Department of Pharmacology, ISF College of Pharmacy, Ghal Kalan, Moga, Punjab, India.
J Biochem Mol Toxicol. 2023 May;37(5):e23330. doi: 10.1002/jbt.23330. Epub 2023 Mar 8.
Cardiomyopathy (CDM) and related morbidity and mortality are increasing at an alarming rate, in large part because of the increase in the number of diabetes mellitus cases. The clinical consequence associated with CDM is heart failure (HF) and is considerably worse for patients with diabetes mellitus, as compared to nondiabetics. Diabetic cardiomyopathy (DCM) is characterized by structural and functional malfunctioning of the heart, which includes diastolic dysfunction followed by systolic dysfunction, myocyte hypertrophy, cardiac dysfunctional remodeling, and myocardial fibrosis. Indeed, many reports in the literature indicate that various signaling pathways, such as the AMP-activated protein kinase (AMPK), silent information regulator 1 (SIRT1), PI3K/Akt, and TGF-β/smad pathways, are involved in diabetes-related cardiomyopathy, which increases the risk of functional and structural abnormalities of the heart. Therefore, targeting these pathways augments the prevention as well as treatment of patients with DCM. Alternative pharmacotherapy, such as that using natural compounds, has been shown to have promising therapeutic effects. Thus, this article reviews the potential role of the quinazoline alkaloid, oxymatrine obtained from the Sophora flavescensin CDM associated with diabetes mellitus. Numerous studies have given a therapeutic glimpse of the role of oxymatrine in the multiple secondary complications related to diabetes, such as retinopathy, nephropathy, stroke, and cardiovascular complications via reductions in oxidative stress, inflammation, and metabolic dysregulation, which might be due to targeting signaling pathways, such as AMPK, SIRT1, PI3K/Akt, and TGF-β pathways. Thus, these pathways are considered central regulators of diabetes and its secondary complications, and targeting these pathways with oxymatrine might provide a therapeutic tool for the diagnosis and treatment of diabetes-associated cardiomyopathy.
心肌病（CDM）及其相关发病率和死亡率正在以惊人的速度增长，在很大程度上是由于糖尿病病例的增加。与非糖尿病患者相比，与 CDM 相关的临床后果是心力衰竭（HF），而糖尿病患者的情况要糟糕得多。糖尿病性心肌病（DCM）的特征是心脏结构和功能出现故障，包括舒张功能障碍后出现收缩功能障碍、心肌细胞肥大、心脏功能障碍性重构和心肌纤维化。事实上，文献中的许多报告表明，各种信号通路，如 AMP 激活的蛋白激酶（AMPK）、沉默信息调节因子 1（SIRT1）、PI3K/Akt 和 TGF-β/smad 通路，都与糖尿病相关的心肌病有关，这增加了心脏功能和结构异常的风险。因此，针对这些途径可以增强 DCM 患者的预防和治疗效果。替代药物治疗，如使用天然化合物的治疗方法，已显示出有希望的治疗效果。因此，本文综述了来源于苦参的喹唑啉生物碱氧化苦参碱在与糖尿病相关的心肌病中的潜在作用。许多研究通过降低氧化应激、炎症和代谢失调，为氧化苦参碱在与糖尿病相关的多种继发性并发症（如视网膜病变、肾病、中风和心血管并发症）中的作用提供了治疗前景，这可能是由于靶向 AMPK、SIRT1、PI3K/Akt 和 TGF-β 等信号通路。因此，这些途径被认为是糖尿病及其继发性并发症的核心调节剂，用氧化苦参碱靶向这些途径可能为诊断和治疗糖尿病相关的心肌病提供一种治疗工具。
