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Sildenafil Prevents Podocyte Injury via PPAR-γ-Mediated TRPC6 Inhibition

R. Sonneveld, J. Hoenderop, A. Isidori, Carole Hénique, H. Dijkman, J. Berden, P. Tharaux, J. van der Vlag et al.

Journal of the American Society of Nephrology, 2017

64 citations

Abstract

Transient receptor potential channel C6 (TRPC6) gain-of-function mutations and increased TRPC6 expression in podocytes induce glomerular injury and proteinuria. Sildenafil reduces TRPC6 expression and activity in nonrenal cell types, although the mechanism is unknown. Peroxisome proliferator–activated receptor γ (PPAR- γ ) is a downstream target of sildenafil in the cyclic guanosine monophosphate (cGMP)–activated protein kinase G (PKG) axis. PPAR- γ agonists, like pioglitazone, appear antiproteinuric. We hypothesized that sildenafil inhibits TRPC6 expression in podocytes through PPAR- γ –dependent mechanisms, thereby counteracting podocyte injury and proteinuria. Treatment with sildenafil, the cGMP derivative 8-bromoguanosine 3′,5′-cyclic monophosphate sodium salt (8-Br-cGMP), or pioglitazone dose-dependently downregulated podocyte injury-induced TRPC6 expression in vitro . Knockdown or application of antagonists of PKG or PPAR- γ enhanced TRPC6 expression in podocytes and counteracted effects of sildenafil and 8-Br-cGMP. We observed similar effects on TRPC6 promoter activity and TRPC6–dependent calcium influx. Chromatin immunoprecipitation showed PPAR- γ binding to the TRPC6 promoter. Sildenafil or pioglitazone treatment prevented proteinuria and the increased TRPC6 expression in rats with adriamycin-induced nephropathy and mice with hyperglycemia-induced renal injury. Rats receiving PPAR- γ antagonists displayed proteinuria and increased podocyte TRPC6 expression, as did…

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