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Exosomes: a potential biomarker and therapeutic targets in diabetic cardiomyopathy
1 Nanjing Drum Tower Hospital Center of Molecular Diagnostic and Therapy, Chinese Academy of Medical Sciences Research Unit of Extracellular RNA, State Key Laboratory of Pharmaceutical Biotechnology, Jiangsu Engineering Research Center for MicroRNA Biology and Biotechnology, NJU Advanced Institute of Life Sciences (NAILS), School of Life Sciences, Nanjing University, Nanjing, Jiangsu, China
2 The Research Center of Military Exercise Science, The Army Engineering University of PLA, Nanjing, Jiangsu, China
3 Shenzhen Institute, Peking University, Shenzhen, Guangdong, China
4 Pingshan Translational Medicine Center, Shenzhen Bay Laboratory, Shenzhen, Guangdong, China
  • Volume
  • Citation
    Anwar A, Ma J, Yin X. Exosomes: a potential biomarker and therapeutic targets in diabetic cardiomyopathy. ExRNA 2024(3):0015, https://doi.org/10.55092/exrna20240015. 
  • DOI
  • Copyright
    Copyright2024 by the authors. Published by ELSP.
Abstract

Diabetic cardiomyopathy (DCM) refers to a complication that arises in diabetic patients and leads to various cardiac dysfunctions. These dysfunctions include oxidative stress, myocardial apoptosis, mitochondrial dysfunction, inflammation, lipotoxicity, fibrosis, impaired Ca2+ handling, and increased fatty acid utilization. Despite significant research efforts, the molecular mechanism underlying DCM remains incompletely understood. Recent studies have highlighted the role of exosomes, which are endogenous nanovesicles, in carrying detrimental components capable of initiating and propagating disease-related signaling events. In this review, we summarize the potential underlying mechanisms of DCM and discuss the potential use of exosomes in understanding the cellular mechanisms involved and exploring therapeutic approaches for DCM. These insights and opportunities may pave the way for new advancements in the field.

Keywords

exosomes; diabetic cardiomyopathy; miRNA

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References
  • [1] ElSayed NA, Aleppo G, Aroda VR, Bannuru RR, Brown FM, et al. 13. Older Adults: Standards of Care in Diabetes-2023. Diabetes Care 2023, 46(Suppl 1):S216–S229.
  • [2] Patel SM, Kang YM, Im K, Neuen BL, Anker SD, et al. Sodium-Glucose Cotransporter-2 Inhibitors and Major Adverse Cardiovascular Outcomes: A SMART-C Collaborative Meta-Analysis. Circulation 2024, 149(23):1789–1801.
  • [3] Neuen BL, Heerspink HJL, Vart P, Claggett BL, Fletcher RA, et al. Estimated Lifetime Cardiovascular, Kidney, and Mortality Benefits of Combination Treatment With SGLT2 Inhibitors, GLP-1 Receptor Agonists, and Nonsteroidal MRA Compared With Conventional Care in Patients With Type 2 Diabetes and Albuminuria. Circulation 2024, 149(6):450–462.
  • [4] You M, Liu Y, Wang B, Li L, Zhang H, et al. Asprosin induces vascular endothelial-to-mesenchymal transition in diabetic lower extremity peripheral artery disease. Cardiovasc. Diabetol. 2022, 21(1):25.
  • [5] Rubler S, Dlugash J, Yuceoglu YZ, Kumral T, Branwood AW, et al. New type of cardiomyopathy associated with diabetic glomerulosclerosis. Am. J. Cardiol. 1972, 30(6):595–602.
  • [6] Ye B, Zhou H, Chen Y, Luo W, Lin W, et al. USP25 Ameliorates Pathological Cardiac Hypertrophy by Stabilizing SERCA2a in Cardiomyocytes. Circ. Res. 2023, 132(4):465–480.
  • [7] Lin J, Li J, Huang B, Liu J, Chen X, et al. Exosomes: novel biomarkers for clinical diagnosis. Sci. World J. 2015, 2015:657086.
  • [8] Arya SB, Collie SP, Parent CA. The ins-and-outs of exosome biogenesis, secretion, and internalization. Trends Cell Biol. 2024, 34(2):90–10
  • [9] Vietri M, Radulovic M, Stenmark H. The many functions of ESCRTs. Nat. Rev. Mol. Cell Biol. 2020, 21(1):25–42.
  • [10] Kalluri R, LeBleu VS. The biology, function, and biomedical applications of exosomes. Science 2020, 367(6478): eaau6977.
  • [11] Chen X, Ba Y, Ma L, Cai X, Yin Y, et al. Characterization of microRNAs in serum: a novel class of biomarkers for diagnosis of cancer and other diseases. Cell Res. 2008, 18(10):997–1006.
  • [12] Yuan J, Fu X. MicroRNA-21 mediates the protective role of emulsified isoflurane against myocardial ischemia/reperfusion injury in mice by targeting SPP1. Cell. Signalling 2021, 86:110086.
  • [13] Costantino S, Paneni F, Luscher TF,Cosentino F. MicroRNA profiling unveils hyperglycaemic memory in the diabetic heart. Eur. Heart J. 2016, 37(6):572–576.
  • [14] Mendez-Mancilla A, Turijan-Espinoza E, Vega-Cardenas M, Hernandez-Hernandez GE, Uresti-Rivera EE, et al. miR-21, miR-221, miR-29 and miR-34 are distinguishable molecular features of a metabolically unhealthy phenotype in young adults. PLoS One 2024, 19(4):e0300420.
  • [15] Gonzalez P, Lozano P, Ros G,Solano F. Hyperglycemia and Oxidative Stress: An Integral, Updated and Critical Overview of Their Metabolic Interconnections. Int. J. Mol. Sci. 2023, 24(11):9352.
  • [16] Zheng D, Ma J, Yu Y, Li M, Ni R, et al. Silencing of miR-195 reduces diabetic cardiomyopathy in C57BL/6 mice. Diabetologia 2015, 58(8):1949–1958.
  • [17] Ghosh N, Katare R. Molecular mechanism of diabetic cardiomyopathy and modulation of microRNA function by synthetic oligonucleotides. Cardiovasc. Diabetol. 2018, 17(1):1–25.
  • [18] Jakubik D, Fitas A, Eyileten C, Jarosz-Popek J, Nowak A, et al. MicroRNAs and long non-coding RNAs in the pathophysiological processes of diabetic cardiomyopathy: emerging biomarkers and potential therapeutics. Cardiovasc Diabetol 2021, 20(1):1–29.
  • [19] Gross P, Johnson J, Romero CM, Eaton DM, Poulet C, et al. Interaction of the Joining Region in Junctophilin-2 With the L-Type Ca(2+) Channel Is Pivotal for Cardiac Dyad Assembly and Intracellular Ca(2+) Dynamics. Circ. Res. 2021, 128(1):92–114.
  • [20] Sanganalmath SK, Dubey S, Veeranki S, Narisetty K,Krishnamurthy P. The interplay of inflammation, exosomes and Ca(2+) dynamics in diabetic cardiomyopathy. Cardiovasc. Diabetol. 2023, 22(1):37.
  • [21] Emanueli C, Shearn AI, Angelini GD,Sahoo S. Exosomes and exosomal miRNAs in cardiovascular protection and repair. Vasc. Pharmacol. 2015, 71:24–30.
  • [22] Lin KH, Ng SC, Lu SY, Lin YM, Lin SH, et al. Diallyl trisulfide (DATS) protects cardiac cells against advanced glycation end-product-induced apoptosis by enhancing FoxO3A-dependent upregulation of miRNA-210. J. Nutr. Biochem. 2024, 125:109567.
  • [23] Barile L, Lionetti V, Cervio E, Matteucci M, Gherghiceanu M, et al. Extracellular vesicles from human cardiac progenitor cells inhibit cardiomyocyte apoptosis and improve cardiac function after myocardial infarction. Cardiovasc Res. 2014, 103(4):530–541.
  • [24] Zhao X, Wang Y, Sun X. The functions of microRNA-208 in the heart. Diabetes Res. Clin. Pract. 2020, 160:108004.
  • [25] Callis TE, Pandya K, Seok HY, Tang RH, Tatsuguchi M, et al. MicroRNA-208a is a regulator of cardiac hypertrophy and conduction in mice. J. Clin. Invest. 2009, 119(9):2772–2786.
  • [26] Grote Beverborg N, Spater D, Knoll R, Hidalgo A, Yeh ST, et al. Phospholamban antisense oligonucleotides improve cardiac function in murine cardiomyopathy. Nat. Commun. 2021, 12(1):5180.
  • [27] Li J, Sha Z, Zhu X, Xu W, Yuan W, et al. Targeting miR-30d reverses pathological cardiac hypertrophy. EBioMedicine 2022, 81:104108.
  • [28] de Gonzalo-Calvo D, van der Meer RW, Rijzewijk LJ, Smit JW, Revuelta-Lopez E, et al. Serum microRNA-1 and microRNA-133a levels reflect myocardial steatosis in uncomplicated type 2 diabetes. Sci. Rep. 2017, 7(1):47.
  • [29] Che H, Wang Y, Li H, Li Y, Sahil A, et al. Melatonin alleviates cardiac fibrosis via inhibiting lncRNA MALAT1/miR-141-mediated NLRP3 inflammasome and TGF-beta1/Smads signaling in diabetic cardiomyopathy. FASEB J. 2020, 34(4):5282–5298.
  • [30] Wang X, Huang W, Liu G, Cai W, Millard RW, et al. Cardiomyocytes mediate anti-angiogenesis in type 2 diabetic rats through the exosomal transfer of miR-320 into endothelial cells. J. Mol. Cell. Cardiol. 2014, 74:139–150.
  • [31] Kuwabara Y, Horie T, Baba O, Watanabe S, Nishiga M, et al. MicroRNA-451 exacerbates lipotoxicity in cardiac myocytes and high-fat diet-induced cardiac hypertrophy in mice through suppression of the LKB1/AMPK pathway. Circ. Res. 2015, 116(2):279–288.
  • [32] Li Y, Duan JZ, He Q,Wang CQ. miR‑155 modulates high glucose‑induced cardiac fibrosis via the Nrf2/HO‑1 signaling pathway. Mol. Med. Rep. 2020, 22(5):4003–4016.
  • [33] Galeone A, Annicchiarico A, Buccoliero C, Barile B, Luciani GB, et al. Diabetic Cardiomyopathy: Role of Cell Death, Exosomes, Fibrosis and Epicardial Adipose Tissue. Int. J. Mol. Sci. 2024, 25(17):9481.
  • [34] Li AY, Yang Q, Yang K. miR-133a mediates the hypoxia-induced apoptosis by inhibiting TAGLN2 expression in cardiac myocytes. Mol. Cell. Biochem. 2015, 400(1–2):173–181.
  • [35] Nielsen LB, Wang C, Sorensen K, Bang-Berthelsen CH, Hansen L, et al. Circulating levels of microRNA from children with newly diagnosed type 1 diabetes and healthy controls: evidence that miR-25 associates to residual beta-cell function and glycaemic control during disease progression. Exp. Diabetes Res. 2012, 2012(1):896362.
  • [36] Liang G, Zhu Y, Ali DJ, Tian T, Xu H, et al. Engineered exosomes for targeted co-delivery of miR-21 inhibitor and chemotherapeutics to reverse drug resistance in colon cancer. J. Nanobiotechnol. 2020, 18(1):1–15.
  • [37] Fu Z, Zhang X, Zhou X, Ur-Rehman U, Yu M, et al. In vivo self-assembled small RNAs as a new generation of RNAi therapeutics. Cell Res. 2021, 31(6): 631–648.
  • [38] Pordzik J, Jakubik D, Jarosz-Popek J, Wicik Z, Eyileten C, et al. Significance of circulating microRNAs in diabetes mellitus type 2 and platelet reactivity: bioinformatic analysis and review. Cardiovasc. Diabetol. 2019, 18(1):1–19.
  • [39] Zhang X, Yuan S, Li H, Zhan J, Wang F, et al. The double face of miR-320: cardiomyocytes-derived miR-320 deteriorated while fibroblasts-derived miR-320 protected against heart failure induced by transverse aortic constriction. Signal Transduct. Target. Ther. 2021, 6(1):69.
  • [40] Wang S, Aurora AB, Johnson BA, Qi X, McAnally J, et al. The endothelial-specific microRNA miR-126 governs vascular integrity and angiogenesis. Dev. Cell 2008, 15(2):261–271.
  • [41] Yildirim SS, Akman D, Catalucci D,Turan B. Relationship between downregulation of miRNAs and increase of oxidative stress in the development of diabetic cardiac dysfunction: junctin as a target protein of miR-1. Cell Biochem. Biophys. 2013, 67(3):1397–1408.
  • [42] Nandi SS, Zheng H, Sharma NM, Shahshahan HR, Patel KP, et al. Lack of miR-133a Decreases Contractility of Diabetic Hearts: A Role for Novel Cross Talk Between Tyrosine Aminotransferase and Tyrosine Hydroxylase. Diabetes 2016, 65(10):3075–3090.
  • [43] Lai JJ, Chau ZL, Chen SY, Hill JJ, Korpany KV, et al. Exosome Processing and Characterization Approaches for Research and Technology Development. Adv. Sci.2022, 9(15):e2103222.
  • [44] Eschenhagen T, Bolli R, Braun T, Field LJ, Fleischmann BK, et al. Cardiomyocyte Regeneration: A Consensus Statement. Circulation 2017, 136(7):680–686.
  • [45] Mondal J, Pillarisetti S, Junnuthula V, Saha M, Hwang SR, et al. Hybrid exosomes, exosome-like nanovesicles and engineered exosomes for therapeutic applications. J. Control. Release 2023, 353:1127–1149.
  • [46] Baysoy A, Bai Z, Satija R,Fan R. The technological landscape and applications of single-cell multi-omics. Nat. Rev. Mol. Cell Biol. 2023, 24(10):695–713.
  • [47] Tappu R, Haas J, Lehmann DH, Sedaghat-Hamedani F, Kayvanpour E, et al. Multi-omics assessment of dilated cardiomyopathy using non-negative matrix factorization. PLoS One 2022, 17(8):e0272093.