Ichinose Kunihiro, Maeshima Yohei, Yamamoto Yoshihiko, Kinomura Masaru, Hirokoshi Kumiko, Kitayama Hiroyuki, Takazawa Yuki, Sugiyama Hitoshi, Yamasaki Yasushi, Agata Naoki, Makino Hirofumi
Department of Medicine and Clinical Science, Okayama University Graduate School of Medicine, Dentistry and Pharmaceutical Sciences, 2-5-1 Shikata-cho, Okayama 700-8558, Japan.
Diabetes. 2006 May;55(5):1232-42.
One of the mechanisms involved in the progression of diabetic nephropathy, the most common cause of end-stage renal failure, is angiogenic phenomenon associated with the increase of angiogenic factors such as vascular endothelial growth factor (VEGF)-A and angiopoietin (Ang)-2, an antagonist of Ang-1. In the present study, we examined the therapeutic efficacy of 2-(8-hydroxy-6-methoxy-1-oxo-1H-2-benzopyran-3-yl) propionic acid (NM-3), a small molecule isocoumarin with antiangiogenic activity, using diabetic db/db mice, a model of obese type 2 diabetes. Increases in kidney weight, glomerular volume, creatinine clearance, urinary albumin excretion, total mesangial fraction, glomerular type IV collagen, glomerular endothelial area (CD31(+)), and monocyte/macrophage accumulation (F4/80(+)) observed in control db/db mice were significantly suppressed by daily intraperitoneal injection of NM-3 (100 mg/kg, for 8 weeks). Increases in renal expression of VEGF-A, Ang-2, fibrogenic factor transforming growth factor (TGF)-beta1, and chemokine monocyte chemoattractant protein-1 but not tumor necrosis factor-alpha were also inhibited by NM-3 in db/db mice. Furthermore, decreases of nephrin mRNA and protein levels in db/db mice were recovered by NM-3. In addition, treatment of db/db mice with NM-3 did not affect body weight, blood glucose, serum insulin, or food consumption. NM-3 significantly suppressed the increase of VEGF induced by high glucose in cultured podocytes and also suppressed the increase of VEGF and TGF-beta induced by high glucose in cultured mesangial cells. Taken together, these results demonstrate the potential use of NM-3 as a novel therapeutic agent for renal alterations in type 2 diabetes.
糖尿病肾病是终末期肾衰竭最常见的病因,其进展涉及的机制之一是血管生成现象,这与血管生成因子如血管内皮生长因子(VEGF)-A和血管生成素(Ang)-2(Ang-1的拮抗剂)水平升高有关。在本研究中,我们使用肥胖型2型糖尿病模型——糖尿病db/db小鼠,研究了具有抗血管生成活性的小分子异香豆素2-(8-羟基-6-甲氧基-1-氧代-1H-2-苯并吡喃-3-基)丙酸(NM-3)的治疗效果。对照db/db小鼠出现的肾重量增加、肾小球体积增大、肌酐清除率升高、尿白蛋白排泄增加、系膜总分数增加、肾小球IV型胶原增加、肾小球内皮面积(CD31(+))增加以及单核细胞/巨噬细胞积聚(F4/80(+)),通过每日腹腔注射NM-3(100 mg/kg,持续8周)得到显著抑制。db/db小鼠肾组织中VEGF-A、Ang-2、促纤维化因子转化生长因子(TGF)-β1和趋化因子单核细胞趋化蛋白-1的表达增加,但肿瘤坏死因子-α未增加,也被NM-3抑制。此外,NM-3使db/db小鼠中nephrin mRNA和蛋白水平的降低得到恢复。另外,用NM-3治疗db/db小鼠不影响体重、血糖、血清胰岛素或食物摄入量。NM-3显著抑制高糖诱导的培养足细胞中VEGF的增加,也抑制高糖诱导的培养系膜细胞中VEGF和TGF-β的增加。综上所述,这些结果表明NM-3作为2型糖尿病肾脏病变新型治疗药物的潜在用途。