Molecular therapy for cardiac dysfunction: Canagliflozin (trade name: Invokana), a medication used to treat hyperglycemia, decreases Mir-29 expression, activates Wnt- signaling and its components GSK3B, ICAT/CTNNBIP1, HBP1, and GLIS2, attenuates pathologic hypertrophy, inhibits fibrosis of the heart tissue, and improves cardiac function, via upregulation of its target gene, 22/April/2018, 10.31 pm

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Introduction: What they say:  

A recent study from the Institute of Pharmacology and Toxicology, Technical University Munich (TUM), 80802, Munich, Germany; DZHK (German Center for Cardiovascular Research), partner site Munich Heart Alliance, 80802, Munich, Germany; and Mount Sinai, Cardiovascular Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, 10029, USA shows that “Cardiac myocyte miR-29 promotes pathological remodeling of the heart by activating Wnt signaling.” This study was published, in the 20 November 2018 issue of the journal “Nature communications (One of the best journals in general science with an impact factor of 12+), by Prof Engelhardt, Sassi and others.


What we say:

On the foundation of this interesting finding, Dr L Boominathan PhD, Director-cum-chief Scientist of GBMD, reports that:  Molecular therapy for cardiac dysfunction: Canagliflozin (trade name: Invokana), a medication used to treat hyperglycemia, decreases Mir-29 expression, activates Wnt- signaling and its components GSK3B, ICAT/CTNNBIP1, HBP1, and GLIS2, attenuates pathologic hypertrophy, inhibits fibrosis of the heart tissue, and improves cardiac function, via upregulation of its target gene

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From the significance of the study to Public Health Relevance:

Given that: (1) cardiovascular disease is the leading cause of death worldwide; (2) the raise of death rate, due to cardiovascular disease, has increased from 123 lakhs in 1990 to 173 lakhs in 2013; (3) 85% of people over 80 years are susceptible to cardiovascular diseases;(4) in India, in 2004, 14.6 lakhs deaths (14% of total deaths) were due to ischemic heart disease; (3) the death due to cardiovascular disease is higher in low-to-middle income countries compared to developed countries; (4) the global economic cost spent in the treatment of cardiovascular disease in 2011 was little more than 10 billion US dollars; (5) an alarming number of people, such as 230 lakhs people, will die from cardiovascular diseases from 2030 onwards; (6) over 240 lakhs people suffer from heart failure globally, with only treatment option being the heart transplant, there is an urgent need to find: (i) a way to induce regeneration of cardiomyocytes that were lost in Myocardial patients; (ii) a cheaper alternative to the existing expensive drugs; and (iv) a side-effect-free Natural product-based drug.


What is known?

Cardiac stress, in long-term, has been shown to promote pathologic hypertrophy; and fibrosis of the myocardium. Recently, Prof. Engelhardt’s research team has shown that MiRNA-29: (1) augments pathologic hypertrophy; (2) promotes cardiac dysfunction; and (3) deletion or antisense: (a) prevents cardiac hypertrophy; (b) prevents fibrosis; (c) activates the Wnt pathway components, such as GSK3B, ICAT/CTNNBIP1, HBP1 and GLIS2, suggesting that agents that decrease the expression of MiR-29 in adult cardiomyocytes may inhibit wnt pathway and improve cardiac function by attenuating cardiac hypertrophy and pathologic fibrosis.


From Research Findings to Therapeutic Opportunity:

I had suggested earlier ( on 15/November/2018 at 10.02 pm) that Canagliflozin  may protect against myocardial dysfunction (https://genomediscovery.org/2018/11/the-known-anti-hyperglycemic-agent-empagliflozin-empa-may-safeguard-your-heart-against-cardiac-dysfunction-empagliflozin-empa-a-drug-used-in-the-treatment-of-tiidm/).

Evidently, a very recent study from the the Stanford Center for Clinical Research, Department of Medicine, Stanford University School of Medicine, Stanford, CA, the George Institute for Global Health, University of New South Wales Sydney, the Royal North Shore Hospital and others shows that “Canagliflozin and Renal Outcomes in Type 2 Diabetes and Nephropathy.” This study was published, in the 14 April 2019 issue of of the prestigious journal N Engl J Med. (NEJM) (Impact factor: 79.258+) ,  by Prof. Mahaffey KW, Perkovic V, Brenner BM and others. In concordance with what I stated earlier, this study suggests that Canagliflozin lowers the risk of heart failure.  However, the mechanism of action of this drug is not known yet. 

This study suggests, for the first time, that Canagliflozin, by increasing the expression of its target genes, it may decrease the expression of miR-29 (fig.1). Thereby, it may: (1) increase the expression of GSK3B, ICAT/CTNNBIP1, HBP1, and GLIS2; (2) inhibit the Wnt pathway; (3) increase the expression of a number of other gene products that attenuate cardiac hypertrophy and pathological fibrosis; and (4) prevent cardiac hypertrophy (fig 1). Thus, by recommending Canagliflozin for cardiac patients, cardiologists may prevent pathological cardiac hypertrophy and fibrosis of the myocardium. Together, this study suggests, for the first time, that Canagliflozin or its analogs, either alone or in combination with other cardioprotective drugs,” may be used to improve cardiac functions (fig. 2).

Figure 1.  Mechanistic insights into how Canagliflozin attenuates cardiac hypertrophy and fibrosis.  Canagliflozin attenuates cardiac hypertrophy and fibrosis through down-regulation of MiR-29 and other genes

Figure 2.   Canagliflozin functions as a cardioprotective agent.

Details of the research findings:

Idea Proposed/Formulated (with experimental evidence) by:

Dr L Boominathan Ph.D.

Terms & Conditions apply http://genomediscovery.org/registration/terms-and-conditions/

Undisclosed mechanistic information: How does  Canagliflozin decrease the expression of MiR-29?

Amount: $750 #

# Research cooperation

For purchase and payment details, you may reach us at admin@genomediscovery.org


References:

Web:http://genomediscovery.org or http://newbioideas.com/

Citation: Boominathan, L., Molecular therapy for cardiac dysfunction: Canagliflozin (trade name: Invokana), a medication used to treat hyperglycemia, decreases Mir-29 expression, activates Wnt- signaling and its components GSK3B, ICAT/CTNNBIP1, HBP1, and GLIS2, attenuates pathologic hypertrophy, inhibits fibrosis of the heart tissue, and improves cardiac function, via upregulation of its target gene, 22/April/2018, 10.31 pm, Genome-2-Biomedicine Discovery center (GBMD), http://genomediscovery.org

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