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Iwane S, Nemoto W, Miyamoto T, Hayashi T, Tanaka M, Uchitani K, Muranaka T, Fujitani M, Koizumi Y, Hirata A, Tsubota M, Sekiguchi F, Tan-No K, Kawabata A. Clinical and preclinical evidence that angiotensin-converting enzyme inhibitors and angiotensin receptor blockers prevent diabetic peripheral neuropathy. Sci Rep 2024; 14:1039. [PMID: 38200077 PMCID: PMC10781693 DOI: 10.1038/s41598-024-51572-z] [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: 10/03/2023] [Accepted: 01/06/2024] [Indexed: 01/12/2024] Open
Abstract
Given possible involvement of the central and peripheral angiotensin system in pain processing, we conducted clinical and preclinical studies to test whether pharmacological inhibition of the angiotensin system would prevent diabetic peripheral neuropathy (DPN) accompanying type 2 diabetes mellitus (T2DM). In the preclinical study, the nociceptive sensitivity was determined in leptin-deficient ob/ob mice, a T2DM model. A clinical retrospective cohort study was conducted, using the medical records of T2DM patients receiving antihypertensives at three hospitals for nearly a decade. In the ob/ob mice, daily treatment with perindopril, an angiotensin-converting enzyme inhibitor (ACEI), or telmisartan, an angiotensin receptor blocker (ARB), but not amlodipine, an L-type calcium channel blocker (CaB), significantly inhibited DPN development without affecting the hyperglycemia. In the clinical study, the enrolled 7464 patients were divided into three groups receiving ACEIs, ARBs and the others (non-ACEI, non-ARB antihypertensives). Bonferroni's test indicated significantly later DPN development in the ARB and ACEI groups than the others group. The multivariate Cox proportional analysis detected significant negative association of the prescription of ACEIs or ARBs and β-blockers, but not CaBs or diuretics, with DPN development. Thus, our study suggests that pharmacological inhibition of the angiotensin system is beneficial to prevent DPN accompanying T2DM.
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Affiliation(s)
- Shiori Iwane
- Laboratory of Pharmacology and Pathophysiology, Faculty of Pharmacy, Kindai University, Higashi-Osaka, 577-8502, Japan
- Department of Pharmacy, Kansai Medical University Hospital, Hirakata, 573-1191, Japan
| | - Wataru Nemoto
- Division of Pharmacology, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, 981-8558, Japan
| | - Tomoyoshi Miyamoto
- Laboratory of Pharmacology and Pathophysiology, Faculty of Pharmacy, Kindai University, Higashi-Osaka, 577-8502, Japan
- School of Pharmacy, Hyogo Medical University, Kobe, 650-8530, Japan
| | - Tomonori Hayashi
- Department of Pharmacy, Kindai University Nara Hospital, Ikoma, 630-0293, Japan
| | - Masayuki Tanaka
- Department of Pharmacy, Kansai Medical University Hospital, Hirakata, 573-1191, Japan
| | - Kazuki Uchitani
- Department of Pharmacy, Kansai Medical University Hospital, Hirakata, 573-1191, Japan
| | - Tatsuya Muranaka
- Department of Pharmacy, Kansai Medical University Hospital, Hirakata, 573-1191, Japan
| | - Masanori Fujitani
- Department of Pharmacy, Seichokai Fuchu Hospital, Izumi, 594-0076, Japan
| | - Yuichi Koizumi
- Department of Pharmacy, Seichokai Fuchu Hospital, Izumi, 594-0076, Japan
| | - Atsushi Hirata
- Department of Pharmacy, Kindai University Nara Hospital, Ikoma, 630-0293, Japan
| | - Maho Tsubota
- Laboratory of Pharmacology and Pathophysiology, Faculty of Pharmacy, Kindai University, Higashi-Osaka, 577-8502, Japan
| | - Fumiko Sekiguchi
- Laboratory of Pharmacology and Pathophysiology, Faculty of Pharmacy, Kindai University, Higashi-Osaka, 577-8502, Japan
| | - Koichi Tan-No
- Division of Pharmacology, Faculty of Pharmaceutical Sciences, Tohoku Medical and Pharmaceutical University, Sendai, 981-8558, Japan
| | - Atsufumi Kawabata
- Laboratory of Pharmacology and Pathophysiology, Faculty of Pharmacy, Kindai University, Higashi-Osaka, 577-8502, Japan.
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