Lee Hong-Joo, Jeong Kyung Hwan, Kim Yang Gyun, Moon Joo Young, Lee Sang Ho, Ihm Chun Gyoo, Sung Ji Youn, Lee Tae Won
Department of Nephrology, Seoul Red Cross Hospital, Seoul, Korea.
Am J Nephrol. 2014;40(1):56-63. doi: 10.1159/000363421. Epub 2014 Jul 11.
Oxidative stress and inflammation are known to play central roles in the development of diabetic nephropathy (DN). Febuxostat is a novel non-purine xanthine oxidase (XO)-specific inhibitor developed to treat hyperuricemia. In this study, we investigated whether febuxostat could ameliorate DN via renoprotective mechanisms such as alleviation of oxidative stress and anti-inflammatory actions.
Male Sprague-Dawley rats were divided into three groups: a normal group, a diabetes group (DM group), and a febuxostat-treated diabetes group (DM+Fx group). We administered 5 mg/kg of febuxostat to experimental rats for 7 weeks and evaluated clinical and biochemical parameters and XO and xanthine dehydrogenase (XDH) activity in hepatic tissue. The degree of oxidative stress and extent of inflammation were evaluated from urine samples and renal tissue collected from each group.
Diabetic rats (DM and DM+Fx groups) had higher blood glucose and kidney weight relative to body weight than normal rats. Albuminuria was significantly reduced in febuxostat-treated diabetic rats compared with untreated diabetic rats. Quantitative analysis showed that hepatic XO and XDH activities were higher in the DM groups, but decreased after treatment with febuxostat. Urinary 8-OHdG concentrations and renal cortical nitrotyrosine also indicated reduced oxidative stress in the DM+Fx group relative to the DM group. The number of ED-1-stained cells in the glomerulus and tubule of diabetic renal tissue decreased in febuxostat-treated diabetic rats relative to that of non-treated diabetic rats. Diabetic rats also expressed higher transcript levels of inflammatory genes (E-selectin and VCAM-1), an inflammation-induced enzyme (COX-2), and inflammatory mediators (ED-1 and NF-κB) than control rats; expression of these genes was significantly reduced by treatment with febuxostat.
Febuxostat prevents diabetic renal injury such as albuminuria. This renoprotective effect appears to be due to attenuation of the inflammatory and oxidative effects of diabetes-induced renal damage through inhibition of XO and XDH activities.
氧化应激和炎症在糖尿病肾病(DN)的发展过程中起着核心作用。非布司他是一种新型的非嘌呤黄嘌呤氧化酶(XO)特异性抑制剂,用于治疗高尿酸血症。在本研究中,我们调查了非布司他是否能通过减轻氧化应激和抗炎作用等肾脏保护机制来改善糖尿病肾病。
将雄性Sprague-Dawley大鼠分为三组:正常组、糖尿病组(DM组)和非布司他治疗的糖尿病组(DM+Fx组)。我们给实验大鼠施用5mg/kg的非布司他,持续7周,并评估临床和生化参数以及肝组织中的XO和黄嘌呤脱氢酶(XDH)活性。从每组收集的尿液样本和肾组织中评估氧化应激程度和炎症程度。
与正常大鼠相比,糖尿病大鼠(DM组和DM+Fx组)的血糖和肾脏重量相对于体重更高。与未治疗的糖尿病大鼠相比,非布司他治疗的糖尿病大鼠的蛋白尿明显减少。定量分析表明,DM组肝组织中的XO和XDH活性较高,但在非布司他治疗后降低。尿8-OHdG浓度和肾皮质硝基酪氨酸也表明,与DM组相比,DM+Fx组的氧化应激降低。与未治疗的糖尿病大鼠相比,非布司他治疗的糖尿病大鼠的糖尿病肾组织肾小球和肾小管中ED-1染色细胞数量减少。糖尿病大鼠还比对照大鼠表达更高水平的炎症基因(E-选择素和血管细胞黏附分子-1)、一种炎症诱导酶(COX-2)和炎症介质(ED-1和核因子κB);非布司他治疗可显著降低这些基因的表达。
非布司他可预防糖尿病肾损伤,如蛋白尿。这种肾脏保护作用似乎是由于通过抑制XO和XDH活性减轻了糖尿病诱导的肾损伤的炎症和氧化作用。