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Unraveling Diabetic Cardiomyopathy (DCM): The Critical Role of the Yap–miR-22-3p–Sirt1 axis in the Pathogenesis of DCM

ABSTRACT: Background: Diabetic cardiomyopathy (DCM), characterized by myocardial hypertrophy and myocardial fibrosis, is a severe complication of diabetes. Yes-associated protein (Yap) activation contributes to myocardial remodeling and cardiac dysfunction. This study investigated the role of Yap and its molecular mechanism in DCM. Methods: Yap expression was assessed in mice with type 2 diabetes mellitus (T2DM) and high glucose (HG) + insulin-treated neonatal rat cardiomyocytes (NRCMs). Adeno-associated virus transfection, siRNA transfection, and a transgenic mouse model were used to manipulate Yap and sirtuin 1 (Sirt1) expression in vivo and in vitro. RNA sequencing, differential gene analysis, and miRNA sequencing were used to identify downstream targets of Yap and the underlying mechanisms. Functional assays were used to evaluate cardiomyocyte hypertrophy and fibrosis through molecular markers, cell morphology, and echocardiography. Results: Yap expression was increased in HG + insulin-treated NRCMs and in the hearts of mice with T2DM, thereby promoting myocardial hypertrophy and fibrosis. Yap inhibition reduced the cardiomyocyte cross-sectional area, collagen deposition, and the levels of the hypertrophy markers atrial natriuretic peptide and β-myosin heavy chain. RNA sequencing identified Sirt1 as a downstream target of Yap. Bioinformatic analysis suggested that Yap positively regulates miR-22-3p, which inhibits Sirt1. Yap inhibition increased Sirt1 expression, mitigating myocardial remodeling. Conversely, Sirt1 knockdown reversed the protective effects of Yap inhibition, restoring hypertrophy and fibrosis. Conclusion: Yap promotes DCM progression by increasing miR-22-3p expression and suppressing Sirt1 expression. Targeting the Yap–miR-22-3p–Sirt1 axis might represent a novel therapeutic strategy for DCM, thereby improving myocardial structure and function.

ORGANISM(S): Rattus norvegicus

PROVIDER: GSE290303 | GEO | 2026/02/28

REPOSITORIES: GEO

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Project description:Diabetic cardiomyopathy (DCM) is a major complication of diabetes mellitus. Excessive activation of the canonical Wnt/β-catenin pathway contributes to the development of cardiomyopathy in type 1 diabetes mellitus (T1DM). Transcription factor 7-like 2 (TCF7L2) is the main β-catenin partner of the TCF family in adult human hearts. In this study, we investigated the role of Wnt/β-catenin in the development of cardiomyopathy in type 2 diabetes mellitus (T2DM) by using streptozotocin (STZ)/high-fat diet (HFD)-induced diabetic mice and high glucose-stimulated neonatal rat cardiomyocytes (NRCMs) as in-vivo and in-vitro models of T2DM, respectively. Compared with the control mice, the T2DM mice exhibited increased myocardial β-catenin and TCF7L2 expression that was concentrated in the nucleus. Treatment of diabetic mice with the β-catenin/TCF7L2 bipartite inhibitor iCRT14 prevented myocardial remodeling and improved cardiac dysfunction. iCRT14 also prevented high glucose-induced hypertrophy in NRCMs, while the β-catenin stabilizer SKL2001 worsened hypertrophy. Immunoprecipitation experiments confirmed the formation of the β-catenin/TCF7L2 bipartite in the control and T2DM mouse cardiomyocytes. Moreover, carbonic anhydrase 2 (CA2) was upregulated in T2DM cardiomyocytes in vitro and in vivo. TCF7L2 overexpression upregulated CA2, while iCRT14 treatment or TCF7L2 knockdown downregulated CA2. Chromatin immunoprecipitation (ChIP) experiments revealed an increased interaction between β-catenin/TCF7L2 and the transcription initiation region of CA2 in the heart tissue of T2DM mice. CA2 knockdown ameliorated NRCM hypertrophy induced by high glucose and SKL2001. A luciferase reporter assay confirmed that CA2 is directly regulated by the β-catenin/TCF7L2 bipartite. Collectively, these results indicate that the canonical Wnt/β-catenin pathway upregulates CA2 via TCF7L2 to promote cardiomyopathy in T2DM. This research sheds new light on the pathogenesis of DCM and presents new potential therapeutic targets for this disease.

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Unraveling Diabetic Cardiomyopathy (DCM): The Critical Role of the Yap–miR-22-3p–Sirt1 axis in the Pathogenesis of DCM

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