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替米沙坦通过抑制血管紧张素 1 型受体和脂联素受体 1 的二聚化来减轻糖尿病肾病的进展。

Telmisartan attenuates diabetic nephropathy progression by inhibiting the dimerization of angiotensin type-1 receptor and adiponectin receptor-1.

机构信息

Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, China.

Department of Nephrology, Zhongnan Hospital of Wuhan University, Wuhan, China.

出版信息

Life Sci. 2019 Mar 15;221:109-120. doi: 10.1016/j.lfs.2019.01.044. Epub 2019 Jan 27.

Abstract

AIMS

The heterodimerization of angiotensin II receptors (AT1R and AT2R) with adiponectin receptor AdipoR1 and AdipoR2 may instigate high glucose (HG)-induced renal tubulointerstitial injury. This study examined the effect of telmisartan on diabetic nephropathy (DN) and its underlying mechanism.

MAIN METHODS

Diabetes was induced in rats through a single intraperitoneal injection of streptozotocin. Diabetic rats treated with or without the intravenous injection of AdipoR1 siRNA were intragastrically administered with 5 mg/kg/d telmisartan or a vehicle for 12 weeks. The rat proximal tubular epithelial cell line NRK-52E was treated with HG (30 mmol/L) with or without telmisartan (10 μM) for 48 h.

KEY FINDINGS

In streptozotocin-induced diabetic rats, telmisartan treatment could decrease the inulin clearance rate, restore the glomerular surface area and mesangial area, alleviate renal fibrosis, and decrease urinary albumin excretion. Furthermore, diabetic rats exhibited increased AT1R-AdipoR1 heterodimers in the renal tubular compartment, which could be attenuated by telmisartan treatment, accompanied by a decrease in the expression level of cytokines MIP-1α, ICAM-1 and MCP-1. In vitro, HG promoted the dimerization formation of AT1R-AdipoR1 in cultured NRK-52E cells, but this effect was not found in NRK-52E cells transfected with the AdipoR1-G269E,G273E mutant. Telmisartan could inhibit HG-induced AT1R-AdipoR1 dimerization, downregulate the expression levels of inflammatory cytokines, and alleviate cell apoptosis in NRK-52E cells. Furthermore, AdipoR1 knockdown could abate the renoprotective benefits of telmisartan.

SIGNIFICANCE

The heterodimerization of AT1R-AdipoR1 probably contributes to the renal injury of DN, and provides an additional mechanistic insight into how telmisartan prevents the development and progression of DN.

摘要

目的

血管紧张素 II 受体(AT1R 和 AT2R)与脂联素受体 AdipoR1 和 AdipoR2 的异二聚化可能引发高糖(HG)诱导的肾间质损伤。本研究探讨了替米沙坦对糖尿病肾病(DN)的影响及其潜在机制。

主要方法

通过单次腹腔注射链脲佐菌素诱导大鼠糖尿病。糖尿病大鼠经静脉注射 AdipoR1 siRNA 处理后,给予 5mg/kg/d替米沙坦或载体灌胃 12 周。用 HG(30mmol/L)处理体外培养的大鼠近端肾小管上皮细胞系 NRK-52E 48h,同时用或不用替米沙坦(10μM)处理。

主要发现

在链脲佐菌素诱导的糖尿病大鼠中,替米沙坦治疗可降低菊粉清除率,恢复肾小球表面积和系膜面积,减轻肾纤维化,减少尿白蛋白排泄。此外,糖尿病大鼠肾小管区 AT1R-AdipoR1 异二聚体增加,替米沙坦治疗可减轻这种增加,同时细胞因子 MIP-1α、ICAM-1 和 MCP-1 的表达水平降低。体外,HG 促进培养的 NRK-52E 细胞中 AT1R-AdipoR1 的二聚体形成,但在转染 AdipoR1-G269E、G273E 突变体的 NRK-52E 细胞中未发现这种作用。替米沙坦可抑制 HG 诱导的 AT1R-AdipoR1 二聚化,下调炎症细胞因子的表达水平,减轻 NRK-52E 细胞的细胞凋亡。此外,AdipoR1 敲低可减弱替米沙坦的肾保护作用。

意义

AT1R-AdipoR1 的异二聚化可能导致 DN 的肾损伤,为替米沙坦预防 DN 的发生和发展提供了另一种机制见解。

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