Uchida Takahiro, Oda Takashi, Matsubara Hidehito, Watanabe Atsushi, Takechi Hanako, Oshima Naoki, Sakurai Yutaka, Kumagai Hiroo
a Department of Nephrology and Endocrinology , National Defense Medical College , Tokorozawa , Saitama , Japan.
b Department of Nephrology , Tokyo Medical University Hachioji Medical Center , Hachioji , Tokyo , Japan.
Ren Fail. 2017 Nov;39(1):340-349. doi: 10.1080/0886022X.2017.1279553.
Although the effects of dipeptidyl peptidase 4 (DPP-4) inhibitors beyond their hypoglycemic action have been reported, whether these inhibitors have renoprotective effects in nondiabetic chronic kidney disease (CKD) is unclear. We examined the therapeutic effects of DPP-4 inhibition in mice with unilateral ureteral obstruction (UUO), a nondiabetic model of progressive renal fibrosis. After UUO surgery, mice were administered either the DPP-4 inhibitor alogliptin or a vehicle by oral gavage once a day for 10 days. Physiological parameters, degrees of renal fibrosis and inflammation, and molecules related to renal fibrosis and inflammation were then evaluated using sham-operated mice as controls. Positive area of α-smooth muscle actin was significantly smaller and expression of transforming growth factor β messenger RNA was significantly lower in the alogliptin-treated group than in the vehicle-treated group. Renal total collagen content was also significantly lower in the alogliptin-treated group than in the vehicle-treated group. These results suggest that alogliptin exerted renoprotective antifibrotic effects. The positive area of F4/80 was significantly smaller and expression of CD68 messenger RNA was significantly lower in the alogliptin-treated group than in the vehicle-treated group, suggesting an anti-inflammatory action by the DPP-4 inhibitor. Compared to the results for the vehicle-treated group, expression of markers for M1 macrophages tended to be lower in the alogliptin-treated group, and the relative expression of M2 macrophages tended to be higher. These data indicate the various protective effects of DPP-4 inhibition in nondiabetic mice with UUO. DPP-4 inhibitors may therefore be promising therapeutic choices even for nondiabetic CKD patients.
尽管已有报道称二肽基肽酶4(DPP-4)抑制剂具有降血糖作用之外的其他效应,但这些抑制剂在非糖尿病慢性肾脏病(CKD)中是否具有肾脏保护作用尚不清楚。我们研究了DPP-4抑制对单侧输尿管梗阻(UUO)小鼠的治疗效果,UUO是一种非糖尿病性进行性肾纤维化模型。UUO手术后,小鼠每天经口灌胃给予DPP-4抑制剂阿格列汀或赋形剂,持续10天。然后以假手术小鼠作为对照,评估生理参数、肾纤维化和炎症程度以及与肾纤维化和炎症相关的分子。阿格列汀治疗组α-平滑肌肌动蛋白的阳性面积显著小于赋形剂治疗组,转化生长因子β信使核糖核酸的表达也显著低于赋形剂治疗组。阿格列汀治疗组的肾脏总胶原含量也显著低于赋形剂治疗组。这些结果表明阿格列汀具有肾脏保护抗纤维化作用。阿格列汀治疗组F4/80的阳性面积显著小于赋形剂治疗组,CD68信使核糖核酸的表达也显著低于赋形剂治疗组,提示DPP-4抑制剂具有抗炎作用。与赋形剂治疗组的结果相比,阿格列汀治疗组M1巨噬细胞标志物的表达趋于降低,M2巨噬细胞的相对表达趋于升高。这些数据表明DPP-4抑制对UUO非糖尿病小鼠具有多种保护作用。因此,即使对于非糖尿病CKD患者,DPP-4抑制剂也可能是有前景的治疗选择。