A small-molecule inhibitor of hypoxia-inducible factor prolyl hydroxylase improves obesity, nephropathy and cardiomyopathy in obese ZSF1 rats

PLoS One. 2021 Aug 2;16(8):e0255022. doi: 10.1371/journal.pone.0255022. eCollection 2021.

Abstract

Prolyl hydroxylase (PH) enzymes control the degradation of hypoxia-inducible factor (HIF), a transcription factor known to regulate erythropoiesis, angiogenesis, glucose metabolism, cell proliferation, and apoptosis. HIF-PH inhibitors (HIF-PHIs) correct anemia in patients with renal disease and in animal models of anemia and kidney disease. However, the effects of HIF-PHIs on comorbidities associated with kidney disease remain largely unknown. We evaluated the effects of the HIF-PHI FG-2216 in obese ZSF1 (Ob-ZSF1) rats, an established model of kidney failure with metabolic syndrome. Following unilateral nephrectomy (Nx) at 8 weeks of age, rats were treated with 40 mg/kg FG-2216 or vehicle by oral gavage three times per week for up to 18 weeks. FG-2216 corrected blood hemoglobin levels and improved kidney function and histopathology in Nx-Ob-ZSF1 rats by increasing the glomerular filtration rate, decreasing proteinuria, and reducing peritubular fibrosis, tubular damage, glomerulosclerosis and mesangial expansion. FG-2216 increased renal glucose excretion and decreased body weight, fat pad weight, and serum cholesterol in Nx-Ob-ZSF1 rats. Additionally, FG-2216 corrected hypertension, improved diastolic and systolic heart function, and reduced cardiac hypertrophy and fibrosis. In conclusion, the HIF-PHI FG-2216 improved renal and cardiovascular outcomes, and reduced obesity in a rat model of kidney disease with metabolic syndrome. Thus, in addition to correcting anemia, HIF-PHIs may provide renal and cardiac protection to patients suffering from kidney disease with metabolic syndrome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Biomarkers / blood
  • Cardiomegaly / blood
  • Cardiomegaly / complications
  • Cardiomegaly / physiopathology
  • Cardiomyopathies / blood
  • Cardiomyopathies / complications
  • Cardiomyopathies / drug therapy*
  • Cardiomyopathies / physiopathology
  • Glucose / metabolism
  • Hemoglobins / metabolism
  • Hypertension / blood
  • Hypertension / complications
  • Hypertension / physiopathology
  • Hypoxia-Inducible Factor-Proline Dioxygenases / antagonists & inhibitors*
  • Hypoxia-Inducible Factor-Proline Dioxygenases / metabolism
  • Kidney / physiopathology
  • Kidney Diseases / blood
  • Kidney Diseases / complications
  • Kidney Diseases / physiopathology
  • Male
  • Obesity / blood
  • Obesity / complications
  • Obesity / drug therapy*
  • Obesity / physiopathology
  • Prolyl-Hydroxylase Inhibitors / pharmacology
  • Prolyl-Hydroxylase Inhibitors / therapeutic use*
  • Rats
  • Small Molecule Libraries / pharmacology
  • Small Molecule Libraries / therapeutic use*

Substances

  • Biomarkers
  • Hemoglobins
  • Prolyl-Hydroxylase Inhibitors
  • Small Molecule Libraries
  • Hypoxia-Inducible Factor-Proline Dioxygenases
  • Glucose

Grants and funding

This research was funded by FibroGen, Inc. P.E.S., G.G., Z. W., W. Z., A.L., and U. d. B. are employees, and/or stock owners of FibroGen Inc. The funder provided support in the form of salaries for authors P.E.S., G.G., Z. W., W. Z., A.L., and U. d. B., but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. The specific roles of these authors are articulated in the ‘author contributions’ section.