Diabetes & Metabolism Journal

Original Article

Basic and Translational Research
PUM2 Lowers HDAC9 mRNA Stability to Improve Contrast-Induced Acute Kidney Injury by Attenuating Oxidative Stress and Promoting Autophagy: Wei Chen, Hengcheng Lu, Wenni Dai, Hao Li, Yinyin Chen, Guoyong Liu, Liyu He; Diabetes Metab J. 2026;50(4):672-687. Published online September 10, 2025; DOI: https://doi.org/10.4093/dmj.2024.0396

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Background
Contrast-induced acute kidney injury (CIAKI) is the third leading cause of hospital-acquired acute kidney injury and diabetes mellitus (DM) has been identified as a risk factor for CIAKI. However, the molecular mechanism underlying DM-CIAKI remains unclear and requires further investigation.
Methods
Mouse and cell models of DM-CIAKI were established. Kidney function was evaluated by measuring biochemical indicators and using hematoxylin and eosin staining. Gene and protein abundance was assessed using real-time quantitative reverse transcription polymerase chain reaction, immunohistochemistry, immunofluorescence, and Western blotting. Glutathione peroxidase, superoxide dismutase, and malondialdehyde were measured using commercial kits, and reactive oxygen species were detected using a dihydroethidium (DHE) probe and the 2ʹ,7ʹ-dichlorofluorescein diacetate (DCFH-DA) method. Apoptosis in tissues and cells was evaluated by terminal deoxynucleotidyl transferase dUTP nick end labeling (TUNEL). Cell viability and proliferation were measured using Cell Counting Kit-8 and 5-ethynyl-2ʹ-deoxyuridine (EdU) assays. The interaction between pumilio RNA binding family member 2 (PUM2) and histone deacetylase 9 (HDAC9) was validated using RNA immunoprecipitation (RIP) and RNA pull-down assays.
Results
PUM2 expression was markedly reduced in DM-CIAKI models, whereas HDAC9 expression was notably increased. Subsequently, PUM2 silencing aggravated kidney injury in DM-CIAKI mice by enhancing oxidative stress and suppressing autophagy, whereas HDAC9 inhibition or HDAC9 silencing had the opposite effects. Mechanistically, PUM2 could suppressed the stability of HDAC9 mRNA, thereby attenuating HDAC9 expression. Furthermore, HDAC9 overexpression abolished PUM2 overexpression-mediated inhibition of oxidative stress and promotion of autophagy in high glucose- and contrast media-treated human kidney-2 (HK-2) cells.
Conclusion
PUM2 overexpression suppressed oxidative stress and promoted autophagy to alleviate renal injury in DM-CIAKI by interacting with HDAC9 mRNA, which mediated HDAC9 and mRNA degradation and inhibited HDAC9 expression.

Citations

Citations to this article as recorded by

Purpurin Rescues Contrast-Induced Acute Rat Kidney Injury via Inducing Autophagy and Inhibiting Apoptosis
Kangxu He, Xiaoying Sun, Xinhui Pan, Xiaoda Yang, Qi Wang, Kai Liao
Pharmaceuticals.2026; 19(1): 116. CrossRef
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Xiaoying Sun, Kangxu He, Guanzhong Chen, Xiaoda Yang, Xinhui Pan, Kai Liao
Molecules.2026; 31(2): 316. CrossRef
Research progress on risk factors and early predictors of contrast-induced nephropathy
Yemei Ma
American Journal of Translational Research.2026; 18(4): 2795. CrossRef

Review

Guideline/Fact Sheet
Metformin Treatment for Patients with Diabetes and Chronic Kidney Disease: A Korean Diabetes Association and Korean Society of Nephrology Consensus Statement: Kyu Yeon Hur, Mee Kyoung Kim, Seung Hyun Ko, Miyeun Han, Dong Won Lee, Hyuk-Sang Kwon; Diabetes Metab J. 2020;44(1):3-10. Published online February 21, 2020; DOI: https://doi.org/10.4093/dmj.2020.0004

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The safety of metformin use for patients with type 2 diabetes mellitus (T2DM) and advanced kidney disease is controversial, and more recent guidelines have suggested that metformin be used cautiously in this group until more definitive evidence concerning its safety is available. The Korean Diabetes Association and the Korean Society of Nephrology have agreed on consensus statements concerning metformin use for patients with T2DM and renal dysfunction, particularly when these patients undergo imaging studies using iodinated contrast media (ICM). Metformin can be used safely when the estimated glomerular filtration rate (eGFR) is ≥45 mL/min/1.73 m². If the eGFR is between 30 and 44 mL/min/1.73 m², metformin treatment should not be started. If metformin is already in use, a daily dose of ≤1,000 mg is recommended. Metformin is contraindicated when the eGFR is <30 mL/min/1.73 m². Renal function should be evaluated prior to any ICM-related procedures. During procedures involving intravenous administration of ICM, metformin should be discontinued starting the day of the procedures and up to 48 hours post-procedures if the eGFR is <60 mL/min/1.73 m².

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