Fouda Mohamed A, Ruben Peter C
Department of Biomedical Physiology and Kinesiology, Simon Fraser University, Burnaby, BC, Canada.
Department of Pharmacology and Toxicology, Alexandria University, Alexandria, Egypt.
Front Pharmacol. 2021 Apr 28;12:668657. doi: 10.3389/fphar.2021.668657. eCollection 2021.
Cardiovascular anomalies are predisposing factors for diabetes-induced morbidity and mortality. Recently, we showed that high glucose induces changes in the biophysical properties of the cardiac voltage-gated sodium channel (Nav1.5) that could be strongly correlated to diabetes-induced arrhythmia. However, the mechanisms underlying hyperglycemia-induced inflammation, and how inflammation provokes cardiac arrhythmia, are not well understood. We hypothesized that inflammation could mediate the high glucose-induced biophyscial changes on Nav1.5 through protein phosphorylation by protein kinases A and C. We also hypothesized that this signaling pathway is, at least partly, involved in the cardiprotective effects of cannabidiol (CBD) and 17β-estradiol (E). To test these ideas, we used Chinese hamster ovarian (CHO) cells transiently co-transfected with cDNA encoding human Nav1.5 α-subunit under control, a cocktail of inflammatory mediators or 100 mM glucose conditions (for 24 h). We used electrophysiological experiments and action potential modeling. Inflammatory mediators, similar to 100 mM glucose, right shifted the voltage dependence of conductance and steady-state fast inactivation and increased persistent current leading to computational prolongation of action potential (hyperexcitability) which could result in long QT3 arrhythmia. We also used human iCell cardiomyocytes derived from inducible pluripotent stem cells (iPSC-CMs) as a physiologically relevant system, and they replicated the effects produced by inflammatory mediators observed in CHO cells. In addition, activators of PK-A or PK-C replicated the inflammation-induced gating changes of Nav1.5. Inhibitors of PK-A or PK-C, CBD or E mitigated all the potentially deleterious effects provoked by high glucose/inflammation. These findings suggest that PK-A and PK-C may mediate the anti-inflammatory effects of CBD and E against high glucose-induced arrhythmia. CBD, via Nav1.5, may be a cardioprotective therapeutic approach in diabetic postmenopausal population.
心血管异常是糖尿病导致发病和死亡的诱发因素。最近,我们发现高糖会引起心脏电压门控钠通道(Nav1.5)生物物理特性的变化,这可能与糖尿病诱发的心律失常密切相关。然而,高血糖诱导炎症的潜在机制以及炎症如何引发心律失常,目前尚不清楚。我们推测炎症可能通过蛋白激酶A和C介导的蛋白磷酸化作用,介导高糖对Nav1.5生物物理特性的改变。我们还推测,这条信号通路至少部分参与了大麻二酚(CBD)和17β-雌二醇(E)的心脏保护作用。为了验证这些想法,我们使用了瞬时共转染编码人Nav1.5α亚基cDNA的中国仓鼠卵巢(CHO)细胞,分别处于对照、炎症介质混合物或100 mM葡萄糖条件下(持续24小时)。我们采用了电生理实验和动作电位建模。炎症介质与100 mM葡萄糖类似,使电导的电压依赖性和稳态快速失活向右偏移,并增加了持续电流,导致动作电位的计算延长(兴奋性增强),这可能导致长QT3心律失常。我们还使用了源自诱导多能干细胞的人诱导性心肌细胞(iPSC-CMs)作为生理相关系统,它们重现了在CHO细胞中观察到的炎症介质产生的效应。此外,蛋白激酶A或蛋白激酶C的激活剂重现了炎症诱导的Nav1.5门控变化。蛋白激酶A或蛋白激酶C的抑制剂、CBD或E减轻了高糖/炎症引发的所有潜在有害影响。这些发现表明,蛋白激酶A和蛋白激酶C可能介导了CBD和E对高糖诱导的心律失常的抗炎作用。通过Nav1.5,CBD可能是糖尿病绝经后人群的一种心脏保护治疗方法。
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