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基于IRS1/PI3K/Akt通路探讨黄蜀葵总黄酮改善糖尿病肾病胰岛素抵抗及足细胞上皮-间质转化的作用及机制

[Effects and mechanisms of total flavones of Abelmoschus manihot in improving insulin resistance and podocyte epithelial-mesenchymal transition in diabetic kidney disease based on IRS1/PI3K/Akt pathway].

作者信息

Wang Yu, Cao Dong-Wei, Wan Yi-Gang, Mu Geng-Lin, Wu Wei, Fang Qi-Jun, Li Ya-Jing, Cha Si-Yu, Tu Yue, Wan Zi-Yue

机构信息

Department of Traditional Chinese Medicine,Nanjing Drum Tower Hospital Clinical College of Nanjing University of Chinese Medicine Nanjing 210008,China Department of Traditional Chinese Medicine,Nanjing Drum Tower Hospital,the Affiliated Hospital of Nanjing University Medical School Nanjing 210008,China Institute of Chinese Medicine,Nanjing University Nanjing 210008,China.

Department of Nephrology,Shanghai Municipal Hospital of Traditional Chinese Medicine,Shanghai University of Traditional Chinese Medicine Shanghai 200071,China.

出版信息

Zhongguo Zhong Yao Za Zhi. 2023 May;48(10):2646-2656. doi: 10.19540/j.cnki.cjcmm.20221111.703.

Abstract

This study aimed to explore the effects and mechanisms of total flavones of Abelmoschus manihot(TFA), the extracts from traditional Chinese medicine indicated for kidney diseases, on insulin resistance(IR) and podocyte epithelial-mesenchymal transition(EMT) in diabetic kidney disease(DKD), and further to reveal the scientific connotation. Thirty-two rats were randomly divided into a normal group, a model group, a TFA group, and a rosiglitazone(ROS) group. The modified DKD model was induced in rats by methods including high-fat diet feeding, unilateral nephrectomy, and streptozotocin(STZ) intraperitoneal injection. After modeling, the rats in the four groups were given double-distilled water, TFA suspension, and ROS suspension correspondingly by gavage every day. At the end of the 8th week of drug administration, all rats were sacrificed, and the samples of urine, blood, and kidney tissues were collected. The parameters and indicators related to IR and podocyte EMT in the DKD model rats were examined and observed, including the general condition, body weight(BW) and kidney weight(KW), the biochemical parameters and IR indicators, the protein expression levels of the key signaling molecules and structural molecules of slit diaphragm in the renal insulin receptor substrate(IRS) 1/phosphatidylinositol 3-kinase(PI3K)/serine-threonine kinase(Akt) pathway, foot process form and glomerular basement membrane(GBM) thickness, the expression of the marked molecules and structural molecules of slit diaphragm in podocyte EMT, and glomerular histomorphological characteristics. The results showed that for the DKD model rats, both TFA and ROS could improve the general condition, some biochemical parameters, renal appearance, and KW. The ameliorative effects of TFA and ROS were equivalent on BW, urinary albumin(UAlb)/urinary creatinine(UCr), serum creatinine(Scr), triglyceride(TG), and KW. Secondly, they could both improve IR indicators, and ROS was superior to TFA in improving fast insulin(FIN) and homeostasis model assessment of insulin resistance(HOMA-IR). Thirdly, they could both improve the protein expression levels of the key signaling molecules in the IRS1/PI3K/Akt pathway and glomerulosclerosis in varying degrees, and their ameliorative effects were similar. Finally, both could improve podocyte injury and EMT, and TFA was superior to ROS. In conclusion, this study suggested that podocyte EMT and glomerulosclerosis could be induced by IR and the decreased activation of the IRS1/PI3K/Akt pathway in the kidney in DKD. Similar to ROS, the effects of TFA in inhibiting podocyte EMT in DKD were related to inducing the activation of the IRS1/PI3K/Akt pathway and improving IR, which could be one of the scientific connotations of TFA against DKD. This study provides preliminary pharmacological evidence for the development and application of TFA in the field of diabetic complications.

摘要

本研究旨在探讨中药黄蜀葵总黄酮(TFA)对糖尿病肾病(DKD)胰岛素抵抗(IR)及足细胞上皮-间质转化(EMT)的影响及其机制,进而揭示其科学内涵。将32只大鼠随机分为正常组、模型组、TFA组和罗格列酮(ROS)组。采用高脂饮食喂养、单侧肾切除及链脲佐菌素(STZ)腹腔注射等方法诱导大鼠建立改良DKD模型。造模后,四组大鼠分别每天经口灌胃给予双蒸水、TFA混悬液和ROS混悬液。给药第8周结束时,处死所有大鼠,收集尿液、血液及肾脏组织样本。检测并观察DKD模型大鼠与IR及足细胞EMT相关的参数和指标,包括一般状况、体重(BW)和肾脏重量(KW)、生化参数及IR指标、肾胰岛素受体底物(IRS)1/磷脂酰肌醇3激酶(PI3K)/丝氨酸-苏氨酸激酶(Akt)通路中裂孔隔膜关键信号分子和结构分子的蛋白表达水平、足突形态及肾小球基底膜(GBM)厚度、足细胞EMT中裂孔隔膜标志性分子和结构分子的表达以及肾小球组织形态学特征。结果显示,对于DKD模型大鼠,TFA和ROS均可改善其一般状况、部分生化参数、肾脏外观及KW。TFA和ROS在改善BW、尿白蛋白(UAlb)/尿肌酐(UCr)、血清肌酐(Scr)、甘油三酯(TG)及KW方面的改善效果相当。其次,二者均可改善IR指标,且在改善空腹胰岛素(FIN)和胰岛素抵抗稳态模型评估(HOMA-IR)方面,ROS优于TFA。第三,二者均可不同程度改善IRS1/PI3K/Akt通路关键信号分子的蛋白表达水平及肾小球硬化,且改善效果相似。最后,二者均可改善足细胞损伤及EMT,且TFA优于ROS。综上所述,本研究提示IR及肾脏中IRS1/PI3K/Akt通路激活降低可诱导DKD足细胞EMT及肾小球硬化。与ROS相似,TFA在DKD中抑制足细胞EMT的作用与诱导IRS1/PI3K/Akt通路激活及改善IR有关,这可能是TFA防治DKD的科学内涵之一。本研究为TFA在糖尿病并发症领域的开发应用提供了初步药理学证据。

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