A direct thrombin inhibitor, dabigatran etexilate protects from renal fibrosis by inhibiting protease activated receptor-1

MA Saifi, S Annaldas, C Godugu - European Journal of Pharmacology, 2021 - Elsevier
MA Saifi, S Annaldas, C Godugu
European Journal of Pharmacology, 2021Elsevier
Chronic kidney disease (CKD) involves interstitial fibrosis as an influential underlying
pathological process associated with compromised renal function regardless of etiological
cause of the injury. The tubulointerstitial fibrosis is found to be well correlated with declining
renal function and its subsequent culmination into renal failure. Given the prominent role of
thrombin in multiple diseases, it was tempting for us to investigate the outcome of a direct
thrombin inhibitor in renal injury. We investigated the involvement of thrombin in renal injury …
Abstract
Chronic kidney disease (CKD) involves interstitial fibrosis as an influential underlying pathological process associated with compromised renal function regardless of etiological cause of the injury. The tubulointerstitial fibrosis is found to be well correlated with declining renal function and its subsequent culmination into renal failure. Given the prominent role of thrombin in multiple diseases, it was tempting for us to investigate the outcome of a direct thrombin inhibitor in renal injury. We investigated the involvement of thrombin in renal injury and fibrosis by using an FDA approved orally active, direct thrombin inhibitor, dabigatran etexilate (DB). We used a robust experimental model of unilateral ureteral obstruction (UUO)-induced renal injury which shows progressive tubulointerstitial fibrosis (TIF) along with tubular injury and inflammation. The obstructed kidney showed severe TIF as compared to control kidneys. The administration of DB significantly inhibited UUO-induced collagen-1 and TIF by inhibition of thrombin activated protease activated receptor (PAR)-1 expression in fibrotic kidney. In addition, DB administration improved histoarchitecture of obstructed kidney, inhibited TGF-β and SNAI2-induced epithelial-mesenchymal transition (EMT) program. Our study highlights the importance of thrombin signalling in TIF and provides strong evidences to support the notion that a direct thrombin inhibitor ameliorates TIF by PAR-1 mediated mechanism.
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