Receptor for advanced glycation end products (RAGE) and connective tissue growth factor (CTGF) play a key role in diabetic
myocardial fibrosis, and peroxisome proliferator-activated receptor-γ (PPAR-γ) activation has been reported to reduce RAGE
and CTGF expression. This study investigated the effects of the PPAR-γ agonist, rosiglitazone, on myocardial expression of
RAGE and CTGF, extent of cardiac fibrosis, and left ventricular (LV) diastolic function in type 2 diabetic (T2D) rats. Twenty-week-old
T2D rats were randomized to treatment with either 20 weeks of rosiglitazone (20 mg/kg) or saline (n = 10 in each group). Serial echocardiographic examinations were performed just before randomization (20 weeks) and at study
completion (40 weeks). Fibrosis extent and RAGE and CTGF expression were assessed in previously imaged hearts by picrosirius
red staining, and by real-time reverse transcriptase-coupled polymerase chain reaction (RT-PCR) and immunoblotting, respectively.
Results of the latter assessments were further validated by immunohistochemical staining. Rosiglitazone treatment significantly
improved E/A ratio in serial echocardiography assessment, and reduced LV collagen volume fraction as demonstrated by picrosirius red staining.
Real-time RT-PCR and immunoblots of myocardial tissue from rosiglitazone-treated rats revealed reduced RAGE and CTGF mRNA
and protein signals compared to those of saline-treated T2D rats, which were consistent with reduced proportions of myocardial
RAGE and CTGF staining in the hearts of T2D rats. PPAR-γ agonist therapy reduces cardiac fibrosis and improves LV diastolic
dysfunction as assessed by serial echocardiographic imaging. Suppression of RAGE and CTGF expression in the diabetic myocardium
appears to contribute to the antifibrotic effect of rosiglitazone. These results support the potential of PPAR-γ agonists
as antifibrotic agents in diabetic cardiomyopathy.
Keywords Diabetes mellitus - Myocardial fibrosis - PPAR gamma - CTGF - RAGE