Enhanced Expression and Function of Renal SGLT2 (Sodium-Glucose Cotransporter 2) in Heart Failure: Role of Renal Nerves.

Abstract

BACKGROUND:

Recent clinical studies demonstrate that SGLT2 (sodium-glucose cotransporter 2) inhibitors ameliorate heart failure (HF). The present study was conducted to assess the expression and function of renal SGLT2 and the influence of enhanced renal sympathetic tone in HF.

METHODS:

Four weeks after coronary artery ligation surgery to induce HF, surgical bilateral renal denervation (RDN) was performed in rats. Four groups of rats (Sham-operated control [Sham], Sham+RDN, HF and HF+RDN; n=6/group) were used. Immunohistochemistry and Western blot analysis were performed to evaluate the renal SGLT2 expression. One week after RDN (5 weeks after induction of HF), intravenous injection of SGLT2 inhibitor dapagliflozin were performed to assess renal excretory responses. In vitro, human embryonic kidney cells were used to investigate the fractionation of SGLT2 after norepinephrine treatment.

RESULTS:

In rats with HF, (1) SGLT2 expression in the proximal tubule of the kidney was increased; (2) the response of increases in urine flow, sodium excretion, and glucose excretion to dapagliflozin were greater; and (3) RDN attenuated renal SGLT2 expression and normalized renal functional responses to dapagliflozin. In vitro, norepinephrine promoted translocation of SGLT2 to the cell membrane.

CONCLUSIONS:

These results indicate that the enhanced tonic renal sympathetic nerve activation in HF increases the expression and functional activity of renal SGLT2. Potentiated trafficking of SGLT2 to cell surface in renal proximal tubules mediated by norepinephrine may contribute to this functional activation of SGLT2 in HF. These findings provide critical insight into the underlying mechanisms for the beneficial effects of SGLT2 inhibitors on HF reported in the clinical studies.

• Authors: Kenichi Katsurada, Shyam S Nandi, Neeru M Sharma, Kaushik P Patel
• Journal: Circulation. Heart failure (Circ Heart Fail) Vol. 14 Issue 12 Pg. e008365 (12 2021) ISSN: 1941-3297 [Electronic] United States
• PMID: 34789005 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)

Chemical References

• Slc5a2 protein, rat
• Sodium-Glucose Transporter 2
• Sodium-Glucose Transporter 2 Inhibitors
• Sodium
• Glucose

Topics

• Animals
• Glucose (metabolism)
• Heart Failure (metabolism, physiopathology)
• Kidney (drug effects, innervation, metabolism)
• Male
• Rats, Sprague-Dawley
• Sodium (metabolism)
• Sodium-Glucose Transporter 2 (metabolism)
• Sodium-Glucose Transporter 2 Inhibitors (therapeutic use)
• Sympathetic Nervous System (drug effects, physiopathology)
• Rats