MECHANISTIC INSIGHTS INTO THE PROTECTIVE EFFECTS OF SGLT2 INHIBITORS ON DIABETIC KIDNEY FUNCTION AND INFLAMMATION: EXPERIMENTAL STUDIES

 

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MECHANISTIC INSIGHTS INTO THE PROTECTIVE EFFECTS OF SGLT2 INHIBITORS ON DIABETIC KIDNEY FUNCTION AND INFLAMMATION: EXPERIMENTAL STUDIES

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Abu Alqumboz
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Abu Alqumboz YM 700043527@uaeu.ac.ae Untied Arab Emirates Univesity Internal Medicine Al Ain United Arab Emirates *
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Diabetic kidney disease (DKD) is a severe complication of diabetes that significantly contributes to morbidity and mortality. Sodium-glucose cotransporter 2 (SGLT2) inhibitors have shown promise in improving kidney survival in DKD. However, the underlying mechanisms for the protective effect of SGLT2 inhibitors remain unclear. This study aimed to examine the effect of inhibition of SGLT2 on the oxidative and inflammatory stress of diabetic kidney disease, and its impact on glomerular function. 

A three-month experimental study was performed using Wistar rats (n = 10), randomly assigned to five groups: a naïve control group, a diabetic control group (induced with streptozotocin [STZ]), and three ERTU-treated groups. ERTU was administered orally at 2 mg/kg from diabetes onset (E-ERU 2 mg/kg), at 2 mg/kg beginning seven weeks post-induction (L-ERU 2 mg/kg), and at 5 mg/kg beginning seven weeks post-induction (L-ERU 5 mg/kg). At the end of the 12 weeks, glomerular function and biological and immunological studies were performed. Tissue homogenates were used to determine oxidative stress markers (total nitric oxide, thiobarbituric acid reactive substances, glutathione, and superoxide dismutase) and kidney injury/inflammatory biomarkers (Kidney Injury Molecule 1, cystatin C, adiponectin, IL-1b, and IL-18). Immunohistochemistry staining was used for the measurement of the expression of NLRP3 inflammasome complex (Apoptosis-associated speck-like protein containing a CARD, Pro-caspase-1, and NLRP3 inflammasome) and its downstream product IL-18. The statistical difference was measured by using the Kruskal-Wallis test and one-way ANOVA test, where (<0.05) was considered statistically significant.

NLRP3 Complex                                                                                                           ERTU treatment significantly reduced kidney injury, oxidative stress, and activation of NLRP3 Inflammasome complex (<0.05). 

In conclusion, the SGLT2 inhibitor exhibited dose-dependent and time-dependent antioxidant and anti-inflammatory effects that may have contributed to the stabilization of kidney function. Study of the NLRP3 inflammasome pathway may reveal additional insights into the direct impact of ERTU’s renal protection.

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