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This process promotes extracellular matrix production and accelerates the pathological progression of fibrotic diseases. Alternative splicing plays an important role in multiple disease development, while U2 small nuclear RNA auxiliary factor 2 (U2AF2) is an essential factor in the early steps of pre-mRNA splicing. However, the molecular mechanism underlying abnormal\n                    <jats:italic>CCN2<\/jats:italic>\n                    expression upon TGF-\u03b2 stimulation remains unclear. This study elucidates that SIRT4 acts as a master regulator for CCN2 expression in response to TGF-\u03b2 by modulating U2AF2-mediated alternative splicing. Analyses of renal biopsy specimens from patients with CKD and mouse fibrotic kidney tissues revealed marked nuclear accumulation of SIRT4. The tubulointerstitial fibrosis was alleviated by global deletion or tubular epithelial cell (TEC)-specific knockout of\n                    <jats:italic>Sirt4<\/jats:italic>\n                    , and aggravated by adeno-associated virus-mediated SIRT4 overexpression in TECs. Furthermore, SIRT4 was found to translocate from the mitochondria to the cytoplasm through the BAX\/BAK pore under TGF-\u03b2 stimulation. In the cytoplasm, TGF-\u03b2 activated the ERK pathway and induced the phosphorylation of SIRT4 at Ser36, which further promoted its interaction with importin \u03b11 and subsequent nuclear translocation. In the nucleus, SIRT4 was found to deacetylate U2AF2 at K413, facilitating the splicing of CCN2 pre-mRNA to promote CCN2 protein expression. Importantly, exosomes containing anti-SIRT4 antibodies were found to effectively mitigate the UUO-induced kidney fibrosis in mice. Collectively, these findings indicated that SIRT4 plays a role in kidney fibrosis by regulating CCN2 expression via the pre-mRNA splicing.\n                  <\/jats:p>","DOI":"10.7554\/elife.98524","type":"journal-article","created":{"date-parts":[[2024,8,19]],"date-time":"2024-08-19T09:32:08Z","timestamp":1724059928000},"update-policy":"https:\/\/doi.org\/10.7554\/elife.98524","source":"Crossref","is-referenced-by-count":7,"title":["Nuclear translocation of SIRT4 mediates deacetylation of U2AF2 to modulate renal fibrosis through alternative splicing-mediated upregulation of CCN2"],"prefix":"10.7554","volume":"13","author":[{"given":"Guangyan","family":"Yang","sequence":"first","affiliation":[{"id":[{"id":"https:\/\/ror.org\/01hcefx46","id-type":"ROR","asserted-by":"publisher"}],"name":"Department of Geriatrics, Shenzhen People's Hospital (The Second Clinical Medical College, Jinan University; The First Affiliated Hospital, Southern University of Science and Technology)","place":["Guangdong, China"]},{"id":[{"id":"https:\/\/ror.org\/01hcefx46","id-type":"ROR","asserted-by":"publisher"}],"name":"Guangdong Provincial Clinical Research Center for Geriatrics, Shenzhen Clinical Research Center for Geriatrics, Shenzhen People\u2019s Hospital (The Second Clinical Medical College, Jinan University; 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