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Publication : The Adiponectin Receptor Agonist AdipoRon Ameliorates Diabetic Nephropathy in a Model of Type 2 Diabetes.

First Author  Kim Y Year  2018
Journal  J Am Soc Nephrol Volume  29
Issue  4 Pages  1108-1127
PubMed ID  29330340 Mgi Jnum  J:291496
Mgi Id  MGI:6436047 Doi  10.1681/ASN.2017060627
Citation  Kim Y, et al. (2018) The Adiponectin Receptor Agonist AdipoRon Ameliorates Diabetic Nephropathy in a Model of Type 2 Diabetes. J Am Soc Nephrol 29(4):1108-1127
abstractText  Adiponectin exerts renoprotective effects against diabetic nephropathy (DN) by activating the AMP-activated protein kinase (AMPK)/peroxisome proliferative-activated receptor-alpha (PPARalpha) pathway through adiponectin receptors (AdipoRs). AdipoRon is an orally active synthetic adiponectin receptor agonist. We investigated the expression of AdipoRs and the associated intracellular pathways in 27 patients with type 2 diabetes and examined the effects of AdipoRon on DN development in male C57BLKS/J db/db mice, glomerular endothelial cells (GECs), and podocytes. The extent of glomerulosclerosis and tubulointerstitial fibrosis correlated with renal function deterioration in human kidneys. Expression of AdipoR1, AdipoR2, and Ca(2+)/calmodulin-dependent protein kinase kinase-beta (CaMKKbeta) and numbers of phosphorylated liver kinase B1 (LKB1)- and AMPK-positive cells significantly decreased in the glomeruli of early stage human DN. AdipoRon treatment restored diabetes-induced renal alterations in db/db mice. AdipoRon exerted renoprotective effects by directly activating intrarenal AdipoR1 and AdipoR2, which increased CaMKKbeta, phosphorylated Ser(431)LKB1, phosphorylated Thr(172)AMPK, and PPARalpha expression independently of the systemic effects of adiponectin. AdipoRon-induced improvement in diabetes-induced oxidative stress and inhibition of apoptosis in the kidneys ameliorated relevant intracellular pathways associated with lipid accumulation and endothelial dysfunction. In high-glucose-treated human GECs and murine podocytes, AdipoRon increased intracellular Ca(2+) levels that activated a CaMKKbeta/phosphorylated Ser(431)LKB1/phosphorylated Thr(172)AMPK/PPARalpha pathway and downstream signaling, thus decreasing high-glucose-induced oxidative stress and apoptosis and improving endothelial dysfunction. AdipoRon further produced cardioprotective effects through the same pathway demonstrated in the kidney. Our results show that AdipoRon ameliorates GEC and podocyte injury by activating the intracellular Ca(2+)/LKB1-AMPK/PPARalpha pathway, suggesting its efficacy for treating type 2 diabetes-associated DN.
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