Anti-inflammatory Pathways of Novel Anti-diabetic Therapies. A Literature Review

Abstract

SGLT2 inhibitors (SGLT2is) and GLP-1 receptor agonists (GLP-1RAs) are two novel anti-diabetic therapeutic classes with an important impact on cardiovascular outcomes. Ongoing clinical trials are further investigating their potential beneficial effects on multiple cardiovascular conditions. Even though the underlying mechanisms are not yet fully understood, it is speculated that their cardiovascular protection goes beyond simply lowering plasma glucose levels. By reducing chronic inflammation through multiple pathways, these therapeutic agents seem to have pleiotropic effects on the cardiovascular system. This descriptive review summarizes the most important anti-inflammatory pathways of SGLT2 is and GLP1-RAs, as described in present literature. We focus on inflammatory cytokines, oxidative stress, immune cell and mitochondrial function modulation, inflammatory pathway regulation and endothelial dysfunction improvement, with particular emphasis on their role in cardiovascular protection. A better understanding of the molecular mechanisms leading to the beneficial effects of these drugs could be crucial in developing a more specific therapeutic approach to various cardiovascular diseases.

Keywords: GLP-1 receptor agonists; Inflammation; SGLT2 inhibitors; atherosclerosis; cardiovascular; review.