Department of Clinical and Experimental Medicine, School of Medicine, University of Padova, Padova, Italy.
Diabetes Care. 2010 Jul;33(7):1607-9. doi: 10.2337/dc10-0187. Epub 2010 Mar 31.
Vasculoprotective endothelial progenitor cells (EPCs) are regulated by stromal-derived factor-1alpha (SDF-1alpha) and are reduced in type 2 diabetes. Because SDF-1alpha is a substrate of dipeptidyl-peptidase-4 (DPP-4), we investigated whether the DPP-4 inhibitor sitagliptin modulates EPC levels in type 2 diabetic patients.
This was a controlled, nonrandomized clinical trial comparing 4-week sitagliptin (n = 16) versus no additional treatment (n = 16) in addition to metformin and/or secretagogues in type 2 diabetic patients. We determined circulating EPC levels and plasma concentrations of SDF-1alpha, monocyte chemoattractant protein-1 (MCP-1), vascular endothelial growth factor (VEGF), and nitrites/nitrates.
There was no difference in clinical baseline data between the sitagliptin and control arms. After 4 weeks, as compared with control subjects, patients receiving sitagliptin showed a significant increase in EPCs and SDF-1alpha and a decrease in MCP-1.
Sitagliptin increases circulating EPCs in type 2 diabetic patients with concomitant upregulation of SDF-1alpha. This ancillary effect of DPP-4 inhibition might have potential favorable cardiovascular implications.
血管保护内皮祖细胞（EPCs）受基质衍生因子-1α（SDF-1α）调控，在 2 型糖尿病中减少。因为 SDF-1α 是二肽基肽酶-4（DPP-4）的底物，我们研究了 DPP-4 抑制剂西他列汀是否能调节 2 型糖尿病患者的 EPC 水平。
这是一项对照、非随机临床试验，比较了在二甲双胍和/或促分泌素治疗的基础上，4 周西他列汀（n=16）与额外治疗（n=16）对 2 型糖尿病患者的影响。我们测定了循环 EPC 水平和 SDF-1α、单核细胞趋化蛋白-1（MCP-1）、血管内皮生长因子（VEGF）和亚硝酸盐/硝酸盐的血浆浓度。
西他列汀组和对照组的临床基线数据无差异。4 周后，与对照组相比，接受西他列汀治疗的患者 EPCs 和 SDF-1α 显著增加，MCP-1 降低。
西他列汀增加了 2 型糖尿病患者的循环 EPCs，同时上调了 SDF-1α。DPP-4 抑制的这种辅助作用可能对心血管有潜在的有利影响。
