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钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂对2型糖尿病急性心肌梗死炎症小体通路的影响:一项综述

Impact of sodium-glucose transport protein-2 (SGLT2) inhibitors on the inflammasome pathway in acute myocardial infarction in type 2 diabetes mellitus: a comprehensive review.

作者信息

Yoo Thomas T, Baek In Hae, Stoletniy Liset, Hilliard Anthony, Sakr Antoine, Doycheva Desislava

机构信息

Department of Internal Medicine, Loma Linda University Medical Center, Loma Linda, CA, 92354, USA.

Division of Cardiology, School of Medicine, Loma Linda University, 11234 Anderson St, Loma Linda, CA, 92354, USA.

出版信息

Cardiovasc Diabetol. 2025 May 26;24(1):227. doi: 10.1186/s12933-025-02777-7.

Abstract

Sodium-glucose transport protein-2 (SGLT2) inhibitors, initially developed for glycemic control in type 2 diabetes mellitus (T2DM), have emerged as potential cardioprotective agents, reducing cardiovascular mortality and improving heart failure outcomes. Recent evidence suggests that SGLT2 inhibitors exert anti-inflammatory effects, particularly through modulating the inflammasome pathway. This review explores the role of the inflammasome in acute myocardial infarction (AMI) in T2DM and discusses the mechanisms by which SGLT2 inhibitors influence this pathway. We evaluate current studies on the impact of SGLT2 inhibitors on key inflammatory mediators, particularly the NLRP3 inflammasome, and discuss their potential therapeutic implications for reducing inflammation and myocardial injury in patients with T2DM experiencing AMI. In summary, the key novelties in this review lie in its focused mechanistic approach on the inflammasome pathway, its integration of diabetes and cardiovascular research, and its potential to influence future therapeutic strategies for AMI in T2DM patients. It offers a novel angle by tying together molecular mechanisms of inflammation with clinical implications in a specific patient population that faces high cardiovascular risk.

摘要

钠-葡萄糖协同转运蛋白2(SGLT2)抑制剂最初是为控制2型糖尿病(T2DM)的血糖而研发的,现已成为潜在的心脏保护药物,可降低心血管死亡率并改善心力衰竭的预后。最近的证据表明,SGLT2抑制剂具有抗炎作用,特别是通过调节炎性小体途径。本综述探讨了炎性小体在T2DM急性心肌梗死(AMI)中的作用,并讨论了SGLT2抑制剂影响该途径的机制。我们评估了目前关于SGLT2抑制剂对关键炎症介质影响的研究,特别是NLRP3炎性小体,并讨论了它们对降低T2DM合并AMI患者炎症和心肌损伤的潜在治疗意义。总之,本综述的关键新颖之处在于其对炎性小体途径的聚焦机制研究方法、糖尿病与心血管研究的整合,以及对T2DM患者AMI未来治疗策略的潜在影响。它通过将炎症的分子机制与面临高心血管风险的特定患者群体的临床意义联系起来,提供了一个新的视角。

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