Natriuretic effect by exendin-4, but not the DPP-4 inhibitor alogliptin, is mediated via the GLP-1 receptor and preserved in obese type 2 diabetic mice

Am J Physiol Renal Physiol. 2012 Oct;303(7):F963-71. doi: 10.1152/ajprenal.00259.2012. Epub 2012 Jul 25.

Abstract

Activation of the glucagon-like peptide (GLP)-1 receptor (GLP-1R) and inhibition of dipeptidyl peptidase-4 (DPP-4) are new antidiabetic strategies. The GLP-1R and DPP-4 are also expressed in the renal proximal tubular brush border, where they may regulate Na(+) reabsorption. Exendin-4 (EX4) is a naturally occurring antidiabetic polypeptide (from the saliva of the lizard Heloderma suspectum) and GLP-1R agonist; however, part of its nonglucoregulatory effects are through GLP-1R-independent mechanisms. DPP-4 cleaves and inactivates GLP-1; thus the natriuretic effect of DPP-4 inhibition may be mediated by the GLP-1R. We report that parenteral application of EX4 in wild-type mice induced a diuresis and natriuresis associated with increases in glomerular filtration rate, fractional urinary fluid and Na(+) excretion, and renal membrane expression of the Na(+)/H(+) exchanger NHE3 phosphorylated at S552 and S605, established consensus sites for cAMP-dependent PKA. These effects were absent in mice lacking the GLP-1R and independent of adenylyl cyclase 6. In comparison, parenteral application of the DPP-4 inhibitor alogliptin reduced plasma DPP-4 activity by 95% and induced a diuresis and natriuresis independent of the presence of the GLP-1R or changes in phosphorylated NHE3. The inhibitory effect on renal fluid and Na(+) reabsorption of EX4, but not alogliptin, was preserved in diabetic db/db mice and associated with a modest reduction in blood pressure. These results reveal mechanistic differences in how EX4 vs. DPP-4 inhibition induces diuresis and natriuresis under normal states, with preservation of GLP-1R-mediated, but not DPP-4 inhibitor-dependent, natriuretic mechanisms in a mouse model of obese type 2 diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Blood Glucose / metabolism
  • Diabetes Mellitus, Type 2 / metabolism*
  • Dipeptidyl-Peptidase IV Inhibitors / pharmacology
  • Exenatide
  • Glucagon-Like Peptide 1 / metabolism
  • Glucagon-Like Peptide-1 Receptor
  • Hypoglycemic Agents / pharmacology
  • Kidney / drug effects
  • Kidney / metabolism
  • Mice
  • Mice, Knockout
  • Natriuresis / drug effects
  • Natriuretic Agents / pharmacology*
  • Obesity / metabolism*
  • Peptides / pharmacology*
  • Phosphorylation / drug effects
  • Piperidines / pharmacology*
  • Receptors, Glucagon / genetics
  • Receptors, Glucagon / metabolism*
  • Uracil / analogs & derivatives*
  • Uracil / pharmacology
  • Venoms / pharmacology*

Substances

  • Blood Glucose
  • Dipeptidyl-Peptidase IV Inhibitors
  • Glp1r protein, mouse
  • Glucagon-Like Peptide-1 Receptor
  • Hypoglycemic Agents
  • Natriuretic Agents
  • Peptides
  • Piperidines
  • Receptors, Glucagon
  • Venoms
  • Uracil
  • Glucagon-Like Peptide 1
  • Exenatide
  • alogliptin