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Ocaranza MP, Valderas P, Moya J, Gabrielli L, Godoy I, Córdova S, Nab PM, García L, Farías L, Jalil JE. Rho kinase cascade activation in circulating leukocytes in patients with diabetes mellitus type 2. Cardiovasc Diabetol 2020; 19:56. [PMID: 32375786 PMCID: PMC7203835 DOI: 10.1186/s12933-020-01027-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/24/2020] [Accepted: 04/25/2020] [Indexed: 12/11/2022] Open
Abstract
Background The intracellular ROCK signaling pathway is an important modulator of blood pressure and of cardiovascular and renal remodeling when Rho-kinase activity is increased. Besides, in preclinical models of diabetes, ROCK activation has also a role in abnormal glucose metabolism as well as in subsequent vascular and myocardial dysfunction. In humans, there are a few data assessing ROCK activation in patients with type 2 diabetes mellitus (T2D) and no studies assessing upstream/downstream components of the ROCK pathway. We assessed here levels of ROCK activation and some of the RhoA/ROCK cascade molecules in peripheral blood mononuclear cells (PBMCs) in T2D patients under current treatment. Methods Cross-sectional observational study comparing 28 T2D patients under current antidiabetic treatment with 31 consecutive healthy subjects, matched by age and gender. Circulating levels of malondialdehyde, angiotensin II and inflammatory cytokines IL-6 and IL-8 were determined in all subjects. ROCK activation in PMBCs, upstream and downstream cascade proteins, and levels of the proinflammatory molecules VCAM, ICAM-1 and IL-8 were determined in their PMBCs by Western blot. Results Compared to healthy controls, ROCK activation in T2D patients measured by 2 direct ROCK targets in PBMCs was increased by 420 and 570% (p < 0001) and it correlated significantly with serum glucose levels. p38 MAPK phosphorylation (downstream from ROCK) and JAK-2 (upstream from ROCK) were significantly higher in the T2D patients by 580% and 220%, respectively. In T2D patients, significantly increased PBMC levels of the proinflammatory molecules VCAM-1, ICAM-1 and IL-8 were observed compared to control subjects (by 180%, 360% and 260%, respectively). Circulating levels of Ang II and MDA were significantly higher in T2D patients by 29 and 63%, respectively. Conclusions T2D patients under treatment with glucose-lowering drugs, antihypertensive treatment as well as with statins have significantly increased ROCK activation in their circulating leukocytes along with higher phosphorylation of downstream cascade proteins despite pharmacologic treatment, along with increased plasma angiotensin II and MDA levels. ROCK inhibition might have an additional role in the prevention and treatment of T2D.
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Affiliation(s)
- Maria Paz Ocaranza
- School of Medicine, Division of Cardiovascular Diseases, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Piso 7, 8320000, Santiago, Chile.,Center for New Drugs for Hypertension (CENDHY), Pontificia Universidad Católica de Chile, Santiago, Chile.,Advanced Center for Chronic Diseases (ACCDiS), Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Patricio Valderas
- Facultad de Medicina, Odontología, Universidad de Antofagasta, Avenida Argentina 2000, 1240000, Antofagasta, Chile
| | - Jackeline Moya
- School of Medicine, Division of Cardiovascular Diseases, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Piso 7, 8320000, Santiago, Chile
| | - Luigi Gabrielli
- School of Medicine, Division of Cardiovascular Diseases, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Piso 7, 8320000, Santiago, Chile.,Advanced Center for Chronic Diseases (ACCDiS), Facultad de Medicina, Pontificia Universidad Católica de Chile, Santiago, Chile
| | - Iván Godoy
- School of Medicine, Division of Cardiovascular Diseases, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Piso 7, 8320000, Santiago, Chile
| | - Samuel Córdova
- School of Medicine, Division of Cardiovascular Diseases, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Piso 7, 8320000, Santiago, Chile
| | - Paul Mac Nab
- School of Medicine, Division of Cardiovascular Diseases, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Piso 7, 8320000, Santiago, Chile
| | - Lorena García
- Faculty of Chemical and Pharmaceutical Sciences, Advanced Center for Chronic Diseases (ACCDiS), Universidad de Chile, Santiago, Chile
| | - Luis Farías
- School of Medicine, Division of Cardiovascular Diseases, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Piso 7, 8320000, Santiago, Chile
| | - Jorge E Jalil
- School of Medicine, Division of Cardiovascular Diseases, Pontificia Universidad Católica de Chile, Diagonal Paraguay 362, Piso 7, 8320000, Santiago, Chile. .,Center for New Drugs for Hypertension (CENDHY), Pontificia Universidad Católica de Chile, Santiago, Chile.
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Boza C, Valderas P, Daroch DA, León FI, Salinas JP, Barros DA, Funke RA, Crovari FJ. Metabolic surgery: roux-en-Y gastric bypass and variables associated with diabetes remission in patients with BMI <35. Obes Surg 2015; 24:1391-7. [PMID: 24719226 DOI: 10.1007/s11695-014-1218-x] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
Metabolic results of bariatric surgery have determined an expansion of its traditional indications, being increasingly performed in non-severely obese patients, especially in type 2 diabetes mellitus (T2DM). Our aim is to determine the effectiveness of laparoscopic Roux-en-Y gastric bypass (LRYGB) in T2DM remission in patients with body mass index (BMI) below 35 kg/m(2) and the variables associated with T2DM remission after surgery. Retrospective analysis of diabetic patients with BMI <35 kg/m(2) who underwent LRYGB in our center between 2002 and 2010 was done. We analyzed patient's demographics, comorbidities, BMI, excess weight loss percentage (EWLp), complications, and metabolic results at 3 years. Univariate and multivariate analyses were performed to determine variables associated with T2DM remission. One hundred patients were included. Sixty patients (60 %) were women; median age was 48 years old (interquartile range (IQR) 42-54), and median preoperative BMI was 32.7 kg/m(2) (IQR 31.6-34.1). Median preoperative duration of T2DM was 4 years (IQR 2-7), with 49, 30, 2, and 18 % on treatment with one, two, and three hypoglycemic agents and insulin, respectively. Ninety-four percent achieved 36-month follow-up, and at this time, median EWLp was 93 % (IQR 67-121). A total of 53.2, 9.6, 25.5, and 11.7 % achieved a T2DM complete remission, partial remission, improvement, and no improvement, respectively. T2DM remission only was associated with non-insulin use in multivariate analysis, with an OR = 15.1 (2.8-81.2) and p = 0.002. LRYGB is a reliable and effective treatment in diabetic patients with a BMI <35 kg/m(2) at 3 years. T2DM remission's best results are observed in non-insulin diabetic patients.
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Affiliation(s)
- Camilo Boza
- Department of Digestive Surgery, School of Medicine, Pontificia Universidad Católica de Chile, Marcoleta 350, Región Metropolitana, Santiago, Chile,
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