Peroxidative stress in diabetic blood vessels. Reversal by pancreatic islet transplantation.

Diabetic complications are believed to arise, in part, through an increase in oxidative stress. We characterized antioxidant status in vascular tissue in untreated diabetic rats and in diabetic rats rendered euglycemic by pancreatic islet transplantation. Three key endogenous antioxidant enzymes (e.g., superoxide dismutase, catalase, and glutathione peroxidase) were measured. Sprague-Dawley rats with streptozotocin-induced diabetes were killed after 8 weeks of untreated hyperglycemia and compared with age-matched controls. Eight weeks of untreated diabetes resulted in a significant increase of tissue catalase in aorta, iliac artery, and femoral artery as compared with controls. No significant changes in either superoxide dismutase or glutathione peroxidase were observed in aorta, iliac artery, or femoral artery of diabetic animals. This increase in catalase in diabetic vascular tissue suggests increased oxidative stress due to chronic exposure to H2O2 in vivo. To assess the impact of islet transplantation on oxidative stress in vascular tissue, inbred Lewis strain rats were rendered diabetic with streptozotocin. After 8 weeks of untreated diabetes, rats received an intraportal islet isograft and were monitored for 4 subsequent weeks of euglycemia. Islet transplantation improved weight gain and normalized blood glucose and total glycosylated hemoglobin. While catalase was significantly increased in aorta and iliac artery at 8 and 12 weeks of diabetes, vascular catalase was restored to normal by islet transplantation. These data suggest that islet transplantation is an effective treatment strategy to minimize increased oxidative stress in diabetic vasculature.

Short-term oral administration of L-arginine reverses defective endothelium-dependent relaxation and cGMP generation in diabetes.

In the present study, we evaluated whether acute dietary supplementation with L-arginine in vivo could reverse the defective endothelium-dependent relaxation in diabetic blood vessels assessed ex vivo. At 8 weeks of diabetes, streptozotocin-induced diabetic rats were given 1.25% L-arginine in drinking water 3 days prior to isolation of aortic rings for evaluation ex vivo. Plasma arginine concentration was reduced by diabetes but restored to normal in diabetic rats receiving dietary L-arginine. In norepinephrine-contracted rings, relaxation to acetylcholine but not to nitroglycerin was reduced by diabetes. Dietary treatment with L-arginine restored relaxation to acetylcholine without altering relaxation to nitroglycerin and restored the defect in acetylcholine-stimulated cGMP generation. These data suggest that the substrate for nitric oxide synthesis by the endothelium is likely to be limited in diabetes but can be overcome by dietary supplementation with L-arginine.

Plasma and vascular tissue arginine are decreased in diabetes: acute arginine supplementation restores endothelium-dependent relaxation by augmenting cGMP production.

Arginine is a precursor amino acid for the synthesis of nitric oxide by nitric oxide synthase. A defect in arginine supply could regulate nitric oxide-mediated, endothelium-dependent relaxation. In this study, we evaluated the effect of supplementation with L-arginine given in vitro on both functional relaxation and cGMP generation in response to acetylcholine in the streptozotocin-induced diabetic rat aorta. The concentration of arginine in plasma and aortic tissue were both decreased by diabetes. Acute incubation in vitro with L-arginine augmented the impaired relaxation to acetylcholine in diabetic rings although not altering relaxation in control rings. L-Arginine also enhanced relaxation to acetylcholine in diabetic rings incubated in the presence of either indomethacin or tetraethylammonium to inhibit cyclooxygenase activity and potassium channel activity, respectively. Acetylcholine-stimulated cGMP generation (which was blocked by L-nitroarginine) was diminished in diabetic rings compared with control rings. L-Arginine restored cGMP in diabetic rings (with but not without endothelium) to levels similar to control rings. L-Arginine did not alter cGMP generated by nitroglycerin. Incubation with L-arginine had no effect on acetylcholine-stimulated cGMP generation in control rings (with and without endothelium). These data suggest a potential intracellular substrate deficiency in nitric oxide production by diabetic endothelium which can be overcome acutely in vitro by provision of substrate for nitric oxide synthase.

Antioxidant pyrrolidine dithiocarbamate prevents defective bradykinin-stimulated calcium accumulation and nitric oxide activity following exposure of endothelial cells to elevated glucose concentration.

Previous studies from our laboratory suggest that reactive oxygen contributes to diminished bradykinin-stimulated calcium accumulation in endothelial cells exposed to elevated glucose concentrations. In this study, we evaluated the efficacy of the antioxidant pyrrolidine dithiocarbamate (PDTC), in preventing defects in intracellular calcium signalling and nitric oxide (NO) activity in endothelial cells exposed to elevated glucose concentration. We show that PDTC prevented the elevated glucose-induced impairment in bradykinin-stimulated calcium accumulation without changing the normal calcium accumulation in response to ionomycin. Furthermore, the impaired cyclic GMP in RFL-6 detector cells (an index of NO activity) generated by bradykinin-stimulation of high glucose-exposed endothelial cells was restored to normal by pretreatment with PDTC. These studies support a role of reactive oxygen in elevated glucose-induced defects in calcium signalling and NO activity by endothelial cells and that antioxidants may be useful in preventing this defect.