From the Center for Metabolic Disease Research (P.F., H.S., J.J.S., R.C., J.X., X.J., X.-F.Y., H.W.), Lewis Kats School of Medicine, Temple University, Philadelphia, PA.
Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia (X.L.).
Arterioscler Thromb Vasc Biol. 2019 Oct;39(10):2097-2119. doi: 10.1161/ATVBAHA.119.313138. Epub 2019 Aug 1.
Hyperhomocysteinemia (HHcy) is a potent risk factor for diabetic cardiovascular diseases. We have previously reported that hyperhomocysteinemia potentiates type 1 diabetes mellitus-induced inflammatory monocyte differentiation, vascular dysfunction, and atherosclerosis. However, the effects of hyperhomocysteinemia on vascular inflammation in type 2 diabetes mellitus (T2DM) and the underlying mechanism are unknown. Approach and Results: Here, we demonstrate that hyperhomocysteinemia was induced by a high methionine diet in control mice (homocysteine 129 µmol/L), which was further worsened in T2DM db/db mice (homocysteine 180 µmol/L) with aggravated insulin intolerance. Hyperhomocysteinemia potentiated T2DM-induced mononuclear cell, monocyte, inflammatory monocyte (CD11bLy6C), and M1 macrophage differentiation in periphery and aorta, which were rescued by folic acid-based homocysteine-lowering therapy. Moreover, hyperhomocysteinemia exacerbated T2DM-impaired endothelial-dependent aortic relaxation to acetylcholine. Finally, transfusion of bone marrow cells depleted for Ly6C by shRNA transduction improved insulin intolerance and endothelial-dependent aortic relaxation in hyperhomocysteinemia+T2DM mice.
Hyperhomocysteinemia potentiated systemic and vessel wall inflammation and vascular dysfunction partially via inflammatory monocyte subset induction in T2DM. Inflammatory monocyte may be a novel therapeutic target for insulin resistance, inflammation, and cardiovascular complications in hyperhomocysteinemia+T2DM.
高同型半胱氨酸血症(HHcy)是糖尿病心血管疾病的一个强有力的危险因素。我们之前曾报道过,高同型半胱氨酸血症可增强 1 型糖尿病引起的炎症性单核细胞分化、血管功能障碍和动脉粥样硬化。然而,高同型半胱氨酸血症对 2 型糖尿病(T2DM)血管炎症的影响及其潜在机制尚不清楚。方法和结果:在这里,我们证明高同型半胱氨酸血症可通过高蛋氨酸饮食在对照小鼠(同型半胱氨酸 129µmol/L)中诱导,在伴有加重胰岛素抵抗的 T2DM db/db 小鼠(同型半胱氨酸 180µmol/L)中进一步恶化。高同型半胱氨酸血症增强了 T2DM 诱导的外周和主动脉单核细胞、单核细胞、炎症性单核细胞(CD11bLy6C)和 M1 巨噬细胞分化,这一过程可通过叶酸基同型半胱氨酸降低疗法得到挽救。此外,高同型半胱氨酸血症加剧了 T2DM 损害的内皮依赖性主动脉对乙酰胆碱的舒张反应。最后,用 shRNA 转导耗尽 Ly6C 的骨髓细胞输注可改善高同型半胱氨酸血症+T2DM 小鼠的胰岛素抵抗和内皮依赖性主动脉舒张功能。结论:高同型半胱氨酸血症通过在 T2DM 中诱导炎症性单核细胞亚群,增强了全身和血管壁炎症及血管功能障碍。炎症性单核细胞可能是治疗高同型半胱氨酸血症+T2DM 中胰岛素抵抗、炎症和心血管并发症的一个新的治疗靶点。