Key result
Lentiviral REST shRNA improves cardiac vagal activation in T2DM rats by activating N-type Ca2+ channels.
Why the study?
Cardiac autonomic dysfunction in T2DM increases the risk of arrhythmia-related sudden cardiac death, and mechanisms linking T2DM-elevated H2O2 in AVG neurons to decreased cardiac vagal function required further investigation.
Targeting the H2O2-REST-Cav2.2 channel signaling axis may serve as a potential therapeutic strategy to normalize cardiac vagal dysfunction and related complications in T2DM.
Hypothesis-generating for REST-targeted vagal restoration in T2DM; leaves open translation to human autonomic neuropathy therapy.
Diabetes mellitus, especially type 2 diabetes mellitus (T2DM), is a major health problem worldwide and has become a leading cause of mortality. As a common complication of patients with T2DM, cardiac autonomic dysfunction (including sympathetic overactivation and reduced vagal tone) is associated with a higher risk of arrhythmia-related sudden cardiac death. Our previous study found that T2DM-elevated hydrogen peroxide (H2O2) levels in atrioventricular ganglion (AVG) neurons contribute to the decrease in cardiac vagal function and ventricular arrhythmogenesis through inhibition of N-type Ca2+ channels (Cav2.2). In the present study, treatment with exogenous H2O2 in differentiated NG108-15 cells increased REST expression and decreased Cav2.2-α expression. Adenoviral catalase gene transfection into the AVG neurons significantly reduced the REST levels elevated by a high-fat diet plus streptozotocin-induced T2DM. Lentiviral REST shRNA transfection markedly increased Cav2.2-α expression in the AVG neurons from T2DM rats. REST shRNA also activated N-type Ca2+ channels and increased cell excitability of AVG neurons in T2DM rats. Additionally, REST shRNA markedly improved cardiac vagal activation in T2DM rats. The present study suggests that the H2O2-REST-Cav2.2 channel signaling axis could be a potential therapeutic target to normalize cardiac vagal dysfunction and its related cardiac complications in T2DM.
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Zhang et al. (2025) studied Type 2 diabetes mellitus. Lentiviral REST shRNA and adenoviral catalase gene transfection was evaluated on REST expression, Cav2.2-α expression, and cardiac vagal activation. Lentiviral REST shRNA transfection in atrioventricular ganglion neurons from T2DM rats increased Cav2.2-α expression, activated N-type Ca2+ channels, and improved cardiac vagal activation.
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