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Figueiredo ID, Lima TFO, Carlstrom PF, Assis RP, Brunetti IL, Baviera AM. Lycopene in Combination with Insulin Triggers Antioxidant Defenses and Increases the Expression of Components That Detoxify Advanced Glycation Products in Kidneys of Diabetic Rats. Nutrients 2024; 16:1580. [PMID: 38892513 PMCID: PMC11173891 DOI: 10.3390/nu16111580] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/21/2024] [Revised: 05/17/2024] [Accepted: 05/21/2024] [Indexed: 06/21/2024] Open
Abstract
BACKGROUND Biochemical events provoked by oxidative stress and advanced glycation may be inhibited by combining natural bioactives with classic therapeutic agents, which arise as strategies to mitigate diabetic complications. The aim of this study was to investigate whether lycopene combined with a reduced insulin dose is able to control glycemia and to oppose glycoxidative stress in kidneys of diabetic rats. METHODS Streptozotocin-induced diabetic rats were treated with 45 mg/kg lycopene + 1 U/day insulin for 30 days. The study assessed glycemia, insulin sensitivity, lipid profile and paraoxonase 1 (PON-1) activity in plasma. Superoxide dismutase (SOD) and catalase (CAT) activities and the protein levels of advanced glycation end-product receptor 1 (AGE-R1) and glyoxalase-1 (GLO-1) in the kidneys were also investigated. RESULTS An effective glycemic control was achieved with lycopene plus insulin, which may be attributed to improvements in insulin sensitivity. The combined therapy decreased the dyslipidemia and increased the PON-1 activity. In the kidneys, lycopene plus insulin increased the activities of SOD and CAT and the levels of AGE-R1 and GLO-1, which may be contributing to the antialbuminuric effect. CONCLUSIONS These findings demonstrate that lycopene may aggregate favorable effects to insulin against diabetic complications resulting from glycoxidative stress.
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Affiliation(s)
- Ingrid Delbone Figueiredo
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara 14800-903, SP, Brazil; (I.D.F.); (T.F.O.L.); (P.F.C.); (R.P.A.); (I.L.B.)
| | - Tayra Ferreira Oliveira Lima
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara 14800-903, SP, Brazil; (I.D.F.); (T.F.O.L.); (P.F.C.); (R.P.A.); (I.L.B.)
| | - Paulo Fernando Carlstrom
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara 14800-903, SP, Brazil; (I.D.F.); (T.F.O.L.); (P.F.C.); (R.P.A.); (I.L.B.)
| | - Renata Pires Assis
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara 14800-903, SP, Brazil; (I.D.F.); (T.F.O.L.); (P.F.C.); (R.P.A.); (I.L.B.)
- Institute of Health Sciences, Paulista University (Unip), Araraquara 14804-300, SP, Brazil
| | - Iguatemy Lourenço Brunetti
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara 14800-903, SP, Brazil; (I.D.F.); (T.F.O.L.); (P.F.C.); (R.P.A.); (I.L.B.)
| | - Amanda Martins Baviera
- Department of Clinical Analysis, School of Pharmaceutical Sciences, São Paulo State University (Unesp), Araraquara 14800-903, SP, Brazil; (I.D.F.); (T.F.O.L.); (P.F.C.); (R.P.A.); (I.L.B.)
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Conroy LJ, McCann A, Zhang N, de Gaetano M. The role of nanosystems in the delivery of glucose-lowering drugs for the preemption and treatment of diabetes-associated atherosclerosis. Am J Physiol Cell Physiol 2024; 326:C1398-C1409. [PMID: 38525540 DOI: 10.1152/ajpcell.00695.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2023] [Revised: 03/19/2024] [Accepted: 03/19/2024] [Indexed: 03/26/2024]
Abstract
Diabetes is one of the most prevalent diseases worldwide. In recent decades, type-2 diabetes has become increasingly common, particularly in younger individuals. Diabetes leads to many vascular complications, including atherosclerosis. Atherosclerosis is a cardiovascular disease characterized by lipid-rich plaques within the vasculature. Plaques develop over time, restricting blood flow, and can, therefore, be the underlying cause of major adverse cardiovascular events, including myocardial infarction and stroke. Diabetes and atherosclerosis are intrinsically linked. Diabetes is a metabolic syndrome that accelerates atherosclerosis and increases the risk of developing other comorbidities, such as diabetes-associated atherosclerosis (DAA). Gold standard antidiabetic medications focus on attenuating hyperglycemia. Though recent evidence suggests that glucose-lowering drugs may have broader applications, beyond diabetes management. This review mainly evaluates the role of glucagon-like peptide-1 receptor agonists (GLP-1 RAs), such as liraglutide and semaglutide in DAA. These drugs mimic gut hormones (incretins), which inhibit glucagon secretion while stimulating insulin secretion, thus improving insulin sensitivity. This facilitates delayed gastric emptying and increased patient satiety; hence, they are also indicated for the treatment of obesity. GLP-1 RAs have significant cardioprotective effects, including decreasing low-density lipoprotein (LDL) cholesterol and triglycerides levels. Liraglutide and semaglutide have specifically been shown to decrease cardiovascular risk. Liraglutide has displayed a myriad of antiatherosclerotic properties, with the potential to induce plaque regression. This review aims to address how glucose-lowering medications can be applied to treat diseases other than diabetes. We specifically focus on how nanomedicines can be used for the site-specific delivery of antidiabetic medicines for the treatment of diabetes-associated atherosclerosis.
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Affiliation(s)
- Luke James Conroy
- Diabetes Complications Research Centre, Conway Institute & School of Biomolecular and Biomedical Science, University College Dublin, Dublin, Ireland
| | - Alyssa McCann
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland
| | - Nan Zhang
- School of Mechanical and Materials Engineering, University College Dublin, Dublin, Ireland
| | - Monica de Gaetano
- Diabetes Complications Research Centre, Conway Institute & School of Biomolecular and Biomedical Science, University College Dublin, Dublin, Ireland
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Polkinghorne MD, West HW, Antoniades C. Adipose Tissue in Cardiovascular Disease: From Basic Science to Clinical Translation. Annu Rev Physiol 2024; 86:175-198. [PMID: 37931169 DOI: 10.1146/annurev-physiol-042222-021346] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/08/2023]
Abstract
The perception of adipose tissue as a metabolically quiescent tissue, primarily responsible for lipid storage and energy balance (with some endocrine, thermogenic, and insulation functions), has changed. It is now accepted that adipose tissue is a crucial regulator of metabolic health, maintaining bidirectional communication with other organs including the cardiovascular system. Additionally, adipose tissue depots are functionally and morphologically heterogeneous, acting not only as sources of bioactive molecules that regulate the physiological functioning of the vasculature and myocardium but also as biosensors of the paracrine and endocrine signals arising from these tissues. In this way, adipose tissue undergoes phenotypic switching in response to vascular and/or myocardial signals (proinflammatory, profibrotic, prolipolytic), a process that novel imaging technologies are able to visualize and quantify with implications for clinical prognosis. Furthermore, a range of therapeutic modalities have emerged targeting adipose tissue metabolism and altering its secretome, potentially benefiting those at risk of cardiovascular disease.
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Affiliation(s)
- Murray D Polkinghorne
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom;
- Acute Multidisciplinary Imaging and Interventional Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
| | - Henry W West
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom;
- Acute Multidisciplinary Imaging and Interventional Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
- Central Clinical School, Sydney Medical School, The University of Sydney, Sydney, New South Wales, Australia
| | - Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom;
- Acute Multidisciplinary Imaging and Interventional Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, United Kingdom
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Choi Y, Ko S, Chang K, Yoo KD, Ihm S. Effect of dipeptidyl peptidase-4 inhibitor on the progression of coronary artery disease evaluated by computed tomography in patients receiving insulin therapy for type 2 diabetes mellitus. J Diabetes 2023; 15:944-954. [PMID: 37528628 PMCID: PMC10667629 DOI: 10.1111/1753-0407.13449] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/13/2023] [Revised: 06/23/2023] [Accepted: 07/14/2023] [Indexed: 08/03/2023] Open
Abstract
BACKGROUND We evaluated the effect of a dipeptidyl peptidase-4 inhibitor (DPP-4i) on the progression of obstructive coronary artery disease (OCAD) in patients with type 2 diabetes mellitus (T2DM) receiving insulin therapy. METHODS Using a multicenter clinical data warehouse, we analyzed the patients receiving insulin therapy for T2DM who underwent coronary computed tomography angiography (CCTA) for ≥2 times. The patients were divided into two groups according to the presence of DPP-4i prescription between the two CCTA examinations. The prevalence of OCAD (>50% stenosis on CCTA), new revascularization rates, and changes in the coronary calcium score (CCS) were analyzed. RESULTS A total of 623 patients were included, and a DPP-4i was prescribed to 380 (60.9%) patients. The median time difference between the two CCTAs was 39.0 (17.0-61.4) months. Newly developed OCAD at the follow-up CCTA was detected in 62 (16.3%) patients in the DPP-4i group and 76 (31.3%) patients in the no DPP-4i group (p < 0.001). The risk of new OCAD or new revascularization was lower in the DPP-4i group (19.7% vs. 38.7%; p < 0.001). After propensity score matching, the prevalence of new OCAD (15.9% vs. 29.5%; p = 0.001) and the composite rate of new OCAD or new revascularization (18.7% vs. 37.3%; p < 0.001) were lower in the DPP-4i group. The change in CCS per year did not differ significantly between the two groups (9.1 [0.1-56.8] vs. 13.5 [0.0-78.6]; p = 0.715). CONCLUSIONS Add-on DPP-4i therapy would be beneficial in preventing coronary artery disease progression in patients with T2DM receiving insulin therapy.
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Affiliation(s)
- Young Choi
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
- Cardiovascular Research Institute for Intractable Disease, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
| | - Seung‐Hyun Ko
- Division of Endocrinology and Metabolism, Department of Internal Medicine, St. Vincent's Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
| | - Kiyuk Chang
- Division of Cardiology, Department of Internal Medicine, Seoul St. Mary's Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
- Cardiovascular Research Institute for Intractable Disease, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
| | - Ki Dong Yoo
- Cardiovascular Research Institute for Intractable Disease, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
- Division of Cardiology, Department of Internal Medicine, St. Vincent's Hospital, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
| | - Sang‐Hyun Ihm
- Cardiovascular Research Institute for Intractable Disease, College of MedicineThe Catholic University of KoreaSeoulSouth Korea
- Division of Cardiology, Department of Internal Medicine, Bucheon St. Mary's HospitalThe Catholic University of KoreaSeoulSouth Korea
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Gooch AM, Chowdhury SS, Zhang PM, Hu ZM, Westenfelder C. Significant expansion of the donor pool achieved by utilizing islets of variable quality in the production of allogeneic "Neo-Islets", 3-D organoids of Mesenchymal Stromal and islet cells, a novel immune-isolating biotherapy for Type I Diabetes. PLoS One 2023; 18:e0290460. [PMID: 37616230 PMCID: PMC10449143 DOI: 10.1371/journal.pone.0290460] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/16/2022] [Accepted: 08/09/2023] [Indexed: 08/26/2023] Open
Abstract
Novel biotherapies for Type 1 Diabetes that provide a significantly expanded donor pool and that deliver all islet hormones without requiring anti-rejection drugs are urgently needed. Scoring systems have improved islet allotransplantation outcomes, but their use may potentially result in the waste of valuable cells for novel therapies. To address these issues, we created "Neo-Islets" (NIs), islet-sized organoids, by co-culturing in ultralow adhesion flasks culture-expanded islet (ICs) and Mesenchymal Stromal Cells (MSCs) (x 24 hrs, 1:1 ratio). The MSCs exert powerful immune- and cyto-protective, anti-inflammatory, proangiogenic, and other beneficial actions in NIs. The robust in vitro expansion of all islet hormone-producing cells is coupled to their expected progressive de-differentiation mediated by serum-induced cell cycle entry and Epithelial-Mesenchymal Transition (EMT). Re-differentiation in vivo of the ICs and resumption of their physiological functions occurs by reversal of EMT and serum withdrawal-induced exit from the cell cycle. Accordingly, we reported that allogeneic, i.p.-administered NIs engraft in the omentum, increase Treg numbers and reestablish permanent normoglycemia in autoimmune diabetic NOD mice without immunosuppression. Our FDA-guided pilot study (INAD 012-0776) in insulin-dependent pet dogs showed similar responses, and both human- and canine-NIs established normoglycemia in STZ-diabetic NOD/SCID mice even though the utilized islets would be scored as unsuitable for transplantation. The present study further demonstrates that islet gene expression profiles (α, β, γ, δ) in human "non-clinical grade" islets obtained from diverse, non-diabetic human and canine donors (n = 6 each) closely correlate with population doublings, and the in vivo re-differentiation of endocrine islet cells clearly corresponds with the reestablishment of euglycemia in diabetic mice. Conclusion: human-NIs created from diverse, "non-clinical grade" donors have the potential to greatly expand patient access to this curative therapy of T1DM, facilitated by the efficient in vitro expansion of ICs that can produce ~ 270 therapeutic NI doses per donor for 70 kg recipients.
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Affiliation(s)
- Anna M. Gooch
- SymbioCellTech, LLC, Salt Lake City, Utah, United States of Ameirca
| | | | - Ping M. Zhang
- SymbioCellTech, LLC, Salt Lake City, Utah, United States of Ameirca
| | - Zhuma M. Hu
- SymbioCellTech, LLC, Salt Lake City, Utah, United States of Ameirca
| | - Christof Westenfelder
- SymbioCellTech, LLC, Salt Lake City, Utah, United States of Ameirca
- University of Utah, Health Sciences Center, Salt Lake City, Utah, United States of America
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Akoumianakis I, Zagaliotis A, Konstantaraki M, Filippatos TD. GLP-1 analogs and regional adiposity: A systematic review and meta-analysis. Obes Rev 2023:e13574. [PMID: 37191219 DOI: 10.1111/obr.13574] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/24/2022] [Revised: 04/21/2023] [Accepted: 04/24/2023] [Indexed: 05/17/2023]
Abstract
BACKGROUND Glucagon-like peptide 1 (GLP-1) analogs regulate body weight and liver steatosis. Different body adipose tissue (AT) depots exhibit biological variability. Accordingly, GLP-1 analog effects on AT distribution are unclear. OBJECTIVES To investigate GLP1-analog effects on adiposity distribution. SEARCH METHODS PubMed, Cochrane, and Scopus databases were screened for eligible randomized human trials. Pre-defined endpoints included visceral AT (VAT), subcutaneous AT (SAT), total AT (TAT), epicardial AT (EAT), liver AT (LAT), and waist-to-hip ratio (W:H). Search was conducted until May 17, 2022. DATA COLLECTION AND ANALYSIS Data extraction and bias assessment were performed by two independent investigators. Treatment effects were estimated using random effects models. Analyses were performed on Review Manager v5.3. MAIN RESULTS Out of the 367 screened studies, 45 were included in the systematic review and 35 were used in the meta-analysis. GLP-1 analogs reduced VAT, SAT, TAT, LAT, and EAT, with non-significant effects on W:H. Overall bias risk was low. CONCLUSIONS GLP-1 analog treatment reduces TAT, affecting most studied AT depots, including the pathogenic VAT, EAT, and LAT. GLP-1 analogs may have significant roles in combating metabolic, obesity-associated diseases via reductions of key AT depot volumes.
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Affiliation(s)
- Ioannis Akoumianakis
- Metabolic Diseases Research Unit, Internal Medicine Laboratory, Department of Internal Medicine, School of Medicine, University of Crete, Heraklion, Greece
- Internal Medicine Clinic, University Hospital of Heraklion, Heraklion, Greece
| | - Anastasios Zagaliotis
- Metabolic Diseases Research Unit, Internal Medicine Laboratory, Department of Internal Medicine, School of Medicine, University of Crete, Heraklion, Greece
- Internal Medicine Clinic, University Hospital of Heraklion, Heraklion, Greece
| | - Maria Konstantaraki
- Metabolic Diseases Research Unit, Internal Medicine Laboratory, Department of Internal Medicine, School of Medicine, University of Crete, Heraklion, Greece
| | - Theodosios D Filippatos
- Metabolic Diseases Research Unit, Internal Medicine Laboratory, Department of Internal Medicine, School of Medicine, University of Crete, Heraklion, Greece
- Internal Medicine Clinic, University Hospital of Heraklion, Heraklion, Greece
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Fontes MT, Arruda-Junior DF, dos Santos DS, Ribeiro-Silva JC, Antônio EL, Tucci PF, Rossoni LV, Girardi AC. Dipeptidyl peptidase 4 inhibition rescues PKA-eNOS signaling and suppresses aortic hypercontractility in male rats with heart failure. Life Sci 2023; 323:121648. [PMID: 37001807 DOI: 10.1016/j.lfs.2023.121648] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/26/2022] [Revised: 03/11/2023] [Accepted: 03/28/2023] [Indexed: 03/31/2023]
Abstract
AIMS Vascular dysfunction and elevated circulating dipeptidyl peptidase 4 (DPP4) activity are both reported to be involved in the progression of heart failure (HF). While the cardiac benefits of DPP4 inhibitors (DPP4i) have been extensively studied, little is known about the effects of DPP4i on vascular dysfunction in nondiabetic HF. This study tested the hypothesis that vildagliptin (DPP4i) mitigates aortic hyperreactivity in male HF rats. MATERIALS AND METHODS Male Wistar rats were subjected to left ventricle (LV) radiofrequency ablation to HF induction or sham operation (SO). Six weeks after surgery, radiofrequency-ablated rats who developed HF were treated with vildagliptin (120 mg⸱kg-1⸱day-1) or vehicle for 4 weeks. Thoracic aorta reactivity, dihydroethidium fluorescence, immunoblotting experiments, and enzyme-linked immunosorbent assays were performed. KEY FINDINGS DPP4i ameliorated the hypercontractility of HF aortas to the α-adrenoceptor agonist phenylephrine towards SO levels. In HF, the reduced endothelium and nitric oxide (NO) anticontractile effect on phenylephrine response was restored by DPP4i. At the molecular level, this vasoprotective effect of DPP4i was accompanied by (i) reduced oxidative stress and NADPH oxidase 2 (Nox2) expression, (ii) enhanced total endothelial nitric oxide synthase (eNOS) expression and phosphorylation at Ser1177, and (iii) increased PKA activation, which acts upstream of eNOS. Additionally, DPP4i restored the higher serum angiotensin II concentration towards SO. SIGNIFICANCE Our data demonstrate that DPP4i ameliorates aortic hypercontractility, most likely by enhancing NO bioavailability, showing that the DPP4i-induced cardioprotection in male HF may arise from effects not only in the heart but also in conductance arteries.
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Akoumianakis I, Polkinghorne M, Antoniades C. Non-canonical WNT signalling in cardiovascular disease: mechanisms and therapeutic implications. Nat Rev Cardiol 2022; 19:783-797. [PMID: 35697779 PMCID: PMC9191761 DOI: 10.1038/s41569-022-00718-5] [Citation(s) in RCA: 47] [Impact Index Per Article: 23.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 04/25/2022] [Indexed: 12/15/2022]
Abstract
WNT signalling comprises a diverse spectrum of receptor-mediated pathways activated by a large family of WNT ligands and influencing fundamental biological processes. WNT signalling includes the β-catenin canonical pathway and the non-canonical pathways, namely the planar cell polarity and the calcium-dependent pathways. Advances over the past decade have linked non-canonical WNT signalling with key mechanisms of atherosclerosis, including oxidative stress, endothelial dysfunction, macrophage activation and vascular smooth muscle cell phenotype regulation. In addition, non-canonical WNT signalling is involved in crucial aspects of myocardial biology, from fibrosis to hypertrophy and oxidative stress. Importantly, non-canonical WNT signalling activation has complex effects in adipose tissue in the context of obesity, thereby potentially linking metabolic and vascular diseases. Tissue-specific targeting of non-canonical WNT signalling might be associated with substantial risks of off-target tumorigenesis, challenging its therapeutic potential. However, novel technologies, such as monoclonal antibodies, recombinant decoy receptors, tissue-specific gene silencing with small interfering RNAs and gene editing with CRISPR-Cas9, might enable more efficient therapeutic targeting of WNT signalling in the cardiovascular system. In this Review, we summarize the components of non-canonical WNT signalling, their links with the main mechanisms of atherosclerosis, heart failure and arrhythmias, and the rationale for targeting individual components of non-canonical WNT signalling for the treatment of cardiovascular disease.
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Affiliation(s)
- Ioannis Akoumianakis
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Murray Polkinghorne
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK
| | - Charalambos Antoniades
- Division of Cardiovascular Medicine, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
- Acute Vascular Imaging Centre, Radcliffe Department of Medicine, University of Oxford, Oxford, UK.
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9
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Grace C, Hopewell JC, Watkins H, Farrall M, Goel A. Robust estimates of heritable coronary disease risk in individuals with type 2 diabetes. Genet Epidemiol 2022; 46:51-62. [PMID: 34672391 PMCID: PMC8983061 DOI: 10.1002/gepi.22434] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/21/2021] [Revised: 08/12/2021] [Accepted: 10/04/2021] [Indexed: 11/21/2022]
Abstract
Type 2 diabetes (T2D) is an important heritable risk factor for coronary artery disease (CAD), the risk of both diseases being increased by metabolic syndrome (MS). With the availability of large-scale genome-wide association data, we aimed to elucidate the genetic burden of CAD risk in T2D predisposed individuals within the context of MS and their shared genetic architecture. Mendelian randomization (MR) analyses supported a causal relationship between T2D and CAD [odds ratio (OR) = 1.13 per log-odds unit 95% confidence interval (CI): 1.10-1.16; p = 1.59 × 10-17 ]. Simultaneously adjusting MR analyses for the effects of the T2D instrument including blood pressure, dyslipidaemia, and obesity attenuated the association between T2D and CAD (OR = 1.07, 95% CI: 1.04-1.11). Bayesian locus-overlap analysis identified 44 regions with the same causal variant underlying T2D and CAD genetic signals (FDR < 1%) at a posterior probability >0.7; five (MHC, LPL, ABO, RAI1 and MC4R) of these regions contain genome-wide significant (p < 5 × 10-8 ) associations for both traits. Given the small effect sizes observed in genome-wide association studies for complex diseases, even with 44 potential target regions, this has implications for the likely magnitude of CAD risk reduction that might be achievable by pure T2D therapies.
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Affiliation(s)
- Christopher Grace
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
- Wellcome Centre for Human GeneticsUniversity of OxfordOxfordUK
| | - Jemma C. Hopewell
- Nuffield Department of Population HealthUniversity of OxfordOxfordUK
| | - Hugh Watkins
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
- Wellcome Centre for Human GeneticsUniversity of OxfordOxfordUK
| | - Martin Farrall
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
- Wellcome Centre for Human GeneticsUniversity of OxfordOxfordUK
| | - Anuj Goel
- Division of Cardiovascular Medicine, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
- Wellcome Centre for Human GeneticsUniversity of OxfordOxfordUK
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Schinzari F, Tesauro M, Cardillo C. Vasodilator Dysfunction in Human Obesity: Established and Emerging Mechanisms. J Cardiovasc Pharmacol 2021; 78:S40-S52. [PMID: 34840258 DOI: 10.1097/fjc.0000000000001108] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/03/2021] [Accepted: 06/30/2021] [Indexed: 12/25/2022]
Abstract
ABSTRACT Human obesity is associated with insulin resistance and often results in a number of metabolic abnormalities and cardiovascular complications. Over the past decades, substantial advances in the understanding of the cellular and molecular pathophysiological pathways underlying the obesity-related vascular dysfunction have facilitated better identification of several players participating in this abnormality. However, the complex interplay between the disparate mechanisms involved has not yet been fully elucidated. Moreover, in medical practice, the clinical syndromes stemming from obesity-related vascular dysfunction still carry a substantial burden of morbidity and mortality; thus, early identification and personalized clinical management seem of the essence. Here, we will initially describe the alterations of intravascular homeostatic mechanisms occurring in arteries of obese patients. Then, we will briefly enumerate those recognized causative factors of obesity-related vasodilator dysfunction, such as vascular insulin resistance, lipotoxicity, visceral adipose tissue expansion, and perivascular adipose tissue abnormalities; next, we will discuss in greater detail some emerging pathophysiological mechanisms, including skeletal muscle inflammation, signals from gut microbiome, and the role of extracellular vesicles and microRNAs. Finally, it will touch on some gaps in knowledge, as well as some current acquisitions for specific treatment regimens, such as glucagon-like peptide-1 enhancers and sodium-glucose transporter2 inhibitors, that could arrest or slow the progression of this abnormality full of unwanted consequences.
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Affiliation(s)
| | - Manfredi Tesauro
- Department of Systems Medicine, University of Tor Vergata, Rome, Italy; and
| | - Carmine Cardillo
- Department of Aging, Policlinico A. Gemelli IRCCS, Rome, Italy
- Department of Translational Medicine and Surgery, Catholic University, Rome, Italy
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11
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Bastin G, Luu L, Batchuluun B, Mighiu A, Beadman S, Zhang H, He C, Al Rijjal D, Wheeler MB, Heximer SP. RGS4-Deficiency Alters Intracellular Calcium and PKA-Mediated Control of Insulin Secretion in Glucose-Stimulated Beta Islets. Biomedicines 2021; 9:biomedicines9081008. [PMID: 34440212 PMCID: PMC8391461 DOI: 10.3390/biomedicines9081008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2021] [Revised: 08/04/2021] [Accepted: 08/05/2021] [Indexed: 11/16/2022] Open
Abstract
A number of diverse G-protein signaling pathways have been shown to regulate insulin secretion from pancreatic β-cells. Accordingly, regulator of G-protein signaling (RGS) proteins have also been implicated in coordinating this process. One such protein, RGS4, is reported to show both positive and negative effects on insulin secretion from β-cells depending on the physiologic context under which it was studied. We here use an RGS4-deficient mouse model to characterize previously unknown G-protein signaling pathways that are regulated by RGS4 during glucose-stimulated insulin secretion from the pancreatic islets. Our data show that loss of RGS4 results in a marked deficiency in glucose-stimulated insulin secretion during both phase I and phase II of insulin release in intact mice and isolated islets. These deficiencies are associated with lower cAMP/PKA activity and a loss of normal calcium surge (phase I) and oscillatory (phase II) kinetics behavior in the RGS4-deficient β-cells, suggesting RGS4 may be important for regulation of both Gαi and Gαq signaling control during glucose-stimulated insulin secretion. Together, these studies add to the known list of G-protein coupled signaling events that are controlled by RGS4 during glucose-stimulated insulin secretion and highlight the importance of maintaining normal levels of RGS4 function in healthy pancreatic tissues.
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Affiliation(s)
- Guillaume Bastin
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.L.); (B.B.); (A.M.); (S.B.); (H.Z.); (C.H.); (D.A.R.); (M.B.W.); (S.P.H.)
- Ted Rogers Centre for Heart Research, Translational Biology and Engineering Program, University of Toronto, Toronto, ON M5G 1M1, Canada
- Heart and Stroke/Richard Lewar Centre of Excellence in Cardiovascular Research, Toronto, ON M5S 3H2, Canada
- Correspondence: ; Tel.: +33-658-469-334
| | - Lemieux Luu
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.L.); (B.B.); (A.M.); (S.B.); (H.Z.); (C.H.); (D.A.R.); (M.B.W.); (S.P.H.)
| | - Battsetseg Batchuluun
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.L.); (B.B.); (A.M.); (S.B.); (H.Z.); (C.H.); (D.A.R.); (M.B.W.); (S.P.H.)
| | - Alexandra Mighiu
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.L.); (B.B.); (A.M.); (S.B.); (H.Z.); (C.H.); (D.A.R.); (M.B.W.); (S.P.H.)
| | - Stephanie Beadman
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.L.); (B.B.); (A.M.); (S.B.); (H.Z.); (C.H.); (D.A.R.); (M.B.W.); (S.P.H.)
| | - Hangjung Zhang
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.L.); (B.B.); (A.M.); (S.B.); (H.Z.); (C.H.); (D.A.R.); (M.B.W.); (S.P.H.)
| | - Changhao He
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.L.); (B.B.); (A.M.); (S.B.); (H.Z.); (C.H.); (D.A.R.); (M.B.W.); (S.P.H.)
| | - Dana Al Rijjal
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.L.); (B.B.); (A.M.); (S.B.); (H.Z.); (C.H.); (D.A.R.); (M.B.W.); (S.P.H.)
| | - Michael B. Wheeler
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.L.); (B.B.); (A.M.); (S.B.); (H.Z.); (C.H.); (D.A.R.); (M.B.W.); (S.P.H.)
| | - Scott P. Heximer
- Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada; (L.L.); (B.B.); (A.M.); (S.B.); (H.Z.); (C.H.); (D.A.R.); (M.B.W.); (S.P.H.)
- Ted Rogers Centre for Heart Research, Translational Biology and Engineering Program, University of Toronto, Toronto, ON M5G 1M1, Canada
- Heart and Stroke/Richard Lewar Centre of Excellence in Cardiovascular Research, Toronto, ON M5S 3H2, Canada
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12
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Wang Y, Han D, Zhou T, Chen C, Cao H, Zhang JZ, Ma N, Liu C, Song M, Shi J, Jin X, Cao F, Dong N. DUSP26 induces aortic valve calcification by antagonizing MDM2-mediated ubiquitination of DPP4 in human valvular interstitial cells. Eur Heart J 2021; 42:2935-2951. [PMID: 34179958 DOI: 10.1093/eurheartj/ehab316] [Citation(s) in RCA: 27] [Impact Index Per Article: 9.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/22/2020] [Revised: 03/21/2021] [Accepted: 05/07/2021] [Indexed: 12/21/2022] Open
Abstract
AIMS The morbidity and mortality rates of calcific aortic valve disease (CAVD) remain high while treatment options are limited. Here, we evaluated the role and therapeutic value of dual-specificity phosphatase 26 (DUSP26) in CAVD. METHODS AND RESULTS Microarray profiling of human calcific aortic valves and normal controls demonstrated that DUSP26 was significantly up-regulated in calcific aortic valves. ApoE-/- mice fed a normal diet or a high cholesterol diet (HCD) were infected with adeno-associated virus serotype 2 carrying DUSP26 short-hairpin RNA to examine the effects of DUSP26 silencing on aortic valve calcification. DUSP26 silencing ameliorated aortic valve calcification in HCD-treated ApoE-/- mice, as evidenced by reduced thickness and calcium deposition in the aortic valve leaflets, improved echocardiographic parameters (decreased peak transvalvular jet velocity and mean transvalvular pressure gradient, as well as increased aortic valve area), and decreased levels of osteogenic markers (Runx2, osterix, and osteocalcin) in the aortic valves. These results were confirmed in osteogenic medium-induced human valvular interstitial cells. Immunoprecipitation, liquid chromatography-tandem mass spectrometry, and functional assays revealed that dipeptidyl peptidase-4 (DPP4) interacted with DUSP26 to mediate the procalcific effects of DUSP26. High N6-methyladenosine levels up-regulated DUSP26 in CAVD; in turn, DUSP26 activated DPP4 by antagonizing mouse double minute 2-mediated ubiquitination and degradation of DPP4, thereby promoting CAVD progression. CONCLUSION DUSP26 promotes aortic valve calcification by inhibiting DPP4 degradation. Our findings identify a previously unrecognized mechanism of DPP4 up-regulation in CAVD, suggesting that DUSP26 silencing or inhibition is a viable therapeutic strategy to impede CAVD progression.
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Affiliation(s)
- Yongjun Wang
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Avenue, Wuhan, Hubei 430022, China
| | - Dong Han
- National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China
| | - Tingwen Zhou
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Avenue, Wuhan, Hubei 430022, China
| | - Cheng Chen
- Institute of Geriatrics, National Clinical Research Center for Geriatrics Disease, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China
| | - Hong Cao
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Avenue, Wuhan, Hubei 430022, China
| | - Joe Z Zhang
- Stanford Cardiovascular Institute, Stanford School of Medicine, 265 Campus Drive, Stanford, CA 94305, USA
| | - Ning Ma
- Bioland Laboratory (Guangzhou Regenerative Medicine and Health Guangdong Laboratory), 96# Xingdao South Road, Haizhu District, Guangzhou, Guangdong 510320, China
| | - Chun Liu
- Stanford Cardiovascular Institute, Stanford School of Medicine, 265 Campus Drive, Stanford, CA 94305, USA
| | - Moshi Song
- Institute of Stem Cell and Regeneration, Chinese Academy of Sciences, 1# Beichen West Road, Beijing 100101, China
| | - Jiawei Shi
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Avenue, Wuhan, Hubei 430022, China
| | - Xin Jin
- Department of Urology, The Second Xiangya Hospital, Central South University, 139# Renmin middle road, Changsha, Hunan 410011, China
| | - Feng Cao
- National Clinical Research Center for Geriatric Diseases, 2nd Medical Center, Chinese PLA General Hospital, 28# Fuxing Road, Beijing 100853, China
| | - Nianguo Dong
- Department of Cardiovascular Surgery, Union Hospital, Tongji Medical College, Huazhong University of Science and Technology, 1277# Jiefang Avenue, Wuhan, Hubei 430022, China
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13
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Abstract
CONTEXT Obesity and type 2 diabetes are associated with chronic hyperinsulinemia, elevated plasma levels of dipeptidyl peptidase-4 (DPP4), and a pro-atherosclerotic milieu. EVIDENCE ACQUISITION PubMed search of the term "insulin and atherosclerosis," "hyperinsulinemia," "atherosclerosis," or "cardiovascular outcomes" cross-referenced with "DPP4." Relevant research and review articles were reviewed. EVIDENCE SYNTHESIS Hyperinsulinemia in the setting of insulin resistance promotes vascular inflammation, vascular smooth muscle cell growth, pathological cholesterol profile, hypertension, and recruitment of immune cells to the endothelium, all contributing to atherosclerosis. DPP4 has pleiotropic functions and its activity is elevated in obese humans. DPP4 mirrors hyperinsulinemia's atherogenic actions in the insulin resistant state, and genetic deletion of DPP4 protects rodents from developing insulin resistance and improves cardiovascular outcomes. DPP4 inhibition in pro-atherosclerotic preclinical models results in reduced inflammation and oxidative stress, improved endothelial function, and decreased atherosclerosis. Increased incretin levels may have contributed to but do not completely account for these benefits. Small clinical studies with DPP4 inhibitors demonstrate reduced carotid intimal thickening, improved endothelial function, and reduced arterial stiffness. To date, this has not been translated to cardiovascular risk reduction for individuals with type 2 diabetes with prior or exaggerated risk of cardiovascular disease. CONCLUSION DPP4 may represent a key link between central obesity, insulin resistance, and atherosclerosis. The gaps in knowledge in DPP4 function and discrepancy in cardiovascular outcomes observed in preclinical and large-scale randomized controlled studies with DPP4 inhibitors warrant additional research.
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Affiliation(s)
- Kaitlin M Love
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA
| | - Zhenqi Liu
- Division of Endocrinology and Metabolism, Department of Medicine, University of Virginia Health System, Charlottesville, VA, USA
- Correspondence: Zhenqi Liu, M.D., University of Virginia Health System, Charlottesville, VA, USA.
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14
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Lee HJ, Mariappan MM, Norton L, Bakewell T, Feliers D, Oh SB, Donati A, Rubannelsonkumar CS, Venkatachalam MA, Harris SE, Rubera I, Tauc M, Ghosh Choudhury G, Kahn CR, Sharma K, DeFronzo RA, Kasinath BS. Proximal tubular epithelial insulin receptor mediates high-fat diet-induced kidney injury. JCI Insight 2021; 6:143619. [PMID: 33400689 PMCID: PMC7934847 DOI: 10.1172/jci.insight.143619] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2020] [Accepted: 12/29/2020] [Indexed: 01/04/2023] Open
Abstract
The role of insulin receptor (IR) activated by hyperinsulinemia in obesity-induced kidney injury is not well understood. We hypothesized that activation of kidney proximal tubule epithelial IR contributes to obesity-induced kidney injury. We administered normal-fat diet (NFD) or high-fat diet (HFD) to control and kidney proximal tubule IR–knockout (KPTIRKO) mice for 4 months. Renal cortical IR expression was decreased by 60% in male and female KPTIRKO mice. Baseline serum glucose, serum creatinine, and the ratio of urinary albumin to creatinine (ACR) were similar in KPTIRKO mice compared to those of controls. On HFD, weight gain and increase in serum cholesterol were similar in control and KPTIRKO mice; blood glucose did not change. HFD increased the following parameters in the male control mice: renal cortical contents of phosphorylated IR and Akt, matrix proteins, urinary ACR, urinary kidney injury molecule-1–to-creatinine ratio, and systolic blood pressure. Renal cortical generation of hydrogen sulfide was reduced in HFD-fed male control mice. All of these parameters were ameliorated in male KPTIRKO mice. Interestingly, female mice were resistant to HFD-induced kidney injury in both genotypes. We conclude that HFD-induced kidney injury requires renal proximal tubule IR activation in male mice.
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Affiliation(s)
- Hak Joo Lee
- Center for Renal Medicine, Division of Nephrology
| | | | - Luke Norton
- Division of Diabetes, Department of Medicine
| | | | | | - Sae Byeol Oh
- Center for Renal Medicine, Division of Nephrology
| | | | | | | | - Stephen E Harris
- Department of Periodontics, University of Texas Health, San Antonio, Texas, USA
| | - Isabelle Rubera
- Universite Cote d'Azur, CNRS - UMR-7370, Laboratoire de Physiomédecine Moléculaire, Nice, France
| | - Michel Tauc
- Universite Cote d'Azur, CNRS - UMR-7370, Laboratoire de Physiomédecine Moléculaire, Nice, France
| | - Goutam Ghosh Choudhury
- Center for Renal Medicine, Division of Nephrology.,VA Research and.,Geriatric Research, Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, Texas, USA
| | - C Ronald Kahn
- Joslin Diabetes Center and Harvard Medical School, Boston, Massachusetts, USA
| | - Kumar Sharma
- Center for Renal Medicine, Division of Nephrology.,VA Research and
| | | | - Balakuntalam S Kasinath
- Center for Renal Medicine, Division of Nephrology.,VA Research and.,Geriatric Research, Education and Clinical Center, South Texas Veterans Health Care System, San Antonio, Texas, USA
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15
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Therapies for the Treatment of Cardiovascular Disease Associated with Type 2 Diabetes and Dyslipidemia. Int J Mol Sci 2021; 22:ijms22020660. [PMID: 33440821 PMCID: PMC7826980 DOI: 10.3390/ijms22020660] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2020] [Revised: 01/04/2021] [Accepted: 01/07/2021] [Indexed: 02/06/2023] Open
Abstract
Cardiovascular disease (CVD) is the leading cause of death worldwide and is the clinical manifestation of the atherosclerosis. Elevated LDL-cholesterol levels are the first line of therapy but the increasing prevalence in type 2 diabetes mellitus (T2DM) has positioned the cardiometabolic risk as the most relevant parameter for treatment. Therefore, the control of this risk, characterized by dyslipidemia, hypertension, obesity, and insulin resistance, has become a major goal in many experimental and clinical studies in the context of CVD. In the present review, we summarized experimental studies and clinical trials of recent anti-diabetic and lipid-lowering therapies targeted to reduce CVD. Specifically, incretin-based therapies, sodium-glucose co-transporter 2 inhibitors, and proprotein convertase subtilisin kexin 9 inactivating therapies are described. Moreover, the novel molecular mechanisms explaining the CVD protection of the drugs reviewed here indicate major effects on vascular cells, inflammatory cells, and cardiomyocytes, beyond their expected anti-diabetic and lipid-lowering control. The revealed key mechanism is a prevention of acute cardiovascular events by restraining atherosclerosis at early stages, with decreased leukocyte adhesion, recruitment, and foam cell formation, and increased plaque stability and diminished necrotic core in advanced plaques. These emergent cardiometabolic therapies have a promising future to reduce CVD burden.
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16
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Akoumianakis I, Filippatos T. The renin-angiotensin-aldosterone system as a link between obesity and coronavirus disease 2019 severity. Obes Rev 2020; 21:e13077. [PMID: 32567171 PMCID: PMC7362041 DOI: 10.1111/obr.13077] [Citation(s) in RCA: 23] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2020] [Revised: 05/18/2020] [Accepted: 05/19/2020] [Indexed: 12/14/2022]
Abstract
Coronavirus disease 2019 (COVID-19), caused by the severe acute respiratory distress coronavirus 2 (SARS-CoV2), is a rapidly evolving pandemic challenging the world and posing unprecedented public health issues. Current data show that COVID-19 is associated with increased disease severity in individuals with obesity. Obesity is usually associated with dysregulated renin-angiotensin-aldosterone (RAAS) axis. RAAS has also been implicated in acute lung injury as well as myocardial injury and has thus attracted interest as a potential regulator of COVID-19 severity. Whilst research all over the world is still struggling to provide a detailed characterization of the biology of SARS-CoV2 and its associated disease profile, it has become evident that SARS-CoV2 uses the membrane-bound form of angiotensin-converting enzyme 2 (ACE2) as a receptor for cell internalization. ACE2 is a protective component of the RAAS axis and is downregulated after SARS-CoV2 infection. The RAAS axis could thus be a link between obesity and COVID-19 severity; therefore, more accurate understanding of the underlying mechanisms would be needed with the hope of proposing efficient therapeutic interventions.
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Affiliation(s)
- Ioannis Akoumianakis
- Metabolic Diseases Research Unit, Internal Medicine Laboratory, School of MedicineUniversity of CreteHeraklionGreece
- Cardiovascular Medicine Division, Radcliffe Department of MedicineUniversity of OxfordOxfordUK
| | - Theodosios Filippatos
- Metabolic Diseases Research Unit, Internal Medicine Laboratory, School of MedicineUniversity of CreteHeraklionGreece
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