Glucagon-like peptide-1 receptor signaling modifies the extent of diabetic kidney disease through dampening the receptor for advanced glycation end products–induced inflammation

Dec 9, 2023Kidney international

Glucagon-like peptide-1 receptor signaling may reduce diabetic kidney disease by lowering inflammation caused by harmful sugar-related receptors

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Abstract

Mice lacking the GLP-1 receptor showed an abnormal kidney phenotype that worsened with diabetes and improved when RAGE was also deleted.

GLP-1 receptor agonists may protect the kidneys through mechanisms involving inflammation and cellular responses.
Activation of the GLP-1 receptor with liraglutide was associated with reduced kidney RAGE levels and less kidney damage in diabetic mice.
Liraglutide treatment influenced the behavior of bone marrow cells and promoted a type of immune response that is typically healing.
Single cell transcriptomics indicated that liraglutide led to significant gene expression changes in various kidney cell types related to nutrient handling and inflammation resolution.
The kidney-protective effects of liraglutide were also observed in a model of chronic kidney disease unrelated to diabetes.

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Glucagon like peptide-1 (GLP-1) is a hormone produced and released by cells of the gastrointestinal tract following meal ingestion. GLP-1 receptor agonists (GLP-1RA) exhibit kidney-protective actions through poorly understood mechanisms. Here we interrogated whether the receptor for advanced glycation end products (RAGE) plays a role in mediating the actions of GLP-1 on inflammation and diabetic kidney disease. Mice with deletion of the GLP-1 receptor displayed an abnormal kidney phenotype that was accelerated by diabetes and improved with co-deletion of RAGE in vivo. Activation of the GLP-1 receptor pathway with liraglutide, an anti-diabetic treatment, downregulated kidney RAGE, reduced the expansion of bone marrow myeloid progenitors, promoted M2-like macrophage polarization and lessened markers of kidney damage in diabetic mice. Single cell transcriptomics revealed that liraglutide induced distinct transcriptional changes in kidney endothelial, proximal tubular, podocyte and macrophage cells, which were dominated by pathways involved in nutrient transport and utilization, redox sensing and the resolution of inflammation. The kidney-protective action of liraglutide was corroborated in a non-diabetic model of chronic kidney disease, the subtotal nephrectomised rat. Thus, our findings identify a novel glucose-independent kidney-protective action of GLP-1-based therapies in diabetic kidney disease and provide a valuable resource for exploring the cell-specific kidney transcriptional response ensuing from pharmacological GLP-1R agonism.

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Glucagon-like peptide-1 receptor signaling modifies the extent of diabetic kidney disease through dampening the receptor for advanced glycation end products–induced inflammation

Abstract

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