Metformin prevents stroke damage in non-diabetic female mice with chronic kidney disease

Sci Rep. 2021 Apr 2;11(1):7464. doi: 10.1038/s41598-021-86905-9.

Abstract

Chronic kidney disease (CKD) worsens ischemic stroke severity in both patients and animals. In mice, these poorer functional outcomes are associated with decreased brain activity of AMP-activated protein kinase (AMPK), a molecule that recently emerged as a potential therapeutic target for ischemic stroke. The antidiabetic drug metformin, a well-known activator of AMPK, has improved stroke outcomes in diabetic patients with normal renal function. We investigated whether chronic metformin pre-conditioning can rescue AMPK activity and prevent stroke damage in non-diabetic mice with CKD. Eight-week-old female C57BL/6J mice were assigned to CKD or SHAM groups. CKD was induced through right kidney cortical electrocautery, followed by left total nephrectomy. Mice were then allocated to receive metformin (200 mg/kg/day) or vehicle for 5 weeks until stroke induction by transient middle cerebral artery occlusion (tMCAO). The infarct volumes were lower in CKD mice exposed to metformin than in vehicle-treated CKD mice 24 h after tMCAO. Metformin pre-conditioning of CKD mice improved their neurological score, grip strength, and prehensile abilities. It also enhanced AMPK activation, reduced apoptosis, increased neuron survival and decreased microglia/macrophage M1 signature gene expression as well as CKD-induced activation of the canonical NF-κB pathway in the ischemic lesions of CKD mice.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adenylate Kinase / metabolism
  • Animals
  • Apoptosis / drug effects
  • Body Weight
  • Brain Infarction / blood
  • Brain Infarction / complications
  • Brain Infarction / drug therapy
  • Brain Infarction / genetics
  • Enzyme Activation / drug effects
  • Female
  • Gene Expression Regulation
  • Gliosis / blood
  • Gliosis / complications
  • Gliosis / drug therapy
  • Infarction, Middle Cerebral Artery / blood
  • Infarction, Middle Cerebral Artery / complications
  • Infarction, Middle Cerebral Artery / drug therapy
  • Infarction, Middle Cerebral Artery / genetics
  • Ischemic Preconditioning
  • Macrophages / drug effects
  • Macrophages / pathology
  • Metformin / blood
  • Metformin / pharmacology
  • Metformin / therapeutic use*
  • Mice
  • Mice, Inbred C57BL
  • Microglia / drug effects
  • Microglia / pathology
  • Models, Biological
  • NF-kappa B / metabolism
  • Neurons / drug effects
  • Neurons / pathology
  • Renal Insufficiency, Chronic / blood
  • Renal Insufficiency, Chronic / complications*
  • Renal Insufficiency, Chronic / drug therapy*
  • Renal Insufficiency, Chronic / genetics
  • Stroke / drug therapy*
  • Stroke / genetics
  • Stroke / prevention & control*

Substances

  • NF-kappa B
  • Metformin
  • Adenylate Kinase