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胰高血糖素样肽-1 通过调节 AMP 激活的蛋白激酶-雷帕霉素靶蛋白通路激活自噬来减轻糖尿病肾病。

Glucagon-like peptide-1 alleviates diabetic kidney disease through activation of autophagy by regulating AMP-activated protein kinase-mammalian target of rapamycin pathway.

机构信息

Department of Endocrinology, Zhujiang Hospital of Southern Medical University, Guangzhou, Guangdong, China.

Department of Endocrinology, Second Affiliated Hospital of Guizhou Medical University, Kaili, Guizhou, China.

出版信息

Am J Physiol Endocrinol Metab. 2020 Dec 1;319(6):E1019-E1030. doi: 10.1152/ajpendo.00195.2019. Epub 2020 Sep 28.

Abstract

Glucagon-like peptide-1 (GLP-1) is a novel antidiabetic agent used in clinical practice. Recently, it was reported to exert a renoprotective effect in the human kidney-2 cells and kidneys of diabetic rats, which was induced by one type of GLP-1 analog, liraglutide, in the presence of high glucose. However, most of the previous findings mainly focused on its indirect effect in inhibiting the advanced glycation end products. Here, besides glycemic control, we also demonstrated a stimulatory role of liraglutide in promoting autophagy and relieving oxidative stress in Zucker diabetic fatty rats. The renoprotective effect of liraglutide has been demonstrated by significantly decreasing urinary albumin ( < 0.01) and ameliorating renal pathological changes ( < 0.001) in vivo. Besides that, proliferation of human epithelial kidney cell line HKC-8 and human embryonic kidney-293 cells has increased after treating with exendin-4, a GLP-1 receptor (GLP-1R) agonist. Moreover, GLP-1 could positively improve the progression of autophagy in vivo and in vitro through regulating the autophagy-related protein light chain 3 and p62 via AMP-activated protein kinase (AMPK)-mammalian target of rapamycin (mTOR) signaling pathway. Simultaneously, it could reverse NF-erythroid 2-related factor 2 (NRF2) translocation into the nuclei and suppress oxidative stress. In terms of mechanism, the renoprotective effect of GLP-1 would be exerted via the GLP-1R-AMPK-mTOR-autophagy-reactive oxygen species signaling axis. The present study not only illustrates the renoprotective effect of GLP-1 in diabetic kidney disease (DKD) rats, but also for the first time elucidates the underlying mechanism that is independent of controlling glucose, which implies that GLP-1 might be a novel therapeutic strategy for the prevention and treatment of DKD.

摘要

胰高血糖素样肽-1(GLP-1)是一种新型抗糖尿病药物,已在临床实践中使用。最近有报道称,在高糖存在下,一种 GLP-1 类似物利拉鲁肽可在人肾-2 细胞和糖尿病大鼠肾脏中发挥肾保护作用。然而,之前的大多数发现主要集中在其抑制晚期糖基化终产物的间接作用上。在这里,除了血糖控制外,我们还证明了利拉鲁肽在促进自噬和减轻 Zucker 糖尿病肥胖大鼠氧化应激方面的刺激作用。利拉鲁肽的肾保护作用已通过显著降低尿白蛋白(<0.01)和改善体内肾脏病理变化(<0.001)得到证实。此外,GLP-1 受体(GLP-1R)激动剂 exendin-4 处理后,人肾小管上皮细胞系 HKC-8 和人胚肾-293 细胞的增殖增加。此外,GLP-1 可以通过调节自噬相关蛋白 LC3 和 p62 来正向改善体内和体外自噬的进展,通过 AMP 激活的蛋白激酶(AMPK)-雷帕霉素靶蛋白(mTOR)信号通路。同时,它可以逆转 NF-红细胞 2 相关因子 2(NRF2)向核内转移并抑制氧化应激。就机制而言,GLP-1 的肾保护作用是通过 GLP-1R-AMPK-mTOR-自噬-活性氧信号轴发挥的。本研究不仅说明了 GLP-1 在糖尿病肾病(DKD)大鼠中的肾保护作用,而且首次阐明了独立于控制血糖的潜在机制,这意味着 GLP-1 可能成为预防和治疗 DKD 的一种新的治疗策略。

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