Potential roles for eNOS and NrF₂ /HO-1 signaling in the ameliorative effect of lixisenatide on diabetes-induced kidney injury in rats and its amplification by ticagrelor co-administration

Pharmazie. 2024 Oct 1;79(9):187-194. doi: 10.1691/ph.2024.4566.

Abstract

Antioxidant and anti-inflammatory effects of lixisenatide (LX) and ticagrelor (TC) have been previously identified in type 2 diabetes mellitus (T2DM). Diabetic nephropathy is one of the major complications of T2DM. In the current study, we examined the potential protective effects of LX and TC on experimentally induced diabetic nephropathy in T2DM rats and their possible molecular mechanisms. To examine this possibility, rats were fed a high-fat diet (HFD) for 12 weeks, followed by a single injection of 35 mg/kg streptozotocin (STZ) to induce T2DM. 10 μg/kg LX and 25 mg/kg TC were given alone or in combination to T2DM rats for 4 weeks. The kidney examination of T2DM rats showed clear deterioration. T2DM rats exhibited significantly higher body weight, blood glucose, hemostatic model assessment for insulin resistance (HOMA-IR), blood urea nitrogen (BUN), serum creatinine, kidney reactive oxygen species (ROS), nuclear factor-κ B (NF-κ B), and transforming growth factor-β (TGF-β ), and significantly lower serum insulin, urine creatinine, creatinine clearance (CRCL), kidney superoxide dismutase (SOD), glutathione reduced (GSH), nuclear factor erythroid 2 (NrF₂ ), heme oxygenase-1 (HO-1), and endothelial nitric oxide synthase (eNOS) when compared to control rats. Single treatment with LX or TC showed obvious ameliorative effects on kidney complications in T2DM rats, with more ameliorative effects with the combined administration of both drugs. Conclusion: Our investigation found that both LX and TC could significantly ameliorate the development of diabetic nephropathy via stimulating NrF₂ /HO-1 antioxidant pathway in addition to increasing eNOS and decreasing NF-κ B renal tissue concentrations, and these effects were markedly augmented by their combined administration.

MeSH terms

  • Adenosine / administration & dosage
  • Adenosine / analogs & derivatives
  • Animals
  • Antioxidants / administration & dosage
  • Antioxidants / pharmacology
  • Blood Glucose / drug effects
  • Diabetes Mellitus, Experimental* / complications
  • Diabetes Mellitus, Experimental* / drug therapy
  • Diabetes Mellitus, Type 2 / complications
  • Diabetes Mellitus, Type 2 / drug therapy
  • Diabetes Mellitus, Type 2 / metabolism
  • Diabetic Nephropathies* / drug therapy
  • Diabetic Nephropathies* / metabolism
  • Diabetic Nephropathies* / prevention & control
  • Diet, High-Fat / adverse effects
  • Drug Therapy, Combination
  • Glucagon-Like Peptide-2 Receptor
  • Heme Oxygenase (Decyclizing) / metabolism
  • Insulin Resistance
  • Kidney / drug effects
  • Kidney / metabolism
  • Male
  • NF-E2-Related Factor 2* / metabolism
  • Nitric Oxide Synthase Type III* / metabolism
  • Peptides* / administration & dosage
  • Peptides* / pharmacology
  • Rats
  • Rats, Sprague-Dawley
  • Reactive Oxygen Species / metabolism
  • Signal Transduction* / drug effects
  • Streptozocin
  • Ticagrelor* / pharmacology

Substances

  • Ticagrelor
  • lixisenatide
  • NF-E2-Related Factor 2
  • Nitric Oxide Synthase Type III
  • Peptides
  • Nfe2l2 protein, rat
  • Nos3 protein, rat
  • Hmox1 protein, rat
  • Reactive Oxygen Species
  • Antioxidants
  • Heme Oxygenase (Decyclizing)
  • Blood Glucose
  • Adenosine
  • Streptozocin
  • Glucagon-Like Peptide-2 Receptor