The cardioprotective effect of melatonin and exendin-4 treatment in a rat model of cardiorenal syndrome

J Pineal Res. 2016 Nov;61(4):438-456. doi: 10.1111/jpi.12357. Epub 2016 Sep 26.

Abstract

We investigated the cardioprotective effect of melatonin (Mel) and exendin-4 (Ex4) treatment in a rat model of cardiorenal syndrome (CRS). Adult male SD rats (n=48) were randomly and equally divided into sham control (SC), dilated cardiomyopathy (DCM) (doxorubicin 7 mg/kg i.p. every five days/4 doses), CRS (defined as DCM+CKD) only, CRS-Mel (20 mg/kg/d), CRS-Ex4 (10 μg/kg/d), and CRS-Mel-Ex4 groups. In vitro results showed protein expressions of oxidative stress (NOX-1/NOX-2/oxidized protein), DNA/mitochondrial damage (γ-H2AX/cytosolic cytochrome c), apoptosis (cleaved caspase-3/PARP), and senescence (β-galactosidase cells) biomarkers were upregulated, whereas mitochondrial ATP level was decreased in doxorubicin/p-cresol-treated H9c2 cells that were revised by Mel and Ex4 treatments (all P<.001). By day 60, LVEF was highest in the SC and lowest in the CRS, significantly lower in the DCM than in other treatment groups, lower in the CRS-Mel and CRS-Ex4 than in the CRS-Mel-Ex4, and lower in the CRS-Mel than in the CRS-Ex4, whereas LV chamber size and histopathology score showed a pattern opposite to that of LVEF among all groups (all P<.001). Plasma creatinine level was highest in the CRS and lowest in the SC and progressively decreased from the CRS-Mel, CRS-Ex4, CRS-Mel-Ex4 to DCM (P<.0001). Protein expressions of inflammation (TNF-α/NF-κB/MMP-2/MMP-9/IL-1β), apoptosis/DNA damage (Bax/c-caspase-3/c-PARP/γ-H2AX), fibrosis (Smad3/TGF-β), oxidative stress (NOX-1/NOX-2/NOX-4/oxidized protein), cardiac hypertrophy/pressure overload (BNP/β-MHC), and cardiac integrity (Cx43/α-MHC) biomarkers in LV myocardium showed an opposite pattern compared to that of LVEF among all groups (all P<.001). Fibrotic area, DNA damage (γ-H2AX+ /53BP1+ CD90+ /XRCC1+ CD90+ ), and inflammation (CD14+ /CD68+ ) biomarkers in LV myocardium displayed a pattern opposite to that of LVEF among all groups (all P<.001). Combined melatonin and exendin-4 treatment suppressed CRS-induced deterioration of LVEF and LV remodeling.

Keywords: LV remodeling; cardiorenal disease; exendin-4; heart function; melatonin.

MeSH terms

  • Animals
  • Apoptosis / drug effects
  • Cardio-Renal Syndrome / drug therapy*
  • Cardio-Renal Syndrome / metabolism
  • Cardio-Renal Syndrome / pathology
  • Cardiotonic Agents / pharmacology*
  • DNA Damage
  • Disease Models, Animal
  • Exenatide
  • Gene Expression Regulation / drug effects
  • Male
  • Melatonin / pharmacology*
  • Myocardium / metabolism
  • Myocardium / pathology
  • Oxidative Stress / drug effects
  • Peptides / pharmacology*
  • Rats
  • Rats, Sprague-Dawley
  • Venoms / pharmacology*

Substances

  • Cardiotonic Agents
  • Peptides
  • Venoms
  • Exenatide
  • Melatonin