KMID : 0368120200500050443
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Korean Circulation Journal 2020 Volume.50 No. 5 p.443 ~ p.457
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Anti-Inflammatory Effect for Atherosclerosis Progression by Sodium-Glucose Cotransporter 2 (SGLT-2) Inhibitor in a Normoglycemic Rabbit Model
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Lee Seul-Gee
Lee Seung-Jun Lee Jung-Jae Kim Jung-Sun Lee Oh-Hyun Kim Choong-Ki Kim Da-Rae Lee Yong-Ho Oh Jae-Won Park Se-Il Jeon Ok-Hee Hong Sung-Jin Ahn Chul-Min Kim Byeong-Keuk Ko Young-Guk Choi Dong-Hoon Hong Myeong-Ki Jang Yang-Soo
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Abstract
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Background and Objectives: We sought to investigate an anti-atherosclerotic and anti-inflammatory effect of sodium-glucose cotransporter-2 (SGLT-2) inhibitors in normoglycemic atherosclerotic rabbit model.
Methods: Male New Zealand white rabbits (n=26) were fed with a 1% high-cholesterol diet for 7 weeks followed by normal diet for 2 weeks. After balloon catheter injury, the rabbits were administered with the Dapagliflozin (1mg/kg/day) or control-medium for 8 weeks (n=13 for each group). All lesions were assessed with angiography, optical coherence tomography (OCT), and histological assessment.
Results: Atheroma burden (38.51¡¾3.16% vs. 21.91¡¾1.22%, p<0.01) and lipid accumulation (18.90¡¾3.63% vs. 10.20¡¾2.03%, p=0.047) was significantly decreased by SGLT-2 inhibitor treatment. The SGLT-2 inhibitor group showed lower macrophage infiltration (20.23¡¾1.89% vs. 12.72¡¾1.95%, p=0.01) as well as tumor necrosis factor (TNF)-¥á expression (31.17¡¾4.40% vs. 19.47¡¾2.10%, p=0.025). Relative area of inducible nitric oxide synthase+ macrophages was tended to be lower in the SGLT-2 inhibitor-treated group (1.00¡¾0.16% vs. 0.71¡¾0.10%, p=0.13), while relative proportion of Arg1+ macrophage was markedly increased (1.00¡¾0.27% vs. 2.43¡¾0.64%, p=0.04). As a result, progression of atherosclerosis was markedly attenuated in SGLT-2 inhibitor treated group (OCT area stenosis, 32.13¡¾1.20% vs. 22.77¡¾0.88%, p<0.01). Mechanistically, SGLT-2 treatment mitigated the inflammatory responses in macrophage. Especially, Toll-like receptor 4/nuclear factor-kappa B signaling pathway, and their downstream effectors such as interleukin-6 and TNF-¥á were markedly suppressed by SGLT-2 inhibitor treatment.
Conclusions: These results together suggest that SGLT-2 inhibitor exerts an anti-atherosclerotic effect through favorable modulation of inflammatory response as well as macrophage characteristics in non-diabetic situation.
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KEYWORD
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Atherosclerosis, Sodium-glucose transporter-2, Sodium-glucose transporter 2 inhibitors, Macrophages
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