Uncontrolled inflammation is one of the leading causes of kidney failure. Pro-inflammatory responses can occur in the absence of infection, a process called sterile inflammation. Here we show that the purinergic receptor P2Y14 (GPR105) is specifically and highly expressed in collecting duct intercalated cells (ICs) and mediates sterile inflammation in the kidney. P2Y14 is activated by UDP-glucose, a damage-associated molecular pattern molecule (DAMP) released by injured cells. We found that UDP-glucose increases pro-inflammatory chemokine expression in ICs as well as MDCK-C11 cells, and UDP-glucose activates the MEK1/2-ERK1/2 pathway in MDCK-C11 cells. These effects were prevented following inhibition of P2Y14 with the small molecule PPTN. Tail vein injection of mice with UDP-glucose induced the recruitment of neutrophils to the renal medulla. This study identifies ICs as novel sensors, mediators and effectors of inflammation in the kidney via P2Y14.

Conflict of interest:SB is a cofounder of Kantum Pharma (previously "Kantum Diagnostics Inc."), a company developing a diagnostic and therapeutic combination to prevent and treat acute kidney injury. SB and her spouse own equity in the privately held company. SB and DB are inventors on a patent (US Patent 10,088,489) covering technology that has been licensed to the company through Massachusetts General Hospital (MGH). SB's and DB's interests were reviewed and are managed by MGH and Partners HealthCare in accordance with their conflict-of-interest policies.