Diabetic nephropathy remains an area of high unmet medical need, with current therapies slowing, but not preventing the progression of disease. A reduced phosphorylation state of adenosine monophosphate-activated protein kinase (AMPK) has been correlated with diminished kidney function in both human subjects and animal models of kidney disease. Here, we describe the identification of novel, potent, small molecule activators of AMPK that selectively activate AMPK heterotrimers containing the β1 subunit. After confirming that human and rodent kidney predominately express AMPK β1, we explore the effects of pharmacologic activation of AMPK in the ZSF-1 rat model of diabetic nephropathy. Chronic administration of these direct activators elevate the phosphorylation of AMPK in the kidney, without impacting blood glucose levels, and reduce the progression of proteinuria to a greater degree than the ACE-inhibitor ramipril. Further analysis of urine biomarkers and kidney tissue gene expression reveal AMPK activation leads to the modulation of multiple pathways implicated in kidney injury, including cellular hypertrophy, fibrosis, and oxidative stress. These results support the need for further investigation into the potential beneficial effects of AMPK activation in kidney disease.
- The American Society for Pharmacology and Experimental Therapeutics