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Shabab S, Mahmoudabady M, Gholamnezhad Z, Niazmand S, Fouladi M, Mousavi Emadi Z. Endurance Exercise Prevented Diabetic Cardiomyopathy through the Inhibition of Fibrosis and Hypertrophy in Rats. Rev Cardiovasc Med 2024; 25:173. [PMID: 39076482 PMCID: PMC11267178 DOI: 10.31083/j.rcm2505173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/05/2023] [Revised: 02/13/2024] [Accepted: 02/27/2024] [Indexed: 07/31/2024] Open
Abstract
Background Exercise training could be essential in preventing pathological cardiac remodeling in diabetes. Therefore, the effects of moderate-intensity continuous training (MICT) and high-intensity interval training (HIIT) singly or plus metformin on diabetes-induced cardiomyopathy were investigated in this study. Methods Forty-nine Wistar rats (male) were recruited. Seven groups of animals were treated for six weeks as control, diabetes, MICT (15 m/min, 40 min/day), HIIT (20 m/min, 40 min/day), metformin (300 mg/kg), HIIT+metformin (Met-HIIT), and MICT+metformin (Met-MICT). The metformin was orally administered with an intragastrical needle, and the exercised rats were trained (5 days/week) with a motorized treadmill. Metabolic parameters, echocardiographic indices, histopathology evaluation, and assessment of gene expression connected with cardiac fibrosis, hypertrophy, mitochondrial performance, and intracellular calcium homeostasis were investigated. Results Our results demonstrated that all the interventions prevented weight loss and enhanced heart weight/body weight ratio and fasting plasma glucose in diabetic rats. Both types of exercise and their metformin combinations improved diabetic animals' echocardiography indices by enhancing heart rate, fractional shortening (FS), ejection fraction (EF) and reducing end-systolic and end-diastolic diameter of left ventricular (LVESD and LVEDD). Gene expression of atrial natriuretic peptide (ANP), brain natriuretic peptide (BNP), transforming growth factor (TGF)- β , and collagen increased in the diabetes group. In contrast, the gene expression of peroxisome proliferator-activated receptor gamma coactivator 1 alpha (PGC-1 α ), AMP-activated protein kinase (AMPK), ryanodine receptors (RyR), and Ca 2 + ATPase pump of the sarcoplasmic reticulum (SERCA) was reduced in diabetic animals. Exercise training alone or in combination with metformin reversed these changes. Moreover, diabetes-induced cardiac fibrosis was ameliorated in treated groups. All indicators of diabetic cardiomyopathy were improved more in the Met-HIIT group than in other groups. Conclusions Exercise training, notably with metformin combination, alleviated diabetes-induced cardiac complications. The beneficial effects of exercise could be related to improving pathological cardiac remodeling and enhancing cardiac function.
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Affiliation(s)
- Sadegh Shabab
- Department of Physiology, Faculty of Medicine, Mashhad University of
Medical Sciences, 91779 48564 Mashhad, Iran
| | - Maryam Mahmoudabady
- Department of Physiology, Faculty of Medicine, Mashhad University of
Medical Sciences, 91779 48564 Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical
Sciences, 91779 48564 Mashhad, Iran
| | - Zahra Gholamnezhad
- Department of Physiology, Faculty of Medicine, Mashhad University of
Medical Sciences, 91779 48564 Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical
Sciences, 91779 48564 Mashhad, Iran
| | - Saeed Niazmand
- Department of Physiology, Faculty of Medicine, Mashhad University of
Medical Sciences, 91779 48564 Mashhad, Iran
- Applied Biomedical Research Center, Mashhad University of Medical
Sciences, 91779 48564 Mashhad, Iran
| | - Mahtab Fouladi
- Department of Physiology, Faculty of Medicine, Mashhad University of
Medical Sciences, 91779 48564 Mashhad, Iran
| | - Zahra Mousavi Emadi
- Department of Pediatrics, Mashhad University of Medical Sciences, 91779
48564 Mashhad, Iran
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Zhang F, Lin JJ, Tian HN, Wang J. Effect of exercise on improving myocardial mitochondrial function in decreasing diabetic cardiomyopathy. Exp Physiol 2024; 109:190-201. [PMID: 37845840 PMCID: PMC10988701 DOI: 10.1113/ep091309] [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: 05/22/2023] [Accepted: 09/11/2023] [Indexed: 10/18/2023]
Abstract
Diabetic cardiomyopathy (DCM) is a significant cause of heart failure in patients with diabetes, and its pathogenesis is closely related to myocardial mitochondrial injury and functional disability. Studies have shown that the development of diabetic cardiomyopathy is related to disorders in mitochondrial metabolic substrates, changes in mitochondrial dynamics, an imbalance in mitochondrial Ca2+ regulation, defects in the regulation of microRNAs, and mitochondrial oxidative stress. Physical activity may play a role in resistance to the development of diabetic cardiomyopathy by improving myocardial mitochondrial biogenesis, the level of autophagy and dynamic changes in fusion and division; enhancing the ability to cope with oxidative stress; and optimising the metabolic substrates of the myocardium. This paper puts forward a new idea for further understanding the specific mitochondrial mechanism of the occurrence and development of diabetic cardiomyopathy and clarifying the role of exercise-mediated myocardial mitochondrial changes in the prevention and treatment of diabetic cardiomyopathy. This is expected to provide a new theoretical basis for exercise to reduce diabetic cardiomyopathy symptoms.
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Affiliation(s)
- Feng Zhang
- Sports Physiology DepartmentBeijing Sport UniversityBeijingChina
| | - Jian jian Lin
- PE Teaching and Research OfficeUniversity of International RelationshipBeijingChina
| | - Hao nan Tian
- Sports Physiology DepartmentBeijing Sport UniversityBeijingChina
| | - Jun Wang
- Sports Physiology DepartmentBeijing Sport UniversityBeijingChina
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Damiano S, Lauritano C, Longobardi C, Andretta E, Elagoz AM, Rapisarda P, Di Iorio M, Florio S, Ciarcia R. Effects of a Red Orange and Lemon Extract in Obese Diabetic Zucker Rats: Role of Nicotinamide Adenine Dinucleotide Phosphate Oxidase. J Clin Med 2020; 9:jcm9051600. [PMID: 32466228 PMCID: PMC7290772 DOI: 10.3390/jcm9051600] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/18/2020] [Revised: 05/08/2020] [Accepted: 05/19/2020] [Indexed: 12/15/2022] Open
Abstract
Diabetic nephropathy (DN) is the primary cause of end-stage renal disease, worldwide, and oxidative stress has been recognized as a key factor in the pathogenesis and progression of DN. Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase has the most important contribution to reactive oxygen species generation during the development of DN. Bioactive compound use has emerged as a potential approach to reduce chronic renal failure. Therefore, a red orange and lemon extract (RLE) rich in anthocyanins was chosen in our study, to reduce the toxic renal effects during the development of DN in Zucker diabetic fatty rat (ZDF). RLE effects were examined daily for 24 weeks, through gavage, in ZDF rats treated with RLE (90 mg/kg). At the end of the experiment, ZDF rats treated with RLE showed a reduction of the diabetes-associated up-regulation of both NOX4 and the p47-phox and p22-phox subunits, and restored the BAX/BCL-2 ratio respect to ZDF rats. Furthermore, RLE was able to reduce the oxidative DNA damage measured in urine samples in ZDF rats. This study showed that RLE could prevent the renal damage induced by DN through its capacity to inhibit NOX4 and apoptosis mechanisms.
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Affiliation(s)
- Sara Damiano
- Department of Veterinary Medicine and Animal Productions, University of Naples “Federico II”, 80137 Naples, Italy; (E.A.); (S.F.); (R.C.)
- Correspondence: ; Tel.: +39-081-2536027-092
| | - Chiara Lauritano
- Marine Biotechnology Department, Stazione Zoologica Anton Dohrn, 80121 Naples, Italy;
| | - Consiglia Longobardi
- Department of Mental, Physical Health and Preventive Medicine, University of Campania “Luigi Vanvitelli”, 80138 Naples, Italy;
| | - Emanuela Andretta
- Department of Veterinary Medicine and Animal Productions, University of Naples “Federico II”, 80137 Naples, Italy; (E.A.); (S.F.); (R.C.)
| | - Ali Murat Elagoz
- Laboratory of Developmental Neurobiology, Department of Biology, Faculty of Science, KU Leuven, 3000 Leuven, Belgium;
| | - Paolo Rapisarda
- Council for Agricultural Research and Economics (CREA), Research Centre for Olive, Citrus and Tree Fruit, 95024 Acireale, Italy;
| | | | - Salvatore Florio
- Department of Veterinary Medicine and Animal Productions, University of Naples “Federico II”, 80137 Naples, Italy; (E.A.); (S.F.); (R.C.)
| | - Roberto Ciarcia
- Department of Veterinary Medicine and Animal Productions, University of Naples “Federico II”, 80137 Naples, Italy; (E.A.); (S.F.); (R.C.)
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Effting PS, Brescianini SMS, Sorato HR, Fernandes BB, Fidelis GDSP, Silva PRLD, Silveira PCL, Nesi RT, Ceddia RB, Pinho RA. Resistance Exercise Modulates Oxidative Stress Parameters and TNF-α Content in the Heart of Mice with Diet-Induced Obesity. Arq Bras Cardiol 2019; 112:545-552. [PMID: 31038529 PMCID: PMC6555563 DOI: 10.5935/abc.20190072] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/29/2018] [Accepted: 10/02/2018] [Indexed: 01/13/2023] Open
Abstract
Background Obesity can be characterized by low-grade chronic inflammation and is
associated with an excesso production of reactive oxygen species, factors
that contribute to coronary heart disease and other cardiomyopathies. Objective To verify the effects of resistance exercise training on oxidative stress and
inflammatory parameters on mice with obesity induced by a high-fat diet
(HFD). Methods 24 Swiss mice were divided into 4 groups: standard diet (SD), SD + resistance
exercise (SD + RE), diet-induced obesity (DIO), DIO + RE. The animals were
fed SD or HFD for 26 weeks and performed resistance exercises in the last 8
weeks of the study. The insulin tolerance test (ITT) and body weight
monitoring were performed to assess the clinical parameters. Oxidative
stress and inflammation parameters were evaluated in the cardiac tissue.
Data were expressed by mean and standard deviation (p < 0.05). Results The DIO group had a significant increase in reactive oxygen species levels
and lipid peroxidation with reduction after exercise. Superoxide dismutase
and the glutathione system showed no significant changes in DIO animals,
with an increase in SD + RE. Only catalase activity decreased with both diet
and exercise influence. There was an increase in tumor necrosis factor-alpha
(TNF-α) in the DIO group, characterizing a possible inflammatory
condition, with a decrease when exposed to resistance training (DIO+RE). Conclusion The DIO resulted in a redox imbalance in cardiac tissue, but the RE was able
to modulate these parameters, as well as to control the increase in
TNF-α levels.
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Affiliation(s)
- Pauline Souza Effting
- Laboratório de Fisiologia e Bioquímica do Exercício (LAFIBE) - Programa de Pós-Graduação em Ciências da Saúde (PPGCS) - Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC - Brazil
| | - Stella M S Brescianini
- Laboratório de Fisiologia e Bioquímica do Exercício (LAFIBE) - Programa de Pós-Graduação em Ciências da Saúde (PPGCS) - Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC - Brazil
| | - Helen R Sorato
- Laboratório de Fisiologia e Bioquímica do Exercício (LAFIBE) - Programa de Pós-Graduação em Ciências da Saúde (PPGCS) - Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC - Brazil
| | - Bruna Barros Fernandes
- Laboratório de Fisiologia e Bioquímica do Exercício (LAFIBE) - Programa de Pós-Graduação em Ciências da Saúde (PPGCS) - Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC - Brazil
| | - Giulia Dos S Pedroso Fidelis
- Laboratório de Fisiologia e Bioquímica do Exercício (LAFIBE) - Programa de Pós-Graduação em Ciências da Saúde (PPGCS) - Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC - Brazil
| | - Paulo Roberto L da Silva
- Laboratório de Fisiologia e Bioquímica do Exercício (LAFIBE) - Programa de Pós-Graduação em Ciências da Saúde (PPGCS) - Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC - Brazil
| | - Paulo César L Silveira
- Laboratório de Fisiologia e Bioquímica do Exercício (LAFIBE) - Programa de Pós-Graduação em Ciências da Saúde (PPGCS) - Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC - Brazil.,Laboratório de Fisiopatologia Experimental - Programa de Pós-Graduação em Ciências da Saúde (PPGCS) - Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC - Brazil
| | - Renata T Nesi
- Laboratório de Fisiologia e Bioquímica do Exercício (LAFIBE) - Programa de Pós-Graduação em Ciências da Saúde (PPGCS) - Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC - Brazil
| | - Rolando B Ceddia
- Muscle Health Research Center, School of Kinesiology and Health Center - York University, Toronto, ON - Canadá
| | - Ricardo A Pinho
- Laboratório de Fisiologia e Bioquímica do Exercício (LAFIBE) - Programa de Pós-Graduação em Ciências da Saúde (PPGCS) - Universidade do Extremo Sul Catarinense (UNESC), Criciúma, SC - Brazil.,Laboratório de Bioquímica do Exercício em Saúde (BioEx) - Programa de Pós-Graduação em Ciências da Saúde (PPGCS) - Pontifícia Universidade Católica do Paraná (PUCPR), Curitiba, PR - Brazil
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Taghi Beigi H, Esfarjani F, Marandi SM, Karami H. The Effect of 8-Week Aerobic Exercise on the Expression of Regulatory Subunits of NADPH Oxidase 2 (p47phox and p67phox) in the Cardiac Tissue of Diabetic Rats. INTERNATIONAL JOURNAL OF BASIC SCIENCE IN MEDICINE 2019. [DOI: 10.15171/ijbsm.2019.05] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
Introduction: Oxidative stress seems to play a major role in diabetes-induced cardiac dysfunction, known as diabetic cardiomyopathy (DCM). Nicotinamide adenine dinucleotide phosphate (NADPH) oxidase 2 is considered as one of the main enzymatic systems which primarily contributes to the production of reactive oxygen species in various organs including the heart. The present study aimed to investigate the effects of 8 weeks of aerobic exercise (AE) on the expression of p47phox and p67phox, which are regarded as the regulatory subunits of NADPH oxidase 2 in the cardiac tissue in diabetic rats. Methods: A total of 36 male Wistar rats with a mean weight of 231±25 g were randomly divided into non-diabetic, control diabetic, and trained diabetic groups (each containing 12 rats). Nicotinamide and streptozotocin were used to induce diabetes in the rats. The cardiac muscle was removed under sterile conditions 48 hours following the last training session. Finally, the mRNA levels of p47phox and p67phox were evaluated using the real-time polymerase chain reaction. Results: The results showed that diabetes induction significantly increased the gene expressions of p47phox and p67phox in the cardiac tissue of diabetic rats. The expression of these genes was significantly attenuated after 8 weeks of AE. Conclusion: In general, AE was found to prevent the negative effects of diabetes by suppressing p47phox and p67phox in the cardiac tissue of diabetic rats. Therefore, this can improve cardiac function and may be a potential preventive or therapeutic modality for DCM.
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Affiliation(s)
- Hamid Taghi Beigi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Fahimeh Esfarjani
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Seyed Mohammad Marandi
- Department of Exercise Physiology, Faculty of Sport Sciences, University of Isfahan, Isfahan, Iran
| | - Hadi Karami
- Department of Molecular Medicine and Biotechnology, Faculty of Medical Sciences, Arak University of Medical Sciences, Arak, Iran
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Paloschi MV, Boeno CN, Lopes JA, Eduardo Dos Santos da Rosa A, Pires WL, Pontes AS, da Silva Setúbal S, Soares AM, Zuliani JP. Role of l-amino acid oxidase isolated from Calloselasma rhodostoma venom on neutrophil NADPH oxidase complex activation. Toxicon 2018; 145:48-55. [PMID: 29499246 DOI: 10.1016/j.toxicon.2018.02.046] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/16/2017] [Revised: 02/01/2018] [Accepted: 02/26/2018] [Indexed: 01/02/2023]
Abstract
The action of Cr-LAAO, an l-amino acid oxidase isolated from Calloselasma rhodosthoma snake venom, on NADPH oxidase activation in isolated human neutrophil function was investigated. This enzyme has an intrinsic activity of hydrogen peroxide production. Cr-LAAO, in its native form, induces the ROS production in neutrophil and migration of cytosolic NADPH oxidase components p40phox, p47phox and p67phox to the membrane, and Rac, a GTPase protein member, with the involvement of intracellular signaling mediated by phospho PKC-α. In its inactive form, iCr-LAAO does not induce NADPH oxidase activation in neutrophil showing that the intrinsic enzymatic activity does not have a role in this process, suggesting that its primary structure is essential for the cell's stimulation. Accordingly, the data showed for the first time that the Cr-LAAO has a role in NADPH oxidase complex activation triggering relevant proinflammatory events in human neutrophils.
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Affiliation(s)
- Mauro Valentino Paloschi
- Laboratório de Imunologia Celular Aplicada à Saúde, Fundação Oswaldo Cruz, FIOCRUZ Rondônia, Porto Velho, RO, Brazil
| | - Charles Nunes Boeno
- Laboratório de Imunologia Celular Aplicada à Saúde, Fundação Oswaldo Cruz, FIOCRUZ Rondônia, Porto Velho, RO, Brazil
| | - Jéssica Amaral Lopes
- Laboratório de Imunologia Celular Aplicada à Saúde, Fundação Oswaldo Cruz, FIOCRUZ Rondônia, Porto Velho, RO, Brazil
| | | | - Weverson Luciano Pires
- Laboratório de Imunologia Celular Aplicada à Saúde, Fundação Oswaldo Cruz, FIOCRUZ Rondônia, Porto Velho, RO, Brazil
| | - Adriana Silva Pontes
- Laboratório de Imunologia Celular Aplicada à Saúde, Fundação Oswaldo Cruz, FIOCRUZ Rondônia, Porto Velho, RO, Brazil
| | - Sulamita da Silva Setúbal
- Laboratório de Imunologia Celular Aplicada à Saúde, Fundação Oswaldo Cruz, FIOCRUZ Rondônia, Porto Velho, RO, Brazil
| | - Andreimar Martins Soares
- Centro de Estudos de Biomoléculas Aplicadas à Saúde (CEBio), Fundação Oswaldo Cruz, FIOCRUZ Rondônia e Departamento de Medicina, Universidade Federal de Rondônia, UNIR, Porto Velho, RO, Brazil
| | - Juliana Pavan Zuliani
- Laboratório de Imunologia Celular Aplicada à Saúde, Fundação Oswaldo Cruz, FIOCRUZ Rondônia, Porto Velho, RO, Brazil; Centro de Estudos de Biomoléculas Aplicadas à Saúde (CEBio), Fundação Oswaldo Cruz, FIOCRUZ Rondônia e Departamento de Medicina, Universidade Federal de Rondônia, UNIR, Porto Velho, RO, Brazil.
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Mahmoud AM. Exercise Amaliorates Metabolic Disturbances and Oxidative Stress in Diabetic Cardiomyopathy: Possible Underlying Mechanisms. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2017; 999:207-230. [DOI: 10.1007/978-981-10-4307-9_12] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
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Silva FS, Bortolin RH, Araújo DN, Marques DE, Lima JPM, Rezende AA, Vieira WH, Silva NB, Medeiros KC, Ackermann PW, Abreu BJ, Dias FA. Exercise training ameliorates matrix metalloproteinases 2 and 9 messenger RNA expression and mitigates adverse left ventricular remodeling in streptozotocin-induced diabetic rats. Cardiovasc Pathol 2017; 29:37-44. [DOI: 10.1016/j.carpath.2017.05.003] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/19/2017] [Revised: 04/30/2017] [Accepted: 05/16/2017] [Indexed: 01/22/2023] Open
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High-Intensity Exercise Reduces Cardiac Fibrosis and Hypertrophy but Does Not Restore the Nitroso-Redox Imbalance in Diabetic Cardiomyopathy. OXIDATIVE MEDICINE AND CELLULAR LONGEVITY 2017; 2017:7921363. [PMID: 28698769 PMCID: PMC5494101 DOI: 10.1155/2017/7921363] [Citation(s) in RCA: 29] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/10/2017] [Revised: 04/18/2017] [Accepted: 04/27/2017] [Indexed: 01/25/2023]
Abstract
Diabetic cardiomyopathy refers to the manifestations in the heart as a result of altered glucose homeostasis, reflected as fibrosis, cellular hypertrophy, increased oxidative stress, and apoptosis, leading to ventricular dysfunction. Since physical exercise has been indicated as cardioprotective, we tested the hypothesis that high-intensity exercise training could reverse the cardiac maladaptations produced by diabetes. For this, diabetes was induced in rats by a single dose of alloxan. Diabetic rats were randomly assigned to a sedentary group or submitted to a program of exercise on a treadmill for 4 weeks at 80% of maximal performance. Another group of normoglycemic rats was used as control. Diabetic rat hearts presented cardiomyocyte hypertrophy and interstitial fibrosis. Chronic exercise reduced both parameters but increased apoptosis. Diabetes increased the myocardial levels of the mRNA and proteins of NADPH oxidases NOX2 and NOX4. These altered levels were not reduced by exercise. Diabetes also increased the level of uncoupled endothelial nitric oxide synthase (eNOS) that was not reversed by exercise. Finally, diabetic rats showed a lower degree of phosphorylated phospholamban and reduced levels of SERCA2 that were not restored by high-intensity exercise. These results suggest that high-intensity chronic exercise was able to reverse remodeling in the diabetic heart but was unable to restore the nitroso-redox imbalance imposed by diabetes.
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Abstract
Macrovascular complications of diabetes, including diabetic cardiovascular disease (CVD), occur through a number of hyperglycaemia-induced mechanisms that include generation of oxidative stress, accumulation of advanced glycation end-products (AGE) and activation of protein kinase C (PKC). Cardiac oxidative stress is associated with increased cardiac fibrosis and hypertrophy, and reduced cardiac performance and contractility, leading to severe cardiac dysfunction and potentially fatal cardiac events. It occurs under conditions of excessive synthesis of reactive oxygen species (ROS). The ensuing activation of transcription factors such as nuclear factor-κB produces inflammation, fibrosis, hypertrophy and further oxidative stress, which itself causes DNA and membrane damage. This review summarises the mechanisms that generate ROS in the diabetic heart: mitochondrial electron leakage, activity of ROS-generating enzymes such as NADPH oxidase, xanthine oxidase and 12/15 lipoxygenase, uncoupling of nitric oxide synthase, accumulation of AGEs and activation of PKC. There is interaction between many of these ROS-generating pathways, with data from a range of published studies indicating that a common upstream pathway is the interaction of AGEs with their receptor (RAGE), which further promotes ROS synthesis. Therefore, agents targeted at decreasing ROS production have been investigated for prevention or treatment of diabetic CVD through reducing oxidative stress, and this review considers some of the studies carried out with anti-oxidant therapies and the feasibility of this approach for protecting against diabetic cardiomyopathy.
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Affiliation(s)
- Alyssa Faria
- Diabetes Research Group, Division of Diabetes & Nutritional Sciences, King's College London, London SE1 1UL, United Kingdom
| | - Shanta J Persaud
- Diabetes Research Group, Division of Diabetes & Nutritional Sciences, King's College London, London SE1 1UL, United Kingdom.
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