Figure 2
Direct endothelial protection by SGLT-2i’s :
Sodium-glucose co-transporter 2 inhibitors (SGLT-2i’s) have favourable effects on endothelial cells (ECs), including (1) inhibition of reactive oxidative species (ROS) production, (2) prevention of the inflammatory reaction, (3) restoration of nitric oxide (NO) bioavailability, and (4) modulation of angiogenesis. Anti-oxidative effects of SGLT-2i’s might be mediated via inhibition of nicotinamide adenine dinucleotide phosphate oxidases (NOXs), sodium-hydrogen exchanger (NHE), and mitochondrial fission. The anti-inflammatory effect of SGLT-2i’s is hallmarked with downregulation of vascular cell adhesion molecule 1 (VCAM-1) and intracellular adhesion molecule 1 (ICAM-1), reduction in cytokine secretion, and prevention of monocyte-endothelium adhesion. SGLT-2i’s might restore NO bioavailability of endothelial cells via improving phosphorylation of endothelial nitric oxide synthase (eNOS) and scavenging ROS (Created with Biorender.com).