Sodium-glucose transporters SGLT1 and SGLT2 in equine renal, hepatic and pancreatic tissue.
Authors: Anger-Håål Camilla, Fjordbakk Cathrine T, Ekstrand Carl, Skedsmo Fredrik S, Rørtveit Runa
Journal: BMC veterinary research
Summary
# Editorial Summary Sodium-glucose cotransporter inhibitors (SGLT2i) have emerged as a promising pharmacological approach for managing hyperinsulinemia in equine metabolic syndrome, yet their mechanism of action in horses remains incompletely understood—particularly regarding tissue distribution beyond the kidneys. Anger-Hål and colleagues used immunohistochemistry and Western blotting to map SGLT1 and SGLT2 protein expression across renal, hepatic and pancreatic tissue samples from healthy horses, establishing a baseline understanding of where these transporters are functionally present in equine physiology. The researchers confirmed that both transporter proteins are expressed in equine kidneys, liver and pancreas, mirroring the distribution pattern documented in humans and laboratory models, though the relative abundance and localisation within specific cell types and tissue compartments differed between organs. These findings provide a mechanistic foundation for understanding why different SGLT2i drugs—which vary in their selectivity for SGLT2 over SGLT1 and their tissue penetration—may produce different clinical outcomes in treated horses, and suggest that extra-renal effects on glucose metabolism and insulin regulation deserve consideration when selecting agents for EMS management. For practitioners, this work underscores the importance of matching SGLT2i choice to individual patient presentations, as inhibitor selectivity profiles may influence efficacy and adverse effect risk through actions on hepatic glucose handling and pancreatic insulin secretion in addition to renal glucose handling.
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Practical Takeaways
- •SGLT2 inhibitors have a physiological basis for use in equine EMS management, with confirmed transporter presence in target tissues
- •Different SGLT2i drugs may have varying efficacy or side effect profiles in horses due to differential drug specificity and tissue expression patterns—selecting the appropriate agent matters
- •The presence of these transporters in liver and pancreas explains why SGLT2i may help manage insulin dysregulation beyond simple renal effects
Key Findings
- •SGLT2 and SGLT1 transporter proteins are present in equine renal, hepatic, and pancreatic tissue, supporting the biological plausibility of SGLT2 inhibitor use in horses
- •Differential expression patterns of SGLT1 and SGLT2 across equine tissues may explain variable treatment effects between different SGLT2 inhibitor drugs
- •Extra-renal presence of these transporters in liver and pancreas suggests potential mechanisms beyond renal glucose reabsorption for SGLT2i therapeutic effects in EMS