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| Author(s): |
Gabriela Cozin Aragão
Total Authors: 1
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| Document type: | Doctoral Thesis |
| Press: | São Paulo. |
| Institution: | Universidade de São Paulo (USP). Faculdade de Medicina (FM/SBD) |
| Defense date: | 2016-12-02 |
| Examining board members: |
Adriana Castello Costa Girardi;
Gustavo Rodrigues Pedrino;
Luciana Venturini Rossoni
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| Advisor: | Adriana Castello Costa Girardi |
| Abstract | |
Glucagon-like peptide-1 (GLP-1) is an incretin intestinal hormone that primarily exerts anti-hyperglycemic actions. In order to possibilitate the clinical use of this peptide for the treatment of type 2 diabetes mellitus, the incretin based therapies were created, which include the gliptins, drugs that increase the half-life of endogenous GLP-1 through the inhibition of the enzyme dipeptidil peptidase-4, and exogenous agonists of the receptor of GLP-1 (GLP-1R). It is well established that these classes of drugs exert cardiorenal beneficial effects that go beyond glycemic control. Among these cardiorenal effects are diuresis, natriuresis and reduction of blood pressure. We have recently demonstrated that acute blocking of thebaselineGLP-1Rsignaling, via systemic administration of theGLP-1Rantagonist, Exendin-9, causes anti-diuretic and anti-natriuretic effects in normotensive rats. These renal effects are associated with reduction of the glomerular filtration rate (GFR) and stimulation of proximal tubule Na+/H+ exchanger activity isoform 3 (NHE3). However, the effects of the chronic administration of the GLP-1R blocker on renal function and blood pressure levels remain obscure. Thus, this study aimed to test the hypothesis that GLP-1Rblockade elevates blood pressure in spontaneously hypertensive rats (SHR) and that these effects are associated with upregulation of NHE3 activity. Additionally, we tested the hypothesis that GLP-1R blockade worsens kidney damage in hypertensive rats while pharmacological agonism of GLP-1R exerts renoprotection. To this end, 5-week-oldSHR were treated during 4 weeks with Exendin-9 (EX-9; 25 ug/mouse/day), the agonist of GLP-1R receptor, Exendin-4 (EX-4, 2.5 ?g/rat/day) or saline (control), via osmotic minipumps. Blood pressure was weekly measured by plethysmography and urine and blood samples were collected for renal function evaluation. Direct measurement of blood pressure, collection of biological samples for histological, biochemical and molecular analysis were performed at the end of the treatment. At the end of the treatment, 4-5 rats/group were used for determination of NHE3 proximal tubule activity by in vivo determined by stationary microperfusion. SHRs treated with EX-9 displayed higher blood pressure values than SHRs treated with vehicle (182 ± 4 vs. 172 ± 1 mmHg, p < 0.05), while Exendin-4 treatment attenuated blood pressure compared to controls (161 ± 4 vs. 172 ± 1 mmHg, p < 0.01). Blood pressure increase in SHRs treated with EX-9 was associated with higher NHE3 activity (1.78 ± 0.08 nmol/cm2/s) in proximal renal tubule compared to controls (1.48 ± 0.10 nmol/cm2/s; p < 0.05), whileEX-4-treatedSHR treated displayed lower NHE3 activity (1.19 ± 0.07 nmol/cm2/s, p < 0.01). Additionally, SHRs treated with the GLP-1R antagonist show higher levels of urinary protein excretion, fibrosis, inflammation, oxidative stress markers and intrarenal renin angiotensin system (RAS) activity compared to control. On the other hand, systemic administration of EX-4 exertedanti-proteinuric, anti-inflammatory and antioxidant effects. The renoprotection conferred by EX-4 treatment was accompanied by lower renal cortex angiotensin II levels suggesting that GLP-1R activation reduces intra renal RAS activity. Collectively, these results demonstrate that chronic GLP-1R blockade in hypertensive rats intensifies blood pressure increase and exacerbates renal damage. On the other hand, the GLP-1R agonism exerts anti-hypertensive and renoprotetor effects (AU) | |
| FAPESP's process: | 12/09036-5 - Molecular mechanisms of the anti-hypertensive action of incretin mimetics and dipeptidyl peptidase IV inhibitors |
| Grantee: | Gabriela Cozin Aragão |
| Support Opportunities: | Scholarships in Brazil - Doctorate (Direct) |