Abstract

The development of diabetic cardiomyopathy is a key contributor to heart failure and mortality in obesity and type 2 diabetes (T2D). Current therapeutic interventions for T2D have limited impact on the development of diabetic cardiomyopathy. Clearly, new therapies are urgently needed. A potential therapeutic target is protein kinase D (PKD), which is activated by metabolic insults and implicated in the regulation of cardiac metabolism, contractility and hypertrophy. We therefore hypothesised that PKD inhibition would enhance cardiac function in T2D mice. We first validated the obese and T2D db/db mouse as a model of early stage diabetic cardiomyopathy, which was characterised by both diastolic and systolic dysfunction, without overt alterations in left ventricular morphology. These functional characteristics were also associated with increased PKD2 phosphorylation in the fed state and a gene expression signature characteristic of PKD activation. Acute administration of the PKD inhibitor CID755673 to normal mice reduced both PKD1 and 2 phosphorylation in a time and dose-dependent manner. Chronic CID755673 administration to T2D db/db mice for two weeks reduced expression of the gene expression signature of PKD activation, enhanced indices of both diastolic and systolic left ventricular function and was associated with reduced heart weight. These alterations in cardiac function were independent of changes in glucose homeostasis, insulin action and body composition. These findings suggest that PKD inhibition could be an effective strategy to enhance heart function in obese and diabetic patients and provide an impetus for further mechanistic investigations into the role of PKD in diabetic cardiomyopathy.

Highlights

  • Obesity and type 2 diabetes (T2D) are associated with the development of heart failure, which accounts for ~65% of deaths in obese and diabetic patients, based on US statistics [1]

  • We report that T2D db/db mice are a model of early stage diabetic cardiomyopathy, characterised by both diastolic and systolic dysfunction, without overt alterations in left ventricular morphology, which was associated with elevated PKD2 auto phosphorylation in the fed state and a gene expression signature characteristic of protein kinase D (PKD) activation

  • New therapeutic strategies are needed to attenuate the incidence of cardiovascular disease mortality in obese and T2D patients, which would be most effectively targeted in the early stages of diabetic cardiomyopathy development

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Summary

Introduction

Obesity and type 2 diabetes (T2D) are associated with the development of heart failure, which accounts for ~65% of deaths in obese and diabetic patients, based on US statistics [1]. Diabetic cardiomyopathy describes abnormalities in cardiac metabolism that impair contractile function and induce pathological ventricular hypertrophy [2]. The early stages of diabetic cardiomyopathy are characterised by impaired cardiac metabolism, which include insulin resistance, PLOS ONE | DOI:10.1371/journal.pone.0120934. CID755673 Administration in Diabetic Cardiomyopathy reduced glucose oxidation and increased lipid oxidation [3]. These metabolic alterations result in an energetic deficit that first manifests as diastolic dysfunction, before progressing to systolic dysfunction, and later hypertrophy and heart failure [4]. Existing therapeutics for T2D have limited impact on preventing the development of diabetic cardiomyopathy and some even aggravate the condition [5,6]. New therapies that effectively combat the development of diabetic cardiomyopathy are urgently needed

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