Journal
DIABETES
Volume 62, Issue 4, Pages 1289-1296Publisher
AMER DIABETES ASSOC
DOI: 10.2337/db12-0988
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Funding
- Boehringer Ingelheim Pharma GmbH Co. KG
- Stockholm County Council
- Karolinska Institutet
- AFA Insurance
- European Foundation for the Study of Diabetes/sanofi-aventis grant
- Magnus Bergvalls Stiftelse
- Fredrik and Ingrid Thuring's Foundation
- Axel and Signe Lagerman's Donation Foundation
- Loo and Hans Osterman's Foundation
- Stohne's stiftelse
- Ahlen-stiftelsen
- STROKE-Riksforbundet stiftelser och fonder
- Diabetes Research & Wellness Foundation
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Type 2 diabetes is a strong risk factor for stroke. Linagliptin is a dipeptidyl peptidase-4 (DPP-4) inhibitor in clinical use against type 2 diabetes. The aim of this study was to determine the potential antistroke efficacy of linagliptin in type 2 diabetic mice. To understand whether efficacy was mediated by glycemia regulation, a comparison with the sulfonylurea glimepiride was done. To determine whether linagliptin-mediated efficacy was dependent on a diabetic background, experiments in nondiabetic mice were performed. Type 2 diabetes was induced by feeding the mice a high-fat diet for 32 weeks. Mice were treated with linagliptin/glimepiride for 7 weeks. Stroke was induced at 4 weeks into the treatment by transient middle cerebral artery occlusion. Blood DPP-4 activity, glucagon-like peptide-1 (GLP-1) levels, glucose, body weight, and food intake were assessed throughout the experiments. Ischemic brain damage was measured by determining stroke volume and by stereologic quantifications of surviving neurons in the striatum/cortex. We show pronounced antistroke efficacy of linagliptin in type 2 diabetic and normal mice, whereas glimepiride proved efficacious against stroke in normal mice only. These results indicate a linagliptin-mediated neuroprotection that is glucose-independent and likely involves GLP-1. The findings may provide an impetus for the development of DPP-4 inhibitors for the prevention and treatment of stroke in diabetic patients. Diabetes 62:1289-1296, 2013
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