Figure 4.

Kidney immune crosstalk in health and sepsis. Uromodulin’s immunomodulatory and anti-oxidative stress roles are well established in the healthy kidney, but it is unknown if these extend to sepsis. Vitamin D is known to promote phagocytosis and chemotaxis while suppressing inflammatory cytokine production. It can also mitigate renal oxidative stress. Erythropoeitin promotes efferocytosis and suppresses inflammatory gene expression. Damage- and pathogen-associated molecular patterns (DAMPs/PAMPs) increase in sepsis due to pathogen infiltration and cell damage. Kidney injury can modulate the levels of kidney-derived molecules. Erythropoietin increases with kidney injury while sufficient levels of kidney injury can deplete both uromodulin and vitamin D.