Effects of L-Carnitine Treatment on Kidney Mitochondria and Macrophages in Mice with Diabetic Nephropathy

Kidney Blood Press Res. 2022;47(4):277-290. doi: 10.1159/000522013. Epub 2022 Feb 1.

Abstract

Introduction: In diabetic nephropathy (DN), mitochondrial dysfunction and leakage of mitochondrial DNA (mtDNA) are caused by the downregulation of superoxide dismutase 2 (SOD2). mtDNA induces the activation of Toll-like receptor (TLR) 9, which is present in macrophages (Mφs), and triggers their activation.

Methods: We orally administered L-carnitine, which exerts protective effects on the mitochondria, to obesity-induced DN (db/db) mice for 8 weeks. We then investigated the effects of L-carnitine on kidney mitochondrial reactive oxygen species (mtROS) production, circulating mtDNA content, and kidney CD11bhigh/CD11blow Mφ functions.

Results: In db/db mice, mtROS production increased in proximal tubular cells and kidney CD11blow Mφs; both Mφ types showed enhanced TLR9 expression. L-Carnitine treatment suppressed mtROS production in both proximal tubular cells and CD11blow Mφs (p < 0.01), with improved SOD2 expression in the kidney (p < 0.01), decreased circulating mtDNA content, and reduced albuminuria. Moreover, it suppressed Mφ infiltration into kidneys and reduced TLR9 expression in Mφs (p < 0.01), thereby lowering tumor necrosis factor-α production in CD11bhigh Mφs (p < 0.05) and ROS production by CD11blow Mφs (p < 0.01). Collectively, these changes alleviated DN symptoms.

Conclusion: The positive effects of L-carnitine on DN suggest its potential as a novel therapeutic agent against obesity-linked DN.

Keywords: Diabetic nephropathy; L-Carnitine; Macrophage; Mitochondria; Toll-like receptor 9; Tumor necrosis factor-α.

MeSH terms

  • Animals
  • Carnitine / pharmacology
  • Carnitine / therapeutic use
  • DNA, Mitochondrial / metabolism
  • DNA, Mitochondrial / pharmacology
  • DNA, Mitochondrial / therapeutic use
  • Diabetes Mellitus* / metabolism
  • Diabetic Nephropathies* / pathology
  • Kidney / pathology
  • Macrophages / metabolism
  • Mice
  • Mitochondria / metabolism
  • Obesity / metabolism
  • Toll-Like Receptor 9 / metabolism

Substances

  • DNA, Mitochondrial
  • Toll-Like Receptor 9
  • Carnitine