4.7 Review

Emerging Roles of Sodium Glucose Cotransporter 2 (SGLT-2) Inhibitors in Diabetic Cardiovascular Diseases: Focusing on Immunity, Inflammation and Metabolism

Journal

FRONTIERS IN PHARMACOLOGY
Volume 13, Issue -, Pages -

Publisher

FRONTIERS MEDIA SA
DOI: 10.3389/fphar.2022.836849

Keywords

diabetic cardiovascular diseases; inflammation; SGLT-2 inhibitors; immunological factors; metabolism

Funding

  1. National Key Research and Development Project [2018YFE0114500]
  2. National Natural Science Foundation of China [81820108007, 81600649, 81800745]
  3. National Science Foundation of Hunan Province for Excellent Young Scholars [2020JJ3056]
  4. Science and Technology Innovation Program of Hunan Province [2021RC 3033]

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Diabetes patients face increased cardiovascular risks and SGLT-2 inhibitors have potential cardiovascular protective effects, although their mechanisms of action are not fully understood. This review summarizes the multifactorial mechanisms of SGLT-2 inhibitors in regulating immunity, inflammation, and metabolism, and presents future directions for preventing or delaying cardiovascular complications in diabetes.
Diabetes mellitus (DM) is one of the most fast evolving global issues characterized by hyperglycemia. Patients with diabetes are considered to face with higher risks of adverse cardiovascular events. Those are the main cause of mortality and disability in diabetes patients. There are novel antidiabetic agents that selectively suppress sodium-glucose cotransporter-2 (SGLT-2). They work by reducing proximal tubule glucose reabsorption. Although increasing evidence has shown that SGLT-2 inhibitors can contribute to a series of cardiovascular benefits in diabetic patients, including a reduced incidence of major adverse cardiovascular events and protection of extracardiac organs, the potential mechanisms of SGLT2 inhibitors' cardiovascular protective effects are still not fully elucidated. Given the important role of inflammation and metabolism in diabetic cardiovascular diseases, this review is intended to rationally compile the multifactorial mechanisms of SGLT-2 inhibitors from the point of immunity, inflammation and metabolism, depicting the fundamental cellular and molecular processing of SGLT-2 inhibitors exerting regulating immunity, inflammation and metabolism. Finally, future directions and perspectives to prevent or delay cardiovascular complications in DM by SGLT-2 inhibitors are presented.

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