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Dapagliflozin, a selective SGLT2 Inhibitor, attenuated cardiac fibrosis by regulating the macrophage polarization via STAT3 signaling in infarcted rat hearts.

Abstract
During myocardial infarction, infiltrated macrophages have pivotal roles in cardiac remodeling and delayed M1 toward M2 macrophage phenotype transition is considered one of the major factors for adverse ventricular remodeling. We investigated whether dapagliflozin, a sodium-glucose cotransporter 2 (SGLT2) inhibitor, attenuates cardiac fibrosis via regulating macrophage phenotype by a reactive oxygen and nitrogen species (RONS)/STAT3-dependent pathway in postinfarcted rats. Normoglycemic male Wistar rats were subjected to coronary ligation and then randomized to either saline, dapagliflozin (a specific SGLT2 inhibitor), phlorizin (a nonspecific SGLT1/2 inhibitor), dapagliflozin + S3I-201 (a STAT3 inhibitor), or phlorizin + S3I-201 for 4 weeks. There were similar infarct sizes among the infarcted groups at the acute and chronic stages of infarction. At day 3 after infarction, post-infarction was associated with increased levels of superoxide and nitrotyrosine, which can be inhibited by administering either dapagliflozin or phlorizin. SGLT2 inhibitors significantly increased STAT3 activity, STAT3 nuclear translocation, myocardial IL-10 levels and the percentage of M2 macrophage infiltration. At day 28 after infarction, SGLT2 inhibitors were associated with attenuated myofibroblast infiltration and cardiac fibrosis. Although phlorizin decreased myofibroblast infiltration, the effect of dapagliflozin on attenuated myofibroblast infiltration was significantly higher than phlorizin. The effects of SGLT2 inhibitors on cardiac fibrosis were nullified by adding S3I-201. Furthermore, the effects of dapagliflozin on STAT3 activity and myocardial IL-10 levels can be reversed by 3-morpholinosydnonimine, a peroxynitrite generator. Taken together, these observations provide a novel mechanism of SGLT2 inhibitors-mediated M2 polarization through a RONS-dependent STAT3-mediated pathway and selective SGLT2 inhibitors are more effective in attenuating myofibroblast infiltration during postinfarction remodeling.
AuthorsTsung-Ming Lee, Nen-Chung Chang, Shinn-Zong Lin
JournalFree radical biology & medicine (Free Radic Biol Med) Vol. 104 Pg. 298-310 (03 2017) ISSN: 1873-4596 [Electronic] United States
PMID28132924 (Publication Type: Journal Article)
CopyrightCopyright © 2017 Elsevier Inc. All rights reserved.
Chemical References
  • Benzhydryl Compounds
  • Glucosides
  • Reactive Oxygen Species
  • STAT3 Transcription Factor
  • Slc5a2 protein, rat
  • Sodium-Glucose Transporter 2
  • Sodium-Glucose Transporter 2 Inhibitors
  • Stat3 protein, rat
  • Interleukin-10
  • dapagliflozin
Topics
  • Animals
  • Benzhydryl Compounds (administration & dosage)
  • Fibrosis (drug therapy, genetics, pathology)
  • Gene Expression Regulation (drug effects)
  • Glucosides (administration & dosage)
  • Humans
  • Interleukin-10 (genetics)
  • Macrophages (drug effects, metabolism)
  • Myocardial Infarction (drug therapy, genetics, pathology)
  • Myocardium (metabolism, pathology)
  • Rats
  • Reactive Oxygen Species (metabolism)
  • STAT3 Transcription Factor (genetics)
  • Signal Transduction (drug effects)
  • Sodium-Glucose Transporter 2 (genetics)
  • Sodium-Glucose Transporter 2 Inhibitors

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