Dapagliflozin Prevents Kidney Glycogen Accumulation and Improves Renal Proximal Tubule Cell Functions in a Mouse Model of Glycogen Storage Disease Type 1b

Mariavittoria D'Acierno, Roberta Resaz, Anna Iervolino, Rikke Nielsen, Donato Sardella, Sabrina Siccardi, Vincenzo Costanzo, Luciano D'Apolito, Yoko Suzumoto, Daniela Segalerba, Simonetta Astigiano, Alessandra F Perna, Giovambattista Capasso, Alessandra Eva, Francesco Trepiccione

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Abstract

Background: Mutations in SLC37A4, which encodes the intracellular glucose transporter G6PT, cause the rare glycogen storage disease type 1b (GSD1b). A long-term consequence of GSD1b is kidney failure, which requires kidney replacement therapy. The main protein markers of proximal tubule function, including NaPi2A, NHE3, SGLT2, GLUT2, and AQP1, are downregulated as part of the disease phenotype. Methods: We utilized an inducible mouse model of GSD1b, TM-G6PT -/-, to show that glycogen accumulation plays a crucial role in altering proximal tubule morphology and function. To limit glucose entry into proximal tubule cells and, thus, to prevent glycogen accumulation, we administered a SGLT2-inhibitor, dapagliflozin, to TM-G6PT -/- mice. Results: In proximal tubule cells, G6PT suppression stimulates the upregulation and activity of hexokinase I, which increases availability of the reabsorbed glucose for intracellular metabolism. Dapagliflozin prevented glycogen accumulation and improved kidney morphology by promoting a metabolic switch from glycogen synthesis towards lysis and restored expression levels of the main proximal tubule functional markers. Conclusion: We provide proof of concept for the efficacy of dapagliflozin in preserving kidney function in GSD1b mice. Our findings could represent the basis for repurposing this drug to treat GSD1b patients.

OriginalsprogEngelsk
TidsskriftJournal of the American Society of Nephrology : JASN
Vol/bind33
Nummer10
Sider (fra-til)1864-1875
Antal sider12
ISSN1046-6673
DOI
StatusUdgivet - okt. 2022

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