The effect of empagliflozin on circulating endothelial progenitor cells in patients with diabetes and stable coronary artery disease.

IF 8.5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Cardiovascular Diabetology Pub Date : 2024-10-28 DOI:10.1186/s12933-024-02466-x

Roy Hershenson, Inbar Nardi-Agmon, Dorit Leshem-Lev, Ran Kornowski, Alon Eisen

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引用次数: 0

Abstract

Background: Diabetes mellitus (DM) is associated with premature atherosclerotic disease, coronary artery disease (CAD) and chronic heart failure (HF), leading to increased morbidity and mortality. Sodium-Glucose Co-transporter 2 Inhibitors (SGLT2i) exhibit cardioprotective benefits beyond glucose lowering, reducing the risk of major cardiovascular events (MACE) and HF hospitalizations in patients with DM and CAD. Endothelial progenitor cells (EPCs) are bone marrow-derived cells involved in vascular repair, mobilized in response to vascular injury. The number and function of circulating EPCs (cEPCs) are negatively affected by cardiovascular risk factors, including DM. This study aimed to examine the response of cEPCs to SGLT2i treatment in DM patients with stable CAD.

Methods: A prospective single-center study included patients with DM and stable CAD who were started on an SGLT2i (empagliflozin). Peripheral blood samples were collected at baseline, 1 month, and 3 months to evaluate cEPC levels and function by flow cytometry, immunohistochemistry and MTT assays.

Results: Eighteen patients were included in the study (median age 73, (IQR 69, 77) years, 67% male). After 1 month of treatment with empagliflozin, there was no significant change in cEPCs level or function. However, following 3 months of treatment, a significant increase was observed both in cell levels (CD34(+)/VEGFR-2(+): from 0.49% (IQR 0.32, 0.64) to 1.58% (IQR 0.93, 1.82), p = 0.0006; CD133(+)/VEGFR-2(+): from 0.38% (IQR 0.27, 0.6) to 0.82% (IQR 0.7, 1.95), p = 0.0001) and in cell function (from 0.25 CFUs (IQR 0, 0.5) at baseline, to 2 CFUs (IQR 1, 2) at 3 months, p = 0.0012).

Conclusions: Empagliflozin treatment in patients with DM and stable CAD increases cEPC levels and function, implying a cardioprotective mechanism. These findings highlight the potential of SGLT2i in treating cardiovascular diseases, warranting further research to explore these effects and their long-term implications.

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empagliflozin对糖尿病合并稳定型冠心病患者循环内皮祖细胞的影响。

背景：糖尿病（DM）与过早发生动脉粥样硬化疾病、冠状动脉疾病（CAD）和慢性心力衰竭（HF）有关，导致发病率和死亡率增加。钠-葡萄糖共转运体 2 抑制剂（SGLT2i）具有降糖之外的心脏保护作用，可降低糖尿病和冠心病患者发生重大心血管事件（MACE）和高血压住院治疗的风险。内皮祖细胞（EPCs）是参与血管修复的骨髓衍生细胞，在血管损伤时被动员起来。循环EPCs（cEPCs）的数量和功能受到包括糖尿病在内的心血管风险因素的负面影响。本研究旨在探讨稳定型 CAD 的 DM 患者中 cEPCs 对 SGLT2i 治疗的反应：这项前瞻性单中心研究纳入了开始接受SGLT2i（empagliflozin）治疗的DM合并稳定型CAD患者。在基线、1个月和3个月时采集外周血样本，通过流式细胞术、免疫组化和MTT检测评估cEPC的水平和功能：18名患者参与了研究（中位年龄为73岁（IQR为69岁至77岁），67%为男性）。使用恩格列净治疗1个月后，cEPCs水平和功能无明显变化。然而，治疗 3 个月后，细胞水平（CD34(+)/VEGFR-2(+)：从 0.49% (IQR 0.32, 0.64) 升至 1.58% (IQR 0.93, 1.82)，p = 0.0006；CD133(+)/VEGFR-2(+)：从 0.38% (IQR 0.27, 0.6) 到 0.82% (IQR 0.7, 1.95)，p = 0.0001）和细胞功能（从基线时的 0.25 CFUs (IQR 0, 0.5) 到 3 个月时的 2 CFUs (IQR 1, 2)，p = 0.0012）：Empagliflozin治疗糖尿病和稳定型CAD患者可提高cEPC的水平和功能，这意味着一种心脏保护机制。这些发现凸显了 SGLT2i 在治疗心血管疾病方面的潜力，值得进一步研究探讨这些作用及其长期影响。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Cardiovascular Diabetology 医学-内分泌学与代谢

CiteScore

12.30

自引率

15.10%

发文量

240

审稿时长

1 months

期刊介绍： Cardiovascular Diabetology is a journal that welcomes manuscripts exploring various aspects of the relationship between diabetes, cardiovascular health, and the metabolic syndrome. We invite submissions related to clinical studies, genetic investigations, experimental research, pharmacological studies, epidemiological analyses, and molecular biology research in this field.