Dapagliflozin Activates Neurons in the Central Nervous System and Regulates Cardiovascular Activity by Inhibiting SGLT-2 in Mice

Diabetes Metab Syndr Obes. 2020 Aug 5:13:2781-2799. doi: 10.2147/DMSO.S258593. eCollection 2020.

Abstract

Purpose: This study investigates the possible effect and central mechanism of novel antidiabetic medication sodium glucose transporter-2 (SGLT-2i) on the cardiovascular activity.

Material and methods: Thirty-four normal male C57BL/6 mice were randomly assigned to 2 groups to receive single Dapagliflozin (1.52mg/kg) dose via intragastric gavage or a comparable dose of saline. Glycemic level (BG), blood pressure (BP) and heart rate (HR) were measured 2 hours after administration of the respective treatments. Immunohistochemical tests were performed to determine the effect of SGLT-2i on neural localization of SGLT-2 and c-Fos, a neural activator. The distributional relationships of SGLT-2 and c-Fos were examined by immunofluorescence.

Results: Administration of SGLT-2i significantly decreased BP but did not affect the HR. There was no difference in BG between the two groups. Results showed that SGLT-2 was localized to specific regions involved in autonomic control. Expression of c-Fos was significantly higher in major critical nuclei in the aforementioned regions in groups treated with Dapagliflozin.

Conclusion: This study demonstrates that SGLT-2 is expressed in CNS tissues involved in autonomic control and possibly influence cardiovascular function. Dapagliflozin influences central autonomic activity via unidentified pathways by inhibiting central or peripheral SGLT-2. These results provide a new concept that sympathetic inhibition by SGLT-2i can be mediated by central autonomic system, a mechanism that explains how SGLT-2i improves the cardiovascular function.

Keywords: brain nuclei; c-Fos; cardiovascular activity; dapagliflozin; sodium glucose co-transporter-2.

Grants and funding

This work was supported by Special Department Fund of the Pudong, New Area Health Planning Commission (PWZzk2017-03), and Integrative Medicine special fund of Shanghai Municipal Health Planning Committee (ZHYY-ZXYJHZX-2-201712), National Natural Science Foundation of China (81370932), Outstanding Leaders Training Program of Pudong Health Bureau of Shanghai (PWR12014-06), the Outstanding Clinical Discipline Project of Shanghai Pudong (PWYgy-2018-08), the Natural Science Foundation of China (21675034), Shanghai Natural Science Foundation (19ZR1447500).