Department of Endocrinology, Hospital of Chengdu University of Traditional Chinese Medicine, Chengdu, China.
Eur Rev Med Pharmacol Sci. 2019 Aug;23(3 Suppl):117-125. doi: 10.26355/eurrev_201908_18638.
To explore the protective effect of liraglutide on renal damage in rats with diabetic kidney disease (DKD) through the protein kinase B-mammalian target of rapamycin (Akt-mTOR) pathway.
A total of 45 specific pathogen-free male Sprague-Dawley rats were divided into healthy group (no diabetes, n=15), diabetes group (diabetes, n=15), and liraglutide group (diabetes + liraglutide intervention, n=15). The differences in the biochemical indexes, lesion degree, glomerular Nephrin expression level, and mRNA and protein expressions of Akt-mTOR in renal tissues were detected in three groups via hematoxylin-eosin (HE) staining, immunohistochemistry, Western blotting, and quantitative Reverse Transcription-Polymerase Chain Reaction (qRT-PCR), respectively.
The albumin-to-creatinine ratio (ACR) and levels of serum creatinine (Scr), urine microalbumin (UmAlb), fasting blood glucose (FBG), glycated hemoglobin (HbA1c), triglyceride (TG), low-density lipoprotein cholesterol (LDL-C), and total cholesterol (TC) in renal tissues were the lowest in healthy group and the highest in diabetes group, while they significantly declined in liraglutide group compared with those in diabetes group. Also, there were statistically significant differences (p<0.05). The level of high-density lipoprotein cholesterol (HDL-C) in renal tissues was the highest in healthy group and the lowest in diabetes group, while it was significantly increased in liraglutide group compared with that in diabetes group. Also, there were statistically significant differences (p<0.05). In healthy group, the mesangial structure and renal tubules were normal, the tubular basement membrane was smooth and intact, and there were no interstitial widening and inflammatory cell infiltration. Compared with diabetes group, the mesangial cell proliferation and vacuolar degeneration were alleviated, while the tubular dilatation or atrophy, fibrous tissues, and inflammatory cells were reduced in liraglutide group. Moreover, the results of immunohistochemical staining revealed that the glomerular Nephrin protein was arranged uniformly and showed the blue-black particles in healthy group. The glomerular Nephrin protein expressed was significantly decreased and arranged disorderly in diabetes group compared with that in healthy group, while it was increased in liraglutide group compared with that in diabetes group (p<0.05). The protein expression of Akt-mTOR in renal tissues was the lowest in healthy group and the highest in diabetes group, while it markedly declined in liraglutide group compared with that in diabetes group, displaying statistically significant differences (p<0.05). Similarly, the mRNA expression of Akt-mTOR in renal tissues was the lowest in healthy group and the highest in diabetes group, while it markedly declined in liraglutide group compared with that in diabetes group, displaying also statistically significant differences (p<0.05).
Liraglutide can significantly reduce the blood glucose and improve the renal function in rats by suppressing the protein expression of AKT-mTOR, thereby exerting a protective effect on renal damage in rats with DKD.
通过蛋白激酶 B-雷帕霉素靶蛋白(Akt-mTOR)通路探讨利拉鲁肽对糖尿病肾病(DKD)大鼠肾脏损伤的保护作用。
45 只特定病原体无特定病原体雄性 Sprague-Dawley 大鼠分为健康组(无糖尿病,n=15)、糖尿病组(糖尿病,n=15)和利拉鲁肽组(糖尿病+利拉鲁肽干预,n=15)。通过苏木精-伊红(HE)染色、免疫组织化学、Western blot 和定量逆转录-聚合酶链反应(qRT-PCR)分别检测三组大鼠的生化指标、病变程度、肾小球 Nephrin 表达水平以及肾脏组织中 Akt-mTOR 的 mRNA 和蛋白表达。
健康组白蛋白与肌酐比值(ACR)和血清肌酐(Scr)、尿微量白蛋白(UmAlb)、空腹血糖(FBG)、糖化血红蛋白(HbA1c)、甘油三酯(TG)、低密度脂蛋白胆固醇(LDL-C)和总胆固醇(TC)水平最低,糖尿病组最高,利拉鲁肽组较糖尿病组明显下降。差异有统计学意义(p<0.05)。健康组高密度脂蛋白胆固醇(HDL-C)水平最高,糖尿病组最低,利拉鲁肽组较糖尿病组明显升高。差异有统计学意义(p<0.05)。健康组肾小球系膜结构和肾小管正常,肾小管基底膜光滑完整,无间质增宽和炎性细胞浸润。与糖尿病组相比,利拉鲁肽组系膜细胞增殖和空泡变性减轻,肾小管扩张或萎缩、纤维组织和炎性细胞减少。此外,免疫组化染色结果显示,健康组肾小球 Nephrin 蛋白排列均匀,呈蓝黑色颗粒。与健康组相比,糖尿病组肾小球 Nephrin 蛋白表达明显减少,排列紊乱,利拉鲁肽组较糖尿病组增加(p<0.05)。肾脏组织 Akt-mTOR 蛋白表达水平健康组最低,糖尿病组最高,利拉鲁肽组较糖尿病组明显下降,差异有统计学意义(p<0.05)。同样,肾脏组织 Akt-mTOR 的 mRNA 表达水平健康组最低,糖尿病组最高,利拉鲁肽组较糖尿病组明显下降,差异有统计学意义(p<0.05)。
利拉鲁肽通过抑制 AKT-mTOR 蛋白表达,显著降低大鼠血糖,改善肾功能,对 DKD 大鼠肾脏损伤发挥保护作用。