Abstract
Acute kidney injury (AKI) is a sudden episode of kidney failure linked to a wide range of health conditions. High mortality in AKI highlights the need to identify new therapeutic approaches. Homeostasis in multicellular organisms is exquisitely regulated by phagocytosis of apoptotic cells, also known as ‘efferocytosis’. Apoptotic cells are frequently observed at sites of inflammation, including in AKI. Engulfment and cell motility protein-1 (ELMO1) is a regulator of the actin cytoskeleton that promotes apoptotic cell removal by phagocytes during efferocytosis. Mutations in the human ELMO1 gene are linked with diabetic nephropathy and, in animal models of this disease, high ELMO1 levels promote renal dysfunction. However, the role of ELMO1 in AKI was not known. Here, we describe the links between ELMO1 and kidney pathology and test global and tissue-specific ELMO1-deficient mice in models of AKI. While global loss of Elmo1 expression did not impact the immediate loss of renal function after ischemia-reperfusion elicited AKI, ELMO1 deficiency resulted in increased tissue injury in AKI caused by cisplatin injection. Cisplatin induced robust renal cell apoptosis that was significantly elevated in mice with the global loss of ELMO1, but not in mice with the macrophage-specific Elmo1 deletion. Using primary cell culture and immunofluorescence approaches, we highlight the role of ELMO1 in efferocytosis by several renal cell types, suggesting possible additive effects during nephrotoxic injury.
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The authors thank members of the Arandjelovic laboratory and the University of Virginia Center for Immunity, Inflammation, and Regenerative Medicine (CIIR) for discussions, and Alban Gaultier and Lisa Haney for critical reading of the manuscript. This work is supported by funding to S.A. from the NIH R01AI158596 and the University of Virginia.
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This work is supported by funding to S.A. from the NIH R01AI158596 and the University of Virginia.
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This study did not utilize human participants that would require ethical approval. All animal procedures were approved by and performed according to the guidelines of the Institutional Animal Care and Use Committee (IACUC) at the University of Virginia under the protocol #4320.
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Baffert, B., Cholko, M., Sabapathy, V. et al. ELMO1 dependent efferocytosis protects from nephrotoxin induced acute kidney injury. Cell Death Discov. (2026). https://doi.org/10.1038/s41420-026-03140-9
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DOI: https://doi.org/10.1038/s41420-026-03140-9


