MOBIDIC trial: Use of peripheral blood mononuclear cells (PBMC) as biomarkers of diabetic cardiomyopathy

Abstract

Type 2 diabetes (T2D) patients, especially when associated with metabolic syndrome (MS) are at high risk to develop heart failure with preserved ejection fraction (HFpEF) or heart failure with mildly reduced ejection fraction (HFmrEF), and the specific impact of T2D + MS on cardiac function impairment is usually known as “diabetic cardiomyopathy” (DCM). Cardiac remodeling (i.e. hypertrophy) and subtle myocardial dysfunction are highly prevalent in T2D + MS but not specific enough to predict further HFpEF or HFmrEF. Also, current biomarkers can identify but do not predict HFpEF or HFmrEF in T2D patients. Therefore, specific biomarkers are needed. Recently, peripheral blood mononuclear cells (PBMC) have emerged as complementary and non-invasive biomarkers to stratify the patients in several pathologies, but not yet in DCM. We hypothesize that the calcic and inflammatory profile of PBMC may reflect the degree of cardiac dysfunction encountered during DCM. To this end, we will perform a clinical study including 30 T2D + MS and 30 non-diabetic and non-MS patients without HF or with HFpEF/HFmrEF. A deep characterization of their cardiac function will be assessed by echocardiography. A biocollection of PBMC will be done to study by flow cytometry the calcium fluxes and the inflammatory cell subtypes. MOBIDIC trial is expected to start on February 2023. We expect that PBMC obtained from a peripheral blood sample would provide insights from calcic and inflammatory pathways, and may identify more specific molecular signatures shared between T2D + MS and HFpEF/HFmrEF.