Abstract

Diabetic cardiomyopathy (DCM) has been increasingly considered as a main cause of heart failure and death in diabetic patients. At present, no effective treatment exists to prevent its development. In the present study, we describe the potential protective effects and mechanisms of myricitrin (Myr) on the cardiac function of streptozotosin-induced diabetic mice and on advanced glycation end products (AGEs)-induced H9c2 cardiomyocytes. In vitro experiments revealed that pretreatment with Myr significantly decreased AGEs-induced inflammatory cytokine expression, limited an increase in ROS levels, and reduced cell apoptosis, fibrosis, and hypertrophy in H9c2 cells. These effects are correlated with Nrf2 activation and NF-κB inhibition. In vivo investigation demonstrated that oral administration of Myr at 300 mg/kg/day for 8 weeks remarkably decreased the expression of enzymes associated with cardiomyopathy, as well as the expression of inflammatory cytokines and apoptotic proteins. Finally, Myr improved diastolic dysfunction and attenuated histological abnormalities. Mechanistically, Myr attenuated diabetes-induced Nrf2 inhibition via the regulation of Akt and ERK phosphorylation in the diabetic heart. Collectively, these results strongly indicate that Myr exerts cardioprotective effects against DCM through the blockage of inflammation, oxidative stress, and apoptosis. This suggests that Myr might be a potential therapeutic agent for the treatment of DCM.

Highlights

  • Diabetes mellitus (DM) has become a global public health issue

  • To investigate the protective effects of Myr on advanced glycation end products (AGEs)-induced H9c2 cardiomyocyte death, we initially evaluated the general toxicity of AGEs

  • In vitro AGEs-induced H9c2 cardiomyocyte injury, characterized by cell fibrosis and hypertrophy accompanied by aggressive inflammation and oxidative stress, could effectively be attenuated by Myr preconditioning

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Summary

Introduction

Diabetes mellitus (DM) has become a global public health issue. The total number of adults worldwide experiencing DM was 415 million in 2015, and is estimated to increase to 642 million by 20401. High levels of AGEs appear to be tightly related to instances of DCM, which result in superfluous oxidative stress and inflammatory responses. Ko and his colleagues found that 400 μg/ml AGEs could increase ROS production through suppression of antioxidant Nrf-2 and downstream pathway in H9c2 cells[12]. Serum AGEs levels were increased in patients with osteoporosis (14.75 vs 8.12 U/ml)[13], but in DM patients with vascular complications (3.40 vs 1.12 μg/ml)[14], indicating that AGEs are associated with cardiac injury resulting from DCM Both oxidative stress, and inflammation directly triggered by persistent high glucose or AGEs, may occur as upstream events. The protective effects of myricitrin on DCM has not yet been investigated

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