IMR Press / FBL / Volume 29 / Issue 4 / DOI: 10.31083/j.fbl2904145
Open Access Review
Progenitor Cell Function and Cardiovascular Remodelling Induced by SGLT2 Inhibitors
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1 Department of Cardiothoracic Surgery, Democritus University of Thrace – University General Hospital, 68100 Alexeandroupolis, Greece
2 Second Propaedeutic Department of Internal Medicine, Hippokration General Hospital, Aristotle University of Thessaloniki, 54642 Thessaloniki, Greece
3 Department of Adult and Congenital Cardiac Surgery, Mitera Hospital, 15123 Marousi, Greece
4 Department of Anesthesia, St. Michael's Hospital, University of Toronto, Toronto, ON M5B 1W8, Canada
*Correspondence: theodorastougiannos@gmail.com (Theodora M. Stougiannou)
Front. Biosci. (Landmark Ed) 2024, 29(4), 145; https://doi.org/10.31083/j.fbl2904145
Submitted: 10 December 2023 | Revised: 18 February 2024 | Accepted: 28 February 2024 | Published: 9 April 2024
Copyright: © 2024 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.
Abstract

Sodium-glucose cotransporters 2 (SGLT2) are high-capacity, low-affinity transporters, expressed mainly in the early portion of the proximal renal tube, mediating up to 90% of renal glucose uptake, while SGLT1 receptors are found mainly in the small intestine, facilitating glucose absorption. SGLT2 inhibitors (SGLT2i) originally emerged as agents for the treatment of type 2 diabetes mellitus; however, they soon demonstrated remarkable cardio- and renoprotective actions that led to their licensed use for the treatment of heart failure and chronic kidney disease, regardless of the diabetic status. Cardiovascular remodelling represents an umbrella term that encompasses changes that occur in the cardiovascular system, from the molecular and cellular level, to tissue and organs after local injury, chronic stress, or pressure. SGLT modulation has been shown to positively affect many of these molecular and cellular changes observed during pathological remodelling. Among the different pathophysiological mechanisms that contribute to adverse remodelling, various stem and progenitor cells have been shown to be involved, through alterations in their number or function. Recent studies have examined the effects of SGLT2i on stem and progenitor cell populations and more specifically on endothelial progenitor cells (EPCs). Although some found no significant effect, others showed that SGLT2i can modulate the morphology and function of EPCs. These preliminary observations of the effect of SGLT2i on EPCs may be responsible for some of the beneficial effects of gliflozins on pathological remodelling and, by extension, on cardiovascular disease. The purpose of this narrative review is to critically discuss recent evidence on the cardioprotective effects of SGLT2is, in the context of cardiac remodelling.

Keywords
cardiac remodelling
heart failure
endothelial progenitor
hemopoietic stem cells
Figures
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