SUMMARY
Obesity is particularly severe in terms of escalating kidney dysfunction, disrupted body fluid homeostasis, kidney
injury. Our diet-induced obesity (DIO) mouse model (20-wk, ad lib 45% high fat diet, HFD) dampened feeding
cycles, impaired kidney mitochondrial metabolism, amplified kidney medullary oxidative stress and excretion of
reactive oxygen species (ROS), as well as increased medullary interstitial fibrosis compared to mice on a normal
diet. Remarkably, restoring feeding-fasting cycles through time-restricted food intake (TRF), without altering total
caloric intake during the final 2 weeks of DIO, re-established whole body diurnal energy metabolism, normalized
excretion of oxidants and renal injury markers, as well as abolished renal interstitial fibrosis and T cell infiltration.
These remarkable findings clearly indicate that feeding-fasting cycles are critical for kidney health in obesity. The
goal of the proposed studies is to determine specifically how timing of feeding-fasting cycles impacts kidney
mitochondrial respiration, inflammation and fibrosis in obesity. Our central hypothesis states that timed feeding-
fasting ameliorates DIO-driven kidney fibrosis by reinstating kidney mitochondrial function and reducing T cell
activation and migration to the kidney. Prior studies suggest that the clock gene, Bmal1, regulates mitochondrial
function, but whether this is critical for DIO-induced metabolic dysfunction in the kidney is unknown. Our new
data reveal significant, time-of-day differences in mitochondrial respiration in renal medulla of Bmal1 knockouts
compared to wildtype littermates. In our model of DIO, we observed that circadian rhythms in whole body energy
metabolism are lost but restored by TRF. We also observed that DIO causes a phase shift in the circadian
molecular clock in the kidney. We posit that the mechanisms responsible for the TRF effects in obesity to restore
kidney mitochondrial metabolism is via re-establishing clock activity and suppressing ROS production.
Furthermore, TRF abolishes kidney interstitial fibrosis and kidney vasa recta-associated T cell infiltration in obese
mice suggesting that timed feeding-fasting promotes kidney health by reducing kidney T cell inflammation. Our
new data found that endothelium-derived ET-1 specifically mediates kidney pro-inflammatory CD4+T cell
activation. We show that gut pro-inflammatory T cell activation and cytokine production is ETA dependent and
that CD4+T cells in the gut migrate to peripheral tissues. Thus, we further propose that TRF mitigates DIO-driven
kidney medullary fibrosis by reinstating diurnal rhythms of kidney endothelium-derived ET-1 with T cell clock
activity and ETA dependent T cell activation and migration from the gut to the kidney. Studies will address two
specific aims: First, to test the hypothesis that TRF reduces kidney fibrosis in DIO through Bmal1 mediated
restoration of mitochondrial function and reduced mitochondrial-derived ROS. Second, to test the hypothesis
that TRF mitigates DIO-driven kidney fibrosis by reinstating physiological endothelium-derived ET-1 in the kidney
with T cell activation.