Gao Haiyang, Wu Dewei, Zhang Erli, Liang Tuo, Meng Xianmin, Chen Lanying, Wu Yongjian
State Key Laboratory of Cardiovascular Disease, Department of Cardiology, Cardiovascular Institute, Fuwai Hospital, National Center for Cardiovascular Diseases, Chinese Academy of Medical Sciences and Peking Union Medical College Beijing, China.
Beijing Key Laboratory of Metabolic Disorder Related Cardiovascular Disease, Cardiovascular Center, Beijing Friendship Hospital, Capital Medical University Beijing, China.
Am J Transl Res. 2019 Feb 15;11(2):911-930. eCollection 2019.
JAK2/STAT3 is a cardio-protective, pro-inflammation pathway, the function of which in cardiomyopathy caused by diabetic (DCM) is currently unknown. Here we explore the role of the JAK2/STAT3 pathway in DCM employing different time courses and a type 2 DM (T2DM) rat model. We examined the interactions of metformin and sitagliptin treatment with the JAK2/STAT3 pathway and cardiac remodeling. A T2DM rat model was induced by high fat diet/streptozotocin (HFD/STZ) and treated with metformin, sitagliptin (10 mg/d or 20 mg/d) or a placebo. Cell inflammation markers, cardiac remodeling and cardiomyocyte apoptosis were evaluated. We observed an activated inflammation reaction as well as activation of the JAK2/STAT3 thought-out the experiment in the simple HFD group only in the early stage of the disease (until week 9). JAK2/STAT3 activity showed a phasic peculiarity as increased inflammation was observed in prolongation of the DCM accompanied with an accelerated cardiac dysfunction but reduced phosphorylation of myocardial STAT3. Moreover, in the metformin but not the sitagliptin treated group, JAK2/STAT3 activation was associated with having better improved cardiac remolding and reduced myocardial apoptosis. In vitro studies further validated that metformin could activate JAK2/STAT3 pathway and alleviate apoptosis of NRCMs under hyperglycemia incubation. The phasic feature of JAK2/STAT3 pathway activation may participate in the pathophysiological development of DCM. The superior cardio-protective effect of metformin over sitagliptin treatment may partly account for the differences we observed in JAK2/STAT3 activation, indicating that measuring JAK2/STAT3 pathway coupled with metformin treatment may give insight into a more promising DM treatment.
JAK2/STAT3是一条具有心脏保护作用的促炎信号通路,其在糖尿病性心肌病(DCM)中的作用目前尚不清楚。在此,我们采用不同的时间进程和2型糖尿病(T2DM)大鼠模型,探究JAK2/STAT3信号通路在DCM中的作用。我们研究了二甲双胍和西他列汀治疗与JAK2/STAT3信号通路及心脏重塑之间的相互作用。通过高脂饮食/链脲佐菌素(HFD/STZ)诱导建立T2DM大鼠模型,并给予二甲双胍、西他列汀(10mg/d或20mg/d)或安慰剂治疗。评估细胞炎症标志物、心脏重塑和心肌细胞凋亡情况。我们观察到,仅在疾病早期(直至第9周),单纯HFD组在整个实验过程中出现炎症反应激活以及JAK2/STAT3激活。JAK2/STAT3活性呈现阶段性特征,在DCM病程延长时,炎症增加,同时伴有心脏功能障碍加速,但心肌STAT3磷酸化水平降低。此外,在二甲双胍治疗组而非西他列汀治疗组中,JAK2/STAT3激活与心脏重塑改善及心肌凋亡减少相关。体外研究进一步证实,二甲双胍可激活JAK2/STAT3信号通路,并减轻高糖培养条件下新生大鼠心肌细胞(NRCMs)的凋亡。JAK2/STAT3信号通路激活的阶段性特征可能参与了DCM的病理生理发展过程。二甲双胍相对于西他列汀治疗具有更优的心脏保护作用,这可能部分解释了我们在JAK2/STAT3激活方面观察到的差异,表明检测JAK2/STAT3信号通路并联合二甲双胍治疗可能为糖尿病治疗提供更有前景的思路。