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      Adeno-associated viral (AAV) vector-mediated therapeutics for diabetic cardiomyopathy – current and future perspectives

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          Abstract

          Diabetes increases the prevalence of heart failure by 6–8-fold, independent of other comorbidities such as hypertension and coronary artery disease, a phenomenon termed diabetic cardiomyopathy. Several key signalling pathways have been identified that drive the pathological changes associated with diabetes-induced heart failure. This has led to the development of multiple pharmacological agents that are currently available for clinical use. While fairly effective at delaying disease progression, these treatments do not reverse the cardiac damage associated with diabetes. One potential alternative avenue for targeting diabetes-induced heart failure is the use of adeno-associated viral vector (AAV) gene therapy, which has shown great versatility in a multitude of disease settings. AAV gene therapy has the potential to target specific cells or tissues, has a low host immune response and has the possibility to represent a lifelong cure, not possible with current conventional pharmacotherapies. In this review, we will assess the therapeutic potential of AAV gene therapy as a treatment for diabetic cardiomyopathy.

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          Empagliflozin, Cardiovascular Outcomes, and Mortality in Type 2 Diabetes.

          The effects of empagliflozin, an inhibitor of sodium-glucose cotransporter 2, in addition to standard care, on cardiovascular morbidity and mortality in patients with type 2 diabetes at high cardiovascular risk are not known.
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            Dapagliflozin in Patients with Heart Failure and Reduced Ejection Fraction

            In patients with type 2 diabetes, inhibitors of sodium-glucose cotransporter 2 (SGLT2) reduce the risk of a first hospitalization for heart failure, possibly through glucose-independent mechanisms. More data are needed regarding the effects of SGLT2 inhibitors in patients with established heart failure and a reduced ejection fraction, regardless of the presence or absence of type 2 diabetes.
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              IDF Diabetes Atlas: Global estimates of diabetes prevalence for 2017 and projections for 2045

              Since the year 2000, IDF has been measuring the prevalence of diabetes nationally, regionally and globally.
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                Author and article information

                Contributors
                Journal
                Clin Sci (Lond)
                Clin Sci (Lond)
                cs
                Clinical Science (London, England : 1979)
                Portland Press Ltd.
                0143-5221
                1470-8736
                June 2021
                02 June 2021
                : 135
                : 11
                : 1369-1387
                Affiliations
                [1 ]Departments of Drug Discovery Biology, Monash Institute of Pharmaceutical Sciences, Monash University Parkville Campus, Australia
                [2 ]Diabetes, Monash University, Clayton, Victoria 3800, Australia
                [3 ]Pharmacology, Monash University, Clayton, Victoria 3800, Australia
                Author notes
                Correspondence: Rebecca H. Ritchie ( rebecca.ritchie@ 123456monash.edu )
                Author information
                http://orcid.org/0000-0001-6621-6478
                http://orcid.org/0000-0002-8610-0058
                Article
                CS20210052
                10.1042/CS20210052
                8187922
                34076247
                92dd7d5b-bf34-49fa-9a86-8c15342452f5
                © 2021 The Author(s).

                This is an open access article published by Portland Press Limited on behalf of the Biochemical Society and distributed under the Creative Commons Attribution License 4.0 (CC BY). Open access for this article was enabled by the participation of University of Monash in an all-inclusive Read & Publish pilot with Portland Press and the Biochemical Society under a transformative agreement with CAUL.

                History
                : 09 February 2021
                : 17 May 2021
                : 18 May 2021
                Page count
                Pages: 19
                Categories
                Diabetes & Metabolic Disorders
                Cardiovascular System & Vascular Biology
                Translational Science
                Pharmacology & Toxicology
                Virology
                Review Articles

                Medicine
                aav,diabetes,diabetic cadiomyopathy,gene therapy
                Medicine
                aav, diabetes, diabetic cadiomyopathy, gene therapy

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