diaendoСахарный диабетDiabetes mellitus2072-03512072-0378Endocrinology research centre10.14341/DM8005diaendo-8005Research ArticleДиагностика, контроль, лечениеDiagnosis, control, treatmentЭмпаглифлозин: новая стратегия нефропротекции при сахарном диабетеEmpagliflozin: a new strategy for nephroprotection in diabeteshttps://orcid.org/0000-0003-3502-5892КорбутАнтон ИвановичKorbutAnton Ivanovich

Младший научный сотрудник лабораторим эндокринологии

MD, junior research associate laboratory of Endocrinology

anton.korbut@gmail.comhttps://orcid.org/0000-0002-5407-8722КлимонтовВадим ВалерьевичKlimontovVadim Valer'evich

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

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

klimontov@mail.ru<p>ФГБНУ Научно-исследовательский институт клинической и экспериментальной лимфологии</p>Россия<p>Scientific Institute of Clinical and Experimental Lymphology</p>Russian Federation2017110520172017584Copyright &#x00A9; Корбут А.И., Климонтов В.В., 20172017Корбут 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/8005

Ингибитор глюкозо-натриевого симпортера 2 (SGLT2) эмпаглифлозин – представитель нового класса сахароснижающих препаратов с многочисленными плейотропными эффектами. В обзоре суммированы данные о влиянии эмпаглифлозина на структурные и функциональные изменения в почках в моделях сахарного диабета (СД) и у пациентов с СД. Поиск источников проведен в базах данных Medline/PubMed, Scopus, Web of Science, ClinicalTrials.gov, eLibrary. Результаты экспериментальных исследований свидетельствуют о снижении гликемии и АД, уменьшении клубочковой гиперфильтрации и гиперэкспрессии провоспалительных и фиброгенных факторов в почках под влиянием эмпаглифлозина. В большинстве клинических исследований показан антиальбуминурический эффект эмпаглифлозина у пациентов с СД2. В исследовании EMPA-REG OUTCOME выявлено замедление прогрессирования хронической болезни почек, снижение частоты новых случаев терминальной почечной недостаточности и смерти от почечных причин у больных СД2 на лечении эмпаглифлозином в сравнении с плацебо. Механизм нефропротективного действия эмпаглифлозина включает системные и почечные эффекты. Снижение гипергликемии, артериального давления, массы тела, устранение клубочковой гиперфильтрации, увеличение экскреции натрия, подавление воспалительных и фиброгенных сигнальных путей в почках могут способствовать замедлению развития диабетического поражения почек под влиянием эмпаглифлозина. Возможность экстраполяции доказанных для эмпаглифлозина свойств на другие ингибиторы SGLT2 нуждается в дальнейших исследованиях.

Empagliflozin, an inhibitor of sodium–glucose symporter type 2 (SGLT2), is a new class of antidiabetic agents with numerous pleiotropic effects. The review summarises data on the influence of empagliflozin on the structural and functional changes in the kidneys of the models of diabetes mellitus (DM) and of patients with DM. A literature search was conducted using the databases of Medline/PubMed, Scopus, Web of Science, ClinicalTrials.gov and eLibrary. The experimental results showed a decrease in the blood glucose level, blood pressure, glomerular hyperfiltration and overexpression of proinflammatory and fibrogenic factors in the kidneys under the influence of empagliflozin. Most clinical studies have demonstrated the albuminuria-lowering effect of empagliflozin in patients with type 2 DM. The EMPA-REG OUTCOME study has demonstrated slowing of the chronic kidney disease progression, decrease in the incidence of end-stage renal failure and death from renal causes in patients with type 2 DM undergoing the empagliflozin treatment compared with those receiving placebo. The mechanisms of the nephroprotective effect of empagliflozin included systemic and renal effects. The decrease in hyperglycaemia, blood pressure and body weight; reduction in glomerular hyperfiltration; enhancement of sodium excretion and suppression of inflammatory and fibrogenic signalling pathways in the kidneys may help slow the development of diabetic kidney damage under the influence of empagliflozin. The possibility of extrapolating the confirmed properties of empagliflozin to other SGLT2 inhibitors needs further investigation.

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