Impact of Sodium-Glucose Co-Transporter 2 Inhibitors on Cardiac Protection.
Victor Chien-Chia WuYan-Rong LiChao-Yung WangPublished in: International journal of molecular sciences (2021)
Sodium-glucose co-transporter 2 (SGLT2) inhibitors have been approved as a new class of anti-diabetic drugs for type 2 diabetes mellitus (T2DM). The SGLT2 inhibitors reduce glucose reabsorption through renal systems, thus improving glycemic control in all stages of diabetes mellitus, independent of insulin. This class of drugs has the advantages of no clinically relevant hypoglycemia and working in synergy when combined with currently available anti-diabetic drugs. While improving sugar level control in these patients, SGLT2 inhibitors also have the advantages of blood-pressure improvement and bodyweight reduction, with potential cardiac and renal protection. In randomized control trials for patients with diabetes, SGLT2 inhibitors not only improved cardiovascular and renal outcomes, but also hospitalization for heart failure, with this effect extending to those without diabetes mellitus. Recently, dynamic communication between autophagy and the innate immune system with Beclin 1-TLR9-SIRT3 complexes in response to SGLT2 inhibitors that may serve as a potential treatment strategy for heart failure was discovered. In this review, the background molecular pathways leading to the clinical benefits are examined in this new class of anti-diabetic drugs, the SGLT2 inhibitors.
Keyphrases
- glycemic control
- type diabetes
- heart failure
- blood pressure
- blood glucose
- left ventricular
- immune response
- inflammatory response
- oxidative stress
- chronic kidney disease
- newly diagnosed
- atrial fibrillation
- insulin resistance
- ejection fraction
- cardiovascular disease
- double blind
- ischemia reperfusion injury
- toll like receptor
- heart rate
- drug induced
- phase ii
- acute heart failure
- placebo controlled
- combination therapy