Urinary DPP4 correlates with renal dysfunction, and DPP4 inhibition protects against the reduction in megalin and podocin expression in experimental CKD

Am J Physiol Renal Physiol. 2021 Mar 1;320(3):F285-F296. doi: 10.1152/ajprenal.00288.2020. Epub 2020 Dec 21.

Abstract

This study investigated the molecular mechanisms underlying the antiproteinuric effect of DPP4 inhibition in 5/6 renal ablation rats and tested the hypothesis that the urinary activity of DPP4 correlates with chronic kidney disease (CKD) progression. Experiments were conducted in male Wistar rats who underwent 5/6 nephrectomy (Nx) or sham operation followed by 8 wk of treatment with the DPP4 inhibitor (DPP4i) sitagliptin or vehicle. Proteinuria increased progressively in Nx rats throughout the observation period. This increase was remarkably mitigated by sitagliptin. Higher levels of proteinuria in Nx rats compared to control rats were accompanied by higher urinary excretion of retinol-binding protein 4, a marker of tubular proteinuria, as well as higher urinary levels of podocin, a marker of glomerular proteinuria. Retinol-binding protein 4 and podocin were not detected in the urine of Nx + DPP4i rats. Tubular and glomerular proteinuria was associated with the reduced expression of megalin and podocin in the renal cortex of Nx rats. Sitagliptin treatment partially prevented this decrease. Besides, the angiotensin II renal content was significantly reduced in the Nx rats that received sitagliptin compared to vehicle-treated Nx rats. Interestingly, both urinary DPP4 activity and abundance increased progressively in Nx rats. Additionally, urinary DPP4 activity correlated positively with serum creatinine levels, proteinuria, and blood pressure. Collectively, these results suggest that DPP4 inhibition ameliorated both tubular and glomerular proteinuria and prevented the reduction of megalin and podocin expression in CKD rats. Furthermore, these findings suggest that urinary DPP4 activity may serve as a biomarker of renal disease and progression.

Keywords: angiotensin II; biomarker; dipeptidyl peptidase-4; glomeruli; proteinuria; proximal tubule.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Angiotensin II / metabolism
  • Animals
  • Biomarkers / urine
  • Dipeptidyl Peptidase 4 / urine*
  • Dipeptidyl-Peptidase IV Inhibitors / pharmacology*
  • Disease Models, Animal
  • Fibrosis
  • Intracellular Signaling Peptides and Proteins / metabolism*
  • Kidney / drug effects*
  • Kidney / enzymology
  • Kidney / pathology
  • Low Density Lipoprotein Receptor-Related Protein-2 / metabolism*
  • Male
  • Membrane Proteins / metabolism*
  • Proteinuria / enzymology
  • Proteinuria / pathology
  • Proteinuria / prevention & control*
  • Proteinuria / urine
  • Rats
  • Rats, Wistar
  • Renal Insufficiency, Chronic / enzymology
  • Renal Insufficiency, Chronic / pathology
  • Renal Insufficiency, Chronic / prevention & control*
  • Renal Insufficiency, Chronic / urine
  • Retinol-Binding Proteins, Plasma / urine
  • Signal Transduction
  • Sitagliptin Phosphate / pharmacology*

Substances

  • Biomarkers
  • Dipeptidyl-Peptidase IV Inhibitors
  • Intracellular Signaling Peptides and Proteins
  • Low Density Lipoprotein Receptor-Related Protein-2
  • Lrp2 protein, rat
  • Membrane Proteins
  • NPHS2 protein
  • Rbp4 protein, rat
  • Retinol-Binding Proteins, Plasma
  • Angiotensin II
  • DPP4 protein, rat
  • Dipeptidyl Peptidase 4
  • Sitagliptin Phosphate