Cardioprotective Potential of an SGLT2 Inhibitor Against Doxorubicin-Induced Heart Failure

BACKGROUND AND OBJECTIVES: Recent studies have shown that sodium-glucose co-transporter 2 (SGLT2) inhibitors reduce the risk of heart failure (HF)-associated hospitalization and mortality in patients with diabetes. However, it is not clear whether SGLT2 inhibitors have a cardiovascular benefit in patients without diabetes. We aimed to determine whether empagliflozin (EMPA), an SGLT2 inhibitor, has a protective role in HF without diabetes. METHODS: Cardiomyopathy was induced in C57BL/6J mice using intraperitoneal injection of doxorubicin (Dox). Mice with HF were fed a normal chow diet (NCD) or an NCD containing 0.03% EMPA. Then we analyzed their phenotypes and performed in vitro experiments to reveal underlying mechanisms of the EMPA's effects. RESULTS: Mice fed NCD with EMPA showed improved heart function and reduced fibrosis. In vitro studies showed similar results. Phloridzin, a non-specific SGLT inhibitor, did not show any protective effect against Dox toxicity in H9C2 cells. SGLT2 inhibitor can cause increase in blood ketone levels. Beta hydroxybutyrate (βOHB), which is well known ketone body associated with SGLT2 inhibitor, showed a protective effect against Dox in H9C2 cells and in Dox-treated mice. These results suggest elevating βOHB might be a convincing mechanism for the protective effects of SGLT2 inhibitor. CONCLUSIONS: SGLT2 inhibitors have a protective effect in Dox-induced HF in mice. This implied that SGLT2 inhibitor therapy could be a good treatment strategy even in HF patients without diabetes.

Comparison of Improving Effects for Diabetic Erectile Dysfunction according to the Anti-Glycemic Agents: Phlorizin and Insulin

PURPOSE: To compare the improving effects of diabetic erectile dysfunction with two anti-glycemic agents; phlorizin and insulin. MATERIALS AND METHODS: Sixty Sprague-Dawley rats were divided into four groups (n=15 in each group): normal control (C), untreated diabetic rats (D), and diabetic rats treated by phlorizin (P) or insulin (I). Ten weeks after the diabetic induction using an injection of streptozotocin (55 mg/kg), four weeks of diabetic control was conducted. Erectile response, Western blot, and immunohistochemistry were assessed. RESULTS: During the experiment, the C-group showed continuous weight gain, while the other groups suffered from weight loss. After start of diabetic control, the body weight of I-group was increased; whereas, there was no meaningful change in the P-group. Meanwhile, comparable blood glucose levels were achieved in the P- and I-groups. The erectile response was markedly decreased in the D-group, whereas the P- and I-groups were similar as good as the C-group. In addition, D-group showed the significant decrease in the cavernosal smooth muscle content and increased apoptosis. Platelet endothelial cell adhesion molecule-1 protein expression, phosphorylation of endothelial nitric oxide synthase and myosin phosphatase target subunit 1 were significantly distorted in the D-group, while the P- and I-groups were comparable with the C-group. CONCLUSIONS: Phlorizin treatment resulted in the improvement of erectile function as same as insulin despite the lack of anabolic weight gains. These results suggest that control of blood glucose level rather than a type of anti-glycemic agents is more important for the prevention and treatment of diabetic erectile dysfunction

High glucose dialysate enhances peritoneal fibrosis through upregulating glucose transporters GLUT1 and SGLT1 / 浙江大学学报·医学版

To investigate the role of glucose transporter 1 (GLUT1) and sodium-glucose cotransporter 1 (SGLT1) in high glucose dialysate-induced peritoneal fibrosis.Thirty six male SD rats were randomly divided into 6 groups (6 in each):normal control group, sham operation group, peritoneal dialysis group (PD group), PD+phloretin group (PD+T group), PD+phlorizin group (PD+Z group), PD+phloretin+phlorizin group (PD+T+Z group). Rat model of uraemia was established using 5/6 nephrotomy, and 2.5% dextrose peritoneal dialysis solution was used in peritoneal dialysis. Peritoneal equilibration test was performed 24 h after dialysis to evaluate transport function of peritoneum in rats; HE staining was used to observe the morphology of peritoneal tissue; and immunohistochemistry was used to detect the expression of GLUT1, SGLT1, TGF-β1 and connective tissue growth factor (CTGF) in peritoneum. Human peritoneal microvascular endothelial cells (HPECs) were divided into 5 groups:normal control group, peritoneal dialysis group (PD group), PD+phloretin group (PD+T group), PD+phlorezin group (PD+Z group), and PD+phloretin+phlorezin group (PD+T+Z group). Real time PCR and Western blotting were used to detect mRNA and protein expressions of GLUT1, SGLT1, TGF-β1, CTGF in peritoneal membrane and HPECs., compared with sham operation group, rats in PD group had thickened peritoneum, higher ultrafiltration volume, and the mRNA and protein expressions of GLUT1, SGLT1, CTGF, TGF-β1 were significantly increased (all<0.05); compared with PD group, thickened peritoneum was attenuated, and the mRNA and protein expressions of GLUT1, SGLT1, CTGF, TGF-β1 were significantly decreased in PD+T, PD+Z and PD+T+Z groups (all<0.05). Pearson's correlation analysis showed that the expressions of GLUT1, SGLT1 in peritoneum were positively correlated with the expressions of TGF-β1 and CTGF (all<0.05)., the mRNA and protein expressions of GLUT1, SGLT1, TGF-β1, CTGF were significantly increased in HPECs of peritoneal dialysis group (all<0.05), and those in PD+T, PD+Z, and PD+T+Z groups were decreased (all<0.05). Pearson's correlation analysis showed that the expressions of GLUT1, SGLT1 in HPECs were positively correlated with the expressions of TGF-β1 and CTGF (all<0.05).High glucose peritoneal dialysis fluid may promote peritoneal fibrosis by upregulating the expressions of GLUT1 and SGLT1.

Effects of phlorizin on vascular complications in diabetes db/db mice / 中华医学杂志(英文版)

<p><b>BACKGROUND</b>Diabetic macrovascular complications are important causes of cardiovascular and cerebrovascular diseases and also one of the major causes of morbidity and mortality in patients with type 2 diabetes mellitus (T2DM). Phlorizin has been reported to be effective in reducing the blood glucose level in diabetic mellitus, while little is known about its effects on vascular complications. This study aimed to observe the effects of phlorizin on the aorta of diabetes db/db mice and explore its mechanism.</p><p><b>METHODS</b>Diabetic db/db mice (n = 16) and age-matched db/m mice (n = 8) were divided into three groups: normal control group (CC group, db/m mice, n = 8), untreated diabetic group (DM group, db/db mice, n = 8) and diabetic group treated by phlorizin (DMT group, db/db mice, n = 8). Phlorizin (20 mg/kg body weight) was given in normal saline solution intragastrically for 10 weeks. Animals were weighed weekly. At the 10th weekend, all mice were fasted overnight and then sacrificed. Fasting blood was collected, and the aortas were dissected. The blood samples were analyzed for fasting blood glucose (FBG), serum advanced glycation end products (AGEs), malondialdehyde (MDA) and superoxide dismutase (SOD) activity, the aortic ultrastructure was studied.</p><p><b>RESULTS</b>The weight and serum concentration of FBG, AGEs, and MDA in the DM group were higher than that in the CC group (P < 0.01), and they were significantly lower in the DMT group (P < 0.05). Serum SOD activity was lower than that in the CC group (P < 0.01), and it is significantly higher in the DMT group (P < 0.05). The severity of aorta damage in the DMT group was less than that in the DM group.</p><p><b>CONCLUSIONS</b>Phlorizin protected the db/db mice from diabetic macrovascular complications, attributed to the decreasing of blood glucose and AGEs level, and its antioxidant potential. This study may provide a new natural medicine for treating diabetic macrovascular complications.</p>

Determination of the content of phloridzin using reversed-phase high-performance liquid chromatography / 南方医科大学学报

<p><b>OBJECTIVE</b>To establish a reversed-phase high-performance liquid chromatographic (RP-HPLC) method for determination of phloridzin content.</p><p><b>METHODS</b>A RP-HPLC method was established for determination of phloridzin using an Inertsil ODS-3 (4.6×150 mm, 5 µm) column with the detection wavelength of 288 nm, flow rate of 1.0 ml/min, and column temperature of 25 degrees celsius;.</p><p><b>RESULTS</b>The result showed that the phloridzin had a good linear relationship when its concentration ranged between 0.5988 and 89.72 µg/ml. The regression equation was Y=46.370 X-0.6728 (r=0.9999, n=3). The average recovery of phloridzin was 99.40% with the relative standard deviations (RSD) of 0.67%.</p><p><b>CONCLUSION</b>This method is simple, quick and accurate for determination of phloridzin content.</p>

Glucosa-6-fosfatasa de envoltura nuclear de hígado de rata / Glucose-6-phosphatase from nuclear envelope in rat liver

Se comparó la actividad de la glucosa-6-fosfatasa (G-6-Pasa) de envoltura nuclear (EN) con la microsomal. Los microsomas intactos fueron incapaces de hidrolizar manosa-6-fosfato (M-6-P); por el contrario, la EN intacta fue capaz de hidrolizar dicho substrato. La galactosa-6-fosfato mostró ser un buen substrato tanto para la enzima de EN como microsomal, con una latencia similar a la obtenida para M-6-P utilizando microsomas, por lo cual galactosa-6-fosfato fue usado para medir el porcentaje de EN intactas. Los parámetros cinéticos (Kii y Kis) de la inhibición por floricina de la G-6-Pasa de EN intactas, utilizando glucosa-6-fosfato (G-6-P) y M-6-P como substrato, fueron aproximadamente iguales. El transportador T1 de EN fue más sensible a la amiloride que el microsomal. Por el contrario, el sistema microsomal fue más sensible al efecto de N-etilmaleimida (NEM) que el de EN y este último, fue prácticamente insensible a los inhibidores de transporte aniónico DIDS y SITS, los cuales afectan fuertemente la enzima microsomal. Los resultados anteriores permiten sugerir que en la EN existe un transportador de hexosas-6-fosfato, capaz de transportar G-6-P y M-6-P y quizás otras hexosas-6-fosfato y que, o es diferente al T1 microsomal, o si es igual es influenciado por las características del sistema membranoso en el cual está incluido. La capacidad superior de hidrólisis de PPi de la G-6-Pasa de EN intacta, en comparación con la de microsomas intactos, sugiere diferencias en el transportador de Pi/PPi (T2) de ambos sistemas. La menor sensibilidad de la G-6-Pasa de EN al NEM sugiere que la subunidad catalítica de este sistema también podría tener algunas diferencias con la isoforma microsomal.

Renal glycosuria induced by acute thioacetamide administration to rats

La administración de tioacetamida (TAA) en ratas (75 mg/kg de peso vía subcutánea) produjo un incremento estadísticamente significativo de la eliminación urinaria de glucosa, Na+ y fosfato. Adicionalmente, ocurrió una disminución de la presión arterial y de la velocidad de filtración glomerular, sin cambios en la excreción urinaria de K+, H+, aminoácidos ni en la glucemia. Se observó una disminución del 60 por ciento y 75 por ciento del Tmax y Tmin para la glucosa, respectivamente. La TAA alteró la captación de [14C]-glucosa por vesículas de membrana de borde apical renal (BBMV), disminuyendo en un 16 por ciento el pico de captación a los 30 s, en un 63 por ciento la Vmax y en aproximadamente un 82 por ciento el Km. También disminuyó en un 52 por ciento el Kd y cerca de un 59 por ciento el número de sitios de unión para [3H]-floricina en BBMV. Estos resultados sugieren fuertemente que la droga reduce la cantidad del co-transportador Na+/glucosa (SGLT1) presente en la membrana apical del túbulo contorneado proximal. La disminución de la temperatura de transición de la maltasa y de la fosfatasa alcalina de las BBMV así como el incremento de la cantidad de ácidos grasos insaturados presentes en los fosfolipidos de las BBMV sugieren un incrementoen la fluidez de dichas membranas. Estos resultados pudieran explicar el incremento en la afinidad del SGLT1 por la glucosa producida por la TAA.

Effects of ethanol on Na+-dependent solute uptake in rabbit renal brush-border membrane vesicles

This study was undertaken to examine the effect of ethanol on Na+-dependent transport systems (glucose, phosphate, and dicarboxylate) in renal brush-border membrane vesicles (BBMV). Ethanol inhibited Na+-dependent uptakes of glucose, phosphate, and succinate in a dose-dependent manner, but not the uptakes of Na+-independent. The H+/TEA antiport was reduced by 8% ethanol. Kinetic analysis showed that ethanol caused a decrease in Vmax of three transport systems, leaving Km values unchanged. Ethanol decreased phlorizin binding, which was closely correlated with the decrease in Vmax of Na+-glucose uptake. These results indicate that ethanol inhibits Na+-dependent uptakes of glucose, phosphate, and dicaboxylate and that the reduction in Vmax of Na+-glucose uptake is caused by a decrease in the number of active carrier proteins in the membrane.

Effect of cisplatin on sodium-dependent hexose transport in LLC-PK-1 renal epithelial cells

Cis-dichlorodiammine platinum II (Cisplatin), an effective chemotherapeutic agent, induces acute renal failure by unknown mechanisms. To investigate direct toxic effects of cisplatin on the renal proximal tubular transport system, LLC-PK-1 cell line was selected as a cell model and the sugar transport activity was evaluated during a course of cisplatin treatment. Cells grown to confluence were treated with cisplatin for 60 min, washed, and then incubated for up to 5 days. At appropriate intervals, cells were tested for sugar transport activity using alpha-methyl-D-(14C)glucopyranoside (AMG) as a model substrate. In cells treated with 100 micrometer cisplatin, the AMG uptake was progressively impaired after 3 days. The viability of cells was not substantially changed with cisplatin of less than 100 micrometer, but it decreased markedly with 150 and 200 micrometer. In cisplatin-treated cells, the Na+/-dependent AMG uptake was drastically inhibited with no change in the Na+/-independent uptake. Kinetic analysis indicated that Vmax was suppressed, but Km was not altered. The Na+/-dependent phlorizin binding was also decreased in cisplatin-treated cells. However, the AMG efflux from preloaded cells was not apparently retarded by cisplatin treatment. These data indicate that the cisplatin treatment impairs Na+/-hexose cotransporters in LLC-PK-1 cells and suggest strongly that defects in transporter function at the luminal plasma membrane of the proximal tubular cells constitute an important pathogenic mechanism of cisplatin nephrotoxicity.

Effects of phlorizin and acipimox on insulin resistance in STZ-diabetic rats

To evaluate the roles of hyperglycemia and increased plasma FFA level in the development of insulin resistance, we examined the effects of phlorizin and acipimox treatments on tissue sensitivity to insulin in streptozotocin(STZ)-diabetic rats. Insulin sensitivity was assessed with the glucose-insulin clamp technique. Blood glucose concentration was clamped at basal levels of control and diabetic states, and plasma insulin concentrations were clamped at the levels of basal, approximately 60 and approximately 1500 microU/ml. In diabetic rats, the basal blood glucose and plasma FFA levels in the fasting state were elevated, while the plasma insulin concentration was lower than in normal controls. Moreover, diabetic rats became glucose intolerant after intravenous injection of glucose. The metabolic clearance rate(MCR) of glucose showed a decrease of basal and insulin stimulated response in diabetic rats. As results of the glucose-insulin clamp study and intravenous glucose tolerance test, insulin resistance was developed in STZ-diabetic rats. Phlorizin treatment of diabetic rats recovered insulin sensitivity to nearly normal levels and improved glucose tolerance, but had no effect on insulin action in controls. Insulin sensitivity was also improved by acipimox treatment in diabetic rats, but did not reach normal levels. These results show that hyperglycemia is an obvious causative factor of insulin resistance, and increased FFA level may also act on the development of insulin resistance in STZ-diabetic rats.

Absorçäo intestinal de glucose em ratos anestesiados I. Padronizaçäo de método para "Screening" de drogas hipoglicemiantes orais (DHO)

This paper presents a method for the screening of natural hypoglycaemic drugs that interfere with the intestinal absorption of glucose. Luminal perfusion of the small intestine (whole length) was carried out on 24 h fasted adult Wistar rats, anaesthetized with sodium pentobarbital. Two rubber Nelaton cannulae were introduced into the organ, the first at the proximal end of the duodenum, just after the pylorus and a second larger one near the ileo-cecal valve. After a preliminary washing with warm physiological saline to remove any alimentary residues and secretions, warm saline containing glucose (plain or with added putative absorption inhibitors), was then introduced into the gut. Ten minutes later the contents was expelled with air and the preparation fully washed with plain warm saline. All perfusates were separately collected up to volume in graduated flasks kept in chipped ice. The glucose concentration was measured in triplicate samples by the specific glucose-oxidase method. The intestinal absorption of the sugar was calculated by difference from the glucose concentration found in the initial solution and in the final perfusate. The method is reliable and highly reproducible