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Proc Natl Acad Sci U S A. 2014 Dec 16;111(50):E5420-8. doi: 10.1073/pnas.1419901111. Epub 2014 Nov 24.

Overactive cannabinoid 1 receptor in podocytes drives type 2 diabetic nephropathy.

Author information

1
Laboratory of Physiologic Studies, Section on Neuroendocrinology, and jourdant@mail.nih.gov george.kunos@nih.gov.
2
Laboratory of Physiologic Studies, Section on Neuroendocrinology, and.
3
Kidney Diseases Section, National Institute on Diabetes, Digestive, and Kidney Diseases, National Institutes of Health, Bethesda, MD 20892; The Johns Hopkins University School of Medicine, Baltimore, MD 21205; and.
4
Skaggs School of Pharmacy and Pharmaceutical Sciences, Department of Pharmaceutical Sciences, University of Colorado Anschutz Medical Campus, Aurora, CO 80045.
5
Section on Oxidative Stress and Tissue Injury, Laboratory of Physiologic Studies, National Institute on Alcohol Abuse and Alcoholism.

Abstract

Diabetic nephropathy is a major cause of end-stage kidney disease, and overactivity of the endocannabinoid/cannabinoid 1 receptor (CB1R) system contributes to diabetes and its complications. Zucker diabetic fatty (ZDF) rats develop type 2 diabetic nephropathy with albuminuria, reduced glomerular filtration, activation of the renin-angiotensin system (RAS), oxidative/nitrative stress, podocyte loss, and increased CB1R expression in glomeruli. Peripheral CB1R blockade initiated in the prediabetic stage prevented these changes or reversed them when animals with fully developed diabetic nephropathy were treated. Treatment of diabetic ZDF rats with losartan, an angiotensin II receptor-1 (Agtr1) antagonist, attenuated the development of nephropathy and down-regulated renal cortical CB1R expression, without affecting the marked hyperglycemia. In cultured human podocytes, CB1R and desmin gene expression were increased and podocin and nephrin content were decreased by either the CB1R agonist arachydonoyl-2'-chloroethylamide, angiotensin II, or high glucose, and the effects of all three were antagonized by CB1R blockade or siRNA-mediated knockdown of CNR1 (the cannabinoid type 1 receptor gene). We conclude that increased CB1R signaling in podocytes contributes to the development of diabetic nephropathy and represents a common pathway through which both hyperglycemia and increased RAS activity exert their deleterious effects, highlighting the therapeutic potential of peripheral CB1R blockade.

KEYWORDS:

angiotensin II; endocannabinoid; hyperglycemia; nephropathy; podocyte

PMID:
25422468
PMCID:
PMC4273328
DOI:
10.1073/pnas.1419901111
[Indexed for MEDLINE]
Free PMC Article

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