Empagliflozin Enhances Autophagy, Mitochondrial Biogenesis, and Antioxidant Defense and Ameliorates Renal Ischemia/Reperfusion in Nondiabetic Rats

• Published in: Oxidative medicine and cellular longevity 2022, Vol.2022, p.1197061-9
• Main Authors: Ala, Moein, Khoshdel, Mohammad Reza Fallahpour, Dehpour, Ahmad Reza
• Format: Article
• Language: English
• Subjects: Animals; Antioxidants - administration & dosage; Apoptosis - drug effects; Autophagy; Autophagy - drug effects; Benzhydryl Compounds - administration & dosage; Biopsy; Biosynthesis; Blood Urea Nitrogen; Clinical trials; Creatinine; Creatinine - blood; Diabetes; Diabetic nephropathy; Disease Models, Animal; Glucosides - administration & dosage; Histology; Histopathology; Inflammation; Interleukin-1beta - metabolism; Ischemia; Kidney Diseases - blood; Kidney Diseases - complications; Kidney Diseases - drug therapy; Kidneys; Kinases; Laboratory animals; Male; Malondialdehyde - metabolism; Metabolism; Organelle Biogenesis; Oxidative stress; Oxidative Stress - drug effects; Rats; Rats, Wistar; Reperfusion Injury - blood; Reperfusion Injury - complications; Reperfusion Injury - drug therapy; Signal Transduction - drug effects; Sodium-Glucose Transporter 2 Inhibitors - administration & dosage; Treatment Outcome; Tumor Necrosis Factor-alpha - metabolism; Tumor necrosis factor-TNF
• ISSN: 1942-0900; 1942-0994
• DOI: 10.1155/2022/1197061

Background. Recent meta-analyses have shown that sodium-glucose cotransporter 2 (SGLT-2) inhibitors alleviate chronic kidney disease and acute kidney injury in diabetic patients. In this study, we aimed to investigate the effect of empagliflozin on renal ischemia/reperfusion (I/R) in nondiabetic rats and find the possible mechanisms. Experimental Approach. Eighteen male Wistar rats were randomly divided into three groups, including healthy control, ischemic control, and empagliflozin-treated group. Thirty minutes of bilateral renal ischemia was induced by clamping the renal hilum. Forty-eight hours after reopening the clamps, rats’ blood samples and tissue specimens were collected. Empagliflozin 10 mg/kg was administered by gavage, 2 hours before ischemia and 24 hours after the first dose. Results. I/R injury led to a significant rise in serum creatinine and blood urea nitrogen which was significantly decreased after treatment with empagliflozin. Empagliflozin also alleviated tubulointerstitial and glomerular damage and significantly decreased tissue histology scores. Empagliflozin decreased the increased levels of malondialdehyde, interleukin 1β, and tumor necrosis factor α. SGLT2 inhibition increased the decreased expression of nuclear factor erythroid 2-related factor 2 and PPARG coactivator 1 alpha that conduct antioxidant defense and mitochondrial biogenesis, respectively. Furthermore, empagliflozin markedly increased LC3-II/LC3-I and bcl2/bax ratios, showing its beneficial effect on activation of autophagy and inhibition of apoptosis. Despite its effects on diabetic nephropathy, empagliflozin did not activate the Sestrin2/AMP-activated protein kinase pathway in this study. Conclusion. Empagliflozin improved renal I/R injury in nondiabetic rats in this study by promoting autophagy and mitochondrial biogenesis and attenuation of oxidative stress, inflammation, and apoptosis.