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Updated: Feb 13, 2026

Mechanism of Kemeng Fang's Inhibition of Podocyte Apoptosis in Rats with Membranous Nephropathy through the PI3K/AKT Signaling Pathway
Published on: August 23, 2024
Enhanced insulin receptor, but not PI3K, signalling protects podocytes from ER stress
Kathryn L Garner1, Virginie M S Betin1, Vanda Pinto1
1Bristol Renal, Bristol Medical School, University of Bristol, Dorothy Hodgkin Building, Whitson Street, Bristol, BS1 3NY, UK.
Abstract:
Disruption of the insulin-PI3K-Akt signalling pathway in kidney podocytes causes endoplasmic reticulum (ER) stress, leading to podocyte apoptosis and proteinuria in diabetic nephropathy. We hypothesised that by improving insulin sensitivity we could protect podocytes from ER stress. Here we use established activating transcription factor 6 (ATF6)- and ER stress element (ERSE)-luciferase assays alongside a novel high throughput imaging-based C/EBP homologous protein (CHOP) assay to examine three models of improved insulin sensitivity. We find that by improving insulin sensitivity at the level of the insulin receptor (IR), either by IR over-expression or by knocking down the negative regulator of IR activity, protein tyrosine-phosphatase 1B (PTP1B), podocytes are protected from ER stress caused by fatty acids or diabetic media containing high glucose, high insulin and inflammatory cytokines TNFα and IL-6. However, contrary to this, knockdown of the negative regulator of PI3K-Akt signalling, phosphatase and tensin homolog deleted from chromosome 10 (PTEN), sensitizes podocytes to ER stress and apoptosis, despite increasing Akt phosphorylation. This indicates that protection from ER stress is conferred through not just the PI3K-Akt pathway, and indeed we find that inhibiting the MEK/ERK signalling pathway rescues PTEN knockdown podocytes from ER stress.
Insights
Improving insulin sensitivity protects kidney podocytes from endoplasmic reticulum (ER) stress and apoptosis in diabetic nephropathy. Targeting the insulin receptor (IR) or inhibiting protein tyrosine-phosphatase 1B (PTP1B) offers protection, while PTEN knockdown sensitizes podocytes.
Area of Science:
- Nephrology
- Molecular Biology
- Diabetology
Background:
- Diabetic nephropathy involves endoplasmic reticulum (ER) stress in kidney podocytes, leading to apoptosis and proteinuria.
- The insulin-PI3K-Akt signaling pathway is crucial in podocyte function and survival.
Purpose of the Study:
- To investigate whether enhancing insulin sensitivity can protect kidney podocytes from ER stress.
- To explore the roles of specific signaling molecules in ER stress response within podocytes.
Main Methods:
- Utilized activating transcription factor 6 (ATF6)- and ER stress element (ERSE)-luciferase assays.
- Employed a novel high-throughput imaging-based C/EBP homologous protein (CHOP) assay.
- Examined three models of enhanced insulin sensitivity in podocytes.
Main Results:
- Over-expressing the insulin receptor (IR) or knocking down protein tyrosine-phosphatase 1B (PTP1B) protected podocytes from ER stress induced by fatty acids or diabetic media.
- Knocking down phosphatase and tensin homolog deleted from chromosome 10 (PTEN) sensitized podocytes to ER stress and apoptosis, despite increased Akt phosphorylation.
- Inhibiting the MEK/ERK signaling pathway rescued PTEN knockdown podocytes from ER stress, suggesting non-PI3K-Akt pathway involvement.
Conclusions:
- Improving insulin sensitivity, particularly at the insulin receptor level, can protect podocytes from ER stress.
- Podocyte protection from ER stress involves complex signaling pathways beyond just PI3K-Akt.
- Targeting specific regulators of insulin signaling may offer therapeutic strategies for diabetic nephropathy.
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