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(Circulation. 2002;106:246.)
© 2002 American Heart Association, Inc.
Basic Science Reports |
From the Department of Medicine, University of Melbourne, Austin and Repatriation Medical Centre, Heidelberg West, Australia (R.C., K.A.J.-D., Z.C., S.P.N., W.C.B., M.E.C., T.J.A.); the Kolling Institute of Medical Research, University of Sydney, Royal North Shore Hospital, St Leonards, Australia (S.M.T.); and the Morphology Laboratory, Baker Medical Research Institute, Melbourne, Australia (R.J.D.).
Correspondence to Dr Terri J. Allen, Division of Diabetes, Lipoproteins and Metabolism, Baker Heart Research Institute, PO Box 6492, Melbourne 8008 Victoria, Australia. E-mail terri.allen{at}baker.edu.au
Background Atherosclerosis is a major complication of diabetes, but the mechanisms by which diabetes promotes macrovascular disease have not been fully delineated. Although several animal studies have demonstrated that inhibition of ACE results in a decrease in the development of atherosclerotic lesions, information about the potential benefits of these agents on complex and advanced atherosclerotic lesions as observed in long-term diabetes is lacking. The aim of this study was to evaluate whether treatment with the ACE inhibitor perindopril affects diabetes-induced plaque formation in the apolipoprotein E (apoE)-deficient mouse.
Methods and Results Diabetes was induced by injection of streptozotocin in 6-week-old apoE-deficient mice. Diabetic animals received treatment with perindopril (4 mg · kg-1 · d-1) or no treatment for 20 weeks. Nondiabetic apoE-deficient mice were used as controls. Induction of diabetes was associated with a 4-fold increase in plaque area compared with nondiabetic animals. This accelerated atherosclerosis was associated with a significant increase in aortic ACE expression and activity and connective tissue growth factor and vascular cell adhesion molecule-1 expression. Perindopril treatment inhibited the development of atherosclerotic lesions and diabetes-induced ACE, connective tissue growth factor, and vascular cell adhesion molecule-1 overexpression in the aorta.
Conclusions The activation of the local renin-angiotensin system in the diabetic aorta and the reduction in atherosclerosis with ACE inhibitor treatment provides further evidence that the renin-angiotensin system plays a pivotal role in the development and acceleration of atherosclerosis in diabetes.
Key Words: atherosclerosis diabetes mellitus angiotensin vessels
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