Elsherbiny Nehal Mohsen, El-Sherbiny Mohamed, Said Eman
Department of Biochemistry, Faculty of Pharmacy, Mansoura University, Mansoura, Egypt.
Department of Anatomy, Faculty of Medicine, Mansoura University, Mansoura, Egypt.
J Physiol Biochem. 2015 Dec;71(4):635-48. doi: 10.1007/s13105-015-0428-6. Epub 2015 Aug 21.
Diabetes mellitus is an ever growing world-wide health problem. The patient has to stick to a firm life-long therapeutic regimen, otherwise diabetic complications will develop. Diabetic nephropathy (DN) is one of the most common diabetic complications and it requires careful medical attendance. Nilotinib hydrochloride is a protein tyrosine kinase inhibitor reported to have numerous therapeutic efficacies besides being an anticancer. In the current study, single I.P. streptozotocin (50 mg/kg) injection was used to induce type I diabetes mellitus in male Sprague-Dawley rats. After 8 weeks, significant deterioration of renal function with urinary excretion of nephrin, podocalyxin, and albumin was observed. Daily oral administration of nilotinib (20 mg/kg) for 8 weeks significantly improved signs of DN on all investigated scales. On a biochemical scale, kidney functions, albuminuria, urinary nephrin, podocalyxin excretion, and host oxidant/antioxidant balance significantly improved. Kidney content of nitric oxide, expression of toll-like receptors 4 and NF-κB/p65 activity significantly declined as well. On a histopathological scale, α-smooth muscle actin and nestin expression significantly declined. Meanwhile, area of fibrosis significantly declined as seen with significant reduction in accumulation of extracellular matrix components and kidney content of collagen. Ultimately, such improvements were accompanied by significant restoration of normal kidney physiology and function. In conclusion, nilotinib can hinder progression of DN through various mechanisms. Reduction of oxidative stress, enhancement of host antioxidant defense system, reduction of inflammation, angiogenesis, tissue hypoxia, and pro-fibrogenic biomarker expression can be implicated in the beneficial therapeutic outcome observed with nilotinib therapy.
糖尿病是一个在全球范围内不断加剧的健康问题。患者必须坚持严格的终身治疗方案,否则会引发糖尿病并发症。糖尿病肾病(DN)是最常见的糖尿病并发症之一,需要精心的医疗护理。盐酸尼罗替尼是一种蛋白酪氨酸激酶抑制剂,除了具有抗癌作用外,还具有多种治疗功效。在本研究中,通过单次腹腔注射链脲佐菌素(50 mg/kg)诱导雄性Sprague-Dawley大鼠患I型糖尿病。8周后,观察到肾功能显著恶化,伴有nephrin、podocalyxin和白蛋白的尿排泄。每日口服尼罗替尼(20 mg/kg),持续8周,在所有研究指标上均显著改善了DN的症状。在生化指标方面,肾功能、蛋白尿、尿nephrin、podocalyxin排泄以及机体氧化/抗氧化平衡均显著改善。肾脏一氧化氮含量、Toll样受体4的表达以及NF-κB/p65活性也显著下降。在组织病理学指标方面,α-平滑肌肌动蛋白和巢蛋白的表达显著下降。同时,纤维化面积显著下降,细胞外基质成分的积累和肾脏胶原蛋白含量也显著减少。最终,这些改善伴随着肾脏正常生理和功能的显著恢复。总之,尼罗替尼可通过多种机制阻碍DN的进展。氧化应激的降低、机体抗氧化防御系统的增强、炎症的减轻、血管生成、组织缺氧以及促纤维化生物标志物表达的降低,都可能与尼罗替尼治疗所观察到的有益治疗效果有关。