Interleukin-1β, Oxidative Stress, and Abnormal Calcium Handling Mediate Diabetic Arrhythmic Risk

JACC Basic Transl Sci. 2021 Jan 20;6(1):42-52. doi: 10.1016/j.jacbts.2020.11.002. eCollection 2021 Jan.

Abstract

Diabetes mellitus (DM) is associated with increased arrhythmia. Type 2 DM (T2DM) mice showed prolonged QT interval and increased ventricular arrhythmic inducibility, accompanied by elevated cardiac interleukin (IL)-1β, increased mitochondrial reactive oxygen species (mitoROS), and oxidation of the sarcoplasmic reticulum (SR) Ca2+ release channel (ryanodine receptor 2 [RyR2]). Inhibiting IL-1β and mitoROS reduced RyR2 oxidation and the ventricular arrhythmia in DM. Inhibiting SR Ca2+ leak by stabilizing the oxidized RyR2 channel reversed the diabetic arrhythmic risk. In conclusion, cardiac IL-1β mediated the DM-associated arrhythmia through mitoROS generation that enhances SR Ca2+ leak. The mechanistic link between inflammation and arrhythmias provides new therapeutic options.

Keywords: APD, action potential duration; DM, diabetes mellitus; EAD, early afterdepolarization; IL, interleukin; IL-1RA, interleukin-1 receptor antagonist; Ito, transient outward potassium current; RyR2, ryanodine receptor; SR, sarcoplasmic reticulum; T1DM, type 1 diabetes mellitus; T2DM, type 2 diabetes mellitus; VT, ventricular tachycardia; calcium handling; inflammation; mitoROS, mitochondrial reactive oxygen species; mitochondria; oxidation; sudden cardiac death.