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拉米地坦通过诱导线粒体生物发生促进急性肾损伤的恢复。

Lasmiditan promotes recovery from acute kidney injury through induction of mitochondrial biogenesis.

机构信息

Department of Pharmacology and Toxicology, College of Pharmacy, University of Arizona, Tucson, Arizona.

Southern Arizona Veterans Affairs Health Care System, Tucson, Arizona.

出版信息

Am J Physiol Renal Physiol. 2023 Jan 1;324(1):F56-F63. doi: 10.1152/ajprenal.00249.2022. Epub 2022 Nov 3.

Abstract

Acute kidney injury (AKI) involves rapid loss of renal function and occurs in 8-16% of hospitalized patients. AKI can be induced by drugs, sepsis, and ischemia-reperfusion (I/R). Hallmarks of AKI include mitochondrial and microvasculature dysfunction as well as renal tubular injury. There is currently no available therapeutic for AKI. Previously, our group identified that serotonin (5-HT) receptor agonism with lasmiditan accelerated endothelial cell recovery and induced mitochondrial biogenesis (MB) in vitro. We hypothesized that lasmiditan, a Federal Drug Administration-approved drug, would induce MB and improve microvascular and renal function in a mouse model of AKI. Male mice were subjected to renal I/R and treated with lasmiditan (0.3 mg/kg) or vehicle beginning 24 h after injury and then daily until euthanasia at 6 or 12 days. Serum creatinine was measured to estimate glomerular filtration rate. The renal cortex was assessed for mitochondrial density, vascular permeability and integrity, tubular damage, and interstitial fibrosis. Lasmiditan increased mitochondrial number (1.4-fold) in renal cortices. At 6 days, serum creatinine decreased 41% in the I/R group and 72% with lasmiditan. At 6 or 12 days, kidney injury molecule-1 increased in the I/R group and decreased 50% with lasmiditan. At 12 days, interstitial fibrosis decreased with lasmiditan by 50% and collagen type 1 by 38%. Evan's blue dye leakage increased 2.5-fold in the I/R group and was restored with lasmiditan. The tight junction proteins zonula occludens-1, claudin-2, and claudin-5 decreased in the I/R group and recovered with lasmiditan. At 6 or 12 days, peroxisome proliferator-activated receptor-γ coactivator-1α and electron transport chain complexes increased only with lasmiditan. In conclusion, lasmiditan treatment beginning AKI induces MB, attenuated vascular and tubular injury, decreased interstitial fibrosis, and lowered serum creatinine. Given that lasmiditan is a Federal Drug Administration-approved drug, these preclinical data support repurposing lasmiditan as a therapeutic for AKI. AKI pathology involves a rapid decline in kidney function and occurs in 8-16% of hospitalized patients. There is currently no therapeutic for AKI. AKI results in mitochondria dysfunction, microvasculature injury, and loss of renal tubular function. In an I/R-induced AKI mouse model, treatment with the FDA-approved 5-HT receptor-selective agonist lasmiditan induced mitochondrial biogenesis, improved vascular integrity, reduced fibrosis, and reduced proximal tubule damage. These data support repurposing lasmiditan for the treatment of AKI.

摘要

急性肾损伤(AKI)涉及肾功能的快速丧失,发生在 8-16%的住院患者中。AKI 可由药物、脓毒症和缺血再灌注(I/R)引起。AKI 的特征包括线粒体和微血管功能障碍以及肾小管损伤。目前尚无 AKI 的治疗方法。以前,我们的研究小组发现,5-羟色胺(5-HT)受体激动剂 lasmiditan 可加速体外内皮细胞的恢复并诱导线粒体生物发生(MB)。我们假设,lasmiditan,一种美国食品和药物管理局批准的药物,将诱导 MB 并改善 AKI 小鼠模型中的微血管和肾功能。雄性小鼠接受肾 I/R,并在损伤后 24 小时开始用 lasmiditan(0.3mg/kg)或载体治疗,然后每天治疗直至在 6 或 12 天处死。测量血清肌酐以估计肾小球滤过率。评估肾皮质的线粒体密度、血管通透性和完整性、管状损伤和间质纤维化。Lasmiditan 增加了肾皮质中的线粒体数量(增加了 1.4 倍)。在 6 天时,I/R 组的血清肌酐降低了 41%,而 lasmiditan 组降低了 72%。在 6 或 12 天时,I/R 组的肾损伤分子-1增加,而 lasmiditan 组降低了 50%。在 12 天时,间质纤维化减少了 50%,胶原 1 减少了 38%。伊文思蓝染料渗漏在 I/R 组增加了 2.5 倍,并用 lasmiditan 恢复。紧密连接蛋白 zonula occludens-1、claudin-2 和 claudin-5 在 I/R 组减少,并被 lasmiditan 恢复。在 6 或 12 天时,过氧化物酶体增殖物激活受体-γ共激活因子-1α 和电子传递链复合物仅在用 lasmiditan 治疗时增加。总之,AKI 开始时的 lasmiditan 治疗诱导 MB,减轻血管和管状损伤,减少间质纤维化,降低血清肌酐。鉴于 lasmiditan 是一种美国食品和药物管理局批准的药物,这些临床前数据支持将 lasmiditan 重新用作 AKI 的治疗药物。AKI 病理涉及肾功能的快速下降,发生在 8-16%的住院患者中。目前尚无 AKI 的治疗方法。AKI 导致线粒体功能障碍、微血管损伤和肾小管功能丧失。在 I/R 诱导的 AKI 小鼠模型中,用美国食品和药物管理局批准的 5-HT 受体选择性激动剂 lasmiditan 治疗可诱导线粒体生物发生,改善血管完整性,减少纤维化并减少近端肾小管损伤。这些数据支持将 lasmiditan 重新用于治疗 AKI。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/1f0d/9762961/195c5d75e3e8/f-00249-2022r01.jpg

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