Department of Traditional Chinese Medicine, Huadong Hospital Affiliated to Fudan University, Shanghai 200040, China.
Department of Nephrology, Shuguang Hospital Affiliated to Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Key Laboratory of Liver and Kidney Diseases, Ministry of Education, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; TCM institute of kidney disease, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China; Shanghai Key Laboratory of Traditional Chinese Clinical Medicine, Shanghai University of Traditional Chinese Medicine, Shanghai 201203, China.
Phytomedicine. 2024 Nov;134:155991. doi: 10.1016/j.phymed.2024.155991. Epub 2024 Aug 27.
Renal tubular injury induced by free fatty acid bound to albumin is the key pathological basis for the progression of diabetic kidney disease. However, effective interventions are limited. Astragaloside IV, as a major bioactive component purified from Astragalus membranaceus (Fisch.) Bunge, possesses pharmacological properties of lowering blood glucose and proteinuria, and renal tubular protection in diabetic kidney disease. Further work is needed to understand the underlying molecular mechanisms.
This study was designed to investigate the mechanism of renal tubular protection by astragaloside IV in diabetic kidney disease.
Rats receiving high-fat diet combined with streptozotocin (30 mg/kg, i.p.) were gavaged with astragaloside IV (10 mg/kg/d or 20 mg/kg/d) or empagliflozin (1.72 mg/kg/d) for 8 weeks. In vitro, the NRK-52E cells were treated with free fatty acid-deleted BSA or palmitic acid-bound BSA in the presence or absence of astragaloside IV (5 μM, 10 μM, 20 μM) or 5 μM of mcc950. The effects of astragaloside IV on mitochondrial function, NLRP3/ASC/IL-18/IL-1β inflammatory cascade, and renal tubular injury were detected by pathological staining, immunoblotting, MitoSOX Red staining. Next, to investigate the mechanism of renal tubular protection by astragaloside IV, we transfected Fatp2 siRNA into BSA-PA-treated NRK-52E cells and injected lipofermata (a FATP2 inhibitor) intraperitoneally into free fatty acid-bound BSA overloaded rats with concomitant astragaloside IV treatment.
Treatment with astragaloside IV for 8 weeks dose-dependently attenuated the blood glucose, ratio of urinary albumin to creatinine, disorder of lipid metabolism, and pathological injury in diabetic kidney disease rats. In addition, astragaloside IV dose-dependently attenuated mitochondrial-derived reactive oxygen species and subsequent inhibiting NLRP3-mediated inflammatory cascade in diabetic kidney disease rats and palmitic acid-bound BSA-treated NRK-52E cells, thereby exerting renal tubular protection. More importantly, the effects of astragaloside IV on restoration of mitochondrial function, inhibition of inflammatory response and amelioration of renal tubular injury in vivo and in vitro were further enhanced when used in combination with Fatp2 siRNA or lipofermata.
Astragaloside IV exerts antioxidant and anti-inflammatory effects in diabetic kidney disease by inhibiting FATP2-mediated fatty acid transport, thereby attenuating renal tubular injury.
与白蛋白结合的游离脂肪酸引起的肾小管损伤是糖尿病肾病进展的关键病理基础。然而,有效的干预措施有限。黄芪甲苷作为从黄芪(膜荚黄芪)中纯化的主要生物活性成分,具有降低血糖和蛋白尿以及保护糖尿病肾病肾小管的药理作用。需要进一步研究以了解潜在的分子机制。
本研究旨在探讨黄芪甲苷在糖尿病肾病中肾小管保护的机制。
接受高脂肪饮食联合链脲佐菌素(30mg/kg,腹腔注射)的大鼠每天灌胃黄芪甲苷(10mg/kg/d 或 20mg/kg/d)或恩格列净(1.72mg/kg/d)8 周。体外,NRK-52E 细胞用游离脂肪酸缺失的 BSA 或棕榈酸结合的 BSA 处理,同时给予或不给予黄芪甲苷(5μM、10μM、20μM)或 5μM 的 mcc950。通过病理染色、免疫印迹、MitoSOX Red 染色检测黄芪甲苷对线粒体功能、NLRP3/ASC/IL-18/IL-1β炎症级联和肾小管损伤的影响。接下来,为了研究黄芪甲苷对肾小管的保护机制,我们将 Fatp2 siRNA 转染到 BSA-PA 处理的 NRK-52E 细胞中,并在给予黄芪甲苷的同时向游离脂肪酸结合的 BSA 超负荷大鼠腹腔内注射 lipofermata(一种 FATP2 抑制剂)。
连续 8 周给予黄芪甲苷治疗可剂量依赖性地减轻糖尿病肾病大鼠的血糖、尿白蛋白与肌酐比值、脂质代谢紊乱和病理损伤。此外,黄芪甲苷可剂量依赖性地减轻糖尿病肾病大鼠和棕榈酸结合的 BSA 处理的 NRK-52E 细胞中线粒体来源的活性氧物质,并随后抑制 NLRP3 介导的炎症级联,从而发挥肾小管保护作用。更重要的是,当与 Fatp2 siRNA 或 lipofermata 联合使用时,黄芪甲苷在体内和体外恢复线粒体功能、抑制炎症反应和改善肾小管损伤的作用进一步增强。
黄芪甲苷通过抑制 FATP2 介导的脂肪酸转运,发挥抗氧化和抗炎作用,从而减轻糖尿病肾病中的肾小管损伤。