Saxagliptin reduces renal tubulointerstitial inflammation, hypertrophy and fibrosis in diabetes

• DOI: 10.1111/nep.12618
• Publication Date: 2015-09-16T13:32:54Z
• Authors: Muralikrishna Gan...; Simon Gross; Amgad Zaky; Carol Pollock; Usha Panchapakesan
• Keywords: Blood Glucose; Male; Mice, Knockout; Dipeptidyl-Peptidase IV Inhibitors; 0303 health sciences; Nitric Oxide Synthase Type III; Dipeptidyl Peptidase 4; Adamantane; Dipeptides; Hypertrophy; Kidney; Fibrosis; 3. Good health; Diabetes Mellitus, Experimental; Fibronectins; 03 medical and health sciences; Diabetes Mellitus, Type 1; Glomerulonephritis; Albuminuria; Animals; Insulin; Nephritis, Interstitial; Diabetic Nephropathies

AbstractAimIn addition to lowering blood glucose in patients with type 2 diabetes mellitus, dipeptidyl peptidase 4 (DPP4) inhibitors have been shown to be antifibrotic and anti‐inflammatory. We have previously shown that DPP4 inhibition in human kidney proximal tubular cells exposed to high glucose reduced fibrotic and inflammatory markers. Hence, we wanted to demonstrate renoprotection in an in vivo model.MethodsWe used a type 1 diabetic animal model to explore the renoprotective potential of saxagliptin independent of glucose lowering. We induced diabetes in enos −/− mice using streptozotocin and matched glucose levels using insulin. Diabetic mice were treated with saxagliptin and outcomes compared with untreated diabetic mice.ResultsWe provide novel data that saxagliptin limits renal hypertrophy, transforming growth factor beta‐related fibrosis and NF‐κBp65‐mediated macrophage infiltration. Overall, there was a reduction in histological markers of tubulointerstitial fibrosis. There was no reduction in albuminuria or glomerulosclerosis.ConclusionOur findings highlight the potential of DPP4 inhibition as additional therapy in addressing the multiple pathways to achieve renoprotection in diabetic nephropathy.