Atorvastatin ameliorated myocardial fibrosis in db/db mice by inhibiting oxidative stress and modulating macrophage polarization

Xian-Min Song; Meng-Nan Zhao; Gui-Zhi Li; Na Li; Ting Wang; Hong Zhou

doi:10.4239/wjd.v14.i12.1849

Atorvastatin ameliorated myocardial fibrosis in db/db mice by inhibiting oxidative stress and modulating macrophage polarization

World J Diabetes. 2023 Dec 15;14(12):1849-1861. doi: 10.4239/wjd.v14.i12.1849.

Authors

Xian-Min Song^{1

2}, Meng-Nan Zhao¹, Gui-Zhi Li¹, Na Li¹, Ting Wang¹, Hong Zhou³

Affiliations

¹ Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China.
² Department of Geriatrics, Handan Central Hospital, Handan 056001, Hebei Province, China.
³ Department of Endocrinology, The Second Hospital of Hebei Medical University, Shijiazhuang 050000, Hebei Province, China. zhoubs2013@163.com.

Abstract

Background: People with diabetes mellitus (DM) suffer from multiple chronic complications due to sustained hyperglycemia, especially diabetic cardiomyopathy (DCM). Oxidative stress and inflammatory cells play crucial roles in the occurrence and progression of myocardial remodeling. Macrophages polarize to two distinct phenotypes: M1 and M2, and such plasticity in phenotypes provide macrophages various biological functions.

Aim: To investigate the effect of atorvastatin on cardiac function of DCM in db/db mice and its underlying mechanisms.

Methods: DCM mouse models were established and randomly divided into DM, atorvastatin, and metformin groups. C57BL/6 mice were used as the control. Cardiac function was evaluated by echocardiography. Hematoxylin and eosin and Masson staining was used to examine the morphology and collagen fibers in myocardial tissues. The expression of transforming growth factor-β1 (TGF-β1), tumor necrosis factor-α (TNF-α), interleukin-1 β (IL-1β),M1 macrophages (iNOS⁺), and M2 macrophages (CD206⁺) were demonstrated by immunohistochemistry and immunofluorescence staining. The levels of TGF-β1, IL-1β, and TNF-α were detected by ELISA and real-time quantitative polymerase chain reaction. Malondialdehyde (MDA) concentrations and superoxide dismutase (SOD) ac-tivities were also measured.

Results: Treatment with atorvastatin alleviated cardiac dysfunction and decreased db/db mice. The broken myocardial fibers and deposition of collagen in the myocardial interstitium were relieved especially by atorvastatin treatment. Atorvastatin also reduced the levels of serum lactate dehydrogenase, creatine kinase isoenzyme, and troponin; lowered the levels of TGF-β1, TNF-α and IL-1β in serum and myocardium; decreased the concentration of MDA and increased SOD activity in myocardium of db/db mice; inhibited M1 macrophages; and promoted M2 macrophages.

Conclusion: Administration of atorvastatin attenuates myocardial fibrosis in db/db mice, which may be associated with the antioxidative stress and anti-inflammatory effects of atorvastatin on diabetic myocardium through modulating macrophage polarization.

Keywords: Atorvastatin; Diabetic cardiomyopathy; Inflammation; Macrophage polarization; Myocardial fibrosis; Oxidative stress.