Article

Inhibiting mPGES-2 impedes renal cyst growth in mice with polycystic kidney disease

Dan-dan Zhong1,2, Cheng Hu1,2,3,4, Lan-lan Zhao1,2,3, Yan Shen1, Ru-meng Zhang5, Ying Liu6, Bu-hui Liu1,2, Wen Su7,8, Bao-xue Yang9, Hui Xiong10, Dong Guo1, Dong Sun3, Ying-ying Zou1,2, Ying Sun1,2
1 Jiangsu Key Laboratory of Geriatric Precision Medicine and Aging Intervention, Xuzhou Medical University, Xuzhou 221004, China
2 Jiangsu Key Laboratory of New Drug Research and Clinical Pharmacy, Xuzhou Medical University, Xuzhou 221004, China
3 Clinical Research Center for Kidney Disease, Xuzhou Medical University, Xuzhou 221004, China
4 Taicang Loujiang New Town Hospital, Suzhou 215400, China
5 Department of Pharmacology, Xuzhou Central Hospital, Xuzhou 221009, China
6 Department of Pathophysiology, Xiangya School of Medicine, Central South University, Changsha 410008, China
7 Department of Pathophysiology, Shenzhen University, Shenzhen 518060, China
8 Shenzhen University Health Science Center, Shenzhen University, Shenzhen 518060, China
9 State Key Laboratory of Vascular Homeostasis and Remodeling, Department of Pharmacology, School of Basic Medical Sciences, Peking University, Beijing 100191, China
10 Department of Urology, Shandong Provincial Hospital affiliated to Shandong First Medical University, Ji-nan 250021, China
Correspondence to: Dong Sun: sundongxz@126.com, Ying-ying Zou: zouyy2378@xzhmu.edu.cn, Ying Sun: yingsun@xzhmu.edu.cn,
DOI: 10.1038/s41401-025-01664-x
Received: 30 April 2025
Accepted: 27 August 2025
Advance online: 17 October 2025

Abstract

Autosomal dominant polycystic kidney disease (ADPKD) is characterized by the development of multiple fluid-filled cysts in the kidneys, resulting in progressive decline and failure of renal function. Microsomal prostaglandin E synthase-2 (mPGES-2) is a unique bifunctional enzyme that catalyzes the conversion of prostaglandin H2 (PGH2) to prostaglandin E2 (PGE2) or to malondialdehyde (MDA) in conjunction with heme. PGE2 and MDA are key mediators that regulate cell growth and proliferation, respectively. In this study, we elucidated the functional role of mPGES-2 in ADPKD. By performing Western blot and immunohistochemical staining on the kidneys of patients with PKD and healthy controls, we showed that the expression levels of mPGES-2 markedly increased. We then crossed mPGES-2 knockout (Ptges2–/–) mice with Ksp-Cre; pkd1flox/+ mice to generate mPGES-2 knockout ADPKD (Ptges2–/–; PKD) mice. We showed that mPGES-2 depletion mitigated ADPKD progression in a mouse model. These findings were corroborated by in vitro experiments in embryonic kidney cells: the application of the mPGES-2 inhibitor SZ0232 (40, 80, and 160 μM) effectively suppressed cyst growth, suggesting a potential therapeutic option for ADPKD. Analysis of mPGES-2 metabolites revealed that mPGES-2 deficiency led to a reduction in PGE2 production, which has not been detected in other renal diseases, likely because of the diminished heme levels in ADPKD kidneys. Moreover, mPGES-2 was implicated in the regulation of the downstream signaling pathway involving β-catenin/STAT3-c-Myc via PGE2–EP4, which promoted abnormal proliferation of renal tubular epithelial cells and influenced cyst formation. Our findings suggest that targeting mPGES-2 is a viable therapeutic strategy for the management of ADPKD.

Keywords: ADPKD; mPGES-2; PGE2; proliferation; β-catenin/STAT3; SZ0232

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