Empagliflozin alleviates type 2 diabetic renal fibrosis by inhibiting SLC7A7-mediated ferroptosis

Abstract Background Diabetic Kidney Disease (DKD) represents the most prevalent secondary kidney condition that progresses to end-stage renal disease globally. Empagliflozin (EMPA) effectively reduce blood glucose levels to mitigate the impact of DKD. Methods Researchers extracted kidney tissues fro...

Full description

Saved in:
Bibliographic Details
Main Authors: Wendi Zhao, Guoxi Jin, Weihua Sun, Chenchen Wu, Qingqing Yang, Li Xue, Shandong Ye
Format: Article
Language:English
Published: BMC 2025-08-01
Series:Diabetology & Metabolic Syndrome
Subjects:
Online Access:https://doi.org/10.1186/s13098-025-01902-6
Tags: Add Tag
No Tags, Be the first to tag this record!
_version_ 1849343403936972800
author Wendi Zhao
Guoxi Jin
Weihua Sun
Chenchen Wu
Qingqing Yang
Li Xue
Shandong Ye
author_facet Wendi Zhao
Guoxi Jin
Weihua Sun
Chenchen Wu
Qingqing Yang
Li Xue
Shandong Ye
author_sort Wendi Zhao
collection DOAJ
description Abstract Background Diabetic Kidney Disease (DKD) represents the most prevalent secondary kidney condition that progresses to end-stage renal disease globally. Empagliflozin (EMPA) effectively reduce blood glucose levels to mitigate the impact of DKD. Methods Researchers extracted kidney tissues from type 2 diabetic (T2DM) rats and performed transcriptome analysis to identify differential gene expression. Results The findings indicated a link to ferroptosis, closely associated with renal fibrosis. Subsequent cellular validation of T2DM and human renal proximal tubular (HK-2) cells under high-glucose conditions revealed that Collagen type I alpha 1 (COL1A1) and alpha -smooth muscle actin (α-SMA) levels increased in high-glucose group but decreased following EMPA treatment. These observations imply that EMPA mitigates renal fibrosis. Transcriptomic analysis revealed varied SLC7A7 expression in T2DM versus normal groups, and was verified by qPCR and WB. Significant changes in ferroptosis-related proteins, specifically acyl-CoA synthetase long-chain family member 4 (ACSL4) and glutathione peroxidase 4 (GPX4), emerged at the protein level. Further exploration revealed that EMPA suppressed ferroptosis by downregulation of SLC7A7 via the AMP-activated protein kinase/Glycogen synthase kinase 3 Beta/Nuclear factor erythroid 2-related factor 2 (AMPK/GSK-3β/NRF2) signaling pathway, thereby reducing renal fibrosis. Conclusions EMPA treatment could inhibit iron death to alleviate renal fibrosis, and the process was found to be related to the AMPK/GSK-3β/NRF2 pathway in subsequent mechanistic studies. EMPA is a proven treatment for diabetes. Understanding EMPA’s mechanism may uncover new drug targets and innovative therapies.
format Article
id doaj-art-64421e27c1c248aa8d59bfb6546a2ecc
institution Kabale University
issn 1758-5996
language English
publishDate 2025-08-01
publisher BMC
record_format Article
series Diabetology & Metabolic Syndrome
spelling doaj-art-64421e27c1c248aa8d59bfb6546a2ecc2025-08-20T03:43:01ZengBMCDiabetology & Metabolic Syndrome1758-59962025-08-0117111610.1186/s13098-025-01902-6Empagliflozin alleviates type 2 diabetic renal fibrosis by inhibiting SLC7A7-mediated ferroptosisWendi Zhao0Guoxi Jin1Weihua Sun2Chenchen Wu3Qingqing Yang4Li Xue5Shandong Ye6Cheeloo College of Medicine, Shandong UniversityDepartment of Endocrinology, The First Affiliated Hospital of Bengbu Medical CollegeDepartment of Endocrinology, The First Affiliated Hospital of Bengbu Medical CollegeDepartment of Endocrinology, The First Affiliated Hospital of Bengbu Medical CollegeDepartment of Endocrinology, The First Affiliated Hospital of Bengbu Medical CollegeDepartment of Endocrinology, The First Affiliated Hospital of Bengbu Medical CollegeCheeloo College of Medicine, Shandong UniversityAbstract Background Diabetic Kidney Disease (DKD) represents the most prevalent secondary kidney condition that progresses to end-stage renal disease globally. Empagliflozin (EMPA) effectively reduce blood glucose levels to mitigate the impact of DKD. Methods Researchers extracted kidney tissues from type 2 diabetic (T2DM) rats and performed transcriptome analysis to identify differential gene expression. Results The findings indicated a link to ferroptosis, closely associated with renal fibrosis. Subsequent cellular validation of T2DM and human renal proximal tubular (HK-2) cells under high-glucose conditions revealed that Collagen type I alpha 1 (COL1A1) and alpha -smooth muscle actin (α-SMA) levels increased in high-glucose group but decreased following EMPA treatment. These observations imply that EMPA mitigates renal fibrosis. Transcriptomic analysis revealed varied SLC7A7 expression in T2DM versus normal groups, and was verified by qPCR and WB. Significant changes in ferroptosis-related proteins, specifically acyl-CoA synthetase long-chain family member 4 (ACSL4) and glutathione peroxidase 4 (GPX4), emerged at the protein level. Further exploration revealed that EMPA suppressed ferroptosis by downregulation of SLC7A7 via the AMP-activated protein kinase/Glycogen synthase kinase 3 Beta/Nuclear factor erythroid 2-related factor 2 (AMPK/GSK-3β/NRF2) signaling pathway, thereby reducing renal fibrosis. Conclusions EMPA treatment could inhibit iron death to alleviate renal fibrosis, and the process was found to be related to the AMPK/GSK-3β/NRF2 pathway in subsequent mechanistic studies. EMPA is a proven treatment for diabetes. Understanding EMPA’s mechanism may uncover new drug targets and innovative therapies.https://doi.org/10.1186/s13098-025-01902-6Diabetic kidneyEmpagliflozinOxidative stressFerroptosisFibrosis
spellingShingle Wendi Zhao
Guoxi Jin
Weihua Sun
Chenchen Wu
Qingqing Yang
Li Xue
Shandong Ye
Empagliflozin alleviates type 2 diabetic renal fibrosis by inhibiting SLC7A7-mediated ferroptosis
Diabetology & Metabolic Syndrome
Diabetic kidney
Empagliflozin
Oxidative stress
Ferroptosis
Fibrosis
title Empagliflozin alleviates type 2 diabetic renal fibrosis by inhibiting SLC7A7-mediated ferroptosis
title_full Empagliflozin alleviates type 2 diabetic renal fibrosis by inhibiting SLC7A7-mediated ferroptosis
title_fullStr Empagliflozin alleviates type 2 diabetic renal fibrosis by inhibiting SLC7A7-mediated ferroptosis
title_full_unstemmed Empagliflozin alleviates type 2 diabetic renal fibrosis by inhibiting SLC7A7-mediated ferroptosis
title_short Empagliflozin alleviates type 2 diabetic renal fibrosis by inhibiting SLC7A7-mediated ferroptosis
title_sort empagliflozin alleviates type 2 diabetic renal fibrosis by inhibiting slc7a7 mediated ferroptosis
topic Diabetic kidney
Empagliflozin
Oxidative stress
Ferroptosis
Fibrosis
url https://doi.org/10.1186/s13098-025-01902-6
work_keys_str_mv AT wendizhao empagliflozinalleviatestype2diabeticrenalfibrosisbyinhibitingslc7a7mediatedferroptosis
AT guoxijin empagliflozinalleviatestype2diabeticrenalfibrosisbyinhibitingslc7a7mediatedferroptosis
AT weihuasun empagliflozinalleviatestype2diabeticrenalfibrosisbyinhibitingslc7a7mediatedferroptosis
AT chenchenwu empagliflozinalleviatestype2diabeticrenalfibrosisbyinhibitingslc7a7mediatedferroptosis
AT qingqingyang empagliflozinalleviatestype2diabeticrenalfibrosisbyinhibitingslc7a7mediatedferroptosis
AT lixue empagliflozinalleviatestype2diabeticrenalfibrosisbyinhibitingslc7a7mediatedferroptosis
AT shandongye empagliflozinalleviatestype2diabeticrenalfibrosisbyinhibitingslc7a7mediatedferroptosis