Canagliflozin impairs T cell effector function via metabolic suppression in autoimmunity

Cell Metab. 2023 Jul 11;35(7):1132-1146.e9. doi: 10.1016/j.cmet.2023.05.001. Epub 2023 May 24.

Abstract

Augmented T cell function leading to host damage in autoimmunity is supported by metabolic dysregulation, making targeting immunometabolism an attractive therapeutic avenue. Canagliflozin, a type 2 diabetes drug, is a sodium glucose co-transporter 2 (SGLT2) inhibitor with known off-target effects on glutamate dehydrogenase and complex I. However, the effects of SGLT2 inhibitors on human T cell function have not been extensively explored. Here, we show that canagliflozin-treated T cells are compromised in their ability to activate, proliferate, and initiate effector functions. Canagliflozin inhibits T cell receptor signaling, impacting on ERK and mTORC1 activity, concomitantly associated with reduced c-Myc. Compromised c-Myc levels were encapsulated by a failure to engage translational machinery resulting in impaired metabolic protein and solute carrier production among others. Importantly, canagliflozin-treated T cells derived from patients with autoimmune disorders impaired their effector function. Taken together, our work highlights a potential therapeutic avenue for repurposing canagliflozin as an intervention for T cell-mediated autoimmunity.

Keywords: CD4 T cell; T cell; autoimmunity; canagliflozin; gliflozins; human; immunometabolism.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Autoimmune Diseases* / drug therapy
  • Autoimmunity
  • Canagliflozin / pharmacology
  • Canagliflozin / therapeutic use
  • Diabetes Mellitus, Type 2* / drug therapy
  • Humans
  • Hypoglycemic Agents / pharmacology
  • Sodium-Glucose Transporter 2 Inhibitors* / therapeutic use
  • T-Lymphocytes

Substances

  • Canagliflozin
  • Sodium-Glucose Transporter 2 Inhibitors
  • Hypoglycemic Agents