2017, Number 4
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Med Int Mex 2017; 33 (4)
iSGLT2 and its potential nephroprotector effect in patients with diabetes mellitus 2
Morales-Olvera D, Obregón-Aguilar A, Pérez-Mendoza MT, Zanabria-Giles P, Fanghänel-Salmón G, Sánchez-Reyes L
Language: Spanish
References: 21
Page: 503-510
PDF size: 260.71 Kb.
ABSTRACT
Type 2 diabetes mellitus 2 (DM2) is already a worldwide epidemic, in addition, diabetic nephropathy has become the leading cause of end-stage renal failure. In patients with DM2 there is an increased expression of the sodium-glucose cotransporters 2(SGLT2) that contribute to the maintenance of hyperglycemia. Therefore, the inhibitors of this transporter represent an innovative therapy independent of the action of insulin or the function of pancreatic beta cells. Recent studies have shown that iSGLT2 have beneficial effects on microvasculature, especially in the progression of diabetic nephropathy. This effect is due not only to improved glycemic control but also to direct effects on the kidney. iSGLT2 induce glycosuria to reverse renal glucotoxicity. In experimental studies it has been observed that, in addition, hyperfiltration as well as inflammatory and fibrotic markers are reduced. There has also been a reduction in effective circulating volume and an increase in the activity of circulating renin-angiotensin-aldosterone system blockers (RAA blockers), thus creating a nephroprotective effect.
REFERENCES
Galindo-Campos M, Carrillo-Ocampo L, Cortázar-Benítez F, Aisa-Álvarez A, et al. Inhibidores del transportador de sodio-glucosa tipo 2 (SGLT2) en el tratamiento de pacientes con diabetes mellitus: el control glucémico a través de la glucosuria. Med Int Mex 2013;29(4):400.
Ruiz-Matus C, Jiménez-Corona ME, Salcedo Ubilla M, Calderón-Cruz B y col. Impuesto al refresco y bebidas con azúcares añadidas. Boletín Epidemiológico del Sistema Nacional de Vigilancia Epidemiológica y del Sistema Único de Información, de la Secretaría de Salud 4 de abril 2015;32(13):1-5.
Torres-Viloria A, Torres-Viloria A, Zacarías-Castillo R. Nefropatía diabética. Rev Hosp Gral Dr. M Gea González 2002;5(1-2):24-32.
Food Drug Administration. La FDA advierte que el uso de inhibidores del SGLT2 para la diabetes puede provocar una grave concentración de ácido en la sangre. 2015. Consultado el: 05/09/2016. Disponible en: http://www.fda.gov/ downloads/Drugs/DrugSafety/UCM447222.pdf
Zanoli L, Granata A, Lentini P, Rastelli S, et al. Sodiumglucose linked transporter-2 inhibitors in chronic kidney disease. Sci World J 2015;2015:1-6.
Bravo, MJJ. Aportaciones de los SGLT-2 y nuevos fármacos en investigación. SEMERGEN-Medicina de Familia 2014;40 Suppl 2:34-40.
Kaneto H, Obata A, Shimoda M, Kimura T, et al. Promising diabetes therapy based on the molecular mechanism for glucose toxicity: Usefulness of SGLT2 inhibitors as well as incretin-related drugs. Curr Med Chem 2016;23(27):3044- 3051.
Scheen AJ. Pharmacokinetic and pharmacodynamic profile of empagliflozin, a sodium glucose co-transporter 2 inhibitor. Clin Pharmacokinet 2014;53(3):213-225.
Zinman B, Wanner C, Lachin JM, Fitchett D, et al. Empagliflozin, cardiovascular outcomes, and mortality in type 2 diabetes. N Engl J Med 2015;373:2117-2128.
Lilly. Resultados del estudio EMPA-REG OUTCOME®, presentados en primicia en la 51a Reunión Anual de la Asociación Europea para el Estudio de la Diabetes (EASD). Consultado el: 09-09-2016. Disponible en: http://www.lilly. es/es/noticias/notas-de-prensa-sobre-areas-terapeuticas/ estudio-empareg220915.pdf
Wanner C, Inzucchi SE, Lachin JM, Fitchett D, et al. Empagliflozin and progression of kidney disease in type 2 diabetes. N Engl J Med 2016;375:323-334.
Pérez-López G, González-Albarrán O, Cano-Megías M. Inhibidores del cotransportador sodio-glucosa tipo 2 (SGLT2): de la glucosuria renal familiar al tratamiento de la diabetes mellitus tipo 2. Ne frología (Madrid) 2010;30:618-625.
Olmos P, Araya-Del-Pino A, González C, Lasoa P, et al. Fisiopatología de la retinopatía y nefropatía diabéticas. Rev Méd Chile 2009;137:1375-1384.
Wilding JP. The role of the kidneys in glucose homeostasis in type 2 diabetes: clinical implications and therapeutic significance through sodium glucose co-transporter 2 inhibitors. Metabolism 2014;63(10):1228-1237.
Schernthaner G, Mogensen CE, Schernthaner GH. The effects of GLP-1 analogues, DPP-4 inhibitors and SGLT2 inhibitors on the renal system. Diab Vasc Dis Res 2014;11(5):306-323.
Vallon V, Gerasimova M, Rose MA, Masuda T, et al. SGLT2 inhibitor empagliflozin reduces renal growth and albuminuria in proportion to hyperglycemia and prevents glomerular hyperfiltration in diabetic Akita mice. Am J Physiol Renal Physiol 2014;306(2):F194-F204.
Panchapakesan U, Pegg K, Gross S, Komala MG, et al. Effects of SGLT2 inhibition in human kidney proximal tubular cells-renoprotection in diabetic nephropathy? PLoS One 2013;8(2):e54442.
Škrtic M, Cherney DZ. Sodium-glucose cotransporter-2 inhibition and the potential for renal protection in diabetic nephropathy. Curr Opin Nephrol Hypertens 2015;24:96-103.
Macha S, Mattheus M, Halabi A, Pinnetti S, et al. Pharmacokinetics, pharmacodynamics and safety of empagliflozin, a sodium glucose cotransporter 2 (SGLT2) inhibitor, in subjects with renal impairment. Diabetes Obes Metab 2014;16(3):215-222.
Barnett AH, Mithal A, Manassie J, Jones R, et al. Efficacy and safety of empagliflozin added to existing antidiabetes treatment in patients with type 2 diabetes and chronic kidney disease: a randomised, double-blind, placebo-controlled trial. Lancet Diabetes Endocrinol 2014;2(5):369-384.
Rosas-Guzmán J, Rosas-Saucedo J, Romero-García ARJ. Inhibidores de SGLT2 para el tratamiento de DM. Revista de la ALAD 2016;5(1):19-37.