Background and Purpose: Diabetic nephropathy (DN) is a common and severe
chronic complication in diabetes mellitus. The purpose of this study was
to explore the effect and mechanism of Astragaloside IV (AS-IV) on renal
pyroptosis in DN. Experimental Approach: High-fat diet and a small dose
of streptozotocin were used to establish the DN model. Rats were treated
with vehicle or AS-IV (20-, 40- and 80-mg/kg/day) or valsartan
(30mg/kg/day) by gavage. After 12 weeks, animals were euthanized;
samples of urine and blood were collected to examine biochemical
indicators, advanced glycation end products (AGEs), inflammatory
cytokines; kidney tissues were collected for histological observation,
TUNEL staining, AGEs, inflammatory cytokines, redox indicators, western
blot, and immunohistochemistry. Key Results: Biochemical results showed
that AS-IV could significantly alleviate the degree of clinical symptoms
and the levels of blood glucose, HbA1C, TG, MDA, AGEs, Interleukin
(IL)-1β, and IL-18 while improving the activity of SOD and the secretion
and sensitivity of insulin. Histological examination and TUNEL staining
indicated that AS-IV attenuated the damage of tissues and cells in the
kidney from DN rats. Western blot results revealed that AS-IV relieved
the activation of NOX4/TXNIP/NLRP3 pathway and the expression of
collagen IV and fibronectin in DN rats. Immunohistochemistry results
showed that AS-IV attenuated collagen IV and fibronectin in the kidney
from DN rats. Conclusion and Implications: The NOX4/TXNIP/NLRP3 pathway
mediated renal pyroptosis could play a crucial role in kidney damage and
DN development in rats. Restoration of renal pyroptosis by AS-IV be a
potential therapeutic strategy against DN.