Involvement of P2Y₁₂ receptor of stellate ganglion in diabetic cardiovascular autonomic neuropathy

Diabetes as a chronic epidemic disease with obvious symptom of hyperglycemia is seriously affecting human health globally due to the diverse diabetic complications. Diabetic cardiovascular autonomic neuropathy (DCAN) is a common complication of both type 1 and type 2 diabetes and incurs high morbidity and mortality. However, the underlying mechanism for DCAN is unclear. It is well known that purinergic signaling is involved in the regulation of cardiovascular function. In this study, we examined whether the P2Y₁₂ receptor could mediate DCAN-induced sympathetic reflexes. Our results revealed that the abnormal changes of blood pressure, heart rate, heart rate variability, and sympathetic nerve discharge were improved in diabetic rats treated with P2Y₁₂ short hairpin RNA (shRNA). Meanwhile, the expression of P2Y₁₂ receptor, interleukin-1β (IL-1β), tumor necrosis factor-α (TNF-α), and connexin 43 (Cx43) in stellate ganglia (SG) was decreased in P2Y₁₂ shRNA-treated diabetic rats. In addition, knocking down the P2Y₁₂ receptor also inhibited the activation of p38 MARK in the SG of diabetic rats. Taken together, these findings demonstrated that P2Y₁₂ receptor in the SG may participate in developing diabetic autonomic neuropathy, suggesting that the P2Y₁₂ receptor could be a potential therapeutic target for the treatment of DCAN.