Anti-inflammatory potential of Empagliflozin
Markus Pirklbauer
Abstract
A recent article by Maayah and coworkers elegantly described a survival benefit with the use of the SGLT2 inhibitor Empagliflozin (Empa) in a murine model of LPSinduced septic shock The authors present evidence that the protective effect of Empa is at least partially mediated by a suppression of LPS-induced renal and systemic inflammation and a reduction of LPS-induced acute kidney injury (AKI) SGLT2 inhibitors (SGLT2i) were developed as anti-glycemic drugs, attenuating renal glucose reabsorption by inhibiting the proximal tubular sodium/glucose co-transporter 2, thereby increasing urinary glucose excretion and lowering hyperglycemia (Vallon and Thomson 2020). HbA1c levels decrease by 0.5-0.7% on average with the use of SGLT2i. Large clinical trials, however, demonstrated SGLT2i-mediated renoprotection in type II diabetic patients with and without chronic kidney disease (CKD) irrespective of glycemic effects Moreover, the DAPA-CKD trial recently demonstrated SGLT2i-mediated nephroprotection in diabetic and non-diabetic CKD patients Renal benefit has been primarily attributed to metabolic and hemodynamic drug effects, including lowering of systemic blood pressure, glomerular hyperfiltration, body weight, and plasma volume as well as reducing renal hypoxia. Direct anti-fibrotic mechanisms have also been demonstrated