Repurposing SGLT2 Inhibitors for Cirrhotic Ascites: From Mechanistic Research to Clinical Exploration (IMAGE)
Caption
SGLT2 inhibitors attenuate proximal tubular sodium reabsorption through a proximal microdomain comprising SGLT2, MAP17, and NHE3. Downstream effects include modulation of the RAAS and sympathetic nervous system, potentially redistributing tissue sodium. These mechanisms directly address the low distal sodium delivery that underlies diuretic resistance in cirrhotic ascites. Early clinical observations indicate promising effects on natriuresis and reductions in ascites burden, with a safety profile consistent with experience from other trials involving SGLT2 inhibitors. Although the current evidence remains preliminary and limited, a coherent translational pathway from “mechanistic rationality” to “clinical feasibility” has been initially established, providing a solid basis for subsequent high-quality clinical validation.
Credit
Zhongjie Hu, Dong Ji
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CC BY-NC