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Tong J, Yang L, Liu Y, Yu Y, Zhang L, Zhang Z, Yang Z, Qin Q, Niu J, Gu Y. Empagliflozin attenuates renal tubular ferroptosis in preeclampsia via tazarotene-induced gene 1. Eur J Pharmacol 2025; 986:177140. [PMID: 39551334 DOI: 10.1016/j.ejphar.2024.177140] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/13/2023] [Revised: 11/07/2024] [Accepted: 11/14/2024] [Indexed: 11/19/2024]
Abstract
Preeclampsia (PE) is a serious pregnancy complication characterized by elevated blood pressure and a major cause of maternal and perinatal morbidities, also known to increase the risk of chronic kidney disease. Mechanisms underlying PE-induced kidney injury remain unclear. Anti-angiotensin II type 1 receptor agonistic autoantibody (AT1-AA) is reported to participate in the pathogenesis of PE-induced kidney injury. Our previous study replicated the major features of PE in pregnant mice by administration of intravenous injection of AT1-AA and found that podocyte senescence plays a role in PE-induced kidney injury. Elevated levels of N-acetyl-β-D glucosaminidase (NAG) and kidney injury molecule-1 (KIM-1) in the urine of patients with PE have been reported, indicating renal tubular injury. In this study, we identified the role of renal proximal tubular epithelial cells (PTECs) in PE-induced kidney injury and the therapeutic value of empagliflozin, an anti-diabetic agent, in a murine model of AT1-AA-induced PE. In our study, higher tubular injury score (Control vs. PE: P < 0.0001) show that PTECs are damaged in AT1-AA-induced PE. We identified ferroptosis as one of the cause of AT1-AA-induced PTEC injury by RNAseq, and confirmed the involvement of ferroptosis by detecting ferrous iron (Control vs. PE: P < 0.0001), reduced glutathione (GSH) (Control vs. PE: P < 0.0001) and lipid peroxidation (Control vs. PE: P < 0.0001). Empagliflozin ameliorates AT1-AA-induced PTEC ferroptosis and injury in PE. Furthermore, we demonstrated that tazarotene-induced gene 1 is involved in AT1-AA-induced PTEC injury. These findings suggest that renal tubules are injured in PE and empagliflozin has therapeutic potential for PE-induced PTEC injury.
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Affiliation(s)
- Jiahao Tong
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Lin Yang
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Yuan Liu
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Ying Yu
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Lihong Zhang
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Zengzhen Zhang
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Zhenhao Yang
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Qiaojing Qin
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China
| | - Jianying Niu
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China.
| | - Yong Gu
- Department of Nephrology, Shanghai Fifth People's Hospital, Fudan University, Shanghai, China; Department of Nephrology, Huashan Hospital, Fudan University, Shanghai, China.
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Matsuyama S, Whiteside S, Li SY. Implantation and Decidualization in PCOS: Unraveling the Complexities of Pregnancy. Int J Mol Sci 2024; 25:1203. [PMID: 38256276 PMCID: PMC10816633 DOI: 10.3390/ijms25021203] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2023] [Revised: 01/15/2024] [Accepted: 01/16/2024] [Indexed: 01/24/2024] Open
Abstract
Polycystic Ovary Syndrome (PCOS) is a prevalent endocrine disorder in women of reproductive age, affecting 5-15% globally with a large proportion undiagnosed. This review explores the multifaceted nature of PCOS and its impact on pregnancy, including challenges in fertility due to hormonal imbalances and insulin resistance. Despite restoring ovulation pharmacologically, women with PCOS face lower pregnancy rates and higher risks of implantation failure and miscarriage. Our review focuses on the complexities of hormonal and metabolic imbalances that impair endometrial receptivity and decidualization in PCOS. Disrupted estrogen signaling, reduced integrity of endometrial epithelial tight junctions, and insulin resistance impair the window of endometrial receptivity. Furthermore, progesterone resistance adversely affects decidualization. Our review also examines the roles of various immune cells and inflammatory processes in the endometrium, contributing to the condition's reproductive challenges. Lastly, we discuss the use of rodent models in understanding PCOS, particularly those induced by hormonal interventions, offering insights into the syndrome's impact on pregnancy and potential treatments. This comprehensive review underscores the need for advanced understanding and treatment strategies to address the reproductive complications associated with PCOS, emphasizing its intricate interplay of hormonal, metabolic, and immune factors.
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Affiliation(s)
| | | | - Shu-Yun Li
- Reproductive Sciences Center, Division of Developmental Biology, Cincinnati Children’s Hospital Medical Center, Cincinnati, OH 45229, USA; (S.M.); (S.W.)
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