Affiliation:
1. Pharmacology Research Division, Institute of Pharmaceutical Research, GLA University, Mathura, Uttar Pradesh, India
Abstract
Abstract:
The objective of the review led to the pursuit of adopting dipeptidyl peptidase-4 inhibitors
(DPP4i) as a novel pharmacotherapy in diabetes mellitus (DM) and cardiorenal syndrome
(CRS). The CRS is defined as the co-existence of myocardial ischemia with renal failure. At present,
the commercially available drugs enhance insulin secretion or action. However, most of the
drugs are associated with adverse effects, such as weight gain or hypoglycemia. As a result, newer
therapies with better safety and efficacy profiles are being explored. The DPP4 protease enzyme
is involved in cardiovascular and renal diseases in association with over-expressed cytokines. The
novel characteristic of DPP4i is to control the elevated blood glucose levels in response to nutrient
ingestion without causing hypoglycemia. Also, DPP4i are indirectly involved in reducing myocardial
ischemia by promoting cardioprotective peptides. They protect the glucagon-like peptide 1
(GLP-1) from the deteriorating effect of the DPP4 enzyme. The GLP-1 receptors (GLP-1R) are
abundantly expressed in renal and cardiovascular tissue. The overexpression of GLP-1R will confer
protection of the heart and kidney during CRS. DPP4i were found to significantly clear plasma
glucose by the simultaneously activating natural thrombolytic system and increasing insulin levels.
They can be used in the early stages of the disease, including pre-diabetes or obesity combined
with impaired incretin response, while the combination of DPP4i with metformin or thiazolidinediones
as insulin sensitizers offers an additional improvement in the treatment of DM. With its positive
attributes in a host of associated parameters of interest, DPP4i are studied extensively in the
present review.
Publisher
Bentham Science Publishers Ltd.
Subject
Immunology and Allergy,Endocrinology, Diabetes and Metabolism
Cited by
2 articles.
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