小柯机器人

研究揭示抑制SGLT2保护肾脏的机制
2020-07-30 14:23

日本志贺大学Hiroshi Maegawa、Shinji Kume等研究人员合作发现,SGLT2抑制通过促进酮体诱导的mTORC1抑制介导对糖尿病肾病的保护。2020年7月28日,《细胞—代谢》杂志在线发表了这项成果。

据研究人员介绍,SGLT2抑制剂在患有糖尿病肾病(DKD)的受试者中提供强大的肾脏保护作用。但是这种保护的机制尚不清楚。
 
研究人员发现,在高脂饮食喂养的ApoE基因敲除小鼠(一种非蛋白尿DKD模型)的近端肾小管中,ATP的产生是由于脂蛋白复合物1(mTORC1 )。研究人员进一步发现,恩格列净增加了内源性酮体(KB)的水平,因此将其与1,3-丁二醇(KB的前体)一起使用或治疗,可防止小鼠肾脏ATP水平降低和器官损伤。恩格列净的肾脏保护作用被酮体生成限速酶Hmgcs2的缺失所消除。此外,KB减弱了糖尿病db/db小鼠中与mTORC1相关的足细胞损伤和蛋白尿。
 
这些研究结果表明,SGLT2抑制相关的肾脏保护作用是由KB升高介导的,从而反过来又纠正了非蛋白尿和蛋白尿DKD中发生的mTORC1过度活化。
 
附:英文原文

Title: SGLT2 Inhibition Mediates Protection from Diabetic Kidney Disease by Promoting Ketone Body-Induced mTORC1 Inhibition

Author: Issei Tomita, Shinji Kume, Sho Sugahara, Norihisa Osawa, Kosuke Yamahara, Mako Yasuda-Yamahara, Naoko Takeda, Masami Chin-Kanasaki, Tatsuroh Kaneko, Eric Mayoux, Michael Mark, Motoko Yanagita, Hisakazu Ogita, Shin-ichi Araki, Hiroshi Maegawa

Issue&Volume: 2020-07-28

Abstract: SGLT2 inhibitors offer strong renoprotection in subjects with diabetic kidney disease(DKD). But the mechanism for such protection is not clear. Here, we report that indamaged proximal tubules of high-fat diet-fed ApoE-knockout mice, a model of non-proteinuricDKD, ATP production shifted from lipolysis to ketolysis dependent due to hyperactivationof the mechanistic target of rapamycin complex 1 (mTORC1). We further found that empagliflozinraised endogenous ketone body (KB) levels, and thus its use or treatment with 1,3-butanediol,a KB precursor, prevented decreases in renal ATP levels and organ damage in the mice.The renoprotective effect of empagliflozin was abolished by gene deletion of Hmgcs2,a rate-limiting enzyme of ketogenesis. Furthermore, KBs attenuated mTORC1-associatedpodocyte damage and proteinuria in diabetic db/db mice. Our findings show that SGLT2 inhibition-associated renoprotection is mediatedby an elevation of KBs that in turn corrects mTORC1 hyperactivation that occurs innon-proteinuric and proteinuric DKD.

DOI: 10.1016/j.cmet.2020.06.020

Source: https://www.cell.com/cell-metabolism/fulltext/S1550-4131(20)30358-2

Cell Metabolism:《细胞—代谢》,创刊于2005年。隶属于细胞出版社,最新IF:31.373
官方网址:https://www.cell.com/cell-metabolism/home
投稿链接:https://www.editorialmanager.com/cell-metabolism/default.aspx


本期文章:《细胞—代谢》:Online/在线发表

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