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Lunder M, Janić M, Šabovič M. Treating Arterial Ageing in Patients with Diabetes: From Mechanisms to Effective Drugs. Int J Mol Sci 2021; 22:ijms22062796. [PMID: 33801956 PMCID: PMC8001638 DOI: 10.3390/ijms22062796] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 03/04/2021] [Accepted: 03/08/2021] [Indexed: 12/17/2022] Open
Abstract
Diabetes mellitus is a major healthcare problem. It is not only characterized by hyperglycemia and chronic complications, but in longer lasting diabetes and a longer living population, it is also associated with accelerated arterial ageing, which importantly contributes to cardiovascular complications. The accelerated arterial ageing in patients with diabetes should be considered separately from arterial ageing in patients without diabetes. Basic and clinical research have allowed better insight into the mechanisms of arterial ageing. In a simplified mechanistic way, it could be considered that the three tightly connected cornerstone characteristics of arterial ageing in patients with diabetes are: phenotypic presentation as endothelial dysfunction and arterial stiffness, and the underlying basic ageing-facilitating mechanism represented as the impaired expression of genetic longevity pathways. Currently, specific drugs for preventing/treating arterial ageing are not available. Therefore, we aimed to review the capacity of available drugs, particularly antidiabetic drugs, to interfere with the arterial ageing process. In the near future, these characteristics could help to guide therapy in patients with diabetes. Overall, it appears that arterial ageing could become a new target in diabetes. The expanding knowledge regarding the capability of antidiabetic drugs and other available drugs to inhibit/delay arterial aging is therefore essential.
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Affiliation(s)
- Mojca Lunder
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška cesta 7, SI-1000 Ljubljana, Slovenia; (M.L.); (M.J.)
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, SI-1000 Ljubljana, Slovenia
| | - Miodrag Janić
- Department of Endocrinology, Diabetes and Metabolic Diseases, University Medical Centre Ljubljana, Zaloška cesta 7, SI-1000 Ljubljana, Slovenia; (M.L.); (M.J.)
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, SI-1000 Ljubljana, Slovenia
| | - Mišo Šabovič
- Faculty of Medicine, University of Ljubljana, Vrazov trg 2, SI-1000 Ljubljana, Slovenia
- Department of Vascular Diseases, University Medical Centre Ljubljana, Zaloška cesta 7, SI-1000 Ljubljana, Slovenia
- Correspondence: ; Tel.: +386-15228032; Fax: +386-15228070
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Yin N, Zhang H, Ye R, Dong M, Lin J, Zhou H, Huang Y, Chen L, Jiang X, Nagaoka K, Zhang C, Jin W. Fluvastatin Sodium Ameliorates Obesity through Brown Fat Activation. Int J Mol Sci 2019; 20:ijms20071622. [PMID: 30939798 PMCID: PMC6479292 DOI: 10.3390/ijms20071622] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2019] [Revised: 03/21/2019] [Accepted: 03/28/2019] [Indexed: 01/13/2023] Open
Abstract
Brown adipose tissue (BAT), an organ that burns energy through uncoupling thermogenesis, is a promising therapeutic target for obesity. However, there are still no safe anti-obesity drugs that target BAT in the market. In the current study, we performed large scale screening of 636 compounds which were approved by Food and Drug Administration (FDA) to find drugs that could significantly increase uncoupling protein 1 (UCP1) mRNA expression by real-time PCR. Among those UCP1 activators, most of them were antibiotics or carcinogenic compounds. We paid particular attention to fluvastatin sodium (FS), because as an inhibitor of the cellular hydroxymethyl glutaryl coenzyme A (HMG-CoA) reductase, FS has already been approved for treatment of hypercholesteremia. We found that in the cellular levels, FS treatment significantly increased UCP1 expression and BAT activity in human brown adipocytes. Consistently, the expression of oxidative phosphorylation-related genes was significantly increased upon FS treatment without differences in adipogenic gene expression. Furthermore, FS treatment resisted to high-fat diet (HFD)-induced body weight gain by activating BAT in the mice model. In addition, administration of FS significantly increased energy expenditure, improved glucose homeostasis and ameliorated hepatic steatosis. Furthermore, we reveal that FS induced browning in subcutaneous white adipose tissue (sWAT) known to have a beneficial effect on energy metabolism. Taken together, our results clearly demonstrate that as an effective BAT activator, FS may have great potential for treatment of obesity and related metabolic disorders.
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Affiliation(s)
- Na Yin
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
- University of the Chinese Academy of Sciences, Beijing 100049, China.
| | - Hanlin Zhang
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
- University of the Chinese Academy of Sciences, Beijing 100049, China.
| | - Rongcai Ye
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
- University of the Chinese Academy of Sciences, Beijing 100049, China.
| | - Meng Dong
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
- University of the Chinese Academy of Sciences, Beijing 100049, China.
| | - Jun Lin
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
- University of the Chinese Academy of Sciences, Beijing 100049, China.
| | - Huiqiao Zhou
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
- University of the Chinese Academy of Sciences, Beijing 100049, China.
| | - Yuanyuan Huang
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
- University of the Chinese Academy of Sciences, Beijing 100049, China.
| | - Li Chen
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
- University of the Chinese Academy of Sciences, Beijing 100049, China.
| | - Xiaoxiao Jiang
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
- University of the Chinese Academy of Sciences, Beijing 100049, China.
| | - Kentaro Nagaoka
- Laboratory of Veterinary Physiology, Department of Veterinary Medicine, Tokyo University of Agriculture and Technology, Fuchu, Tokyo 183-8509, Japan.
| | - Chuanhai Zhang
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
| | - Wanzhu Jin
- Key Laboratory of Animal Ecology and Conservation Biology, Institute of Zoology, Chinese Academy of Sciences, Beijing 100101, China.
- University of the Chinese Academy of Sciences, Beijing 100049, China.
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Lunder M, Janić M, Šabovič M. Prevention of Vascular Complications in Diabetes Mellitus Patients: Focus on the Arterial Wall. Curr Vasc Pharmacol 2018; 17:6-15. [DOI: 10.2174/1570161116666180206113755] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2017] [Revised: 07/16/2017] [Accepted: 11/07/2017] [Indexed: 12/14/2022]
Abstract
In Diabetes Mellitus (DM), hyperglycaemia and insulin resistance progressively lead to both
microvascular and macrovascular complications. Whereas the incidence of microvascular complications
is closely related to tight glycaemic control, this does not apply to macrovascular complications. Hyperglycaemia
influences many interweaving molecular pathways that initially lead to increased oxidative
stress, increased inflammation and endothelial dysfunction. The latter represents the initial in both types
of vascular complications; it represents the “obligatory damage” in microvascular complications development
and only “introductory damage” in macrovascular complications development. Other risk factors,
such as arterial hypertension and dyslipidaemia, also play an important role in the progression of
macrovascular complications. All these effects accumulate and lead to functional and structural arterial
wall damage. In the end, all factors combined lead to the promotion of atherosclerosis and consequently
major adverse cardiovascular events. If we accept the pivotal role of vascular wall impairment in the
pathogenesis and progression of microvascular and macrovascular complications, treatment focused
directly on the arterial wall should be one of the priorities in prevention of vascular complications in
patients with DM. In this review, an innovative approach aimed at improving arterial wall dysfunction is
described, which may show efficacy in clinical studies. In addition, the potential protective effects of
current treatment approaches targeting the arterial wall are summarised.
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Affiliation(s)
- Mojca Lunder
- Department of Vascular Diseases, University Medical Centre Ljubljana, Zaloska cesta 7; SI-1000 Ljubljana, Slovenia
| | - Miodrag Janić
- Department of Vascular Diseases, University Medical Centre Ljubljana, Zaloska cesta 7; SI-1000 Ljubljana, Slovenia
| | - Mišo Šabovič
- Department of Vascular Diseases, University Medical Centre Ljubljana, Zaloska cesta 7; SI-1000 Ljubljana, Slovenia
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Turk Veselič M, Žorž N, Eržen B, Škerl P, Novaković S, Janić M, Šabovič M. Improvement of arterial wall phenotype in subjects at moderate cardiovascular risk induced by very low-dose fluvastatin/valsartan combination: a pilot study. INT ANGIOL 2018; 37:356-364. [PMID: 29952159 DOI: 10.23736/s0392-9590.18.03983-4] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022]
Abstract
BACKGROUND The largest population that suffers from cardiovascular events are subjects at moderate cardiovascular risk. However, no effective and safe preventive treatment is available for this population. We investigated whether their arterial wall phenotype could be turned to a lower risk direction by low-dose fluvastatin/valsartan combination (low-flu/val). METHODS Twenty males at moderate cardiovascular risk (as classified by SCORE) were blindly randomized into the intervention group (N.=10, low-flu/val: 10 mg/20 mg) or control group (N.=10, placebo). At inclusion and after 30 days of treatment, brachial flow-mediated dilatation (FMD), β-stiffness coefficient, carotid pulse wave velocity (c-PWV), carotid-femoral PWV, Reactive Hyperemia Index, high-sensitivity C-reactive protein (hs-CRP), interleukin 6, vascular cell adhesion molecule 1, total antioxidant status and expression of several protective genes (SIRT1, mTOR, NF-κB1, NFE2L2, PRKAA1) were followed. RESULTS Treatment resulted in improved FMD (from 3% to 4.2%, P=0.008), c-PWV (from 6.7 to 6.2 m/s, P=0.006), hs-CRP (from 5.39 to 3.35 mg/L, P=0.041) and SIRT1 expression (3.34-fold difference, P=0.047). No other vascular, inflammation and genetic parameters changed. The hs-CRP values after intervention correlated significantly with SIRT1 expression. The improved FMD persisted even 10 weeks after treatment discontinuation. The obtained changes were not followed by changes of lipids or blood pressure. Overall, the results revealed improvement in three different, although interrelated preventive arterial wall characteristics. CONCLUSIONS This pilot study revealed that intervention with low-flu/val importantly shifts the arterial wall phenotype in a lower risk direction. This improvement could be interpolated into clinical benefits that remain to be further studied.
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Affiliation(s)
- Martina Turk Veselič
- Department of Vascular Diseases, University Medical Centre of Ljubljana, Ljubljana Slovenia.,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Neža Žorž
- Department of Vascular Diseases, University Medical Centre of Ljubljana, Ljubljana Slovenia
| | - Barbara Eržen
- Department of Vascular Diseases, University Medical Centre of Ljubljana, Ljubljana Slovenia
| | - Petra Škerl
- Department of Molecular Diagnostics, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Srdjan Novaković
- Department of Molecular Diagnostics, Institute of Oncology Ljubljana, Ljubljana, Slovenia
| | - Miodrag Janić
- Department of Vascular Diseases, University Medical Centre of Ljubljana, Ljubljana Slovenia
| | - Mišo Šabovič
- Department of Vascular Diseases, University Medical Centre of Ljubljana, Ljubljana Slovenia - .,Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
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Lunder M, Janić M, Savić V, Janež A, Kanc K, Šabovič M. Very low-dose fluvastatin-valsartan combination decreases parameters of inflammation and oxidative stress in patients with type 1 diabetes mellitus. Diabetes Res Clin Pract 2017; 127:181-186. [PMID: 28384560 DOI: 10.1016/j.diabres.2017.03.019] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/19/2016] [Revised: 03/13/2017] [Accepted: 03/16/2017] [Indexed: 11/30/2022]
Abstract
AIMS Previously we revealed the effectiveness of a new therapeutic approach with a short-term, very-low dose fluvastatin-valsartan combination on the improvement of arterial function in type 1 diabetes mellitus patients (T1DM). In this study we explored whether this approach influences inflammation and oxidative stress and explored any association of these effects with arterial function improvement. METHODS This was a supplementary analysis of the two previous double blind randomized studies (included 44 T1DM patients). Treatment group received very-low dose fluvastatin-valsartan, the control group received placebo. Blood samples were collected and inflammation parameters: high-sensitivity CRP (hsCRP), interleukin 6 (IL-6), vascular cell adhesion molecule-1 (VCAM-1) and oxidative stress parameter total antioxidant status (TAS) were measured. RESULTS Treatment decreased hsCRP values (by 56.5%, P<0.05) and IL-6 values (by 33.6%, P<0.05) and increased TAS values (by 21.1%; P<0.05) after 30days of treatment. High sensitivity CRP and TAS remained decreased 3months after treatment discontinuation. Importantly, the anti-inflammatory and anti-oxidative action significantly correlated with arterial function improvement. CONCLUSIONS The approach consisting of short-term (30days) treatment with a very low-dose fluvastatin-valsartan combination acts anti-inflammatory and anti-oxidative in T1DM patients. These observations along with the improvement of arterial function support the assumption that this approach could have an important clinical benefit in T1DM patients.
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Affiliation(s)
- Mojca Lunder
- Department of Vascular Diseases, Ljubljana University Medical Center, Zaloška cesta 7, SI-1000 Ljubljana, Slovenia; Department of Endocrinology, Diabetes and Metabolic Diseases, Ljubljana University Medical Center, Zaloška cesta 7, SI-1000 Ljubljana, Slovenia
| | - Miodrag Janić
- Department of Vascular Diseases, Ljubljana University Medical Center, Zaloška cesta 7, SI-1000 Ljubljana, Slovenia
| | - Vedran Savić
- Department of Vascular Diseases, Ljubljana University Medical Center, Zaloška cesta 7, SI-1000 Ljubljana, Slovenia
| | - Andrej Janež
- Department of Endocrinology, Diabetes and Metabolic Diseases, Ljubljana University Medical Center, Zaloška cesta 7, SI-1000 Ljubljana, Slovenia
| | - Karin Kanc
- Diabetes & Me, Diabetes Center, Židovska cesta 1, SI-1000 Ljubljana, Slovenia
| | - Mišo Šabovič
- Department of Vascular Diseases, Ljubljana University Medical Center, Zaloška cesta 7, SI-1000 Ljubljana, Slovenia.
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The “Rise–Peak–Fall” Pattern of Time Dependency of the Cardiovascular Pleiotropic Effects of Treatment With Low-dose Atorvastatin, Losartan, and a Combination Thereof in Rats. J Cardiovasc Pharmacol 2016; 68:74-80. [DOI: 10.1097/fjc.0000000000000393] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
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