The targeted inhibition of neuraminidase reverses endothelial glycocalyx degradation and improves endothelial function in type 2 diabetes

Abstract

Endothelial dysfunction is a hallmark vascular abnormality of type 2 diabetes (T2D) that is characterized by blunted vasodilatory responses to physiological stimuli such as blood flow‐induced shear stress. Previously, we have reported that plasma neuraminidase levels are increased in a mouse model of diet‐induced obesity that is insulin resistant and considered pre‐diabetic. Neuraminidase is an enzyme that degrades the glycocalyx, which is a structure essential for the mechanotransduction of shear stress in the process of flow‐mediated dilation (FMD). Therefore, we hypothesized that circulating neuraminidase is implicated in the degradation of the endothelial glycocalyx and the diminished FMD that are associated with T2D, and that inhibition of circulating neuraminidase activity is an effective means to restore glycocalyx integrity and endothelial function in diabetic mice. In support of this hypothesis, we provide evidence that endothelial function, as assessed by FMD and insulin‐stimulated vasodilation, is blunted in T2D vs. non‐T2D human subjects and that this impairment concurs with elevated plasma neuraminidase activity and increased concentrations of its enzymatic byproduct, sialic acid. We further demonstrate that ex vivo exposure of mouse arteries to neuraminidase significantly reduces FMD. In cultured endothelial cells, we found that neuraminidase sheds sialic acid and Syndecan‐1, which are components of the glycocalyx and that the neuraminidase inhibitor, Zanamivir, attenuates this shedding. Moreover, in an animal model of diabetes (db/db mice), we demonstrate that Zanamivir reduces plasma neuraminidase activity and concomitantly improves femoral artery FMD and vasodilatory responses to acetylcholine and insulin. We also show that endothelial stiffness, assessed with atomic force microscopy using en face aortic samples, is significantly reduced in Zanamivir‐treated compared to placebo‐treated db/db mice. We conclude that inhibition of plasma neuraminidase activity represents a novel therapeutic approach to ameliorate endothelial dysfunction and cardiovascular risk in T2D patients by reversing glycocalyx degradation.Support or Funding InformationNational Institutes of Health grants: R01 HL137769 (JP), R01 HL088105 (LM‐L).This abstract is from the Experimental Biology 2019 Meeting. There is no full text article associated with this abstract published in The FASEB Journal.