Objective: To investigate the effects of ibuprofen on cardiac fibrosis in a rat model of type 1 diabetes. Methods: The diabetic model was established by injecting streptozotocin into the rats. Then, ibuprofen or pioglitazone was given by gavage for 8 weeks. The cardiac fibrosis was assessed, and the major components of the renin-angiotensin system, the transforming growth factor β1 (TGF-β1) and the mammalian target of rapamycin (mTOR), were evaluated by histopathological, immunohistochemical, Western blot analysis or ELISA assay. Results: Obvious cardiac fibrosis was detected in the diabetic group and was alleviated by ibuprofen treatment. Angiotensin-converting enzyme (ACE), angiotensin (Ang) II and AngII type 1 receptor (AT1-R) levels were higher, and ACE2, Ang(1-7) and Mas receptor (Mas-R) were lower in the diabetic group. The ratio of ACE to ACE2 was raised in the diabetic group. All these changes were ameliorated by ibuprofen. TGF-β1 and mTOR were raised in the hearts of the diabetic group and were attenuated by ibuprofen treatment. There was no significant difference between the ibuprofen and the pioglitazone groups. Conclusion: Ibuprofen could ameliorate the cardiac fibrosis in diabetic rats by reduction of the ACE/AngII/AT1-R axis and enhancement of the ACE2/Ang(1-7)/Mas-R axis, leading to a decrease in TGF-β1 and mTOR.

1.
Asbun J, Villarreal FJ: The pathogenesis of myocardial fibrosis in the setting of diabetic cardiomyopathy. J Am Coll Cardiol 2006;47:693-700.
2.
Kai H, Kuwahara F, Tokuda K, Imaizumi T: Diastolic dysfunction in hypertensive hearts: roles of perivascular inflammation and reactive myocardial fibrosis. Hypertens Res 2005;28:483-490.
3.
Weber KT: Are myocardial fibrosis and diastolic dysfunction reversible in hypertensive heart disease? Congest Heart Fail 2005;11:322-324.
4.
Westermann D, Rutschow S, Jager S, Linderer A, Anker S, Riad A, Unger T, Schultheiss HP, Pauschinger M, Tschope C: Contributions of inflammation and cardiac matrix metalloproteinase activity to cardiac failure in diabetic cardiomyopathy - the role of angiotensin type 1 receptor antagonism. Diabetes 2007;56:641-646.
5.
Nunes S, Soares E, Pereira F, Reis F: The role of inflammation in diabetic cardiomyopathy. Int J Interferon Cytokine Mediator Res 2012;4:59-73.
6.
Fang ZY, Prins JB, Marwick TH: Diabetic cardiomyopathy: evidence, mechanisms, and therapeutic implications. Endocr Rev 2004;25:543-567.
7.
Dhalla NS, Liu X, Panagia V, Takeda N: Subcellular remodeling and heart dysfunction in chronic diabetes. Cardiovasc Res 1998;40:239-247.
8.
Fliser D, Buchholz K, Haller H; European Trial on Olmesartan and Pravastatin in Inflammation and Atherosclerosis Investigators: Antiinflammatory effects of angiotensin II subtype 1 receptor blockade in hypertensive patients with microinflammation. Circulation 2004;110:1103-1107.
9.
Dandona P, Dhindsa S, Ghanim H, Chaudhuri A: Angiotensin II and inflammation: the effect of angiotensin-converting enzyme inhibition and angiotensin II receptor blockade. J Hum Hypertens 2007;21:20-27.
10.
Frustaci A, Kajstura J, Chimenti C, Jakoniuk I, Leri A, Maseri A, Nadal-Ginard B, Anversa P: Myocardial cell death in human diabetes. Circ Res 2000;87:1123-1132.
11.
Patel VB, Bodiga S, Basu R, Das SK, Wang W, Wang Z, Lo J, Grant MB, Zhong J, Kassiri Z, Oudit GY: Loss of angiotensin-converting enzyme-2 exacerbates diabetic cardiovascular complications and leads to systolic and vascular dysfunction: a critical role of the angiotensin II/AT1 receptor axis. Circ Res 2012;110:1322-1335.
12.
Nagashima A, Watanabe R, Ogawa M, Suzuki J, Masumura M, Hishikari K, Shimizu T, Takayama K, Hirata Y, Nagai R, Isobe M: Different roles of PPAR-gamma activity on physiological and pathological alteration after myocardial ischemia. J Cardiovasc Pharmacol 2012;60:158-164.
13.
Ferrario CM: Does angiotensin-(1-7) contribute to cardiac adaptation and preservation of endothelial function in heart failure? Circulation 2002;105:1523-1525.
14.
Santos RA, Simoes e Silva AC, Maric C, Silva DM, Machado RP, de Buhr I, Heringer-Walther S, Pinheiro SV, Lopes MT, Bader M, Mendes EP, Lemos VS, Campagnole-Santos MJ, Schultheiss HP, Speth R, Walther T: Angiotensin-(1-7) is an endogenous ligand for the G protein-coupled receptor Mas. Proc Natl Acad Sci U S A 2003;100:8258-8263.
15.
Santos SH, Fernandes LR, Mario EG, Ferreira AV, Porto LC, Alvarez-Leite JI, Botion LM, Bader M, Alenina N, Santos RA: Mas deficiency in FVB/N mice produces marked changes in lipid and glycemic metabolism. Diabetes 2008;57:340-347.
16.
Mori J, Patel VB, Abo Alrob O, Basu R, Altamimi T, Desaulniers J, Wagg CS, Kassiri Z, Lopaschuk GD, Oudit GY: Angiotensin 1-7 ameliorates diabetic cardiomyopathy and diastolic dysfunction in db/db mice by reducing lipotoxicity and inflammation. Circ Heart Fail 2014;7:327-339.
17.
Liu YW, Zhu X, Zhang L, Lu Q, Zhang F, Guo H, Yin XX: Cerebroprotective effects of ibuprofen on diabetic encephalopathy in rats. Pharmacol Biochem Behav 2014;117:128-136.
18.
Terui G, Goto T, Katsuta M, Aoki I, Ito H: Effect of pioglitazone on left ventricular diastolic function and fibrosis of type III collagen in type 2 diabetic patients. J Cardiol 2009;54:52-58.
19.
Kellstein DE, Waksman JA, Furey SA, Binstok G, Cooper SA: The safety profile of nonprescription ibuprofen in multiple-dose use: a meta-analysis. J Clin Pharmacol 1999;39:520-532.
20.
Murray MD, Brater DC: Adverse effects of nonsteroidal anti-inflammatory drugs on renal function. Ann Intern Med 1990;112:559-560.
21.
Cook ME, Wallin JD, Thakur VD, Kadowitz PJ, McNamara DB, Garcia MM, Lipani JA, Poland M: Comparative effects of nabumetone, sulindac, and ibuprofen on renal function. J Rheumatol 1997;24:1137-1144.
22.
Bakris GL, Starke U, Heifets M, Polack D, Smith M, Leurgans S: Renal effects of oral prostaglandin supplementation after ibuprofen in diabetic subjects: a double-blind, placebo-controlled, multicenter trial. J Am Soc Nephrol 1995;5:1684-1688.
23.
Huang WF, Hsiao FY, Wen YW, Tsai YW: Cardiovascular events associated with the use of four nonselective NSAIDs (etodolac, nabumetone, ibuprofen, or naproxen) versus a cyclooxygenase-2 inhibitor (celecoxib): a population-based analysis in Taiwanese adults. Clin Ther 2006;28:1827-1836.
24.
Farkouh ME, Greenberg JD, Jeger RV, Ramanathan K, Verheugt FW, Chesebro JH, Kirshner H, Hochman JS, Lay CL, Ruland S, Mellein B, Matchaba PT, Fuster V, Abramson SB: Cardiovascular outcomes in high risk patients with osteoarthritis treated with ibuprofen, naproxen or lumiracoxib. Ann Rheum Dis 2007;66:764-770.
25.
Basu S, Larsson A, Vessby J, Vessby B, Berne C: Type 1 diabetes is associated with increased cyclooxygenase- and cytokine-mediated inflammation. Diabetes Care 2005;28:1371-1375.
26.
Wu R, Laplante MA, de Champlain J: Cyclooxygenase-2 inhibitors attenuate angiotensin II-induced oxidative stress, hypertension, and cardiac hypertrophy in rats. Hypertension 2005;45:1139-1144.
27.
Rodriguez WE, Joshua IG, Falcone JC, Tyagi SC: Pioglitazone prevents cardiac remodeling in high-fat, high-calorie-induced type 2 diabetes mellitus. Am J Physiol Heart Circ Physiol 2006;291:H81-H87.
28.
Elrashidy RA, Asker ME, Mohamed HE: Pioglitazone attenuates cardiac fibrosis and hypertrophy in a rat model of diabetic nephropathy. J Cardiovasc Pharmacol Ther 2012;17:324-333.
29.
Zhao SM, Li HW, Guo CY, Shen LH: Cardiac fibrosis in diabetic rats: regulation and mechanism of activation of the PPARgamma signal pathway. Chin J Physiol 2010;53:262-267.
30.
Kashfi K, Rigas B: Non-COX-2 targets and cancer: expanding the molecular target repertoire of chemoprevention. Biochem Pharmacol 2005;70:969-986.
31.
Lehmann JM, Lenhard JM, Oliver BB, Ringold GM, Kliewer SA: Peroxisome proliferator-activated receptors alpha and gamma are activated by indomethacin and other non-steroidal anti-inflammatory drugs. J Biol Chem 1997;272:3406-3410.
32.
Jarajapu YP, Bhatwadekar AD, Caballero S, Hazra S, Shenoy V, Medina R, Kent D, Stitt AW, Thut C, Finney EM, Raizada MK, Grant MB: Activation of the ACE2/angiotensin-(1-7)/Mas receptor axis enhances the reparative function of dysfunctional diabetic endothelial progenitors. Diabetes 2013;62:1258-1269.
33.
Dong B, Yu QT, Dai HY, Gao YY, Zhou ZL, Zhang L, Jiang H, Gao F, Li SY, Zhang YH, Bian HJ, Liu CX, Wang N, Xu H, Pan CM, Song HD, Zhang C, Zhang Y: Angiotensin-converting enzyme-2 overexpression improves left ventricular remodeling and function in a rat model of diabetic cardiomyopathy. J Am Coll Cardiol 2012;59:739-747.
34.
Singh VP, Baker KM, Kumar R: Activation of the intracellular renin-angiotensin system in cardiac fibroblasts by high glucose: role in extracellular matrix production. Am J Physiol Heart Circ Physiol 2008;294:H1675-H1684.
35.
Hafizi S, Wang X, Chester AH, Yacoub MH, Proud CG: ANG II activates effectors of mTOR via PI3-K signaling in human coronary smooth muscle cells. Am J Physiol Heart Circ Physiol 2004;287:H1232-H1238.
36.
Lian H, Ma Y, Feng J, Dong W, Yang Q, Lu D, Zhang L: Heparin-binding EGF-like growth factor induces heart interstitial fibrosis via an Akt/mTor/p70s6k pathway. Plos One 2012;7:e44946.
37.
Finckenberg P, Inkinen K, Ahonen J, Merasto S, Louhelainen M, Vapaatalo H, Muller D, Ganten D, Luft F, Mervaala E: Angiotensin II induces connective tissue growth factor gene expression via calcineurin-dependent pathways. Am J Pathol 2003;163:355-366.
38.
Vilahur G, Juan-Babot O, Pena E, Onate B, Casani L, Badimon L: Molecular and cellular mechanisms involved in cardiac remodeling after acute myocardial infarction. J Mol Cell Cardiol 2011;50:522-533.
39.
Wang WK, Wang B, Lu QH, Zhang W, Qin WD, Liu XJ, Liu XQ, An FS, Zhang Y, Zhang MX: Inhibition of high-mobility group box 1 improves myocardial fibrosis and dysfunction in diabetic cardiomyopathy. Int J Cardiol 2014;172:202-212.
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