Objective To identify potential key targets of henagliflozin in the treatment of diabetic kidney disease (DKD) using transcriptomic profiling combined with ma-chine-learning algorithms, and to construct a microRNA (miRNA)-messenger RNA (mRNA) regulatory network to elucidate its underlying molecular mechanisms.
Methods The action targets of henagliflozin were obtained from public databases and subjected to pathway enrichment analysis using the DAVID platform. Transcriptomic data of DKD patients were obtained from the the GEO database. Differentially expressed genes (DEGs) were screened using R software, and three machine-learning algorithms-least absolute shrinkage and selection operator (LASSO) regression, support vector machine-recursive feature elimination (SVM-RFE), and random forest-were applied to identify consensus dis-ease-related core genes. Upstream miRNAs were predicted using the ENCORI database, core miRNAs were screened by the MCC algorithm in Cytoscape software, and the miRNA-mRNA regulatory network was constructed subsequently.
Results A total of 8,214 mRNAs expression data of DKD patients were obtained, 69 DEGs were screened out, and 8 key genes were ultimately selected using machine learning algorithms. Functional enrichment revealed substantial overlap between the core gene network and pathways associated with henagliflozin, with major enrichment in the phosphatidylinositol 3-kinase (PI3K)/protein kinase B (Akt) signaling pathway.
Conclusion Henagliflozin may improve the progression of DKD by modulating the PI3K/ Akt signaling pathway and its associated miRNA-mRNA regulatory network. The identified core targets provide potential value for disease monitoring and precision intervention. This study offers a molecular basis for the precise clinical application of henagliflozin in patients with DKD.
1. Peng QY, An Y, Jiang ZZ, et al. The role of immune cells in DKD: mechanisms and targeted therapies[J]. J Inflamm Res, 2024, 17: 2103-2118. DOI: 10.2147/JIR.S457526.
2. Barrera-Chimal J, Lima-Posada I, Bakris GL, et al. Mineralocorticoid receptor antagonists in diabetic kidney disease-mechanistic and therapeutic effects[J]. Nat Rev Nephrol, 2022, 18(1): 56-70. DOI: 10.1038/s41581-021-00490-8.
3. Mulder S, Hamidi H, Kretzler M, et al. An integrative systems biology approach for precision medicine in diabetic kidney disease[J]. Diabetes Obes Metab, 2018, 20 (Suppl 3): 6-13. DOI: 10.1111/dom.13416.
4. Fioretto P, Vettor R, Pontremoli R. SGLT2 inhibitors to prevent diabetic kidney disease[J]. Lancet Diabetes Endocrinol, 2024, 17: 2103-2118. DOI: 10.2147/JIR.S457526.
5. Armillotta M, Angeli F, Paolisso P, et al. Cardiovascular therapeutic targets of sodium-glucose co-transporter 2 (SGLT2) inhibitors beyond heart failure[J]. Pharmacol Ther, 2025, 270: 108861. DOI: 10.1016/j.pharmthera.2025.108861.
6. Tomita I, Kume S, Sugahara S, et al. SGLT2 Inhibition mediates protection from diabetic kidney disease by promoting ketone body-induced mTORC1 inhibition[J]. Cell Metab, 2020, 32(3): 404-419. DOI: 10.1016/j.cmet.2020.06.020.
7. Mima A. A narrative review of diabetic kidney disease: previous and current evidence-based therapeutic approaches[J]. Adv Ther, 2022, 39(8): 3488-3500. DOI: 10.1007/s12325-022-02223-0.
8. Votto M, De Silvestri A, Postiglione L, et al. Predicting paediatric asthma exacerbations with machine learning: a systematic review with Meta-analysis[J]. Eur Respir Rev, 2024, 33(174): 240118. DOI: 10.1183/16000617.0118-2024.
9. Lin J, Ma Q, Chen L, et al. Transcriptomic and miRNA signatures of ChAdOx1 nCoV-19 vaccine response using machine learning[J]. Life (Basel), 2025, 15(6): 981. DOI: 10.3390/life15060981.
10. Krisanapan P, Tangpanithandee S, Thongprayoon C, et al. Revolutionizing chronic kidney disease management with machine learning and artificial intelligence[J]. J Clin Med, 2023, 12(8): 3018. DOI: 10.3390/jcm12083018.
11. Li Y, Li X, Xu T, et al. Deciphering shared gene signatures and immune infiltration characteristics between gestational diabetes mellitus and preeclampsia by integrated bioinformatics analysis and machine learning[J]. Reprod Sci, 2025, 32(6): 1886-1904. DOI: 10.1007/s43032-025-01847-1.
12. Kato M, Natarajan R. Epigenetics and epigenomics in diabetic kidney disease and metabolic memory[J]. Nat Rev Nephrol, 2019, 15(6): 327-345. DOI: 10.1038/s41581-019-0135-6.
13. Neuen BL, Heerspink HJL, Vart P, et al. Estimated lifetime cardiovascular, kidney, and mortality benefits of combination treatment with SGLT2 inhibitors, GLP-1 receptor agonists, and nonsteroidal MRA compared with conventional care in patients with type 2 diabetes and albuminuria[J]. Circulation, 2024, 149(6): 450-462. DOI: 10.1161/CIRCULATIONAHA.123.067584.
14. Gajewska A, Wasiak J, Sapeda N, et al. SGLT2 inhibitors in kidney diseases-a narrative review[J]. Int J Mol Sci, 2024, 25(9): 4959. DOI: 10.3390/ijms25094959.
15. Yao L, Liang X, Liu Y, et al. Non-steroidal mineralocorticoid receptor antagonist finerenone ameliorates mitochondrial dysfunction via PI3K/Akt/eNOS signaling pathway in diabetic tubulopathy[J]. Redox Biol, 2023, 68: 102946. DOI: 10.1016/j.redox.2023.102946.
16. Huang X, Liu G, Guo J, et al. The PI3K/AKT pathway in obesity and type 2 diabetes[J]. Int J Biol Sci, 2018, 14(11): 1483-1496. DOI: 10.7150/ijbs.27173.
17. Abdelsalam RM, Hamam HW, Eissa NM, et al. Empagliflozin dampens doxorubicin-induced chemobrain in rats: the possible involvement of oxidative stress and PI3K/Akt/mTOR/NF-κB/TNF-α signaling pathways[J]. Mol Neurobiol, 2025, 62(3): 3480-3492. DOI: 10.1007/s12035-024-04499-5.
18. Shen Y, Cheng L, Xu M, et al. SGLT2 inhibitor empagliflozin downregulates miRNA-34a-5p and targets GREM2 to inactivate hepatic stellate cells and ameliorate non-alcoholic fatty liver disease-associated fibrosis[J]. Metabolism, 2023, 146: 155657. DOI: 10.1016/j.metabol.2023.155657.
19. Orea-Soufi A, Paik J, Bragança J, et al. FOXO transcription factors as therapeutic targets in human diseases[J]. Trends Pharmacol Sci, 2022, 43(12): 1070-1084. DOI: 10.1016/j.tips. 2022.09.010.
20. Lee J, Kim J, Lee JH, et al. SIRT1 promotes host protective immunity against toxoplasma gondii by controlling the FoxO-autophagy axis via the AMPK and PI3K/AKT signalling pathways[J]. Int J Mol Sci, 2022, 23(21): 13578. DOI: 10.3390/ijms232113578.
21. Livingston MJ, Zhang M, Kwon SH, et al. Autophagy activates EGR1 via MAPK/ERK to induce FGF2 in renal tubular cells for fibroblast activation and fibrosis during maladaptive kidney repair[J]. Autophagy, 2024, 20(5): 1032-1053. DOI: 10.1080/15548627.2023.2281156.
22. Yu X, Hu Y, Jiang W. Integrative analysis of mitochondrial and immune pathways in diabetic kidney disease: identification of AASS and CASP3 as key predictors and therapeutic targets[J]. Ren Fail, 2025, 47(1): 2465811. DOI: 10.1080/0886022X. 2025.2465811.
23. Liu Z, Hu H, Jin Y, et al. Artesunate enhances DUSP1-dependent mitochondrial integrity to mitigate renal fibrosis in diabetic kidney disease[J]. Phytother Res, 2025, 39(11): 5085-5101. DOI: 10.1002/ptr.70091.
24. Wu Y, Cheng S, Gu H, et al. Variants within the LPL gene confer susceptility to diabetic kidney disease and rapid decline in kidney function in Chinese patients with type 2 diabetes[J]. Diabetes Obes Metab, 2023, 25(10): 3012-3019. DOI: 10.1111/dom.15199.
25. Perlis ML, Posner D, Riemann D, et al. Insomnia[J]. Lancet, 2022, 400(10357): 1047-1060. DOI: 10.1016/S0140-6736(22)00879-0.
26. 龚豪. 单细胞RNA测序结合机器学习算法揭示肾透明细胞癌新型生物标志物ENO2、VIM及其表达水平的验证[D]. 太原: 山西医科大学, 2023. DOI: 10.27288/d.cnki.gsxyu.2023.000418.
27. Dobyns WB, Aldinger KA, Ishak GE, et al. MACF1 mutations encoding highly conserved zinc-binding residues of the GAR domain cause defects in neuronal migration and axon guidance[J]. Am J Hum Genet, 2018, 103(6): 1009-1021. DOI: 10.1016/j.ajhg. 2018.10.019.