Korean J Intern Med.  2011 Mar;26(1):19-24. 10.3904/kjim.2011.26.1.19.

PPARgamma Agonist Beyond Glucose Lowering Effect

Affiliations
  • 1Department of Advanced Biological Sciences for Regeneration, Tohoku University Graduate School of Medicine, Sendai, Japan. akiras2i@med.tohoku.ac.jp
  • 2Department of Medical Biochemistry, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • 3Division of Nephrology, Endocrinology and Vascular Medicine, Tohoku University Graduate School of Medicine, Sendai, Japan.
  • 4Division of Nephrology, Department of Internal Medicine, Seoul St. Mary's Hospital, The Catholic University of Korea School of Medicine, Seoul, Korea.

Abstract

The nuclear hormone receptor PPARgamma is activated by several agonists, including members of the thiazolidinedione group of insulin sensitizers. Pleiotropic beneficial effects of these agonists, independent of their blood glucose-lowering effects, have recently been demonstrated in the vasculature. PPARgamma agonists have been shown to lower blood pressure in animals and humans, perhaps by suppressing the renin-angiotensin (Ang)-aldosterone system (RAAS), including the inhibition of Ang II type 1 receptor expression, Ang-II-mediated signaling pathways, and Ang-II-induced adrenal aldosterone synthesis/secretion. PPARgamma agonists also inhibit the progression of atherosclerosis in animals and humans, possibly through a pathway involving the suppression of RAAS and the thromboxane A2 system, as well as the protection of endothelial function. Moreover, PPARgamma-agonist-mediated renal protection, especially the reduction of albuminuria, has been observed in diabetic nephropathy, including animal models of the disease, and in non-diabetic renal dysfunction. The renal protective activities may reflect, at least in part, the ability of PPARgamma agonists to lower blood pressure, protect endothelial function, and cause vasodilation of the glomerular efferent arterioles. Additionally, anti-neoplastic effects of PPARgamma agonists have recently been described. Based on the multiple therapeutic actions of PPARgamma agonists, they will no doubt lead to novel approaches in the treatment of lifestyle-related and other diseases.

Keyword

Thiazolidinediones; Angiotensin II; Thromboxane; Endothelium; Kidney

MeSH Terms

Animals
Atherosclerosis/prevention & control
Humans
Hypertension/drug therapy
Hypoglycemic Agents/*pharmacology
Kidney Diseases/etiology
PPAR gamma/*agonists
PPAR-beta/agonists
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