Why the study?
The mechanisms underlaying cardiac mitochondrial dynamism and motility remain poorly understood, especially in heart failure and diabetic cardiomyopathy, where treatment options are limited.
This review highlights the potential role of the mitochondrial-microtubule-inflammatory axis, specifically Miro1-mediated mitochondrial motility and NLRP3 inflammasome activation, in the pathogenesis of diabetic cardiomyopathy and heart failure.
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Mitochondrial fragmentation may signal early bioenergetic failure in diabetic HF; leaves open whether targeting dynamics improves outcomes.
A pathophysiological consequence of both type 1 and 2 diabetes is remodelling of the myocardium leading to the loss of left ventricular pump function and ultimately heart failure (HF). Abnormal cardiac bioenergetics associated with mitochondrial dysfunction occurs in the early stages of HF. Key factors influencing mitochondrial function are the shape, size and organisation of mitochondria within cardiomyocytes, with reports identifying small, fragmented mitochondria in the myocardium of diabetic patients. Cardiac mitochondria are now known to be dynamic organelles (with various functions beyond energy production); however, the mechanisms that underpin their dynamism are complex and links to motility are yet to be fully understood, particularly within the context of HF. This review will consider how the outer mitochondrial membrane protein Miro1 (Rhot1) mediates mitochondrial movement along microtubules via crosstalk with kinesin motors and explore the evidence for molecular level changes in the setting of diabetic cardiomyopathy. As HF and diabetes are recognised inflammatory conditions, with reports of enhanced activation of the NLRP3 inflammasome, we will also consider evidence linking microtubule organisation, inflammation and the association to mitochondrial motility. Diabetes is a global pandemic but with limited treatment options for diabetic cardiomyopathy, therefore we also discuss potential therapeutic approaches to target the mitochondrial-microtubule-inflammatory axis.
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Kassab et al. (2021) studied this question.
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