Department of Pharmacology and Toxicology, Faculty of Pharmacy, Egyptian Russian University, Cairo 11829, Egypt.
Department of Pharmacology and Toxicology, Faculty of Pharmacy, Zagazig University, Zagazig 44519, Egypt.
Life Sci. 2024 Nov 15;357:123046. doi: 10.1016/j.lfs.2024.123046. Epub 2024 Sep 8.
Glibenclamide is one of the most prescribed insulin secretagogues in diabetes due to its low cost, but its efficacy on suppressing diabetic complications is limited. Here, we examine whether addition of either vitamin B1 or calcitriol to glibenclamide could produce more suppression of diabetic nephropathy. Type 2 diabetes was induced by high fructose (10 % in drinking water), high salt (3 % in diet), and high fat diet (25 % in diet) for 3 weeks, followed by single dose of STZ (40 mg/kg, i.p.). Diabetic rats were treated with either glibenclamide (0.6 mg/kg), vitamin B1 (70 mg/kg), glibenclamide/vitamin B1, calcitriol (0.1 μg/kg), or glibenclamide/calcitriol. Addition of either vitamin B1 or calcitriol to glibenclamide therapy enabled more suppression of diabetic nephropathy development as evidenced by more preserved creatinine clearance and less renal damage scores. Combination therapy resulted in mild enhancement in the effect of glibenclamide on glucose tolerance without affecting the area under the curve. Combination therapy was associated with more suppression of inflammatory cascades as evidenced by reducing the expression of high mobility group box-1 (HMGB1), toll-like receptor-4 (TLR4), nuclear factor-kappa B (NF-κB), and tumor necrosis factor-α (TNF-α). In addition, combination therapy enhanced the antioxidant mechanisms as evidenced by increased expression of nuclear factor erythroid 2-related factor 2 (Nrf2) and glutathione content and reducing malondialdehyde and nitric oxide levels. Furthermore, combination therapy provided more suppression of fibrotic pathways as appear from reducing collagen deposition and the expression of α- smooth muscle actin (α-SMA). In conclusion, addition of vitamin B1 or calcitriol to glibenclamide therapy can enhance the therapeutic efficiency of glibenclamide in suppressing diabetic nephropathy progression to the same extend, the protective effect is mediated through modulating HMGB1/TLR4/NF-κB/TNF-α/Nrf2/α-SMA trajectories.
格列本脲是治疗糖尿病最常用的胰岛素促分泌剂之一,因其成本低而被广泛应用。然而,其在抑制糖尿病并发症方面的疗效有限。本研究旨在探讨在格列本脲治疗基础上,联合应用维生素 B1 或骨化三醇是否能更有效地抑制糖尿病肾病。2 型糖尿病模型采用高果糖(10%饮用水)、高盐(3%饮食)和高脂肪(25%饮食)联合诱导 3 周,然后单次腹腔注射链脲佐菌素(40mg/kg)。糖尿病大鼠给予格列本脲(0.6mg/kg)、维生素 B1(70mg/kg)、格列本脲/维生素 B1、骨化三醇(0.1μg/kg)或格列本脲/骨化三醇治疗。结果发现,与格列本脲单药治疗相比,联合应用维生素 B1 或骨化三醇能更有效地抑制糖尿病肾病的发展,表现为肌酐清除率更高,肾损伤评分更低。联合治疗对葡萄糖耐量的影响与格列本脲单药治疗相似,但能更显著地增强格列本脲的作用,且不影响曲线下面积。联合治疗还能更有效地抑制炎症级联反应,表现为降低高迁移率族蛋白 B1(HMGB1)、Toll 样受体 4(TLR4)、核因子-κB(NF-κB)和肿瘤坏死因子-α(TNF-α)的表达。此外,联合治疗能增强抗氧化机制,表现为核因子红细胞 2 相关因子 2(Nrf2)和谷胱甘肽含量增加,丙二醛和一氧化氮水平降低。此外,联合治疗还能更有效地抑制纤维化途径,表现为胶原沉积减少和α-平滑肌肌动蛋白(α-SMA)表达降低。总之,在格列本脲治疗的基础上联合应用维生素 B1 或骨化三醇可以增强格列本脲抑制糖尿病肾病进展的疗效,其保护作用是通过调节 HMGB1/TLR4/NF-κB/TNF-α/Nrf2/α-SMA 途径实现的。
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