Overactive cannabinoid 1 receptor in podocytes drives type 2 diabetic nephropathy

Tony Jourdan*, Gergo Szandaa, Avi Z. Rosenberg, Joseph Tam, Brian James Earley, Grzegorz Godlewski, Resat Cinar, Ziyi Liu, Jie Liu, Cynthia Ju, Pál Pacher, George Kunos

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

104 Scopus citations


Diabetic nephropathy is a major cause of end-stage kidney disease, and overactivity of the endocannabinoid/cannabinoid 1 receptor (CB1R) system contributes to diabetes and its complications. Zucker diabetic fatty (ZDF) rats develop type 2 diabetic nephropathy with albuminuria, reduced glomerular filtration, activation of the reninangiotensin system (RAS), oxidative/nitrative stress, podocyte loss, and increased CB1R expression in glomeruli. Peripheral CB1R blockade initiated in the prediabetic stage prevented these changes or reversed them when animals with fully developed diabetic nephropathy were treated. Treatment of diabetic ZDF rats with losartan, an angiotensin II receptor-1 (Agtr1) antagonist, attenuated the development of nephropathy and down-regulated renal cortical CB1R expression, without affecting the marked hyperglycemia. In cultured human podocytes, CB1R and desmin gene expression were increased and podocin and nephrin content were decreased by either the CB1R agonist arachydonoyl-2′-chloroethylamide, angiotensin II, or high glucose, and the effects of all three were antagonized by CB1R blockade or siRNA-mediated knockdown of CNR1 (the cannabinoid type 1 receptor gene). We conclude that increased CB1R signaling in podocytes contributes to the development of diabetic nephropathy and represents a common pathway through which both hyperglycemia and increased RAS activity exert their deleterious effects, highlighting the therapeutic potential of peripheral CB1R blockade.

Original languageAmerican English
Pages (from-to)E5420-E5428
JournalProceedings of the National Academy of Sciences of the United States of America
Issue number50
StatePublished - 16 Dec 2014
Externally publishedYes

Bibliographical note

Publisher Copyright:
© 2014, National Academy of Sciences. All rights reserved.


  • Angiotensin II
  • Endocannabinoid
  • Hyperglycemia
  • Nephropathy
  • Podocyte


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