PPARs and Diabetes-Associated Atherosclerosis

A.   C.   Calkin; K.   A.   Jandeleit-Dahm; T.   J.   Allen; J.      Mizrahi; M.   E.   Cooper; C.      Tikellis; E.      Sebokova

Abstract

Peroxisome proliferator-activated receptors (PPARs) are ligand-dependent transcription factors affecting the regulation of various genes relevant to the pathogenesis of diabetic complications. A number of drugs have been developed to act as agonists of the three PPARs. To date, PPAR isoforms that have been identified are the α, β/δ, and γ isosforms. Fenofibrate and gemfibrozil are two drugs that act as PPARα agonists and are currently in use in the clinical setting. Rosiglitazone is a PPARγ agonist also in clinical use. These drugs have proved very useful in regulation of either glucose or lipid metabolism and consequently are used in patients with type 2 diabetes. Here, we will review the anti-atherosclerotic potential of PPAR agonists with particular emphasis on recent studies in an animal model of diabetes-associated atherosclerosis, the streptozotocin diabetic apolipoprotein E deficient mouse. These studies have shown both PPARα agonists, gemfibrozil and fenofibrate, confer anti-atherosclerotic effects, partly independent of their metabolic effects. Similar positive findings have also been detected in a dose-dependent manner with the PPARγ agonist, rosiglitazone. The potential clinical implications of these findings are also discussed in view of the recently reported results of the PROACTIVE and FIELD clinical trials with the PPAR agonists rosiglitazone and fenofibrate respectively..

Keywords: PPAR, Diabetes, atherosclerosis, rosiglitazone, fenofibrate

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