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2016 ; 65
(9
): 2784-94
Nephropedia Template TP
gab.com Text
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English Wikipedia
The Na+/Glucose Cotransporter Inhibitor Canagliflozin Activates AMPK by
Inhibiting Mitochondrial Function and Increasing Cellular AMP Levels
#MMPMID27381369
Hawley SA
; Ford RJ
; Smith BK
; Gowans GJ
; Mancini SJ
; Pitt RD
; Day EA
; Salt IP
; Steinberg GR
; Hardie DG
Diabetes
2016[Sep]; 65
(9
): 2784-94
PMID27381369
show ga
Canagliflozin, dapagliflozin, and empagliflozin, all recently approved for
treatment of type 2 diabetes, were derived from the natural product phlorizin.
They reduce hyperglycemia by inhibiting glucose reuptake by sodium/glucose
cotransporter (SGLT) 2 in the kidney, without affecting intestinal glucose uptake
by SGLT1. We now report that canagliflozin also activates AMPK, an effect also
seen with phloretin (the aglycone breakdown product of phlorizin), but not to any
significant extent with dapagliflozin, empagliflozin, or phlorizin. AMPK
activation occurred at canagliflozin concentrations measured in human plasma in
clinical trials and was caused by inhibition of Complex I of the respiratory
chain, leading to increases in cellular AMP or ADP. Although canagliflozin also
inhibited cellular glucose uptake independently of SGLT2, this did not account
for AMPK activation. Canagliflozin also inhibited lipid synthesis, an effect that
was absent in AMPK knockout cells and that required phosphorylation of acetyl-CoA
carboxylase (ACC) 1 and/or ACC2 at the AMPK sites. Oral administration of
canagliflozin activated AMPK in mouse liver, although not in muscle, adipose
tissue, or spleen. Because phosphorylation of ACC by AMPK is known to lower liver
lipid content, these data suggest a potential additional benefit of canagliflozin
therapy compared with other SGLT2 inhibitors.