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. Author manuscript; available in PMC: 2013 Dec 1.
Published in final edited form as: J Immunol. 2012 Oct 29;189(11):5421–5433. doi: 10.4049/jimmunol.1200581

Figure 10. Proposed mechanisms of acute kidney injury induced liver dysfunction and systemic inflammation.

Figure 10

Acute loss of renal function causes small intestinal Paneth cell generation of IL-17A and Paneth cell degranulation. We propos that IL-17A released by Paneth cells directly cause intestinal injury. Our data suggest that intestinal macrophages uptake of released Paneth cell granules promote portal delivery of IL-17A. This leads to hepatic injury (necrosis, inflammation and apoptosis) and increased generation and systemic release of TNF-α and IL-6 propagating multi-organ injury and systemic inflammation. The mechanisms that cause Paneth cells to produce increased IL-17A and degranulate after AKI remain to be determined.