Introduction: What they say
A recent study from the Department of Cardiology, Boston Children’s Hospital, Harvard Medical School, Boston, Massachusetts, USA; and Harvard Stem Cell Institute, Harvard University, Cambridge, Massachusetts, USA shows that “Trbp regulates heart function through microRNA-mediated Sox6 repression.” This study was published, in the 2 June 2015 issue of the journal “Nature Genetics” (the number 1 research journal in Genetics with an impact factor of 29.648), by Prof. Da-Zhi Wang & Jian Ding, and others
What we say:
On the foundation of this interesting finding, Dr L Boominathan PhD, the Director-cum-chief Scientist of GBMD, reports that: Mechanistic insights into how Canagliflozin protects against cardiomyopathy: Canagliflozin (Brand name: Invokana, Sulisent, Prominad), a sodium-glucose cotransporter-2 inhibitor used in the treatment of TIIDM, decreases the expression of Sox6, restores the balance between slow- and fast-twitch myofiber proteins and alleviates Cardiomyopathy, via upregulation of its target gene
From the significance of the study to public health relevance:
Given that: (1) cardiovascular disease is the leading cause of death worldwide; (2) Dilated cardiomyopathy is the leading cause of Heart failure; (3) the raise of death rate, due to cardiovascular disease, has increased from 12.3 million in 1990 to 17.3 million in 2013; (4) 13% of cardiovascular disease occur due to uncontrolled high blood pressure; (5) in India, in 2004, 14.6 lakhs deaths (14% of total deaths) were due to ischemic heart disease; (6) 85% of people over 80 years are susceptible to cardiovascular diseases; (7) the global economic cost spent in the treatment of cardiovascular disease in 2011 was little more than 10 billion US dollars; (8) the death due to cardiovascular disease is higher in low-to-middle income countries compared to developed countries; and (9) an alarming number of people, such as 230 lakhs people, will die from cardiovascular diseases each year by 2030, there is an urgent need to find: (i) a cure to diseases, as mentioned above, leading to cardiovascular disease; (ii) a way to induce regeneration of adult cardiomyocytes that were lost in Myocardial patients; (iii) a cheaper alternative to the existing expensive drugs; and (iv) a side-effect-free Natural product-based drug.
What is known?
A number of studies suggest that Cardiomyopathy is the result of altered gene expression of contractile proteins. Trbp, an RNA binding protein, has been shown to be required for normal functioning of heart contractions. Prof Da-Zhi Wang‘s research team has shown earlier that inactivation of Trbp in mice leads to progressive cardiomyopathy and heart failure.
From research findings to Therapeutic opportunity:
I had suggested earlier ( on 15/November/2018 at 10.02 pm and in other studies) 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 how Canagliflozin may protect against cardiovascular diseases and aid in cardiac regeneration.
Canagliflozin, by increasing the expression of its target gene, it may: (1) decrease the expression of Sox6; (2) increase the expression of cardiac slow-twitch myofiber proteins; (3) decrease the expression of skeletal fast-twitch myofiber proteins; (4) restore the balance between slow- and fast-twitch myofiber proteins; (5) increase the proliferation of cardiomyocyte stem cells; (6) increase the number of beating cardiomyocytes; and (7) alleviate cardiomyopathy (fig. 1).
Thus, canagliflozin or its analogs, either alone or in combination with other cardioprotective drugs,” may be used to inhibit progressive cardiomyopathy and lethal heart failure.
Details of the research findings:
Idea Proposed/Formulated by Dr L Boominathan Ph.D.
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Undisclosed mechanistic information: How does canagliflozin inhibit the expression of Sox6?
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To cite: Boominathan, L., Mechanistic insights into how Canagliflozin protects against cardiomyopathy: Canagliflozin(Brand name: Invokana, Sulisent, Prominad), a sodium-glucose cotransporter-2 inhibitor used in the treatment of TIIDM, decreases the expression of Sox6, restores the balance between slow- and fast-twitch myofiber proteins and alleviates Cardiomyopathy, via upregulation of its target gene, 7/May/2019, 6.17 am, Genome-2-Bio-Medicine Discovery center (GBMD), http://genomediscovery.org
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