Why the study?
Metformin protects against pulmonary hypertension and CB1 receptor blockade reduces lung fibrosis alterations, prompting evaluation of the peripheral CB1 receptor antagonist JD5037 in mono- and polytherapy with metformin.
Does polytherapy with metformin and JD5037 improve right ventricular systolic pressure and remodeling in a rat model of monocrotaline-induced pulmonary hypertension?
Does polytherapy with metformin and JD5037 improve right ventricular systolic pressure and remodeling in a rat model of monocrotaline-induced pulmonary hypertension?
In a rat model of pulmonary hypertension, polytherapy with metformin and the CB1 receptor antagonist JD5037 improved right ventricular hypertrophy and coronary artery remodeling more effectively than either monotherapy.
Supports polytherapy exploration in preclinical PH models; leaves open human translation and clinical testing.
Pulmonary hypertension (PH) is a disease leading to increased pressure in the pulmonary artery and right heart failure. The adenosine monophosphate-activated protein kinase (AMPK) activator, metformin, has a protective effect against PH. CB 1 receptor blockade reduces the number of pathological alterations in experimental lung fibrosis. The current study evaluates the effect of the peripheral cannabinoid CB 1 receptor antagonist JD5037 in mono- and polytherapy with metformin in rat monocrotaline-induced mild PH. Animals received metformin (100 mg/kg), JD5037 (3 mg/kg), or a combination of both once daily for 21 days. Monocrotaline (60 mg/kg) increased right ventricular (RV) systolic pressure (RVSP), led to RV and lung hypertrophy and remodeling, and decreased oxygen saturation. Metformin partially restored the monocrotaline-induced effects, i.e., decreased RVSP, increased oxygen saturation, and counteracted cardiac fibrotic, hypertrophic, and inflammatory changes. JD5037 modified parameters related to inflammation and/or fibrosis. Only polytherapy with metformin and JD5037 improved Fulton’s index and coronary artery hypertrophy and tended to be more effective than monotherapy against alterations in RVSP, oxygen saturation and coronary artery tunica media vacuolization. In conclusion, monotherapy with JD5037 does not markedly influence the PH-related changes. However, polytherapy with metformin tends to be more efficient than any of these compounds alone.
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Remiszewski et al. (2022) studied this question.
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