The Synthetic Flavonoid Hidrosmin Improves Endothelial Dysfunction and Atherosclerotic Lesions in Diabetic Mice

In diabetes, chronic hyperglycemia, dyslipidemia, inflammation and oxidative stress contribute to the progression of macro/microvascular complications. Recently, benefits of the use of flavonoids in these conditions have been established. This study investigates, in two different mouse models of diabetes, the vasculoprotective effects of the synthetic flavonoid hidrosmin on endothelial dysfunction and atherogenesis. In a type 2 diabetes model of leptin-receptor-deficient (db/db) mice, orally administered hidrosmin (600 mg/kg/day) for 16 weeks markedly improved vascular function in aorta and mesenteric arteries without affecting vascular structural properties, as assessed by wire and pressure myography. In streptozotocin-induced type 1 diabetic apolipoprotein E-deficient mice, hidrosmin treatment for 7 weeks reduced atherosclerotic plaque size and lipid content; increased markers of plaque stability; and decreased markers of inflammation, senescence and oxidative stress in aorta. Hidrosmin showed cardiovascular safety, as neither functional nor structural abnormalities were noted in diabetic hearts. Ex vivo, hidrosmin induced vascular relaxation that was blocked by nitric oxide synthase (NOS) inhibition. In vitro, hidrosmin stimulated endothelial NOS activity and NO production and downregulated hyperglycemia-induced inflammatory and oxidant genes in vascular smooth muscle cells. Our results highlight hidrosmin as a potential add-on therapy in the treatment of macrovascular complications of diabetes.

[1]  W. Luo,et al.  Colchicine may become a new cornerstone therapy for coronary artery disease: a meta‐analysis of randomized controlled trials , 2022, Clinical Rheumatology.

[2]  A. Briones,et al.  Microsomal prostaglandin E synthase‐1 is involved in the metabolic and cardiovascular alterations associated with obesity , 2021, British journal of pharmacology.

[3]  J. Egido,et al.  Nephroprotective Effects of Synthetic Flavonoid Hidrosmin in Experimental Diabetic Nephropathy , 2021, Antioxidants.

[4]  S. Stone,et al.  Synthetic Biology towards Improved Flavonoid Pharmacokinetics , 2021, Biomolecules.

[5]  S. Kahn,et al.  Micronized purified flavonoid fraction for the treatment of chronic venous insufficiency, with a focus on postthrombotic syndrome: A narrative review , 2021, Research and practice in thrombosis and haemostasis.

[6]  Bin Liu,et al.  The effects of lipid-lowering therapy on coronary plaque regression: a systematic review and meta-analysis , 2021, Scientific Reports.

[7]  L. Lind,et al.  A longitudinal study over 40 years to study the metabolic syndrome as a risk factor for cardiovascular diseases , 2021, Scientific Reports.

[8]  Asad Ullah,et al.  Important Flavonoids and Their Role as a Therapeutic Agent , 2020, Molecules.

[9]  Linfu Li,et al.  Metabolism and pharmacological activities of the natural health-benefiting compound diosmin. , 2020, Food & function.

[10]  Lei Zheng,et al.  The emerging role of cell senescence in atherosclerosis , 2020, Clinical chemistry and laboratory medicine.

[11]  W. Masson,et al.  Role of non-statin lipid-lowering therapy in coronary atherosclerosis regression: a meta-analysis and meta-regression , 2020, Lipids in Health and Disease.

[12]  M. Wiciński,et al.  Vasculoprotective Effects of Vildagliptin. Focus on Atherogenesis , 2020, International journal of molecular sciences.

[13]  A. Orekhov,et al.  The Diabetes Mellitus–Atherosclerosis Connection: The Role of Lipid and Glucose Metabolism and Chronic Inflammation , 2020, International journal of molecular sciences.

[14]  M. El-Naggar,et al.  Combating atherosclerosis with targeted Diosmin nanoparticles-treated experimental diabetes , 2020, Investigational New Drugs.

[15]  J. Egido,et al.  The Coming Age of Flavonoids in the Treatment of Diabetic Complications , 2020, Journal of clinical medicine.

[16]  T. Ali,et al.  The Potential Protective Effects of Diosmin on Streptozotocin-Induced Diabetic Cardiomyopathy in Rats. , 2020, The American journal of the medical sciences.

[17]  C. Blanchard,et al.  Dietary Polyphenols and Gene Expression in Molecular Pathways Associated with Type 2 Diabetes Mellitus: A Review , 2019, International journal of molecular sciences.

[18]  J. Alves-Filho,et al.  NLRP3 Inflammasome and Mineralocorticoid Receptors Are Associated with Vascular Dysfunction in Type 2 Diabetes Mellitus , 2019, Cells.

[19]  W. Rathmann,et al.  Glucose and insulin levels are associated with arterial stiffness and concentric remodeling of the heart , 2019, Cardiovascular diabetology.

[20]  T. Zubilewicz,et al.  Effect of Diosmin Administration in Patients with Chronic Venous Disorders on Selected Factors Affecting Angiogenesis , 2019, Molecules.

[21]  H. Waagepetersen,et al.  Hypermetabolism and impaired endothelium-dependent vasodilation in mesenteric arteries of type 2 diabetes mellitus db/db mice , 2019, Diabetes & vascular disease research.

[22]  Mona F. Mahmoud,et al.  Effects of diosmin and crocin on metabolic syndrome-associated cardio-vascular complications in rats , 2019, Naunyn-Schmiedeberg's Archives of Pharmacology.

[23]  P. Wilson,et al.  Cardiovascular Safety Trials for All New Diabetes Mellitus Drugs? , 2019, Circulation.

[24]  Ira Tabas,et al.  Inflammation and its resolution in atherosclerosis: mediators and therapeutic opportunities , 2019, Nature Reviews Cardiology.

[25]  P. Ridker Anticytokine Agents: Targeting Interleukin Signaling Pathways for the Treatment of Atherothrombosis , 2019, Circulation research.

[26]  N. Frangogiannis,et al.  Characterization of a mouse model of obesity-related fibrotic cardiomyopathy that recapitulates features of human heart failure with preserved ejection fraction. , 2018, American journal of physiology. Heart and circulatory physiology.

[27]  F. O'Valle,et al.  Moderate Effect of Flavonoids on Vascular and Renal Function in Spontaneously Hypertensive Rats , 2018, Nutrients.

[28]  T. Einarson,et al.  Prevalence of cardiovascular disease in type 2 diabetes: a systematic literature review of scientific evidence from across the world in 2007–2017 , 2018, Cardiovascular Diabetology.

[29]  Young Seol Kim,et al.  The Role of Advanced Glycation End Products in Diabetic Vascular Complications , 2018, Diabetes & metabolism journal.

[30]  R. Touyz,et al.  Vascular dysfunction in obese diabetic db/db mice involves the interplay between aldosterone/mineralocorticoid receptor and Rho kinase signaling , 2018, Scientific Reports.

[31]  A. Nicolaides,et al.  Efficacy of micronized purified flavonoid fraction (Daflon®) on improving individual symptoms, signs and quality of life in patients with chronic venous disease: a systematic review and meta-analysis of randomized double-blind placebo-controlled trials. , 2018, International angiology : a journal of the International Union of Angiology.

[32]  T. Jalili,et al.  Metabolites of flavonoid compounds preserve indices of endothelial cell nitric oxide bioavailability under glucotoxic conditions , 2017, Nutrition &Diabetes.

[33]  P. Libby,et al.  Antiinflammatory Therapy with Canakinumab for Atherosclerotic Disease , 2017, The New England journal of medicine.

[34]  M. Lahkar,et al.  Diosmin Modulates the NF-kB Signal Transduction Pathways and Downregulation of Various Oxidative Stress Markers in Alloxan-Induced Diabetic Nephropathy , 2016, Inflammation.

[35]  A. Goldfine,et al.  Clinical Update: Cardiovascular Disease in Diabetes Mellitus Atherosclerotic Cardiovascular Disease and Heart Failure in Type 2 Diabetes Mellitus – Mechanisms, Management, and Clinical Considerations , 2016, Circulation.

[36]  A. Reiner,et al.  Oxidative stress, inflammation, endothelial dysfunction and incidence of type 2 diabetes , 2016, Cardiovascular Diabetology.

[37]  M. Kozáková,et al.  Arterial stiffness, atherosclerosis and cardiovascular risk: Pathophysiologic mechanisms and emerging clinical indications. , 2016, Vascular pharmacology.

[38]  R. Touyz,et al.  Mineralocorticoid receptor blockade prevents vascular remodelling in a rodent model of type 2 diabetes mellitus. , 2015, Clinical science.

[39]  J. Blanco,et al.  Targeting HSP90 Ameliorates Nephropathy and Atherosclerosis Through Suppression of NF-κB and STAT Signaling Pathways in Diabetic Mice , 2015, Diabetes.

[40]  J. Egido,et al.  Updating Experimental Models of Diabetic Cardiomyopathy , 2015, Journal of diabetes research.

[41]  R. Touyz,et al.  Vascular injury in diabetic db/db mice is ameliorated by atorvastatin: role of Rac1/2-sensitive Nox-dependent pathways. , 2015, Clinical science.

[42]  J. Egido,et al.  Suppressor of Cytokine Signaling 1–Derived Peptide Inhibits Janus Kinase/Signal Transducers and Activators of Transcription Pathway and Improves Inflammation and Atherosclerosis in Diabetic Mice , 2014, Arteriosclerosis, thrombosis, and vascular biology.

[43]  J. Duarte,et al.  Modulation of nitric oxide by flavonoids. , 2014, Food & function.

[44]  A. Briones,et al.  Small artery remodeling in obesity and insulin resistance. , 2014, Current vascular pharmacology.

[45]  B. Raja,et al.  Diosmin, a bioflavonoid reverses alterations in blood pressure, nitric oxide, lipid peroxides and antioxidant status in DOCA-salt induced hypertensive rats. , 2012, European journal of pharmacology.

[46]  David A. Bluemke,et al.  Cardiac remodeling at the population level—risk factors, screening, and outcomes , 2011, Nature Reviews Cardiology.

[47]  K. Varner,et al.  Mesenteric Resistance Arteries in Type 2 Diabetic db/db Mice Undergo Outward Remodeling , 2011, PloS one.

[48]  Joann M Lohr,et al.  Selected Phlebology Abstracts , 2011, Journal of vascular surgery.

[49]  S. Vatner,et al.  Echocardiography in Mice. , 2011, Current protocols in mouse biology.

[50]  W. Hsueh,et al.  Recipes for creating animal models of diabetic cardiovascular disease. , 2007, Circulation research.

[51]  Deng-Chyang Wu,et al.  Activation of telomerase and expression of human telomerase reverse transcriptase in coronary atherosclerosis. , 2005, Cardiovascular pathology : the official journal of the Society for Cardiovascular Pathology.

[52]  D. Rizzoni,et al.  Endothelial Factors and Microvascular Hypertensive Disease , 2001, Journal of cardiovascular pharmacology.

[53]  E. Porteri,et al.  Structural Alterations in Subcutaneous Small Arteries of Normotensive and Hypertensive Patients With Non–Insulin-Dependent Diabetes Mellitus , 2001, Circulation.

[54]  W D Wagner,et al.  A definition of initial, fatty streak, and intermediate lesions of atherosclerosis. A report from the Committee on Vascular Lesions of the Council on Arteriosclerosis, American Heart Association. , 1994, Arteriosclerosis and thrombosis : a journal of vascular biology.

[55]  T. Walther,et al.  Cardiovascular safety of anti-diabetic drugs. , 2016, European heart journal. Cardiovascular pharmacotherapy.

[56]  P Pittaluga,et al.  Editor's Choice - Management of Chronic Venous Disease: Clinical Practice Guidelines of the European Society for Vascular Surgery (ESVS). , 2015, European journal of vascular and endovascular surgery : the official journal of the European Society for Vascular Surgery.

[57]  X. Bonfill,et al.  Phlebotonics for venous insufficiency. , 2005, The Cochrane database of systematic reviews.