Exp Clin Endocrinol Diabetes 2018; 126(01): 27-38
DOI: 10.1055/s-0043-106859
Article
© Georg Thieme Verlag KG Stuttgart · New York

Mitochondrial Dysfunction in Diabetic Cardiomyopathy: Effect of Mesenchymal Stem Cell with PPAR-γ Agonist or Exendin-4

Mohamed Abd Elaziz Wassef
1   Medical Biochemistry & Molecular Biology Department, Faculty of Medicine, Cairo University
,
Ola M. Tork
2   Medical Physiology Department, Faculty of Medicine, Cairo University
,
Laila A. Rashed
1   Medical Biochemistry & Molecular Biology Department, Faculty of Medicine, Cairo University
,
Walaa Ibrahim
1   Medical Biochemistry & Molecular Biology Department, Faculty of Medicine, Cairo University
,
Heba Morsi
1   Medical Biochemistry & Molecular Biology Department, Faculty of Medicine, Cairo University
,
Dina Mohamed Mekawy Rabie
1   Medical Biochemistry & Molecular Biology Department, Faculty of Medicine, Cairo University
› Author Affiliations
Further Information

Publication History

received 10 November 2016
revised 14 March 2017

accepted 22 March 2017

Publication Date:
27 April 2017 (online)

Abstract

Therapy targeting mitochondria may provide novel ways to treat diabetes and its complications. Bone marrow-derived mesenchymal stem cells (MSCs), the peroxisome proliferator-activated receptor gamma (PPAR-γ) agonists and exendin-4; an analog of glucagon-like peptide-1 have shown cardioprotective properties in many cardiac injury models. So, we evaluated their effects in diabetic cardiomyopathy (DCM) in relation to mitochondrial dysfunction. This work included seven groups of adult male albino rats: the control group, the non-treated diabetic group, and the treated diabetic groups: one group was treated with MSCs only, the second with pioglitazone only, the third with MSCs and pioglitazone, the forth with exendin-4 only and the fifth with MSCs and exendin-4. All treatments were started after 6 weeks from induction of diabetes and continued for the next 4 weeks. Blood samples were collected for assessment of glucose, insulin, and cardiac enzymes. Hearts were removed and used for isolated heart studies, and gene expression of: myocyte enhancer factor-2 (Mef2), peroxisome proliferator-activated receptor gamma coactivator1-alpha (PGC1α), nuclear factor kappa B (NFKB) and autophagic markers: light chain 3 (LC3) and beclin by real-time reverse transcription-polymerase chain reaction. The cardiac mitochondrial protein levels of cardiolipin and uncoupler protein 2 (UCP2) were assessed by ELISA and western blot technique, respectively. Treated groups showed significant improvement in left ventricular function associated with improvement in the cardiac injury and myopathic markers compared to the non treated diabetic group. NFKB was down-regulated while cardiolipin, PGC1α, LC.3 and beclin were up-regulated in all treated groups. These data suggest that the cardioprotective effects of MSCs, exendin-4 or pioglitazone based on their ability to improve mitochondrial functions through targeting inflammatory and autophagy signaling. The co- administration of pioglitazone or exendin-4 with MSCs showed significant superior improvement compared with MSCs alone, indicating the ability to use them in supporting cardioprotective effects of MSCs.

 
  • References

  • 1 Katulanda P, Ranasinghe P, Jayawardena R. et al. The prevalence, patterns, and predictors of diabetic peripheral neuropathy in a developing country. Diabetol Metab Syndr 2012; 4: 21-29
  • 2 Genuth SM, Backlund JY, Bayless M. et al. Effect of prior intensive versus conventional therapy and history of glycemia on cardiac function in type 1 diabetes in the DCCT/EDIC. Diabetes 2013; 62: 3561-3569
  • 3 Garcia-Touza M, Sowers JR. Evidence-based hypertension treatment in patients with diabetes. J Clin Hypertens 2012; 14: 97-102
  • 4 Liu Q, Wang S, Cai L. Diabetic cardiomyopathy and its mechanisms: Role of oxidative stress and damage. J Diabetes Investig 2014; 5: 623-634
  • 5 Hill MF. Diabetic Cardiomyopathy: cardiac changes, pathophysiological mechanisms, biologic markers, and the available therapeutic armamentarium. In: Veselka J. (ed.) Cardiomyopathies – from basic research to clinical management. Rijeka: InTech; 2012. pp 487-512
  • 6 Duncan JG. Mitochondrial dysfunction in diabetic cardiomyopathy. Biochimicaet Biophysica Acta 2011; 1813: 1351-1359
  • 7 Ritov VB, Menshikova EV, He J. et al. Deficiency of subsarcolemmal mitochondria in obesity and type 2 diabetes. Diabetes 2005; 54: 8-14
  • 8 Gnecchi M, Danieli P, Cervio E. Mesenchymal stem cell therapy for heart disease. Vascular Pharmacology 2012; 57: 48-55
  • 9 Zingarelli B, Hake PW, Mangeshkar P. et al. Diverse cardioprotective signaling mechanisms of peroxisome proliferator-activated receptor-gamma ligands, 15-deoxy-Delta12,14-prostaglandin J2 and ciglitazone, in reperfusion injury: Role of nuclear factor-kappa B, heat shock factor 1, and Akt. Shock 2007; 28: 554-563
  • 10 Chen T, Jin X, Crawford BH. et al. Cardioprotection from oxidative stress in the newborn heart by activation of PPARγ is mediated by catalase. Free Radic Biol Med 2012; 53: 208-215
  • 11 Ban K, Noyan-Ashraf MH, Hoefer J. et al. Cardioprotective and vasodilatory actions of glucagon-like peptide 1 receptor are mediated through both glucagon-like peptide 1 receptor-dependent and -independent pathways. Circulation 2008; 117: 2340-2350
  • 12 Anagnostis P, Athyros VG, Adamidou F. et al. Glucagon-like peptide-1-based therapies and cardiovascular disease: looking beyond glycaemic control. Diabetes Obes Metab 2011; 13: 302-312
  • 13 Kodera R, Shikata K, Kataoka HU. et al. Glucagon-like peptide-1 receptor agonist ameliorates renal injury through its anti-inflammatory action without lowering blood glucose level in a rat model of type 1 diabetes. Diabetologia 2011; 54: 965-978
  • 14 Mukai E, Fujimoto S, Sato H. et al. Exendin-4 suppresses SRC activation and reactive oxygen species production in diabetic Goto-Kakizaki rat islets in an Epac-dependent manner. Diabetes 2011; 60: 218-226
  • 15 Velmurugan K, Balamurugan AN, Loganathan G. et al. Antiapoptotic actions of exendin-4 against hypoxia and cytokines are augmented by CREB. Endocrinology 2012; 153: 1116-1128
  • 16 Oeseburg H, De Boer RA, Buikema H. et al. Glucagon-like peptide 1 prevents reactive oxygen species-induced endothelial cell senescence through the activation of protein kinase A. Arterioscler Thromb Vasc Biol 2010; 30: 1407-1414
  • 17 Thulesen J, Orskov C, Holst J. et al. Short term insulin treatment prevents the diabetogenic action of streptozotocin in rats. Endocrinology 1997; 138: 162-168
  • 18 Becher PM, Lindner D, Fröhlich M. et al. Assessment of cardiac inflammation and remodeling during the development of streptozotocin-induced diabetic cardiomyopathy in vivo: A time course analysis. Int J Mol Med 2013; 32: 158-164
  • 19 Abdel Aziz MT, El-Asmar MF, Haidara M. et al. Effect of bone marrow-derived mesenchymal stem cells on cardiovascular complications in diabetic rats. Med SciMonit 2008; 14: BR249-BR255
  • 20 Ahire Y, Ghaisas M, Dandawate P. et al. Beneficial effects of co-administration of PPAR-γ agonist with melatonin on cardiovascular complications associated with diabetes. Chronicles of Young Scientists 2013; 4: 59-68
  • 21 Liu J, Wang H, Wang Y. et al. The stem cell adjuvant with Exendin-4 repairs the heart after myocardial infarction via STAT3 activation. J Cell Mol Med 2014; 18: 1381-1391
  • 22 Reichelt ME, Willems L, Hack BA. et al. Cardiac and coronary function in the Langendorff-perfused mouse heart model. Exp Physiol 2009; 94: 54-70
  • 23 Alhadlaq A, Mao J. Mesenchymal stem cells: Isolation and therapeutics. Stem Cells Dev 2004; 13: 436-448
  • 24 Ma Z, Zhao Z, Turk J. Mitochondrial dysfunction and β-cell failure in type 2 diabetes mellitus. Experimental Diabetes Research 2012 Article ID 703538
  • 25 Raev DC. Which left ventricular function is impaired earlier in the evolution of diabetic cardiomyopathy? An echocardiographic study of young type I diabetic patients. Diabetes Care 1994; 17: 633-639
  • 26 Hage FG, Iskandrian AE. Cardiac autonomic denervation in diabetes mellitus. Circ CardiovascImagin 2011; 4: 79-81
  • 27 Li S, Wang X, Li J. et al. Advances in the treatment of ischemic diseases by mesenchymal. Stem cells. Stem Cells 2016; 17: 18-22
  • 28 Nyamandi VZ, Johnsen VL, Hughey CC. et al. Enhanced stem cell engraftment and modulation of hepatic reactive oxygen species production in diet-induced obesity. Obesity (Silver Spring) 2014; 22: 721-729
  • 29 Sanz C, Vázquez P, Blázquez C. et al. Signaling and biological effects of glucagon-like peptide 1 on the differentiation of mesenchymal stem cells from human bone marrow. Am J Physiol Endocrinol Metab 2010; 298: 634-643
  • 30 Chang G, Zhang D, Yu H. et al. Cardioprotective effects of exenatide against oxidative stress-induced injury. Nutr Metab 2013; 892: 1011-1020
  • 31 Monji A, Mitsui T, Bando YK. et al. Glucagon-like peptide-1 receptor activation reverses cardiac remodeling via normalizing cardiac steatosis and oxidative stress in type 2 diabetes. Am J Physiol Heart Circ Physiol 2013; 305: H295-H304
  • 32 Elbassuoni EA. Incretin attenuates diabetes-induced damage in rat cardiac tissue. J Physiol Sci 2014; 64: 357-364
  • 33 Rani N, Bharti S, Bhatia J. et al. Inhibition of TGF-β by a novel PPAR-γ agonist, chrysin, salvages β-receptor stimulated myocardial injury in rats through MAPKs-dependent mechanism. Nutr Metab 2015; 12: 11-16
  • 34 Shen Z, Ye C, McCain K et al. The role of cardiolipin in cardiovascular health. Bio Med Res Inter Article 2015 ID 891707, 12 pages http://dx.doi.org/10.1155/2015/891707
  • 35 Finck BN, Kelly DP. Peroxisome proliferator- activator receptor gamma coactivator -1 (PGC-1) regulatory cascade in cardiac physiology and disease. Circulation 2007; 115: 2540-2548
  • 36 Wang H, Bei Y, Lu Y. et al. Exercise prevents cardiac injury and improves mitochondrial biogenesis in advanced diabetic cardiomyopathy with PGC-1α and Akt Activation. Cell Physiol Biochem 2015; 35: 2159-2168
  • 37 Baar K, Wende AR, Jones TE. et al. Adaptations of skeletal muscle to exercise: rapid increase in the transcriptional coactivator PGC-1. FASEB J 2002; 16: 1879-1886
  • 38 St-Pierre J, Drori S, Uldry M. et al. Suppression of reactive oxygen species and neurodegeneration by the PGC-1 transcriptional coactivators. Cell 2006; 127: 397-408
  • 39 Muñoz P, Chillarón J, Camps M. et al. Evidence for posttranscriptional regulation of GLUT4 expression in muscle and adipose tissue from streptozotocin-induced diabetic and benfluorex-treated rats. Biochem Pharmacol 1996; 52: 1665-1673
  • 40 Nishino N, Tamori Y, Kasuga M. Insulin efficiently stores triglycerides in adipocytes by inhibiting lipolysis and repressing PGC-1alpha induction. Kobe J Med Sci 2007; 53: 99-106
  • 41 Liu J, Li J, Li WJ. et al. The Role of Uncoupling Proteins in Diabetes Mellitus. J of Diabetes Res 2013; Article ID 585897 7 pages
  • 42 Buchanan J, Mazumder PK, Hu P. et al. Reduced cardiac efficiency and altered substrate metabolism precedes the onset of hyperglycemia and contractile dysfunction in two mouse models of insulin resistance and obesity. Endocrinology 2005; 146: 5341-5349
  • 43 Varga ZV, Giricz Z, Liaudet L. et al. Interplay of oxidative, nitrosative/nitrative stress, inflammation, cell death and autophagy in diabetic cardiomyopathy. Biochimicaet Biophysica Acta 2015; 1852: 232-242
  • 44 Fuentes-Antrás J, Ioan M, Tuñón J. et al. Activation of toll-like receptors and inflammasome complexes in the diabetic cardiomyopathy-associated inflammation. Int J Endocrinol 2014; Article ID 847827 10 pages http://dx.doi.org/10.1155/2014/847827
  • 45 Thomas CM, Yong QC, Rosa RM. et al. Cardiac-specific suppression of NF-κBsignaling prevents diabetic cardiomyopathy via inhibition of the renin-angiotensin system. Am J Physiol Heart Circ Physiol 2014; 307: 1036-1045
  • 46 EL-Attar S, Elsayed L, Rashed L. Role of stem cells and antioxidant on modulation of body defense mechanism in lipopolysaccharide-induced acute lung injury in rats. Med J Cairo Univ 2012; 80: 559-573
  • 47 Kemp K, Gray E, Mallam E. et al. Inflammatory cytokine-induced regulation of superoxide dismutase 3 expression by human mesenchymal stem cells. Stem Cell Rev 2010; 6: 548-559
  • 48 Lee Y, Jun H. Anti-inflammatory effects of glp-1-based therapies beyond glucose control. Med of Inflam 2016; Article ID 3094642 11 pages http://dx.doi.org/10.1155/2016/3094642
  • 49 Zhao K, Hao H, Liu J. et al. Bone marrow-derived mesenchymal stem cells ameliorate chronic high glucose-induced β-cell injury through modulation of autophagy. Cell Death and Disease 2015; 6: e1885 doi:10.1038/cddis.2015.230
  • 50 Kobayashi S, Liang Q. Autophagy and mitophagy in diabetic cardiomyopathy. Biochim Biophys Acta 2015; 1852: 252-261
  • 51 Kanamori H, Takemura G, Goto K. et al. Autophagic adaptations in diabetic cardiomyopathy differ between type 1 and type 2 diabetes. Autophagy 2015; 11: 1146-1160
  • 52 Takahashi W, Watanabe E, Fujimura L. et al. Kinetics and protective role of autophagy in a mouse cecal ligation and puncture-induced sepsis. Crit Care 2013; 17: R160 doi:10.1186/cc12839
  • 53 Westermeier F, Riquelme JA, Pavez M. et al. New molecular insights of insulin in diabetic cardiomyopathy. Front Physiol 2016; 7: 125 doi:10.3389/fphys.2016.00125
  • 54 Li H, Jia Z, Li G. et al. Neuroprotective effects of exendin-4 in rat model of spinal cord injury via inhibiting mitochondrial apoptotic pathway. Int J Clin Exp Pathol 2015; 8: 4837-4843
  • 55 Li HT, Zhao XZ, Zhang XR. et al. Exendin-4 enhances motor function recovery via promotion of autophagy and inhibition of neuronal apoptosis after spinal cord injury in rats. Mol Neurobiolg 2016; 53: 4073-4082