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关于文章《用SGLT2抑制剂靶向炎症信号通路:对心血管健康和心脏细胞改善的见解》的综述

A review regarding the article 'Targeting inflammatory signaling pathways with SGLT2 inhibitors: Insights into cardiovascular health and cardiac cell improvement'.

作者信息

He Xiaoqin, Yuan Dou

机构信息

Department of Rheumatology and Immunology, West China Hospital of Sichuan University, West China School of Nursing, Sichuan University, Chengdu, Sichuan 610000, China.

Department of Cardiovascular Surgery, Chengdu Shang Jin Nan Fu Hospital, West China Hospital of Sichuan University, Chengdu, Sichuan Province 610041, China.

出版信息

Curr Probl Cardiol. 2024 Jun;49(6):102563. doi: 10.1016/j.cpcardiol.2024.102563. Epub 2024 Apr 8.

DOI:10.1016/j.cpcardiol.2024.102563
PMID:38599557
Abstract

Sodium-glucose co-transporter 2 (SGLT2) inhibitors have emerged as a novel category of blood glucose-lowering drugs in clinical recommendations for a wide range of diseases. SGLT2 inhibitors are promising anti-inflammatory agents by acting either indirectly via improving metabolism and reducing stress conditions or via direct modulation of inflammatory signaling pathways. The SGLT2 inhibitors empagliflozin and dapagliflozin better vascular function and avert vascular aging by decreasing the reactive oxygen species (ROS) content and increasing nitric oxide bioavailability, respectively. It was discovered that ipragliflozin has the ability to prevent dysfunction of the endothelium, and this effect was connected with oxidative stress. According to published data, SGLT2 inhibitors may delay vascular aging and arrest the development of endothelial dysfunction in animal models of type 2 diabetes (T2D) by reducing inflammation, oxidative stress, and glucose toxicity and increasing the survival of hyperglycemic endothelial cells. The adenosine monophosphate-activated protein kinase (AMPK) molecule plays a vital role in the regulation of bioenergy metabolism and is pivotal in our understanding of diabetes mellitus and other metabolic disorders. It has been hypothesized that SGLT2 inhibitors may indirectly affect AMPK to reduce mammalian target of rapamycin (mTOR) activity. Numerous studies have demonstrated that SGLT2 inhibitors can activate AMPK by restoring the AMP/ATP balance in favor of AMP, which is assumed to be the mechanism by which these medications have positive effects on the cardiac structure and microvessel.

摘要

钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂已成为临床推荐用于多种疾病的新型降血糖药物。SGLT2抑制剂是有前景的抗炎药物,其作用方式要么是通过改善代谢和减轻应激状态间接发挥作用,要么是通过直接调节炎症信号通路。SGLT2抑制剂恩格列净和达格列净分别通过降低活性氧(ROS)含量和增加一氧化氮生物利用度来改善血管功能并避免血管衰老。已发现依帕列净具有预防内皮功能障碍的能力,且这种作用与氧化应激有关。根据已发表的数据,SGLT2抑制剂可能通过减轻炎症、氧化应激和葡萄糖毒性以及提高高血糖内皮细胞的存活率,来延缓2型糖尿病(T2D)动物模型中的血管衰老并阻止内皮功能障碍的发展。腺苷单磷酸激活的蛋白激酶(AMPK)分子在生物能量代谢的调节中起着至关重要的作用,并且在我们对糖尿病和其他代谢紊乱的理解中至关重要。据推测,SGLT2抑制剂可能间接影响AMPK以降低雷帕霉素靶蛋白(mTOR)的活性。大量研究表明,SGLT2抑制剂可通过恢复有利于AMP的AMP/ATP平衡来激活AMPK,这被认为是这些药物对心脏结构和微血管产生积极作用的机制。

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