Abstract

PurposeVascular inflammation and disturbed metabolism are observed in heart failure and type 2 diabetes mellitus. Glycolytic enzyme hexokinase II (HKII) is upregulated by inflammation. We hypothesized that SGLT2 inhibitors Canagliflozin (Cana), Empagliflozin (Empa) or Dapagliflozin (Dapa) reduces inflammation via HKII in endothelial cells, and that HKII-dependent inflammation is determined by ERK1/2, NF-κB. and/or AMPK activity in lipopolysaccharide (LPS)-stimulated human coronary artery endothelial cells (HCAECs).MethodsHCAECs were pre-incubated with 3 μM or 10 μM Cana, 1 μM, 3 μM or 10 μM Empa or 0.5 μM, 3 μM or 10 μM Dapa (16 h) and subjected to 3 h LPS (1 μg/mL). HKII was silenced via siRNA transfection. Interleukin-6 (IL-6) release was measured by ELISA. Protein levels of HK I and II, ERK1/2, AMPK and NF-κB were detected using infra-red western blot.ResultsLPS increased IL-6 release and ERK1/2 phosphorylation; Cana prevented these pro-inflammatory responses (IL-6: pg/ml, control 46 ± 2, LPS 280 ± 154 p < 0.01 vs. control, LPS + Cana 96 ± 40, p < 0.05 vs. LPS). Cana reduced HKII expression (HKII/GAPDH, control 0.91 ± 0.16, Cana 0.71 ± 0.13 p < 0.05 vs. control, LPS 1.02 ± 0.25, LPS + Cana 0.82 ± 0.24 p < 0.05 vs. LPS). Empa and Dapa were without effect on IL-6 release and HKII expression in the model used. Knockdown of HKII by 37% resulted caused partial loss of Cana-mediated IL-6 reduction (pg/ml, control 35 ± 5, LPS 188 ± 115 p < 0.05 vs. control, LPS + Cana 124 ± 75) and ERK1/2 activation by LPS. In LPS-stimulated HCAECs, Cana, but not Empa or Dapa, activated AMPK. AMPK activator A769662 reduced IL-6 release.ConclusionCana conveys anti-inflammatory actions in LPS-treated HCAECs through 1) reductions in HKII and ERK1/2 phosphorylation and 2) AMPK activation. These data suggest a novel anti-inflammatory mechanism of Cana through HKII.

Highlights

  • Electronic supplementary material The online version of this article contains supplementary material, which is available to authorized users.Chronic vascular inflammation is a common early signature in patients with type 2 diabetes mellitus (T2DM) and is strongly associated with an increased risk of cardiovascular disease [1,2,3]

  • HCAECs treated with 10-μM Empa or Dapa exhibited no change in LPSinduced interleukin 6 (IL-6) release (ESM Fig. 1a–b)

  • No changes in IL-6 release were observed in healthy HCAECs exposed to an sodium-glucose cotransporter 2 (SGLT2) inhibitor (Fig. 1a–c)

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Summary

Introduction

Chronic vascular inflammation is a common early signature in patients with type 2 diabetes mellitus (T2DM) and is strongly associated with an increased risk of cardiovascular disease [1,2,3]. The metabolic profile of T2DM consists of hyperglycemia, which instigates a shift toward disturbed glucose utilization leading to accumulation of glycolytic intermediates and reactive oxygen species in endothelial cells [4]. Hexokinase (HKII) is an early glycolytic enzyme that facilitates glucose conversion to glucose-6-phosphate (G6P) leading to increased metabolic flux through glycolysis. Increased expression and activity of HKII and upregulated glycolysis are observed in inflammatory conditions [5,6,7,8]. Blocking HKII ameliorates inflammatory signaling in activated isolated

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