Chronic kidney disease (CKD) is one of the most frequently encountered disorders in cats, having increased in prevalence in recent decades. Affecting nearly 30% of cats by the age of 10, CKD is a complex ailment that can ultimately lead to organ failure and death. There is no cure for kidney disease; however, a Japanese scientist is working to extend the life of CKD cats using a breakthrough therapy that is making its way into veterinary clinics around the world. The treatment, called “AIM,” stands for “apoptosis inhibitor of macrophage.” This blog will explain how the AIM treatment works, and where research and its implementation currently stand.
What is AIM therapy, and how was it discovered?
In 2015, Dr. Toru Miyazaki, an immunology specialist at the University of Tokyo, discovered a blood protein called “apoptosis inhibitor of macrophage” (AIM) that helps the kidneys flush out toxins using immunoglobin antibodies. AIM is naturally found in animals and is mostly inactive as it is bound to a type of antibody called Immunoglobulin M (IgM). When various “waste” substances, such as cellular debris, damaged proteins, or inflammatory molecules released by dead cells accumulate in the body (a process known as apoptosis), AIM separates from IgM and binds to the waste.[1] The AIM that is bound to the waste then acts as a marker, enabling white blood cells known as macrophages to clean up the waste by engulfing AIM with it.
While AIM is present in the blood of many animals, Dr. Miyazaki noticed that the protein doesn’t always function properly in cats. His research concluded that most cats have a type of hereditary disorder that prevents AIM detaching from IgM to undertake the waste cleanup process.[2] In fact, the strength of the AIM-IgM bind is 1,000 times more in cats than in mice. This prevents crucial waste removal in felines, making them susceptible to kidney failure. Dr. Miyazaki’s theory is that by replenishing insufficient AIM, waste can be adequately eliminated, preventing the onset or halting the progression of CKD in cats.
Dr. Miyazaki’s theory was initially tested using mice. Study mice in which their natural AIM was replaced by feline AIM exhibited higher mortality by kidney disease versus a control group. These findings were the basis of a novel AIM therapy targeting AIM-IgM detachment. AIM therapy applied to the diseased mice showed improvement in renal function and survival.
What is next for AIM research and therapy?
After a slowdown in funding and research due to COVID-19, Dr. Miyazaki resumed his research in 2022 and began a series of clinical trials. The trials include cats with progressive kidney disease, and the keystone of the trial is administering a prototype AIM drug. Nutrition is also closely monitored during the trial, as the proper renal diet can significantly impact CKD longevity. The “AIM” injection has shown promising results in ongoing clinical trials, exceeding expectations and even showing improvement in terminally ill cats. An “AIM” injection is expected to be commercially available in 2025. Miyazaki’s team is actively working to ensure the affordability of the medication, making this life-saving treatment accessible to all cat owners.[3].
In 2022, the Japanese pet food company Marukan Co. Ltd. teamed up with Dr. Miyazaki’s team to create and produce cat food with the AIM protein. The AIM supplement in the food is supposed to activate the non-functional AIM in the cat’s blood, allowing enhanced cleansing and expelling of waste matter in a cat’s kidneys. The food, called AIM30, is a dry kibble, and like most kibbles, is made with the usual low-quality feed-grade ingredients, presumably produced using high heat and extrusion.[4] It is important to note that there are no studies that conclusively show that the food is effective in improving kidney function. The supplement, by the manufacturer’s own admission, contains no actual AIM but in fact contains only an unrelated amino acid. The amino acid is meant to help the natural AIM in a cat detach from IgM to facilitate the cleansing process. Even though it is promoted to produce “healthy” kidney function in cats, it is not considered useful at this point.
A second round of larger clinical trials using an AIM therapy injection began in the second half of 2024. While it may be possible to administer orally at some point, that is not how it is being done in research studies. While showing promise, much more information and research is needed regarding AIM therapy. Dr. Miyazaki’s foundation is receiving funding from several private and public sources to continue his research; however, information concerning conflicts of interest is hard to find. The AIM team has lofty goals including:
- Approval and commercialization of animal AIM pharmaceuticals
- Commencement of clinical trials for human AIM pharmaceuticals
- Approval and commercialization of human AIM-based supplements and pet food
- Practical implementation of diagnostic technologies based on AIM[5]
As feline medicine advancements like AIM take root in the world of veterinary medicine, we proceed with hope and optimism but also with caution. The AIM-IgM interaction is crucial for cats’ susceptibility to kidney problems. Tweaking this interaction could lead to innovative treatments. As clinical trials move forward, the need for more information is crucial. In the meantime, navigating cat kidney disease requires attention to species-appropriate nutrition and a proper balance of essential minerals. As Dr. Miyazaki travels the world to speak at scientific and veterinary conferences, we wait expectantly for more answers to reversing or preventing feline CKD. The key is providing longer life expectancy, without the use of sub-par nutrition and potentially dangerous vaccines.
[1] https://iamaim.jp/en/outline/
[2]https://pubmed.ncbi.nlm.nih.gov/27731392/
[3] https://lovecatsworld.com/japanese-scientist-develops-treatment-that-could-help-cats-live-up-to-30-years/
[4] Kick Kibble to the Curb “Revisited” – Kibble: An Inappropriate Diet fo – Dr. Judy Morgan's Naturally Healthy Pets
