| DOI: 10.29090/psa.2025.01.24.2456 | Pharm Sci Asia 2025; 52(1), 30-43 |
A Systematic Review of Antidiabetic Drug Benefits in Mitochondrial Dysfunction-Associated Cardiovascular DiseasesPanipak Wangworawut1,+, Phatjira Srisuwannapa1,+, Sakdichod Petsom1, Linh Thi Truc Pham1, Theerut Luangmonkong1, Warisara Parichatikanond1,*
- 1 Department of Pharmacology, Faculty of Pharmacy, Mahidol University, Bangkok 10400, Thailand
Mitochondrial dysfunction is associated with the development of numerous cardiovascular diseases. Antidiabetic drugs are known to possess cardioprotective effects; however, mechanisms underlying their efficacies on mitochondrial dysfunction-associated cardiovascular diseases have not been systematically reviewed. A comprehensive literature search in the past five years from August 1, 2018, to July 31, 2023, from three electronic databases, including Pubmed, Embase, and Scopus, was carried out according to the defined inclusion and exclusion criteria. A total of 637 articles were identified, out of which 37 research articles were included in this study. We found that the sodium-glucose cotransporter 2 (SGLT-2) inhibitor was the most investigated class of antidiabetic drugs for alleviating cardiovascular diseases associated with mitochondrial dysfunction (16 articles, 43%). Focusing on the spectrum of cardiovascular diseases, the most extensively studied group was classified as other forms of heart disease (e.g., heart failure, myocardial abnormalities, etc.) with a total of 20 articles (56%). The impacts of antidiabetic drugs on mitochondrial structure included maintaining mitochondrial morphology (50%) as well as preserving mitochondrial dynamics via fission (35%) and fusion (15%) processes. For mitochondrial functions, antidiabetic drugs exerted several cardioprotective impacts via different mechanisms, including reducing oxidative stress (33%), decreasing apoptotic cell death (24%), promoting mitochondrial biogenesis (17%), preserving cellular respiration (11%), maintaining autophagy (6%), enhancing mitochondrial membrane potential (6%), reducing ferroptosis (2%), and preserving calcium homeostasis (1%). In conclusion, antidiabetic drugs provide benefits to cardiac defensive mechanisms by controlling biomarkers associated with mitochondrial structure and functions.
Keyword:
Antidiabetic drugs; Cardiovascular diseases; Mitochondrial dysfunction; Systematic review
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