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2013 ; 24
(7
): 1139-50
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Maintenance of endothelial guanosine triphosphate cyclohydrolase I ameliorates
diabetic nephropathy
#MMPMID23620395
Kidokoro K
; Satoh M
; Channon KM
; Yada T
; Sasaki T
; Kashihara N
J Am Soc Nephrol
2013[Jun]; 24
(7
): 1139-50
PMID23620395
show ga
In diabetes, endothelial nitric oxide synthase (eNOS) produces superoxide anion
rather than nitric oxide, referred to as "eNOS uncoupling," which may contribute
to endothelial dysfunction, albuminuria, and diabetic nephropathy. Reduced levels
of endothelium-derived tetrahydrobiopterin (BH4), an essential cofactor for eNOS,
promote eNOS uncoupling. Accelerated degradation of guanosine triphosphate
cyclohydrolase I (GTPCH I), the rate-limiting enzyme in BH4 biosynthesis, also
occurs in diabetes, suggesting that GTPCH I may have a role in diabetic
microvascular disease. Here, we crossed endothelium-dominant GTPCH I transgenic
mice with Ins2(+/Akita) diabetic mice and found that endothelial overexpression
of GTPCH I led to higher levels of intrarenal BH4 and lower levels of urinary
albumin and reactive oxygen species compared with diabetic control mice.
Furthermore, GTPCH I overexpression attenuated the hyperpermeability of
macromolecules observed in diabetic control mice. In addition, we treated
Ins2(+/Akita) mice with metformin, which activates AMP-activated protein kinase
(AMPK) and thereby slows the degradation of GTPCH I; despite blood glucose levels
that were similar to untreated mice, those treated with metformin had
significantly less albuminuria. Similarly, in vitro, treating human glomerular
endothelial cells with AMPK activators attenuated glucose-induced reductions in
phospho-AMPK, GTPCH I, and coupled eNOS. Taken together, these data suggest that
maintenance of endothelial GTPCH I expression and the resulting improvement in
BH4 biosynthesis ameliorate diabetic nephropathy.