whether pretreatment with the Iron-Quercetin complex (IronQ) enhances the therapeutic efficacy of mesenchymal stem cells (MSCs) in AKI and explores the underlying mechanisms. Methods: A cisplatin-induced AKI model was established in male C57BL/6 mice, followed by intravenous administration of 1 * 10^6 MSCs or IronQ-pretreated MSCs (MSC). Renal function, histological changes, and tubular cell apoptosis were assessed three days post-treatment. In vitro, cisplatin-induced apoptosis in mouse tubular epithelial cells (mTECs) was evaluated following treatment with MSC or MSC-conditioned medium (CM) using TUNEL assay, RT-PCR, and western blotting. RNA sequencing (RNA-seq) was performed on MSC to identify key molecular mechanisms. Results: MSC treatment significantly improved renal function and histological recovery while reducing tubular cell apoptosis compared to standard MSC therapy. Similarly, MSC-CM provided greater protection against cisplatin-induced apoptosis in mTECs. Mechanistically, RNA-seq analysis and validation studies revealed that IronQ pretreatment upregulated hepatocyte growth factor (HGF) expression and secretion in MSCs. Functional studies demonstrated that neutralizing HGF or silencing its expression abolished the protective effects of MSC. Additionally, pharmacological inhibition of c-Met, the HGF receptor, further confirmed the essential role of the HGF/c-Met signaling pathway in mediating MSCs anti-apoptotic effects. Conclusions: IronQ pretreatment enhances MSC therapeutic efficacy in AKI by promoting HGF secretion and activating the HGF/c-Met pathway, leading to reduced tubular cell apoptosis. These findings provide novel insights into MSC-based therapy optimization and contribute to the development of more effective AKI treatments.