Department of Internal Medicine, Chung-Shan Medical University Hospital, School of Medicine, Chung-Shan Medical University, No. 110 Sector 1 Jianguo N. Road, Taichung 402, Taiwan.
Cardiovasc Ther. 2012 Apr;30(2):75-84. doi: 10.1111/j.1755-5922.2010.00226.x. Epub 2010 Oct 14.
Diabetic patients are at high risk to develop atherosclerotic cardiovascular disease and have a higher restenotic rate after percutaneous coronary intervention (PCI). Statins improve cardiovascular outcome and reduce restenosis after PCI by inhibiting proliferation and migration of vascular smooth muscle cells (VSMCs). But the effect of statins on diabetes without dyslipidemia was still not fully understood. Our previous study has demonstrated that simvastatin inhibits VSMC proliferation in high glucose status without dyslipidemia, inducing a G0/G1 phase cell cycle growth arrest by acting on multiple steps upstream of pRb, including inhibition of CDK2/4 expression and upregulation of p53, p21, p16, and p27.
Following our previous study, we investigated the mechanism of simvastatin inhibition of VSMC migration in a diabetes-like model (A7r5 cells under high glucose conditions without dyslipidemia).
Under high glucose conditions, simvastatin dose-dependently inhibited VSMC migration, decreased PI3K/Akt pathway activity, reduced c-Raf and Ras expression, increased RhoB but not RhoA, Rac1, and Cdc2 expression, dose-dependently inhibited MMP-2, but not MMP-9, activity, and dose-dependently inhibited NF-κB activity.
The inhibition of VSMC migration under high glucose conditions was via two different pathways. The first pathway is mevalonate-related but not RhoA protein-related and involves suppression of Ras and PI3K/Akt signals. The second pathway is not mevalonate-related and involves increasing RhoB expression directly.
糖尿病患者发生动脉粥样硬化性心血管疾病的风险较高,经皮冠状动脉介入治疗(PCI)后再狭窄率也较高。他汀类药物通过抑制血管平滑肌细胞(VSMCs)的增殖和迁移来改善心血管结局并降低 PCI 后的再狭窄率。但是,他汀类药物在非血脂异常的糖尿病患者中的作用尚不完全清楚。我们之前的研究表明,辛伐他汀在无血脂异常的高血糖状态下抑制 VSMC 的增殖,通过作用于 pRb 上游的多个步骤,包括抑制 CDK2/4 的表达和上调 p53、p21、p16 和 p27,诱导 G0/G1 期细胞周期停滞。
在我们之前的研究基础上,我们研究了辛伐他汀在类似糖尿病的模型(无血脂异常的高糖条件下的 A7r5 细胞)中抑制 VSMC 迁移的机制。
在高葡萄糖条件下,辛伐他汀呈剂量依赖性抑制 VSMC 迁移,降低 PI3K/Akt 通路活性,减少 c-Raf 和 Ras 的表达,增加 RhoB 但不增加 RhoA、Rac1 和 Cdc2 的表达,呈剂量依赖性抑制 MMP-2,但不抑制 MMP-9 的活性,并呈剂量依赖性抑制 NF-κB 的活性。
高葡萄糖条件下 VSMC 迁移的抑制作用是通过两条不同的途径实现的。第一条途径是与甲羟戊酸相关但与 RhoA 蛋白无关,涉及抑制 Ras 和 PI3K/Akt 信号。第二条途径与甲羟戊酸无关,涉及直接增加 RhoB 的表达。