Suoquan Yishen formula attenuates ectopic lipid deposition in diabetic kidney disease by inhibiting UBC9-mediated SUMO1 modification of DRP1.

ETHNOPHARMACOLOGICAL RELEVANCE: Pathological mitochondrial hyperfission and ectopic lipid deposition in renal tubules are critical contributors to the progression of diabetic kidney disease (DKD), with SUMO1-mediated modification of DRP1 functioning as a key driving mechanism. The traditional Chinese medicine formula Suoquan Yishen Formula (SQYSF) has demonstrated clinical efficacy in ameliorating DKD; however, it remains unclear whether it improves the mitochondrial-lipid metabolism network by modulating this post-translational modification. AIM OF THE STUDY: This study aimed to elucidate the molecular mechanism by which SQYSF alleviates renal tubular ectopic lipid deposition in DKD by targeting UBC9-mediated DRP1-SUMO1 modification. MATERIALS AND METHODS: The therapeutic effects of SQYSF on renal function, lipid deposition, mitochondrial morphology, and SUMOylation were systematically assessed in db/db mice and in HK-2 cells stimulated with high glucose and high fat. Evaluations were performed using histopathological staining, transmission electron microscopy, MitoTracker Red fluorescence staining, Western blotting, co-immunoprecipitation (Co-IP), and cellular thermal shift assays. Functional validation was further conducted using the DRP1 inhibitor Mdivi-1 and the UBC9 inhibitor 2-D08. RESULTS: In vivo experiments demonstrated that SQYSF significantly improved renal dysfunction and histopathological injury in DKD mice, accompanied by notable reductions in mitochondrial damage and ectopic lipid deposition. In vitro mechanistic studies showed that SQYSF specifically suppressed both the mRNA and protein expression of the SUMO E2 ligase UBC9, thereby decreasing DRP1-SUMO1 modification. This inhibition downregulated key mitochondrial fission regulators (DRP1, MFF, and FIS1) while concomitantly upregulating essential fatty acid β-oxidation enzymes (CPT1A and CPT2), ultimately leading to reduced lipid accumulation. CONCLUSION: This study demonstrates that SQYSF ameliorates DKD by targeting the UBC9-mediated DRP1-SUMO1 modification axis, thereby suppressing pathological mitochondrial fission and reducing ectopic lipid deposition in renal tubules. These findings offer new mechanistic insight and highlight a promising therapeutic strategy for DKD management using traditional Chinese medicine.