Effect of Sodium-Glucose Co-Transporter 2 Inhibitor, Dapagliflozin, on Renal Renin-Angiotensin System in an Animal Model of Type 2 Diabetes

• Published in: PloS one Vol. 11; no. 11; p. e0165703
• Main Authors: Shin, Seok Joon, Chung, Sungjin, Kim, Soo Jung, Lee, Eun-Mi, Yoo, Young-Hye, Kim, Ji-Won, Ahn, Yu-Bae, Kim, Eun-Sook, Moon, Sung-Dae, Kim, Myung-Jun, Ko, Seung-Hyun
• Format: Journal Article
• Language: English
• Published: United States Public Library of Science 01.11.2016; Public Library of Science (PLoS)
• Subjects: Albumin; Aldosterone - blood; Analysis; Angiotensin; Angiotensin II; Angiotensinogen; Angiotensins; Animals; Antidiabetics; Benzhydryl Compounds - pharmacology; Benzhydryl Compounds - therapeutic use; Biology and Life Sciences; Blood glucose; Cell growth; Chymosin - blood; Collagen; Creatinine; Diabetes; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Type 2 - blood; Diabetes Mellitus, Type 2 - drug therapy; Diabetes Mellitus, Type 2 - metabolism; Diabetes Mellitus, Type 2 - pathology; Diabetic nephropathies; Diabetic Nephropathies - blood; Diabetic Nephropathies - drug therapy; Diabetic Nephropathies - metabolism; Diabetic Nephropathies - pathology; Diabetic nephropathy; Disease Models, Animal; Endocrinology; Fibrosis; Gene expression; Glucose; Glucose transporter; Glucosidase; Glucosides - pharmacology; Glucosides - therapeutic use; Homeostasis; Hyperglycemia; Hyperglycemia - blood; Hyperglycemia - drug therapy; Hyperglycemia - metabolism; Hyperglycemia - pathology; Infiltration; Inflammation; Inhibitors; Internal medicine; Kidney - drug effects; Kidney - metabolism; Kidney - pathology; Kidneys; Kinases; Lipid Peroxidation - drug effects; Male; Medicine; Medicine and Health Sciences; Metabolism; Nephrology; Nephropathy; Oxidative stress; Polymerase chain reaction; Proteins; Rats; Rats, Inbred OLETF; Renin; Renin-angiotensin system; Renin-Angiotensin System - drug effects; Rodents; Sodium; Sodium-Glucose Transporter 2 - metabolism; Sodium-Glucose Transporter 2 Inhibitors; Studies; Type 2 diabetes; Urine; Widening; α-Glucosidase
• ISSN: 1932-6203; 1932-6203
• DOI: 10.1371/journal.pone.0165703

Renal renin-angiotensin system (RAS) activation is one of the important pathogenic mechanisms in the development of diabetic nephropathy in type 2 diabetes. The aim of this study was to investigate the effects of a sodium-glucose co-transporter 2 (SGLT-2) inhibitor, dapagliflozin, on renal RAS in an animal model with type 2 diabetes. Dapagliflozin (1.0 mg/kg, OL-DA) or voglibose (0.6 mg/kg, OL-VO, diabetic control) (n = 10 each) was administered to Otsuka Long-Evans Tokushima Fatty (OLETF) rats for 12 weeks. We used voglibose, an alpha-glucosidase inhibitor, as a comparable counterpart to SGLT2 inhibitor because of its postprandial glucose-lowering effect without proven renoprotective effects. Control Long-Evans Tokushima Otsuka (LT) and OLETF (OL-C) rats received saline (n = 10, each). Changes in blood glucose, urine albumin, creatinine clearance, and oxidative stress were measured. Inflammatory cell infiltration, mesangial widening, and interstitial fibrosis in the kidney were evaluated by histological analysis. The effects of dapagliflozin on renal expression of the RAS components were evaluated by quantitative RT-PCR in renal tissue. After treatment, hyperglycemia and urine microalbumin levels were attenuated in both OL-DA and OL-VO rather than in the OL-C group (P < 0.05). The urine angiotensin II (Ang II) and angiotensinogen levels were significantly decreased following treatment with dapagliflozin or voglibose, but suppression of urine Ang II level was more prominent in the OL-DA than the OL-VO group (P < 0.05). The expressions of angiotensin type 1 receptor and tissue oxidative stress markers were markedly increased in OL-C rats, which were reversed by dapagliflozin or voglibose (P < 0.05, both). Inflammatory cell infiltration, mesangial widening, interstitial fibrosis, and total collagen content were significantly increased in OL-C rats, which were attenuated in OL-DA group (P < 0.05). Dapagliflozin treatment showed beneficial effects on diabetic nephropathy, which might be via suppression of renal RAS component expression, oxidative stress and interstitial fibrosis in OLETF rats. We suggest that, in addition to control of hyperglycemia, partial suppression of renal RAS with an SGLT2 inhibitor would be a promising strategy for the prevention of treatment of diabetic nephropathy.