Ranganathan P, Jayakumar C, Mohamed R, Weintraub NL, Ramesh G. Semaphorin 3A inactivation suppresses ischemia-reperfusion-induced inflammation and acute kidney injury. Am J Physiol Renal Physiol 307: F183-F194, 2014. First published May 14, 2014 doi:10.1152/ajprenal.00177.2014.-Recent studies show that guidance molecules that are known to regulate cell migration during development may also play an important role in adult pathophysiologic states. One such molecule, semaphorin3A (sema3A), is highly expressed after acute kidney injury (AKI) in mice and humans, but its pathophysiological role is unknown. Genetic inactivation of sema3A protected mice from ischemia-reperfusion-induced AKI, improved tissue histology, reduced neutrophil infiltration, prevented epithelial cell apoptosis, and increased cytokine and chemokine excretion in urine. Pharmacological-based inhibition of sema3A receptor binding likewise protected against ischemia-reperfusion-induced AKI. In vitro, sema3A enhanced toll-like receptor 4-mediated inflammation in epithelial cells, macrophages, and dendritic cells. Moreover, administration of sema3A-treated, bone marrow-derived dendritic cells exacerbated kidney injury. Finally, sema3A augmented cisplatininduced apoptosis in kidney epithelial cells in vitro via expression of DFFA-like effector a (cidea). Our data suggest that the guidance molecule sema3A exacerbates AKI via promoting inflammation and epithelial cell apoptosis. acute kidney injury; cisplatin; semaphorin3A ACUTE KIDNEY INJURY (AKI) is a common condition in humans that is complicated by lack of effective therapies or preventative strategies. Although the incidence varies between definitions and populations, the disorder is estimated to occur in 1-9% of hospital inpatients and over 40% of critically ill patients treated for sepsis in the intensive care unit (3,7,(12)(13)(14). The pathogenesis of AKI is complex and multifactorial in nature. Inflammation, tubular epithelial cell apoptosis, and impaired perfusion are prominent features that promote acute tubular necrosis and subsequent progression to end-stage renal failure (5, 9, 24).Guidance cues represent a class of molecules that play a key role in development by directing cells to reach target tissues or organs through attraction or repulsion (1,8,28). Although these molecules are also expressed in adult tissues, their function in adult organs is poorly understood. Semaphorins compromise the largest family of axon guidance cues yet discovered and play a key role in neural development. They are characterized structurally by a conserved ϳ400 amino acid sema domain and classically described as collapsing factors and mediators of axon repulsion, although they may also act as context-dependent chemoattractants (26). Semaphorins are divided into eight classes, with classes 3-7 expressed in vertebrates. Class 3 semaphorins are secreted proteins, classes 4 -6 are transmembranous, and class 7 are membrane-associated via glycosylphosphatidylinositol linkages. Semaphorins have also been shown to ...