Birnbaum Yochai, Chen Huan, Tran Dat, Nylander Sven, Ye Yumei
The Section of Cardiology, Department of Medicine, Baylor College of Medicine, Houston, TX, USA.
The Department of Biochemistry and Molecular Biology, University of Texas Medical Branch, 301 University Blvd, BSB 648, Galveston, TX, 77555, USA.
Cardiovasc Drugs Ther. 2022 Oct;36(5):829-840. doi: 10.1007/s10557-021-07222-x. Epub 2021 Jul 7.
PURPOSE: Ticagrelor and dapagliflozin can suppress the activation of the NOD-like receptor 3 (NLRP3)-inflammasome and activate AMP-activated protein kinase (AMPK). The anti-inflammatory effects of dapagliflozin has been shown to depend on AMPK activation. Dapagliflozin and ticagrelor have been shown to have additive effects on the progression of diabetic cardiomyopathy in BTBR ob/ob mice with type-2 diabetes. We assessed whether dapagliflozin and ticagrelor have additive effects on the activation of the NLRP3-inflammasome and the progression of diabetic nephropathy in mice with type-2 diabetes. METHODS: Eight-week-old BTBR received either no-drug, dapagliflozin (1.5 mg/kg/d), ticagrelor (100 mg/kg/d), or their combination for 12 weeks. Blood was assessed weekly for glucose and urine for glucose and albumin. After 12 weeks, blood creatinine, cystatin C, inflammasome activation, and insulin were assessed by ELISA. Renal cortex samples were assessed by hematoxylin and eosin and periodic acid-Schiff staining. RT-PCR and immunoblotting were used to evaluate fibrosis and the activation of Akt, AMPK and the inflammasome. RESULTS: Both ticagrelor and dapagliflozin reduced serum creatinine and cystatin C levels and urinary albumin. Both drugs attenuated the increase in glomerular area and mesangial matrix index. Both drugs decreased collagen-1 and collagen-3 expression and the activation of the NLRP3-inflammasome. Both drugs increased P-AMPK levels, but only dapagliflozin increased P-Akt levels. Overall, the protective effects of dapagliflozin and ticagrelor were additive. CONCLUSIONS: Dapagliflozin and ticagrelor attenuated the progression of diabetic nephropathy in BTBR ob/ob mice with additive effects of the combination. This was associated with AMPK activation and reduced activation of the NLRP3 inflammasome, whereas only dapagliflozin increased Akt activation.
目的:替格瑞洛和达格列净可抑制NOD样受体3(NLRP3)炎性小体的激活并激活AMP活化蛋白激酶(AMPK)。已证明达格列净的抗炎作用依赖于AMPK的激活。在患有2型糖尿病的BTBR ob/ob小鼠中,达格列净和替格瑞洛对糖尿病性心肌病的进展具有相加作用。我们评估了达格列净和替格瑞洛对2型糖尿病小鼠NLRP3炎性小体的激活及糖尿病肾病进展是否具有相加作用。 方法:8周龄的BTBR小鼠分别接受无药物处理、达格列净(1.5毫克/千克/天)、替格瑞洛(100毫克/千克/天)或它们的组合,持续12周。每周检测血液中的葡萄糖以及尿液中的葡萄糖和白蛋白。12周后,通过酶联免疫吸附测定法(ELISA)评估血肌酐、胱抑素C、炎性小体激活情况和胰岛素水平。用苏木精-伊红染色和过碘酸-希夫染色评估肾皮质样本。采用逆转录-聚合酶链反应(RT-PCR)和免疫印迹法评估纤维化以及Akt、AMPK和炎性小体的激活情况。 结果:替格瑞洛和达格列净均降低了血清肌酐和胱抑素C水平以及尿白蛋白水平。两种药物均减轻了肾小球面积和系膜基质指数的增加。两种药物均降低了Ⅰ型胶原和Ⅲ型胶原的表达以及NLRP3炎性小体的激活。两种药物均提高了磷酸化AMPK(P-AMPK)水平,但只有达格列净提高了磷酸化Akt(P-Akt)水平。总体而言,达格列净和替格瑞洛的保护作用具有相加性。 结论:达格列净和替格瑞洛减轻了BTBR ob/ob小鼠糖尿病肾病的进展,联合使用具有相加作用。这与AMPK激活及NLRP3炎性小体激活减少有关,而只有达格列净增加了Akt激活。
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