Abstract

Both autophagy and podocyte epithelial-mesenchymal transition (EMT) are critical factors in glomerular diseases that involve proteinuria and fibrosis. Here, we sought to determine whether plant-derived saponin astragaloside IV (AS-IV) was able to reverse renal fibrosis and improve renal function through regulation of autophagy and podocyte EMT. Cultured immortalized mouse podocytes and KK-Ay mice models of diabetes were exposed to AS-IV. Western blotting, real-time PCR, immunofluorescence and histochemistry were used to analyze markers of autophagy and podocyte EMT. We observed that AS-IV inhibited glucose-induced podocyte EMT and enhanced autophagy by decreasing NF-κB subunit p65 acetylation as well as increasing Sirtuin1 (SIRT1) expression. Treatment of the cells and animal models with a SIRT1 inhibitor EX527 was able to reverse these effects. The SIRT1 activator SRT1720 was also found to decrease p65 acetylation and enhance autophagy in glucose-induced podocyte EMT. Additionally, further treatment with autophagy inhibitor 3-methyladenine was able to reverse the effects of AS-IV on podocyte EMT, while the autophagy activator rapamycin or the NF-κB pathway inhibitor ammonium pyrrolidinedithiocarbamate (PDTC) were able to reverse glucose-induced podocyte EMT. Notably, both renal fibrosis and renal function in diabetic KK-Ay mice were improved after treatment with AS-IV. These findings support AS-IV as a renoprotective agent that likely exerts its effects on podocyte EMT through modulation of the SIRT1–NF-κB pathway and autophagy activation. Further studies are required to clarify the role of AS-IV as a potential therapeutic agent in glomerular diseases.

Highlights

  • Diabetes is a disease that often targets end organ microvasculature, and is a significant cause of chronic kidney disease

  • The results suggested that high glucose concentrations promoted podocyte epithelial-mesenchymal transition (EMT) which was subsequently reversed upon exposure to Astragaloside IV (AS-IV) in a dose-dependent manner

  • While several studies demonstrated the relationship between AS-IV and autophagy in various cells including podocytes[21,28,29], few have indicated the relationship between autophagy and podocyte EMT

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Summary

Introduction

Diabetes is a disease that often targets end organ microvasculature, and is a significant cause of chronic kidney disease. In response to harmful stimuli, podocytes usually lose their differentiated morphology and epithelial markers like nephrin, podocin, and zonula occludens-1 (ZO-1), and acquire mesenchymal markers such as fibronectin (FN), fibroblast-specific protein-1 (FSP-1) and α-Smooth Muscle Actin (α-SMA)[3,6,7]. Excretion of these plasma proteins into the urine accelerates the progression of renal fibrosis in DKD. The mechanism of how SIRT1 regulates podocyte EMT induced by high glucose concentrations is still not fully understood. Previous studies have reported that autophagy may be directly regulated by SIRT1 in many cells, including podocytes. Our investigation focuses on investigating the probable role of AS-IV in podocyte EMT, focusing on the role of autophagy and SIRT1-facilitated NF-κB p65 subunit deacetylation

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