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Kidney Week

Abstract: FR-PO0316

Role of Total Flavonoids of Abelmoschus manihot (L) Medic in Improving Renal Fibrosis in Diabetic Kidney Disease via O-GlcNAcylation and Fatty Acid Oxidation Pathway

Session Information

Category: Diabetic Kidney Disease

  • 701 Diabetic Kidney Disease: Basic

Authors

  • Weilong, Xu, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
  • Ochi, Akinobu, Osaka Koritsu Daigaku, Osaka, Osaka Prefecture, Japan
  • Shan, Chuchu, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
  • Liu, Zihui, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
  • Zhou, Xiqiao, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
  • Yu, Jiangyi, Jiangsu Province Hospital of Chinese Medicine, Nanjing, Jiangsu, China
Background

Diabetic kidney disease (DKD) progression is driven by 'metabolic memory', where early hyperglycemic injury leads to persistent cellular dysfunction. O-GlcNAcylation plays a key role by activating HIF-1α, impairing fatty acid oxidation (FAO), and promoting fibrosis. Using LC-MS, we profiled the active flavonoids of Abelmoschus manihot (TFA). RNAseq and molecular docking identified glycosylation-related pathways as potential TFA targets. OGT-mediated glycosylation emerged as a pivotal node in this network. This study aimed to elucidate how TFA modulates the O-GlcNAc–HIF-1α–FAO axis to alleviate DKD.

Methods

A db/db mouse model was treated with TFA (97.5–390 mg/kg/day) for 14 weeks. HK-2 cells under high glucose were used for in vitro assays. RNAseq guided downstream validation. O-GlcNAc levels were visualized using HaloTag probes. HIF-1α was modulated via LV. ChIP-qPCR evaluated HIF-1α–CPT1A interaction. Mitochondrial function was assessed by TEM, JC-1, Seahorse, and 14C-palmitate oxidation (Figure attached).

Results

TFA suppressed O-GlcNAcylation/HIF-1α axis and restored FAO.TEM and JC-1 staining showed improved mitochondrial integrity. Seahorse and 14C oxidation assays confirmed FAO recovery, while JC-1 staining revealed restored mitochondrial membrane potential. SPR/ITS validated TFA–OGT interaction. ChIP-qPCR revealed reduced HIF-1α binding to the CPT1A promoter. These effects aligned with reduced fibrosis markers and improved renal metabolism (Figure attached).

Conclusion

TFA alleviates DKD by targeting the O-GlcNAc–HIF-1α–FAO pathway. The integrative evidence supports its druggability and clinical translation potential. These findings establish a rationale for developing TFA into a standardized botanical drug for metabolic complications.

Funding

  • Government Support – Non-U.S.

Digital Object Identifier (DOI)