Empagliflozin treatment of cardiotoxicity: A comprehensive review of clinical, immunobiological, neuroimmune, and therapeutic implications - 11/11/23
Abstract |
Cancer and cardiovascular disorders are known as the two main leading causes of mortality worldwide. Cardiotoxicity is a critical and common adverse effect of cancer-related chemotherapy. Chemotherapy-induced cardiotoxicity has been associated with various cancer treatments, such as anthracyclines, immune checkpoint inhibitors, and kinase inhibitors. Different methods have been reported for the management of chemotherapy-induced cardiotoxicity. In this regard, sodium-glucose cotransporter-2 inhibitors (SGLT2i), a class of antidiabetic agents, have recently been applied to manage heart failure patients. Further, SGLT2i drugs such as EMPA exert protective cardiac and systemic effects. Moreover, it can reduce inflammation through the mediation of major inflammatory components, such as Nucleotide-binding domain-like receptor protein 3 (NLRP3) inflammasomes, Adenosine 5'-monophosphate-activated protein kinase (AMPK), and c-Jun N-terminal kinase (JNK) pathways, Signal transducer and activator of transcription (STAT), and overall decreasing transcription of proinflammatory cytokines. The clinical outcome of EMPA administration is related to improving cardiovascular risk factors, including body weight, lipid profile, blood pressure, and arterial stiffness. Intriguingly, SGLT2 suppressors can regulate microglia-driven hyperinflammation affecting neurological and cardiovascular disorders. In this review, we discuss the protective effects of EMPA in chemotherapy-induced cardiotoxicity from molecular, immunological, and neuroimmunological aspects to preclinical and clinical outcomes.
Le texte complet de cet article est disponible en PDF.Graphical Abstract |
Highlights |
• | Empagliflozin may positively affect blood pressure, lipid profile, renal outcomes, and endothelial function. |
• | The activity of empagliflozin is exerted through various molecular biological, immunological, or neuroimmune pathways. |
• | Empagliflozin affects inflammasomes, NF-KB, AMPK, protein kinase Ga, Bcl2, Na,H exchange, and other mechanisms. |
• | SGLT2 suppressors can regulate microglia-driven hyperinflammation affecting neurological and cardiovascular disorders. |
• | Empagliflozine could be studied in different chemotherapy-related toxicities such as neurotoxicity. |
Keywords : SGLT2i, EMPA, Chemotherapy, Cardiotoxicity, Heart failure
Plan
Vol 168
Article 115686- décembre 2023 Retour au numéroBienvenue sur EM-consulte, la référence des professionnels de santé.
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