Cardioprotective mechanisms of the kallikrein-kinin system in diabetic cardiopathy.
OBJECTIVE
Multiple pathogenic mechanisms contribute to the development of diabetic cardiopathy, including intramyocardial inflammation, cardiac fibrosis, abnormal intracellular Ca handling, microangiopathy and endothelial dysfunction. Moreover, the cardiac kallikrein-kinin system is thought to be altered under diabetic conditions and an improvement of this peptide system, e.g. by gene therapeutic approaches, has also been associated with an amelioration of the diabetic heart. In this review, we will discuss the hypothesis that the stimulation of the kallikrein-kinin system could be a promising target for the treatment of diabetic cardiopathy.


RESULTS
The kallikrein-kinin system has cardioprotective properties, which may be particularly important under diabetic conditions. For example, its potential for endothelium-dependent vasodilation, and for improvement of glucose transport and utilization, make bradykinin an important mediator for reducing the consequences of diabetes-related oxidative stress on both the myocardium and vessels.


CONCLUSIONS
The different synergistic cardioprotective effects of the kallikrein-kinin system in the diabetic heart suggest that the stimulation of the kallikrein-kinin system might open new avenues for the treatment of diabetic cardiopathy.
Spillmann
Frank
F
Department of Cardiology and Pneumology, Charité-University Medicine of Berlin, Campus Benjamin Franklin, Hindenburgdamm 30, 12200 Berlin, Germany.
Van Linthout
Sophie
S
Schultheiss
Heinz-Peter
HP
Tschöpe
Carsten
C
D000818:Animals; D002118:Calcium / Q000378:metabolism; D048909:Diabetes Complications / Q000503:physiopathology*; D004730:Endothelium, Vascular / Q000473:pathology; D005109:Extracellular Matrix / Q000502:physiology; D005947:Glucose / Q000378:metabolism*; D006331:Heart Diseases / Q000209:etiology / Q000503:physiopathology*; D006801:Humans; D016234:Kallikrein-Kinin System / Q000502:physiology*; D051381:Rats
D005947:Glucose; D002118:Calcium