Role of SERCA and AQP-5 in Diabetes Mellitus-Induced Xerostomia in Adult Male Albino Rat and The Potential Therapeutic Effect of Aldose Reductase Inhibitors: Histological Study

Document Type : Original Article

Authors

Histology Department, Faculty of Medicine, Cairo University, Cairo, Egypt

Abstract

Background: Saliva plays essential roles in different biological processes. Autonomic receptors stimulation is the main regulator of its secretion. Ca2+ acts as a 2nd messenger via increasing its cytoplasmic-level (i-Ca2+) &decreasing its endoplasmic reticulum-level (ER-Ca2+) with subsequent protein synthesis as α-amylase and water flow through aquaporin-5 channels (AQP-5). Sarco-ER Ca2+-ATPase (SERCA) pumps i-Ca2+ back to ER-Ca2+ maintaining low i-Ca2+ during rest and allowing its increase during salivary activation. Polyol-pathway overactivity with biological molecules glycation and oxidative-stress is the main mechanism of diabetic complications as xerostomia. As aldose-reductase (AR) is its key-enzyme, multiple AR-inhibitors (ARIs) were newly explored to cure diabetic complications. Aim of work: Investigating SERCA &AQP-5 roles in diabetes-induced xerostomia molecular mechanism in adult male albino rats &the potential ARIs therapeutic effect. Materials &Methods: 32 rats were divided into 2 groups: control &experimental [received 55mg/kg streptozotocin to induce diabetes]. 18 hyperglycemic rats were divided into 3 subgroups: diabetic, diabetic/recovery &diabetic/ARIs [received daily oral 57 mg/kg Epalrestat for 4 weeks]. Serum glucose measurement, saliva collection &biochemical, histological, immunohistochemical [for active SERCA, AQP-5, inactive SERCA &caspase-3] and morphometric studies were done. Results: All serological, biochemical &histological manifestations of diabetes &xerostomia deteriorated from diabetic subgroup to diabetic/recovery subgroup. However, Epalrestat use evidently improved xerostomia manifestations but not diabetic manifestations. Conclusion: The main molecular mechanism of diabetes-induced xerostomia is polyol-pathway overactivity and consequent SERCA inactivation, i-Ca2+ overload, ER-stress, AQP-5 reduction, &α-amylase improper folding. Epalrestat, an ARI, ameliorates such xerostomia by blocking this pathway and preventing these changes with no effect on diabetes itself.

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  1. Aitken-Saavedra J, Rojas-Alcayaga G, Maturana-Ramírez A, Escobar-Álvarez A, Cortes-Coloma A, Reyes-Rojas M, Viera-Sapiain V, Villablanca-Martínez C, Morales-Bozo I. Salivary gland dysfunction markers in type 2 diabetes mellitus patients. J Clin Exp Dent. 2015; 7: e501-5.
  2. Ambudkar IS. Ca²⁺ signaling and regulation of fluid secretion in salivary gland acinar cells. Cell Calcium. 2014; 55:297-305.
  3. Ambudkar IS. Calcium signalling in salivary gland physiology and dysfunction. J Physiol. 2016; 594:2813-24.
  4. Pedersen AML, Sørensen CE, Proctor GB, Carpenter GH, Ekström J. Salivary secretion in health and disease. J Oral Rehabil. 2018; 45:730-46.
  5. Ambudkar I. Calcium signaling defects underlying salivary gland dysfunction. Biochim Biophys Acta Mol Cell Res. 2018; 1865:1771-7.
  6. Ambudkar IS. Regulation of calcium in salivary gland secretion. Crit Rev Oral Biol Med. 2000; 11:4-25.
  7. Liu X, Cheng KT, Bandyopadhyay BC, Pani B, Dietrich A, Paria BC, Swaim WD, Beech D, Yildrim E, Singh BB, Birnbaumer L, Ambudkar IS. Attenuation of store-operated Ca2+ current impairs salivary gland fluid secretion in TRPC1(-/-) mice. Proc Natl Acad Sci U S A. 2007; 104:17542-7.
  8. Hong JH, Li Q, Kim MS, Shin DM, Feske S, Birnbaumer L, Cheng KT, Ambudkar IS, Muallem S. Polarized but differential localization and recruitment of STIM1, Orai1 and TRPC channels in secretory cells. Traffic. 2011; 12:232-45.
  9. Bhattarai KR, Lee HY, Kim SH, Kim HR, Chae HJ. Ixeris dentata Extract Increases Salivary Secretion through the Regulation of Endoplasmic Reticulum Stress in a Diabetes-Induced Xerostomia Rat Model. Int J Mol Sci. 2018; 19:1059.
  10. Melvin JE, Yule D, Shuttleworth T, Begenisich T. Regulation of fluid and electrolyte secretion in salivary gland acinar cells. Annu Rev Physiol. 2005; 67:445-69.
  11. Fedirko NV, Kruglikov IA, Kopach OV, Vats JA, Kostyuk PG, Voitenko NV. Changes in functioning of rat submandibular salivary gland under streptozotocin-induced diabetes are associated with alterations of Ca2+ signaling and Ca2+ transporting pumps. Biochim Biophys Acta. 2006; 1762:294-303.
  12. Pedersen A, Sørensen CE, Proctor GB, Carpenter GH. Salivary functions in mastication, taste and textural perception, swallowing and initial digestion. Oral Dis. 2018; 24:1399-1416.
  13. American Diabetes Association. Diagnosis and classification of diabetes mellitus. Diabetes Care. 2014; 37 1: S81-90.
  14. Thakur S, Gupta SK, Ali V, Singh P, Verma M. Aldose Reductase: a cause and a potential target for the treatment of diabetic complications. Arch Pharm Res. 2021; 44:655-67.
  15. Demir Y, Taslimi P, Koçyiğit ÜM, Akkuş M, Özaslan MS, Duran HE, Budak Y, Tüzün B, Gürdere MB, Ceylan M, Taysi S, Gülçin İ, Beydemir Ş. Determination of the inhibition profiles of pyrazolyl-thiazole derivatives against aldose reductase and α-glycosidase and molecular docking studies. Arch Pharm (Weinheim). 2020; 353: e2000118.
  16. Taslimi P, Aslan HE, Demir Y, Oztaskin N, Maraş A, Gulçin İ, Beydemir S, Goksu S. Diarylmethanon, bromophenol and diarylmethane compounds: Discovery of potent aldose reductase, α-amylase and α-glycosidase inhibitors as new therapeutic approach in diabetes and functional hyperglycemia. Int J Biol Macromol. 2018; 119:857-63.
  17. Chawla A, Chawla R, Jaggi S. Microvasular and macrovascular complications in diabetes mellitus: Distinct or continuum? Indian J Endocrinol Metab. 2016; 20:546-51.
  18. Grewal AS, Bhardwaj S, Pandita D, Lather V, Sekhon BS. Updates on Aldose Reductase Inhibitors for Management of Diabetic Complications and Non-diabetic Diseases. Mini Rev Med Chem. 2016; 16:120-62.
  19. Jannapureddy S, Sharma M, Yepuri G, Schmidt AM, Ramasamy R. Aldose Reductase: An Emerging Target for Development of Interventions for Diabetic Cardiovascular Complications. Front Endocrinol (Lausanne). 2021; 12:636267.
  20. Litwinoff E, Hurtado Del Pozo C, Ramasamy R, Schmidt AM. Emerging Targets for Therapeutic Development in Diabetes and Its Complications: The RAGE Signaling Pathway. Clin Pharmacol Ther. 2015; 98:135-44.
  21. Ruiz HH, Ramasamy R, Schmidt AM. Advanced Glycation End Products: Building on the Concept of the "Common Soil" in Metabolic Disease. Endocrinology. 2020; 161: bqz006.
  22. Egaña-Gorroño L, López-Díez R, Yepuri G, Ramirez LS, Reverdatto S, Gugger PF, Shekhtman A, Ramasamy R, Schmidt AM. Receptor for Advanced Glycation End Products (RAGE) and Mechanisms and Therapeutic Opportunities in Diabetes and Cardiovascular Disease: Insights From Human Subjects and Animal Models. Front Cardiovasc Med. 2020; 7:37.
  23. Bhattarai KR, Junjappa R, Handigund M, Kim HR, Chae HJ. The imprint of salivary secretion in autoimmune disorders and related pathological conditions. Autoimmun Rev. 2018; 17:376-90.
  24. Nanci A. Salivary Glands. In Ten Cate’s Oral Histology: Development, Structure, and Function (Ninth Edition), Elsevier,2016, pp: 536-88.
  25. Johnson BF, Nesto RW, Pfeifer MA, Slater WR, Vinik AI, Chyun DA, Law G, Wackers FJ, Young LH. Cardiac abnormalities in diabetic patients with neuropathy: effects of aldose reductase inhibitor administration. Diabetes Care. 2004; 27:448-54.
  26. Padugupati S, Ramamoorthy S, Thangavelu K, Sarma D, Jamadar D. Effective Dose of Streptozotocin to Induce Diabetes Mellitus and Variation of Biophysical and Biochemical Parameters in Albino Wistar Rats. J Clin of Diagn Res. 2021; 15: BF01-BF05.
  27. Jaiswal S, Ss T, Mishra S. Neuroprotective effect of Epalrestat on memory impairment in streptozotocin-induced type-2 diabetic rats using different behavioral models. Asian J Pharm Clin Res. 2018; 11: 411–5.
  28. Cassandra R. Stewart, Nneka Obi, Elodie C. Epane , Alexander A. Akba , Leslie Halpern, Janet H. Southerland, Pandu R. Gangula. The Effects of Diabetes on Salivary Gland Protein Expression of Tetrahydrobiopterin and Nitric Oxide Synthesis and Function. J Periodontol. 2016; 87: 735–41.
  29. Turner T, Chen X, Zahner M, Opsahl A, DeMarco G, Boucher M, Goodwin B, Perreault M. FGF21 increases water intake, urine output and blood pressure in rats. PLoS ONE. 2018; 14;13: e0202182.
  30. El Agaty SM. Cardioprotective effect of vitamin D2 on isoproterenol-induced myocardial infarction in diabetic rats. Archives of Physiology and Biochemistry. 2019; 125:210-9.
  31. Suvarna K, Layton C, Bancroft J. The hematoxylins and eosin& Immunohistochemical techniques. In Bancroft's Theory and Practice of Histological Techniques (Eighth Edition), Elsevier,2019, pp: 126-38 & 337-94.
  32. Yue XD, Wang JY, Zhang XR, Yang JH, Shan CY, Zheng MY, Ren HZ, Zhang Y, Yang SH, Guo ZH, Chang B, Chang BC. Characteristics and Impact Factors of Renal Threshold for Glucose Excretion in Patients with Type 2 Diabetes Mellitus. J Korean Med Sci. 2017; 32:621-7.
  33. Mathebula SD. Polyol pathway: A possible mechanism of diabetes complications in the eye. Afr. Vision Eye Health. 2015;74: 5 pages.
  34. Yan LJ. Redox imbalance stress in diabetes mellitus: Role of the polyol pathway. Animal Model Exp Med. 2018; 1:7-13.
  35. Shen H, Wang W. Effect of glutathione liposomes on diabetic nephropathy based on oxidative stress and polyol pathway mechanism. J Liposome Res. 2021; 31:317-25. 
  36. Duchen MR. Roles of mitochondria in health and disease. Diabetes. 2004; 53:S96-102. 
  37. Jian Z, Guo H, Liu H, Cui H, Fang J, Zuo Z, Deng J, Li Y, Wang X, Zhao L. Oxidative stress, apoptosis and inflammatory responses involved in copper-induced pulmonary toxicity in mice. Aging (Albany NY). 2020; 12:16867-86. 
  38. Chaudhari N, Talwar P, Parimisetty A, Lefebvre d'Hellencourt C, Ravanan P. A molecular web: endoplasmic reticulum stress, inflammation, and oxidative stress. Front Cell Neurosci. 2014; 8:213.
  39. Cruz PL, Moraes-Silva IC, Ribeiro AA, Machi JF, de Melo MDT, Dos Santos F, da Silva MB, Strunz CMC, Caldini EG, Irigoyen MC. Nicotinamide attenuates streptozotocin-induced diabetes complications and increases survival rate in rats: role of autonomic nervous system. BMC Endocr Disord. 2021; 21:133. 
  40. Tang WH, Cheng WT, Kravtsov GM, Tong XY, Hou XY, Chung SK, Chung SS. Cardiac contractile dysfunction during acute hyperglycemia due to impairment of SERCA by polyol pathway-mediated oxidative stress. Am J Physiol Cell Physiol. 2010; 299:C643-53. 
  41. Horáková L, Strosova MK, Spickett CM, Blaskovic D. Impairment of calcium ATPases by high glucose and potential pharmacological protection. Free Radic Res. 2013; 47:81-92.
  42. Abdelazeim SA, Shehata NI, Aly HF, Shams SGE. Amelioration of oxidative stress-mediated apoptosis in copper oxide nanoparticles-induced liver injury in rats by potent antioxidants. Sci Rep. 2020; 10:10812. 
  43. Laorodphun P, Cherngwelling R, Panya A, Arjinajarn P. Curcumin protects rats against gentamicin-induced nephrotoxicity by amelioration of oxidative stress, endoplasmic reticulum stress and apoptosis. Pharm Biol. 2022; 60:491-500.