Akin Senay, Kubat Gokhan B, Guray Umit, Akin Yesim, Demirel Haydar A
Department of Exercise and Sport Physiology, Faculty of Sport Sciences, Hacettepe University, Ankara, Turkey.
Department of Pathology, Gulhane Training and Research Hospital, Ankara, Turkey.
J Biochem Mol Toxicol. 2021 Apr;35(4):e22717. doi: 10.1002/jbt.22717. Epub 2021 Jan 23.
Glucocorticoids are among the most prescribed drugs globally due to their potent anti-inflammatory and immunosuppressive properties. Although they have positive effects on the treatment of various disease states; long-term administration is associated with high blood pressure, insulin resistance, and susceptibility to type 2 diabetes. The heart attempts to cope with increased blood pressure and a decrease in glucose utilization by developing pathological cardiac remodeling. However, in this process, cardiac fibrosis formation and deterioration in heart structure and functions occur. Galectin-3, a member of the β-galactoside binding lectins, is consistently associated with inflammation and fibrosis in the pathogenesis of various disease states including insulin resistance and heart failure. Galectin-3 expression is markedly increased in activated macrophages and a subset of activated fibroblasts and vascular cells. Also, failing and remodeling myocardium show increased Gal-3 expression and elevated Gal-3 levels are related to heart failure severity and prognosis. Furthermore, Gal-3-related pathways are recently suggested as therapeutic targets both pharmacologically and genetically to increase insulin sensitivity in vivo. The objective of this review is to provide a summary of our current understanding of the role of glucocorticoid-associated insulin resistance, which is important for some cardiac events, and the potential role of galectin in this pathophysiological process.
由于具有强大的抗炎和免疫抑制特性，糖皮质激素是全球处方量最大的药物之一。尽管它们对各种疾病状态的治疗有积极作用，但长期使用会导致高血压、胰岛素抵抗以及易患2型糖尿病。心脏试图通过发生病理性心脏重塑来应对血压升高和葡萄糖利用减少的情况。然而，在此过程中，会出现心脏纤维化形成以及心脏结构和功能的恶化。半乳糖凝集素-3是β-半乳糖苷结合凝集素家族的成员之一，在包括胰岛素抵抗和心力衰竭在内的各种疾病状态的发病机制中，始终与炎症和纤维化相关。半乳糖凝集素-3在活化的巨噬细胞以及一部分活化的成纤维细胞和血管细胞中表达明显增加。此外，衰竭和重塑的心肌显示半乳糖凝集素-3表达增加，且半乳糖凝集素-3水平升高与心力衰竭的严重程度和预后相关。此外，最近有人提出，与半乳糖凝集素-3相关的信号通路在药理学和遗传学上都是增加体内胰岛素敏感性的治疗靶点。本综述的目的是总结我们目前对糖皮质激素相关胰岛素抵抗作用的理解，这对某些心脏事件很重要，以及半乳糖凝集素在这一病理生理过程中的潜在作用。
