References

diaendo

Сахарный диабет

Diabetes mellitus

2072-03512072-0378

Endocrinology research centre

10.14341/DM7727

diaendo-7727

Research Article

Нефропатия

Nephropathy

Терапия, основанная на инкретинах: почечные эффекты

Incretin-based therapy: renal effects

Корбут

Антон Иванович

Korbut

Anton Ivanovich

Младший научный сотрудник лаборатории эндокринологии

MD, Junior Researcher, Laboratory of Endocrinology

anton.korbut@gmail.com

Климонтов

Вадим Валерьевич

Klimontov

Vadim Valerievich

Доктор медицинских наук, заведующий лабораторией эндокринологии, зам. директора по научной работе

MD, PhD, Deputy Director for Science, Head of the Laboratory of Endocrinology

klimontov@mail.ru

ФГБНУ Научно-исследовательский институт клинической и экспериментальной лимфологииРоссияScientific Institute of Clinical and Experimental LymphologyRussian Federation

2016

13012016

1915363

2016

Корбут А.И., Климонтов В.В.

Korbut A.I., Klimontov V.V.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://www.dia-endojournals.ru/jour/article/view/7727

Аналоги глюкагоноподобного пептида-1 (ГПП-1) и ингибиторы дипептидилпептидазы 4 типа (ДПП-4) – новые классы сахароснижающих препаратов с многочисленными плейотропными эффектами. В обзоре суммированы данные о влиянии аналогов ГПП-1 и ингибиторов ДПП-4 на структурные и функциональные изменения в почках при сахарном диабете (СД). Растущий объем данных указывает на то, что почка является одним из локусов реализации эффекта и деградации ГПП-1. Выраженность эффектов ГПП-1 в почках при СД может быть снижена вследствие уменьшения экспрессии рецепторов ГПП-1 и/или усиления деградации гормона. В экспериментальных моделях диабетической нефропатии, а также поражений почек недиабетического генеза, аналоги ГПП-1 и ингибиторы ДПП-4 замедляют развитие фиброза почек и препятствуют снижению функции почек. Механизмы протективного действия включают уменьшение гипергликемии, увеличение экскреции натрия, подавление воспалительных и фиброгенных сигнальных путей, окислительного стресса и апоптоза в почках. В клинических исследованиях продемонстрировано снижение экскреции альбумина с мочой на фоне лечения аналогами ГПП-1 и ингибиторами ДПП-4 у больных СД 2 типа. Долгосрочное влияние данных препаратов на функцию почек при СД заслуживает дальнейших исследований.

Glucagon like peptide-1 (GLP-1) analogues and dipeptidyl peptidase-4 (DPP-4) inhibitors are new classes of hypoglycemic agents with numerous pleiotropic effects. The review summarises data about the influence of GLP-1 analogues and DPP-4 inhibitors on structural and functional changes in diabetic kidneys. Growing evidence indicates that the kidney is one of the loci of the effects and degradation of GLP-1. The potency of the effects of GLP-1 in diabetic kidneys can be reduced by decrease in GLP-1 receptor expression or enhancement of GLP-1 degradation. In experimental models of diabetic nephropathy and non-diabetic renal injury, GLP-1 analogues and DPP-4 inhibitors slow the development of kidney fibrosis and prevent the decline of kidney function. The mechanisms of protective effect include hyperglycaemia reduction, enhancement of sodium excretion, suppression of inflammatory and fibrogenic signalling pathways, reduction of oxidative stress and apoptosis in the kidneys. In clinical studies, the urinary albumin excretion reduction rate while using the GLP-1 analogue and DPP-4 inhibitor treatment was demonstrated in patients with type 2 diabetes. Long-term impact of these agents on renal function in diabetes needs further investigations.

сахарный диабетдиабетическая нефропатияглюкагоноподобный пептид-1дипептидилпептидаза 4 типатерапияоснованная на инкретинах

diabetesdiabetic nephropathyglucagon-like peptide-1dipeptidyl peptidase-4incretin-based therapy

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The authors declare that there are no conflicts of interest present.