1. Reduced O -GlcNAcylation and tubular hypoxia contribute to the antifibrotic effect of SGLT2 inhibitor dapagliflozin in the diabetic kidney.
- Author
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Hodrea J, Balogh DB, Hosszu A, Lenart L, Besztercei B, Koszegi S, Sparding N, Genovese F, Wagner LJ, Szabo AJ, and Fekete A
- Subjects
- Animals, Blood Glucose drug effects, Blood Glucose metabolism, Cell Hypoxia, Cell Line, Collagen metabolism, Diabetes Mellitus, Experimental chemically induced, Diabetes Mellitus, Experimental metabolism, Diabetes Mellitus, Type 1 chemically induced, Diabetes Mellitus, Type 1 metabolism, Diabetic Nephropathies etiology, Diabetic Nephropathies metabolism, Diabetic Nephropathies pathology, Fibronectins metabolism, Fibrosis, Humans, Kidney Tubules, Proximal metabolism, Kidney Tubules, Proximal pathology, Male, Rats, Wistar, Streptozocin, Benzhydryl Compounds pharmacology, Diabetes Mellitus, Experimental drug therapy, Diabetes Mellitus, Type 1 drug therapy, Diabetic Nephropathies prevention & control, Glucosides pharmacology, Glycosylation drug effects, Kidney Tubules, Proximal drug effects, Sodium-Glucose Transporter 2 Inhibitors pharmacology
- Abstract
Diabetic kidney disease is a worldwide epidemic, and therapies are incomplete. Clinical data suggest that improved renal outcomes by Na
+ -glucose cotransporter 2 inhibitor (SGLT2i) are partly beyond their antihyperglycemic effects; however, the mechanisms are still elusive. Here, we investigated the effect of the SGLT2i dapagliflozin (DAPA) in the prevention of elevated O -GlcNAcylation and tubular hypoxia as contributors of renal fibrosis. Type 1 diabetes was induced by streptozotocin in adult male Wistar rats. After the onset of diabetes, rats were treated for 6 wk with DAPA or DAPA combined with losartan (LOS). The effect of hyperglycemia was tested in HK-2 cells kept under normal or high glucose conditions. To test the effect of hypoxia, cells were kept in 1% O2 for 2 h. Cells were treated with DAPA or DAPA combined with LOS. DAPA slowed the loss of renal function, mitigated renal tubular injury markers (kidney injury molecule-1 and neutrophil gelatinase-associated lipocalin), and reduced tubulointerstitial fibrosis. DAPA diminished high glucose-induced protein O -GlcNAcylation and moderated the tubular response to hypoxia through the hypoxia-inducible factor pathway. DAPA alone was as effective as combined treatment with LOS in all outcome parameters. These data highlight the role of ameliorated O -GlcNAcylation and diminished tubular hypoxia as important benefits of SGLT2i treatment. Our results support the link between glucose toxicity, tubular hypoxia, and fibrosis, a vicious trio that could be targeted by SGLT2i in kidney diseases of other origins as well.- Published
- 2020
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