Vulesevic Branka, McNeill Brian, Giacco Ferdinando, Maeda Kay, Blackburn Nick J R, Brownlee Michael, Milne Ross W, Suuronen Erik J
Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada Department of Cellular & Molecular Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Division of Cardiac Surgery, University of Ottawa Heart Institute, Ottawa, Ontario, Canada.
Diabetes. 2016 Jun;65(6):1699-713. doi: 10.2337/db15-0568. Epub 2016 Mar 8.
The mechanisms for the development of diabetic cardiomyopathy remain largely unknown. Methylglyoxal (MG) can accumulate and promote inflammation and vascular damage in diabetes. We examined if overexpression of the MG-metabolizing enzyme glyoxalase 1 (GLO1) in macrophages and the vasculature could reduce MG-induced inflammation and prevent ventricular dysfunction in diabetes. Hyperglycemia increased circulating inflammatory markers in wild-type (WT) but not in GLO1-overexpressing mice. Endothelial cell number was reduced in WT-diabetic hearts compared with nondiabetic controls, whereas GLO1 overexpression preserved capillary density. Neuregulin production, endothelial nitric oxide synthase dimerization, and Bcl-2 expression in endothelial cells was maintained in the hearts of GLO1-diabetic mice and corresponded to less myocardial cell death compared with the WT-diabetic group. Lower receptor for advanced glycation end products and tumor necrosis factor-α (TNF-α) levels were also observed in GLO1-diabetic versus WT-diabetic mice. Over a period of 8 weeks of hyperglycemia, GLO1 overexpression delayed and limited the loss of cardiac function. In vitro, MG and TNF-α were shown to synergize in promoting endothelial cell death, which was associated with increased angiopoietin 2 expression and reduced Bcl-2 expression. These results suggest that MG in diabetes increases inflammation, leading to endothelial cell loss. This contributes to the development of diabetic cardiomyopathy and identifies MG-induced endothelial inflammation as a target for therapy.
糖尿病性心肌病的发病机制在很大程度上仍不清楚。甲基乙二醛(MG)在糖尿病中会蓄积并促进炎症和血管损伤。我们研究了巨噬细胞和脉管系统中MG代谢酶乙二醛酶1(GLO1)的过表达是否能减轻MG诱导的炎症并预防糖尿病中的心室功能障碍。高血糖增加了野生型(WT)小鼠循环中的炎症标志物,但在GLO1过表达小鼠中未增加。与非糖尿病对照组相比,WT糖尿病心脏中的内皮细胞数量减少,而GLO1过表达可维持毛细血管密度。与WT糖尿病组相比,GLO1糖尿病小鼠心脏中神经调节蛋白的产生、内皮型一氧化氮合酶二聚化以及内皮细胞中Bcl-2的表达得以维持,且心肌细胞死亡较少。与WT糖尿病小鼠相比,GLO1糖尿病小鼠中晚期糖基化终产物受体和肿瘤坏死因子-α(TNF-α)水平也较低。在8周的高血糖期间,GLO1过表达延缓并限制了心脏功能的丧失。在体外,MG和TNF-α在促进内皮细胞死亡方面具有协同作用,这与血管生成素2表达增加和Bcl-2表达减少有关。这些结果表明,糖尿病中的MG会增加炎症,导致内皮细胞丢失。这促成了糖尿病性心肌病的发展,并确定MG诱导的内皮炎症为治疗靶点。