Zhu Qiuxiao, Hao Huiyao, Gao Ya, Li Na, Liu Zibo, Shu Linyi, Wang Qian, Zhang Lihui
Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Department of Geriatrics, The Second Hospital of Hebei Medical University, Shijiazhuang, Hebei, China.
Ren Fail. 2025 Dec;47(1):2495111. doi: 10.1080/0886022X.2025.2495111. Epub 2025 Apr 23.
Limb ischemia-reperfusion (I/R) results in both localized tissue harm and injury to distant organs, particularly affecting the kidneys and leading to acute kidney injury. This study evaluates the renoprotective effect of dapagliflozin, a drug frequently prescribed for type 2 diabetes management, in relation to kidney injury caused by limb I/R. The extent of kidney injury was detected through serum marker testing in the rat model. Oxidative stress indicators and inflammatory factors were evaluated in rat and cellular models. Histological changes in the kidneys were examined using HE staining and electron microscopy. Cell pyroptosis was quantified using both TUNEL staining and flow cytometry. Cellular mitochondrial function was analyzed with JC-1 staining. AMPK/SIRT1/NLRP3 pathway-related proteins and their mRNAs were assessed western blotting and RT-qPCR techniques. We showed that dapagliflozin reduced serum CRE, BUN, NGAL and KIM-1 levels and improved renal pathology in rat. Additionally, dapagliflozin significantly raised the concentrations of GSH-Px and SOD, concurrently reduced MDA and ROS levels and . It also lowered the levels of IL-6 and TNF-α and reduced cell pyroptosis. Furthermore, it was observed that dapagliflozin elevated AMPK and SIRT1 expressions, while decreasing NLRP3, ASC, GSDMD, IL-1β, and caspase-1 expressions. Notably, these effects of dapagliflozin were diminished in the presence of AMPK siRNA. Taken together, dapagliflozin exhibits a significant protective effect against kidney injury resulting from limb I/R. This protective effect operates through the inhibition of pyroptosis by activating the AMPK/SIRT1/NLRP3 signaling pathway.
肢体缺血再灌注(I/R)会导致局部组织损伤以及远处器官受损,尤其会影响肾脏并导致急性肾损伤。本研究评估了达格列净(一种常用于治疗2型糖尿病的药物)对肢体I/R所致肾损伤的肾脏保护作用。通过大鼠模型中的血清标志物检测来检测肾损伤程度。在大鼠和细胞模型中评估氧化应激指标和炎症因子。使用苏木精-伊红(HE)染色和电子显微镜检查肾脏的组织学变化。使用TUNEL染色和流式细胞术对细胞焦亡进行定量分析。用JC-1染色分析细胞线粒体功能。采用蛋白质免疫印迹法和逆转录-定量聚合酶链反应(RT-qPCR)技术评估AMPK/SIRT1/NLRP3通路相关蛋白及其mRNA。我们发现,达格列净降低了大鼠血清中肌酐(CRE)、尿素氮(BUN)、中性粒细胞明胶酶相关脂质运载蛋白(NGAL)和肾损伤分子-1(KIM-1)的水平,并改善了肾脏病理学表现。此外,达格列净显著提高了谷胱甘肽过氧化物酶(GSH-Px)和超氧化物歧化酶(SOD)的浓度,同时降低了丙二醛(MDA)和活性氧(ROS)水平。它还降低了白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)的水平,并减少了细胞焦亡。此外,观察到达格列净提高了AMPK和SIRT1的表达,同时降低了NLRP3、凋亡相关斑点样蛋白(ASC)、Gasdermin D(GSDMD)、白细胞介素-1β(IL-1β)和半胱天冬酶-1(caspase-1)的表达。值得注意的是,在存在AMPK小干扰RNA(siRNA)的情况下,达格列净的这些作用减弱。综上所述,达格列净对肢体I/R所致的肾损伤具有显著的保护作用。这种保护作用是通过激活AMPK/SIRT1/NLRP3信号通路抑制细胞焦亡来实现的。