Dapagliflozin attenuates diabetic cardiomyopathy through erythropoietin up-regulation of AKT/JAK/MAPK pathways in streptozotocin-induced diabetic rats

Purpose: This study was designed to investigate the mechanism of Dapagliflozin (Dapa) cardioprotection against diabetic cardiomyopathy (DCM). Structural and functional changes in the heart as well as decrease of erythropoietin (EPO) levels were reported in DCM. EPO simultaneously activates three pathways: the Janus-activated kinase-signal transducer and activator of transcription (JAK2/STAT5), phosphatidylinositol-3-kinase-Akt (PI3K/Akt), and extracellular signal-related kinase (ERK/MAPK) cascades, that result in proliferation and differentiation of cardiac cells. Methods and results: DCM was induced by a high fat diet for 10 weeks followed by administration of streptozotocin. After confirmation of diabetes, rats were divided randomly to 5 groups: Group 1; normal control group, Group 2; untreated diabetic group and Groups (3-5); diabetic groups received Dapa daily (0.75 mg, 1.5 or 3 mg/ Kg, p.o) respectively for a month. At the end of the experiment, full anaesthesia was induced in all rats using ether inhalation and ECG was recorded. Blood samples were collected then rats were sacrificed and their heart were dissected out and processed for biochemical and histopathological studies. Untreated diabetic rats showed abnormal ECG pattern, elevation of serum cardiac enzymes, decrease EPO levels, downregulation of P-Akt, PJAK2 and pMAPK pathways, abnormal histological structure of the heart and increase immunostaining intensity of P53 and TNF alpha in the cardiomyocytes. Dapa in a dose dependent manner attenuated the alterations in the previously mentioned parameters. Conclusion: The cardioprotective effect of Dapa could be mediated by increasing EPO levels and activation of PAkt, P-JAK2 and pMAPK signalling cascades which in turn decrease apoptosis.

Automated summary

This study aimed to investigate the cardioprotective mechanism of Dapagliflozin (Dapa) against diabetic cardiomyopathy (DCM). The results showed that Dapa attenuated cardiac abnormalities in DCM by increasing EPO levels and activating the PAkt, P-JAK2, and pMAPK signaling cascades, thereby reducing apoptosis.