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2018 ; 9
(ä): 114
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Oxidative Stress and NLRP3-Inflammasome Activity as Significant Drivers of
Diabetic Cardiovascular Complications: Therapeutic Implications
#MMPMID29515457
Sharma A
; Tate M
; Mathew G
; Vince JE
; Ritchie RH
; de Haan JB
Front Physiol
2018[]; 9
(ä): 114
PMID29515457
show ga
It is now increasingly appreciated that inflammation is not limited to the
control of pathogens by the host, but rather that sterile inflammation which
occurs in the absence of viral or bacterial pathogens, accompanies numerous
disease states, none more so than the complications that arise as a result of
hyperglycaemia. Individuals with type 1 or type 2 diabetes mellitus (T1D, T2D)
are at increased risk of developing cardiac and vascular complications. Glucose
and blood pressure lowering therapies have not stopped the advance of these
morbidities that often lead to fatal heart attacks and/or stroke. A unifying
mechanism of hyperglycemia-induced cellular damage was initially proposed to link
elevated blood glucose levels with oxidative stress and the dysregulation of
metabolic pathways. Pre-clinical evidence has, in most cases, supported this
notion. However, therapeutic strategies to lessen oxidative stress in clinical
trials has not proved efficacious, most likely due to indiscriminate targeting by
antioxidants such as vitamins. Recent evidence now suggests that oxidative stress
is a major driver of inflammation and vice versa, with the latest findings
suggesting not only a key role for inflammatory pathways underpinning metabolic
and haemodynamic dysfunction in diabetes, but furthermore that these
perturbations are driven by activation of the NOD-like receptor family pyrin
domain containing 3 (NLRP3) inflammasome. This review will address these latest
findings with an aim of highlighting the interconnectivity between oxidative
stress, NLRP3 activation and inflammation as it pertains to cardiac and vascular
injury sustained by diabetes. Current therapeutic strategies to lessen both
oxidative stress and inflammation will be emphasized. This will be placed in the
context of improving the burden of these diabetic complications.