Linagliptin ameliorates tacrolimus-induced renal injury: role of Nrf2/HO-1 and HIF-1α/CTGF/PAI-1

Mol Biol Rep. 2024 May 5;51(1):608. doi: 10.1007/s11033-024-09533-2.

Abstract

Background: Tacrolimus (TAC) is a frequently used immunosuppressive medication in organ transplantation. However, its nephrotoxic impact limits its long-term usage. This study aims to investigate the effect of linagliptin (Lina) on TAC-induced renal injury and its underlying mechanisms.

Methods and results: Thirty-two Sprague Dawley rats were treated with TAC (1.5 mg/kg/day, subcutaneously) and/or Lina (5 mg/kg/day, orally) for 4 weeks. Histological examination was conducted, and serum and urinary biomarkers were measured to assess kidney function and integrity. Furthermore, ELISA, Western blot analysis and immunohistochemical assay were employed to determine signaling molecules of oxidative stress, profibrogenic, hypoxic, and apoptotic proteins. Tacrolimus caused renal dysfunction and histological deterioration evidenced by increased serum creatinine, blood urea nitrogen (BUN), urinary cystatin C, and decreased serum albumin as well as elevated tubular injury and interstitial fibrosis scores. Additionally, TAC significantly increased the expression of collagen type-1, alpha-smooth muscle actin (α-SMA), plasminogen activator inhibitor-1 (PAI-1), and transforming growth factor-beta1 (TGF-β1) renal content. Moreover, TAC decreased the expression of nuclear factor erythroid-2-related factor2 (Nrf2), heme oxygenase 1 (HO-1), and mitochondrial superoxide dismutase (SOD2). In addition, TAC increased protein expression of hypoxia-inducible factor1-alpha (HIF-1α), connective tissue growth factor (CTGF), inducible nitric oxide synthase (iNOS), 8-hydroxy-2-deoxyguanosine (8-OHdG), as well as nitric oxide (NO), 4-hydroxynonenal, caspase-3 and Bax renal contents. Furthermore, TAC decreased Bcl-2 renal contents. The Lina administration markedly attenuated these alterations.

Conclusion: Lina ameliorated TAC-induced kidney injury through modulation of oxidative stress, hypoxia, and apoptosis related proteins.

Keywords: Apoptosis; DPP4 inhibitors; Hypoxia; Oxidative stress; Renal fibrosis.

MeSH terms

  • Acute Kidney Injury / chemically induced
  • Acute Kidney Injury / drug therapy
  • Acute Kidney Injury / metabolism
  • Animals
  • Connective Tissue Growth Factor* / metabolism
  • Heme Oxygenase (Decyclizing) / metabolism
  • Hypoxia-Inducible Factor 1, alpha Subunit* / metabolism
  • Immunosuppressive Agents / pharmacology
  • Kidney* / drug effects
  • Kidney* / metabolism
  • Kidney* / pathology
  • Linagliptin* / pharmacology
  • Male
  • NF-E2-Related Factor 2* / metabolism
  • Oxidative Stress* / drug effects
  • Plasminogen Activator Inhibitor 1 / metabolism
  • Rats
  • Rats, Sprague-Dawley*
  • Signal Transduction / drug effects
  • Tacrolimus* / pharmacology

Substances

  • Tacrolimus
  • Hypoxia-Inducible Factor 1, alpha Subunit
  • NF-E2-Related Factor 2
  • Connective Tissue Growth Factor
  • Linagliptin
  • Nfe2l2 protein, rat
  • Hif1a protein, rat
  • Plasminogen Activator Inhibitor 1
  • CCN2 protein, rat
  • Heme Oxygenase (Decyclizing)
  • Hmox1 protein, rat
  • Immunosuppressive Agents