Abstract
Primary nephrotic syndrome (PNS) is a leading cause of chronic kidney disease in children. Focal segmental glomerulosclerosis (FSGS) remains a clinical challenge in terms of treatment. To investigate the role of the P2X7R-NLRP3 inflammasome pathway in podocyte injury in PNS, focusing on its regulation of CXCL16 in FSGS. Clinical renal tissues from children with PNS were analyzed by immunohistochemistry for P2X7R, NLRP3, and CXCL16 expression. In vitro, adriamycin (ADR)-induced podocyte injury models were established, with P2X7R knockdown via lentiviral transduction. Protein and mRNA levels of pathway components and injury markers were assessed by Western Blot and RT-qPCR; IL-1β and IL-18 were measured by ELISA. In vivo, ADR nephropathy was induced with ADR 25 mg/kg by a single tail vein injection in NLRP3-knockout and wild-type male mice (n = 10 per group C57BL/6J, 5 weeks old). Serum albumin, total cholesterol, 24 h urine protein, renal expression of CXCL16, Nephrin, and inflammatory cytokines, and podocyte ultrastructure were evaluated. Glomerular P2X7R, NLRP3, and CXCL16 were significantly upregulated in PNS patients, particularly in FSGS versus MCD. ADR-induced podocytes showed increased expression of these markers and inflammatory cytokines, which P2X7R knockdown reversed. NLRP3 knockout in mice attenuated ADR nephropathy, improving biochemical parameters, reducing proteinuria, downregulating CXCL16 and inflammatory factors, restoring Nephrin, and ameliorating podocyte ultrastructural injury. The P2X7R-NLRP3 inflammasome pathway promotes podocyte injury in PNS via CXCL16 upregulation, revealing novel mechanistic insights and potential therapeutic targets.
Data availability
The datasets generated and/or analyzed in the present study are available from the corresponding author upon reasonable request.
References
Mishra, O. P. et al. Outcomes of children with idiopathic steroid resistant nephrotic syndrome: A single centre observational study. Braz. J. Nephrol. 45(2), 199–209 (2023).
Cunanan, J., Zhang, D., Peired, A. J. & Barua, M. Podocytes in health and glomerular disease. Front. Cell Dev. Biol. 13, 1564847 (2025).
Qadri AH, Prajapati J, Praghna D, Sinha A, Pasupulati AK. Structural and functional insights of the podocyte slit diaphragm complex. Tissue Barriers. 2025-10-16; 2575198.
Altintas, M. M. et al. Pathogenesis of focal segmental glomerulosclerosis and related disorders. Annu. Rev. Pathol. Mech. Dis. 20(1), 329–353 (2025).
Wang, C., Li, Q., Zhen, J., Xu, Y. & Sun, S. Simvastatin ameliorates renal lipidosis through the suppression of renal CXCL16 expression in mice with adriamycin-induced nephropathy. Int. J. Clin. Exp. Pathol. 8(12), 15696–15707 (2015).
Gutwein, P. et al. CXCL16 is expressed in podocytes and acts as a scavenger receptor for oxidized low-density lipoprotein. Am. J. Pathol. 174(6), 2061–2072 (2009).
Argyris, D. G., Anastasiadou, D. P., Filippou, P. S. & Karagiannis, G. S. An emerging paradigm of CXCL16 involvement in cancer progression. Cytokine Growth Factor Rev. 84, 87–100 (2025).
Zhen, J. et al. Increased serum CXCL16 is highly correlated with blood lipids, urine protein and immune reaction in children with active nephrotic syndrome. Diagn. Pathol. 9, 23 (2014).
Wang, L., Yao, X., Li, Q. & Sun, S. Effect of simvastatin on lipid accumulation and the expression of CXCL16 and nephrin in podocyte induced by oxidized LDL. J. Invest. Surg. 31(2), 69–74 (2018).
Tassetto, M., Scialdone, A., Solini, A. & Di Virgilio, F. The P2X7 receptor: A promising pharmacological target in diabetic retinopathy. Int. J. Mol. Sci. https://doi.org/10.3390/ijms22137110 (2021).
Hu, Z. B. et al. Activation of the CXCL16/CXCR6 pathway by inflammation contributes to atherosclerosis in patients with end-stage renal disease. Int. J. Med. Sci. 13(11), 858–867 (2016).
Xu, J. & Núñez, G. The NLRP3 inflammasome: Activation and regulation. Trends Biochem. Sci. 48(4), 331–344 (2023).
Vande Walle, L. & Lamkanfi, M. Drugging the NLRP3 inflammasome: From signalling mechanisms to therapeutic targets. Nat. Rev. Drug Discov. 23(1), 43–66 (2024).
Üstündağ H. The P2X7 receptor/NLRP3 inflammasome signaling axis in sepsis: molecular mechanisms, organ-specific pathophysiology, and emerging therapeutic strategies. PURINERG SIGNAL. 2026-03-10; 22(2).
Chi, K., Geng, X., Liu, C., Cai, G. & Hong, Q. Research progress on the role of inflammasomes in kidney disease. Mediators Inflamm. 2020, 8032797 (2020).
Zhu, Y., Liu, M., Xun, W., Li, K. & Niu, X. P2X7R antagonist protects against renal injury in mice with adriamycin nephropathy. Exp. Ther. Med. 23(2), 161 (2022).
Youssef, D. M., Abd Al-Atif, A. M., El-Khateeb, S. S. H. & Elshal, A. S. Evaluation of interleukin-18 in children with steroid-sensitive nephrotic syndrome before and after using levamisole. Saudi J. Kidney Dis. Transpl. 29(3), 591–597 (2018).
Zhou, J., Shi, F. & Xun, W. Leptin, hs-CRP, IL-18 and urinary protein before and after treatment of children with nephrotic syndrome. Exp. Ther. Med. 15(5), 4426–4430 (2018).
Nickavar, A., Valavi, E., Safaeian, B., Amoori, P. & Moosavian, M. predictive value of serum interleukins in children with idiopathic nephrotic syndrome. Iran J. Allergy Asthma Immunol. 19(6), 632–639 (2020).
Hu, Z. B. et al. Inflammation activated CXCL16 pathway contributes to tubulointerstitial injury in mouse diabetic nephropathy. Acta Pharmacol. Sin. 39(6), 1022–1033 (2018).
Vivarelli, M. et al. Childhood nephrotic syndrome. Lancet 402(10404), 809–824 (2023).
Lella, G. et al. Nutritional management of idiopathic nephrotic syndrome in pediatric age. Med. Sci. (Basel). 11(3), 47 (2023).
Popovic, Z. V. et al. CD73 overexpression in podocytes: A novel marker of podocyte injury in human kidney disease. Int. J. Mol. Sci. https://doi.org/10.3390/ijms22147642 (2021).
Ma, S., Qiu, Y. & Zhang, C. Cytoskeleton rearrangement in podocytopathies: An update. Int. J. Mol. Sci. https://doi.org/10.3390/ijms25010647 (2024).
Williamson, C. R., Pantic, U. V., Wang, A. Y. & Jones, N. Revisiting nephrin signaling and its specialized effects on the uniquely adaptable podocyte. Biochem. J. https://doi.org/10.1042/bcj20230234 (2025).
Watanabe, M., Takimoto, H. R. & Sasaki, N. Adriamycin-induced nephropathy models: Elucidating CKD pathophysiology and advancing therapeutic strategies. Exp. Anim. 74(2), 132–142 (2025).
Liu, L., Li, Q. & Zhang, G. Systemic inflammation accelerates the development of focal segmental glomerulosclerosis in a mouse model of Adriamycin induced nephrosis. Sci. Rep. 15(1), 14304 (2025).
Sluyter, R. et al. Animal models for the investigation of P2X7 receptors. Int. J. Mol. Sci. 24(9), 8225 (2023).
Liu, X. et al. Unlocking the therapeutic potential of P2X7 receptor: A comprehensive review of its role in neurodegenerative disorders. Front. Pharmacol. 15, 1450704 (2024).
Menzies Robert, I. et al. Purinergic signaling in kidney disease. Kidney Int. 91(2), 315–323 (2017).
Zhu, Y. et al. Blocking P2X7 receptor ameliorates oxidized LDL-mediated podocyte apoptosis. Mol. Biol. Rep. 46(4), 3809–3816 (2019).
Kong, H., Zhao, H., Chen, T., Song, Y. & Cui, Y. Targeted P2X7/NLRP3 signaling pathway against inflammation, apoptosis, and pyroptosis of retinal endothelial cells in diabetic retinopathy. Cell Death Dis. 13(4), 336 (2022).
Hui, T. et al. ATP/P2X7 receptor/NLRP3 pathway facilitates renal tubular epithelial-myofibroblast transdifferentiation and interstitial fibrosis in rats with unilateral ureteral obstruction. Front. Pharmacol. 16, 1598151 (2025).
Zhu, Y. et al. P2X7 receptor inhibition attenuates podocyte injury by oxLDL through deregulating CXCL16. Cell Biol. Int. 46(3), 454–461 (2022).
Luo, Y., Long, M., Wu, X. & Zeng, L. Targeting the NLRP3 inflammasome in kidney disease molecular mechanisms, pathogenic roles, and emerging small-molecule therapeutics. Front. Immunol. 16, 1703560 (2025).
Islamuddin, M. & Qin, X. Renal macrophages and NLRP3 inflammasomes in kidney diseases and therapeutics. Cell Death Discov. 10(1), 229 (2024).
Hou, X. X. et al. Purinergic 2X7 receptor is involved in the podocyte damage of obesity-related glomerulopathy via activating Nucleotide-Binding and Oligomerization Domain-Like Receptor Protein 3 Inflammasome. Chin. Med. J. (Engl.) 131(22), 2713–2725 (2018).
Wu, M. et al. Inhibition of NLRP3 inflammasome ameliorates podocyte damage by suppressing lipid accumulation in diabetic nephropathy. Metabolism 118, 154748 (2021).
Funding
This study is funded by the Natural Science Foundation of Shandong Province (ZR2022MH120).
Author information
Authors and Affiliations
Contributions
ZYJ designed the research. ZYJ, ZZH and LXY performed the experiments. LSW, LQ and ZJH analyzed the data. ZYJ and SSZ drafted the manuscript and analyzed data. ZYJ and SSZ collected and interpreted data and revised the final manuscript. ZYJ, ZZH and LXY wrote the manuscript. All authors read and approved the final manuscript.
Corresponding author
Ethics declarations
Competing interests
The authors declare no competing interests.
Ethical approval and consent to participate
This study was approved by the Ethics Committee of Shandong University Clinical Medical College (No. SDULCLL2021-1-32 [human research]; No. SDULCLL2021-2-32 [animal experiments]). All experiments were performed in accordance with relevant guidelines and regulations.
Additional information
Publisher’s note
Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.
Supplementary Information
Rights and permissions
Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/.
About this article
Cite this article
Zhu, Y., Zong, Z., Li, X. et al. Inhibiting the P2X7R-NLRP3 inflammasome pathway regulates CXCL16 to alleviate podocyte injury in mice with adriamycin nephropathy. Sci Rep (2026). https://doi.org/10.1038/s41598-026-47345-5
Received:
Accepted:
Published:
DOI: https://doi.org/10.1038/s41598-026-47345-5