The C5a/C5aR2 axis promotes renal inflammation and tissue damage.

C5a is a potent inflammatory mediator, which binds C5aR1 and C5aR2. Although pathogenic roles of C5a/C5aR1 axis in inflammatory disorders are well-documented, the roles for C5a/C5aR2 axis in inflammatory disorders and underlying mechanisms remain unclear. Here, we show that C5a/C5aR2 axis contributes to renal inflammation and tissue damage in a mouse model of acute pyelonephritis. Compared with WT littermates, C5ar2-/- mice had significantly reduced renal inflammation, tubular damage and renal bacterial load following bladder inoculation with uropathogenic E coli. The decrease in inflammatory responses in the kidney of C5ar2-/- mice was correlated with reduced intrarenal levels of high mobility group box 1 protein (HMGB1), NLRP3 inflammasome components, cleaved caspase-1 and IL-1beta. In vitro, C5a stimulation of macrophages from C5ar1-/- mice (lacking C5aR1 but expressing C5aR2) led to significant upregulation of HMGB1 release, NLRP3/caspase-1 inflammasome activation and IL-1beta secretion. Furthermore, blockade of HMGB1 significantly reduced C5a-mediated upregulation of NLRP3/caspase-1 inflammasome activation and IL-1beta secretion in the macrophages, implying a HMGB1-dependent upregulation of NLRP3/caspase-1 inflammasome activation in macrophages. Our findings demonstrate a pathogenic role for C5a/C5aR2 axis in renal injury following renal infection and suggest that C5a/C5aR2 axis contributes to renal inflammation and tissue damage through up-regulation of HMGB1 and NLRP3/caspase-1 inflammasome.