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Dipeptidyl peptidase inhibition prevents diastolic dysfunction and reduces myocardial fibrosis in a Mouse model of Western diet induced obesity
Authors:Brian Bostick  Javad Habibi  Lixin Ma  Annayya Aroor  Nathan Rehmer  Melvin R Hayden  James R Sowers
Institution:1. Division of Cardiovascular Medicine, Diabetes Cardiovascular Center, University of Missouri, Columbia, MO, USA;2. Department of Medicine, University of Missouri, Columbia, MO, USA;3. Harry S. Truman Memorial Veterans Hospital, Columbia MO, USA;4. Division of Endocrinology and Metabolism, Diabetes Cardiovascular Center, University of Missouri, Columbia, MO, USA;5. Department of Radiology, University of Missouri, Columbia, MO, USA;6. Department of Medical Pharmacology and Physiology, University of Missouri, Columbia, MO, USA
Abstract:

Objective

Consumption of a high-fat/high-fructose Western diet (WD) is linked to rising obesity and heart disease, particularly diastolic dysfunction which characterizes early obesity/metabolic cardiomyopathy. Mounting evidence supports a role for inflammation, oxidative stress and fibrosis in the pathophysiology of metabolic cardiomyopathy. Dipeptidyl peptidase-4 (DPP-4) is a circulating exopeptidase recently reported to be elevated in the plasma of patients with insulin resistance (IR), obesity and heart failure. We hypothesized that a model of WD induced obesity/metabolic cardiomyopathy would exhibit increased DPP-4 activity and cardiac fibrosis with DPP-4 inhibition preventing cardiac fibrosis and the associated diastolic dysfunction.

Materials/Methods

Four-week-old C57BL6/J mice were fed a high-fat/high-fructose WD with the DPP-4 inhibitor MK0626 for 16 weeks. Cardiac function was examined by high-resolution cine-cardiac magnetic resonance imaging (MRI). Phenotypic analysis included measurements of body and heart weight, systemic IR and DPP-4 activity. Immunohistochemistry and transmission electron microscopy (TEM) were utilized to identify underlying pathologic mechanisms.

Results

We found that chronic WD consumption caused obesity, IR, elevated plasma DPP-4 activity, heart enlargement and diastolic dysfunction. DPP-4 inhibition with MK0626 in WD fed mice resulted in > 75% reduction in plasma DPP-4 activity, improved IR and normalized diastolic relaxation. WD consumption induced myocardial oxidant stress and fibrosis with amelioration by MK0626. TEM of hearts from WD fed mice revealed abnormal mitochondrial and perivascular ultrastructure partially corrected by MK0626.

Conclusions

This study provides evidence of a role for increased DPP-4 activity in metabolic cardiomyopathy and a potential role for DPP-4 inhibition in prevention and/or correction of oxidant stress/fibrosis and associated diastolic dysfunction.
Keywords:WD  Western Diet  CVD  cardiovascular disease  IR  insulin resistance  MetS  metabolic syndrome  HF  heart failure  LV  left ventricle  ROS  reactive oxygen species  RAAS  renin&ndash  angiotensin&ndash  aldosterone system  GLP-1  glucagon-like peptide 1  GIP  glucose-like insulinotrophic peptide  DPP-4  dipeptidyl peptidase-4  CD  control diet  CD     MK  control diet and MK0626  WD     MK  western diet and MK0626  MRI  magnetic resonance imaging  HOMA-IR  homeostatic model of assessment of insulin resistance  RNS  reactive nitrogen species  Col 1  collagen type 1  Col 3  collagen type 3  TGF-β  transforming growth factor-β  MCP-1  monocyte chemoattractant protein-1  3-NT  3-nitrotyrosine  ECM  extracellular matrix  TEM  transmission electron microscopy  NO  nitric oxide
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