The TLR4 antagonist CRX-526 protects against advanced diabetic nephropathy

Kidney Int. 2013 May;83(5):887-900. doi: 10.1038/ki.2013.11. Epub 2013 Feb 20.

Abstract

We recently showed that Toll-like receptor (TLR) TLR4 was overexpressed in the human diabetic kidney, which could promote tubular inflammation. Here we explored whether the TLR4 antagonist, CRX-526, has therapeutic potential to attenuate renal injuries and slow the progression of advanced diabetic nephropathy in wild-type and endothelial nitric oxide synthase (eNOS) knockout mice. In the latter, the endogenous TLR4 ligand, high-mobility group box 1, was upregulated more than in wild-type animals. Four weeks after streptozotocin induction of diabetes, mice were injected with either CRX-526 or vehicle for 8 weeks. CRX-526 significantly reduced albuminuria and blood urea nitrogen without altering blood glucose and systolic blood pressure in diabetic mice. Glomerular hypertrophy, glomerulosclerosis, and tubulointerstitial injury were attenuated by CRX-526, which was associated with decreased chemokine (C-C motif) ligand (CCL)-2, osteopontin, CCL-5 overexpression, subsequent macrophage infiltration, and collagen deposition. These effects were associated with inhibition of TGF-β overexpression and NF-κB activation. In vitro, CRX-526 inhibited high glucose-induced osteopontin upregulation and NF-κB nuclear translocation in cultured human proximal tubular epithelial cells. Thus, we provided evidence that inhibition of TLR4 with the synthetic antagonist CRX-526 conferred renoprotective effects in eNOS knockout diabetic mice with advanced diabetic nephropathy.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Albuminuria / etiology
  • Albuminuria / immunology
  • Albuminuria / prevention & control
  • Animals
  • Blood Glucose / metabolism
  • Blood Urea Nitrogen
  • Chemokine CCL2 / metabolism
  • Chemokine CCL5 / metabolism
  • Collagen / metabolism
  • Diabetes Mellitus, Experimental / blood
  • Diabetes Mellitus, Experimental / chemically induced
  • Diabetes Mellitus, Experimental / complications
  • Diabetes Mellitus, Experimental / drug therapy*
  • Diabetes Mellitus, Experimental / immunology
  • Diabetic Nephropathies / blood
  • Diabetic Nephropathies / etiology
  • Diabetic Nephropathies / immunology
  • Diabetic Nephropathies / pathology
  • Diabetic Nephropathies / prevention & control*
  • Disease Progression
  • Glucosamine / analogs & derivatives*
  • Glucosamine / pharmacology
  • HMGB1 Protein / metabolism
  • Kidney / drug effects*
  • Kidney / immunology
  • Kidney / metabolism
  • Kidney / pathology
  • Macrophages / drug effects
  • Macrophages / immunology
  • Macrophages / metabolism
  • Mice
  • Mice, Knockout
  • NF-kappa B / metabolism
  • Nitric Oxide Synthase Type III / deficiency
  • Nitric Oxide Synthase Type III / genetics
  • Osteopontin / metabolism
  • Streptozocin
  • Time Factors
  • Toll-Like Receptor 4 / antagonists & inhibitors*
  • Toll-Like Receptor 4 / metabolism
  • Transforming Growth Factor beta / metabolism

Substances

  • Blood Glucose
  • CRX-526
  • Ccl2 protein, mouse
  • Ccl5 protein, mouse
  • Chemokine CCL2
  • Chemokine CCL5
  • HMGB1 Protein
  • HMGB1 protein, mouse
  • NF-kappa B
  • Spp1 protein, mouse
  • Tlr4 protein, mouse
  • Toll-Like Receptor 4
  • Transforming Growth Factor beta
  • Osteopontin
  • Streptozocin
  • Collagen
  • Nitric Oxide Synthase Type III
  • Nos3 protein, mouse
  • Glucosamine