Mohany Mohamed, Alanazi Ahmed Z, Alqahtani Faleh, Belali Osamah M, Ahmed Mohammed M, Al-Rejaie Salim S
Department of Pharmacology and Toxicology, College of Pharmacy, King Saud University, Riyadh, Saudi Arabia.
PeerJ. 2020 Jun 19;8:e9196. doi: 10.7717/peerj.9196. eCollection 2020.
Diabetic nephropathy (DN) is among the most common microvascular complications of diabetes resulting in end-stage renal disease and therefore search for candidates which can ameliorate the kidney function is needed simultaneously with standard diabetic pharmacotherapy. The current study was aimed to investigate the effect of long term sacubitril/valsartan therapy (LCZ696) in diabetic rats to assess its ameliorative impact against various pathological parameters such as oxidative stress, inflammation and glomerulosclerosis associated with chronic DN.
A single dose (60 mg/kg/day) of STZ was used to induce type 1 diabetes in adult male wistar rats. 2 weeks after diabetes induction, these rats were treated orally with valsartan (31 mg/kg) or LCZ696 (68 mg/kg) for 6 weeks. At end of the treatment period, serum and kidney samples were collected and analyzed. The serum levels of glucose, insulin, urea, creatinine, TNF-α, IL-1β, IL-6 and IL-10 levels were estimated. In renal tissue homogenate, the levels of inflammatory markers such as TNF-α, IL-1β, IL-6, NF-kB along with oxidative stress biomarkers including thiobarbituric acid-reacting substances (TBARs), glutathione (GSH), superoxide dismutase (SOD), catalase (CAT), glutathione peroxidase (GPx), glutathione S-transferase (GST) were assessed. Histological changes were observed in kidney.
Time course therapy withLCZ696 and valsartan in diabetic rats resulted in significant reduction of serum glucose, urea and creatinine levels ( < 0.05). Additionally, serum of treated diabetic rats showed a diminution in inflammatory (TNF-α, IL-1β, IL-6) and increment in anti-inflammatory (IL-10) cytokines levels ( < 0.05). Tissue homogenate of the kidney extracted from LCZ696 and valsartan treated diabetic rats revealed a substantial reduction in the levels of inflammatory markers such as TNF-α, IL-1β, IL-6, NF-kB and sufficient restoration of anti-oxidant enzyme levels ( < 0.05). Finally, in the histological sections of the kidney, prevention of renal injury was observed with limited necrosis and inflammatory cells infiltration.
Present data suggest that LCZ696 has sufficient therapeutic potential to restrict DN progression through inhibiting inflammation, oxidative stress and glomerulosclerosis.
糖尿病肾病(DN)是糖尿病最常见的微血管并发症之一,可导致终末期肾病,因此在进行标准糖尿病药物治疗的同时,需要寻找能够改善肾功能的药物。本研究旨在探讨长期沙库巴曲缬沙坦治疗(LCZ696)对糖尿病大鼠的影响,以评估其对与慢性DN相关的各种病理参数(如氧化应激、炎症和肾小球硬化)的改善作用。
采用单剂量(60mg/kg/天)链脲佐菌素(STZ)诱导成年雄性Wistar大鼠患1型糖尿病。糖尿病诱导2周后,这些大鼠分别口服缬沙坦(31mg/kg)或LCZ696(68mg/kg),持续6周。在治疗期结束时,收集并分析血清和肾脏样本。测定血清葡萄糖、胰岛素、尿素、肌酐、TNF-α、IL-1β、IL-6和IL-10水平。在肾组织匀浆中,评估炎症标志物(如TNF-α、IL-1β、IL-6、NF-κB)水平以及氧化应激生物标志物(包括硫代巴比妥酸反应物质(TBARs)、谷胱甘肽(GSH)、超氧化物歧化酶(SOD)、过氧化氢酶(CAT)、谷胱甘肽过氧化物酶(GPx)、谷胱甘肽S-转移酶(GST))水平。观察肾脏的组织学变化。
糖尿病大鼠接受LCZ696和缬沙坦的时间进程治疗后,血清葡萄糖、尿素和肌酐水平显著降低(P<0.05)。此外,接受治疗的糖尿病大鼠血清中炎症细胞因子(TNF-α、IL-1β、IL-6)水平降低,抗炎细胞因子(IL-10)水平升高(P<0.05)。从接受LCZ696和缬沙坦治疗的糖尿病大鼠提取的肾脏组织匀浆显示,炎症标志物(如TNF-α、IL-1β、IL-6、NF-κB)水平大幅降低,抗氧化酶水平得到充分恢复(P<0.05)。最后,在肾脏组织切片中,观察到肾损伤得到预防,坏死和炎症细胞浸润有限。
目前的数据表明,LCZ696具有足够的治疗潜力,可通过抑制炎症、氧化应激和肾小球硬化来限制DN的进展。