Nrf-2 mediated heme oxygenase-1 activation contributes to the anti-inflammatory and renal protective effects of Ginkgo biloba extract in diabetic nephropathy

J Ethnopharmacol. 2021 Feb 10:266:113474. doi: 10.1016/j.jep.2020.113474. Epub 2020 Oct 14.

Abstract

Ethnopharmacological relevance: Ginkgo biloba extract (GbE) is derived from a medicinal plant and suggested as a treatment for diabetic nephropathy (DN), but the mechanism was not clarified.

Aim of study: The present study investigated whether GbE prevented DN via activation of heme oxygenase (HO)-1.

Materials and methods: Streptozotocin-induced diabetic mice were fed a high-fat diet to generate DN. Human and murine podocytes were used for the in vitro study.

Results: GbE improved renal function via decreasing glomerular hypertrophy, the kidney/body weight ratio, and albuminuria in DN mice. GbE reversed the reduction of synaptopodin and nephrin and enhanced HO-1 expression in the kidneys of DN mice. GbE decreased the enhancement of TNF-α, IL-6, fibronectin, and lipid accumulation in the glomeruli of DN mice. GbE attenuated the uptake of oxidized low-density lipoprotein and reduced the production of ROS in high glucose-stimulated podocytes, and HO-1 inhibitor treatment abrogated the protective effects of GbE. Nuclear factor erythroid 2-related factor 2 (Nrf-2) siRNA significantly abolished the beneficial effects of GbE via decreased HO-1 expression and enhanced TNF-α and IL-6 levels.

Conclusions: GbE protected podocytes against hyperglycemia and prevented the development of DN via Nrf-2/HO-1 activation. Our findings provide further mechanistic insight into the potential use of GbE in clinical DN.

Keywords: Diabetic nephropathy; Ginkgo biloba extract; Heme oxygenase −1; Podocyte; Proteinuria.

MeSH terms

  • Animals
  • Anti-Inflammatory Agents / pharmacology*
  • Cells, Cultured
  • Diabetes Mellitus, Experimental / complications
  • Diabetes Mellitus, Experimental / drug therapy*
  • Diabetic Nephropathies / prevention & control*
  • Diet, High-Fat
  • Ginkgo biloba
  • Heme Oxygenase-1 / metabolism
  • Humans
  • Hyperglycemia / drug therapy
  • Male
  • Mice
  • Mice, Inbred DBA
  • NF-E2-Related Factor 2 / metabolism
  • Plant Extracts / pharmacology*
  • Podocytes / drug effects
  • Podocytes / metabolism
  • Reactive Oxygen Species / metabolism
  • Streptozocin

Substances

  • Anti-Inflammatory Agents
  • NF-E2-Related Factor 2
  • Plant Extracts
  • Reactive Oxygen Species
  • Ginkgo biloba extract
  • Streptozocin
  • Heme Oxygenase-1