IMR Press / FBL / Volume 28 / Issue 4 / DOI: 10.31083/j.fbl2804083
Open Access Original Research
Comparing and Contrasting the Effects of the SGLT Inhibitors Canagliflozin and Empagliflozin on the Progression of Retinopathy
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1 Dobney Hypertension Centre, School of Biomedical Sciences – Royal Perth Hospital Unit, University of Western Australia, Crawley, WA 6009, Australia
2 Department of Molecular Ophthalmology, University of Western Australia, Crawley, WA 6009, Australia
3 Dobney Hypertension Centre, Medical School – Royal Perth Hospital Unit, University of Western Australia, Crawley, WA 6009, Australia
4 Department of Cardiology and Department of Nephrology, Royal Perth Hospital, Perth, WA 6000, Australia
*Correspondence: vance.matthews@uwa.edu.au (Vance B. Matthews)
These authors contributed equally.
Front. Biosci. (Landmark Ed) 2023, 28(4), 83; https://doi.org/10.31083/j.fbl2804083
Submitted: 15 February 2023 | Revised: 5 April 2023 | Accepted: 7 April 2023 | Published: 27 April 2023
(This article belongs to the Special Issue An Update on Sodium Glucose Co-Transporters)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Background: Diabetic retinopathy (DR) is a leading cause of end-stage blindness globally and is arguably one of the most disabling complications of both Type 1 and Type 2 diabetes. Sodium Glucose Cotransporter-2 (SGLT2) inhibitors have now been successfully introduced to clinical medicine and exert multiple beneficial effects in diabetic patients. Given the broad therapeutic application of SGLT2 inhibitors, we hypothesised that SGLT2 inhibition may alleviate the progression of DR. Therefore, we aimed to compare the effectiveness of two clinically available SGLT2 inhibitors, Empagliflozin and Canagliflozin, on the progression of Retinopathy and DR using well-characterised mouse models, Kimba and Akimba, respectively. Methods: Empagliflozin, Canagliflozin (25 mg/kg/day) or vehicle was administered to 10-week-old mice via drinking water for 8-weeks. Urine glucose levels were measured to ascertain SGLT2 inhibition promoted glucose excretion. Weekly body weight and water intake measurements were obtained. After 8-weeks of treatment, body weight, daily water intake, fasting blood glucose levels were measured and eye tissue was harvested. The retinal vasculature was assessed using immunofluorescence. Results: Empagliflozin treated Akimba mice exhibited metabolic benefits suggested by healthy body weight gain and significantly reduced fasting blood glucose levels. Treatment with Empagliflozin reduced retinal vascular lesions in both Kimba and Akimba mice. Canagliflozin improved body weight gain, reduced blood glucose levels in Akimba mice, and reduced the development of retinal vascular lesions in Kimba mice. Conclusions: Our data demonstrates that Empagliflozin has future potential as a therapeutic for Retinopathy and DR and should now be considered for human trials.

Keywords
diabetic retinopathy
diabetes
Akimba
Kimba
mouse models
sodium glucose cotransporters
SGLT2 inhibitors
empagliflozin
canagliflozin
retinal vasculature
Funding
VM2018/Royal Perth Hospital-Research Foundation WA
Y20G-MATV/Diabetes Australia Research Program
DRWA-LHerat-2020/Diabetes Research WA
Raine-LHerat-2020/Raine Medical Research Foundation, WA
Figures
Fig. 1.
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