Abstract 13422: Sotagliflozin, a Dual SGLT-1/2 Inhibitor, Modulated Expression of Endothelial Proteins That Inhibit Reactive Oxygen Species During Inflammation Compared With Empagliflozin

Abstract

Background: Reactive oxygen species (ROS) generated during endothelial cell (EC) dysfunction contributes to progression of atherosclerosis. The SGLT1/2 inhibitor sotagliflozin (sota) reduced atherothrombotic events and hospitalization for worsening heart failure in patients with diabetes (SCORED, SOLOIST). Unlike selective SGLT2 inhibitors, sotagliflozin significantly reduced ischemic events, including myocardial infarction and stroke. We compared the effects of sota and empagliflozin (empa) on expression of ROS signaling proteins in human vein ECs (HUVECs) challenged with interleukin-6 (IL-6) or lipopolysaccharide (LPS). Methods: HUVECs were treated with sota or empa (100 nM) for 30 minutes and the challenged with IL-6 (12 ng/mL) or LPS (100 ng/mL) for 24 hours. Global proteomic analysis was performed using LC/MS to measure relative expression levels of >1,000 proteins. Only significant (p<0.05) changes in expression between treatment groups >1-fold were included in gene set enrichment analysis (GSEA) of biological pathways. Results: Sota significantly changed expression of 166 and 274 proteins in ECs challenged with IL-6 and LPS, respectively. Empa significantly modulated fewer proteins - 122 and 93 proteins - following challenge with IL-6 and LPS, respectively. GSEA revealed that sota, not empa, modulated proteins related to ROS detoxification within the “cellular response to oxidative stress” pathway (GO:0034599) compared to both IL-6 and LPS (pathway adjusted p-values = 0.0016 and 0.036, respectively). Within this pathway, sota increased expression of peroxiredoxin (PRDX) 5 and PRDX6 (1.2 and 1.1-fold) and glutathione peroxidase-1 (GPX1, 1.1-fold) relative to IL-6 alone. Relative to LPS, sota decreased expression GPX1 (1.2-fold), PRDX1 (1.1-fold), and increased thioredoxin (1.1-fold). None of these proteins were modulated significantly by empa. Conclusions: Sota significantly modulated expression of proteins linked to ROS detoxification and signaling in human ECs during inflammation compared to a selective SGLT2 inhibitor. These favorable effects of dual SGLT1/2 inhibition may have implications for inflammation and reduced atherothrombotic risk as demonstrated in outcome trials.