Abstract

Insulin resistance, closely linked to inflammation, is recognized as a key factor in the onset and aggravation of diabetes, cardio-renal syndrome, hypertension, and obesity. In the renal proximal tubule, insulin resistance may increase renal sodium reabsorption, leading to hypertension, edema and sometimes heart failure. Recently some anti-diabetic agents have been shown to have effects on the transporters in renal proximal tubule. Because renal proximal tubule mediates about 70% of sodium reabsorption, it is quite important to clarify the function of renal proximal tubule under insulin resistance and inflammation.

Highlights

  • The relationship between inflammation and diabetes had been described long ago by the fact that anti-inflammatory drugs such as salicylates decrease blood glucose level [1]

  • These results suggest that the insulin/WNK-oxidative stress-responsive kinase-1 (OSR1)/ SPS1-related proline-alanine-rich kinase (SPAK)-Na+-Cl− cotransporter (NCC) system may play an important role in Na+ retention and hypertension, and may be another therapeutic target in hypertension associated with insulin resistance

  • We have discussed the relationship between insulin resistance and inflammation in the context of the onset of hypertension

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Summary

Introduction

The relationship between inflammation and diabetes had been described long ago by the fact that anti-inflammatory drugs such as salicylates decrease blood glucose level [1]. JNK pathway induces serine phosphorylation of insulin-related substrate (IRS-1) [8,9,10,11]. Phosphorylated IRS-1 itself induces insulin resistance by direct blocking of insulin signaling pathway through IRS-1 [10,11]. Duced insulin resistance and inflammation are promoted by JNK in macrophage [12]. The signals from proinflammatory factors such as TNF-α and interleukin (IL)-1, via IKKβ complex, activate NFκB complex. IKKβ/NFκB pathway is triggered by PI3K/AKT signaling [17,18,19]. These pathways inducing insulin resistance are triggered by such factors as TNF-α, IL-1, endoplasmic reticulum (ER) stress, oxidative stress, and lipids [1].

TNF-α and Sodium Reabsorption in Nephron
Insulin Resistance and Distal Tubules Transporters and Kinases
Findings
Conclusions and Prospectives
Full Text
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