The Concentration-dependent Investigation of the Toxic Effects of the Anorectic Agent Sibutramine on the Electrical Activity of the Cardiomyocytes in Metabolic Syndrome Rat Heart
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Research Article
P: 245-251
August 2021

The Concentration-dependent Investigation of the Toxic Effects of the Anorectic Agent Sibutramine on the Electrical Activity of the Cardiomyocytes in Metabolic Syndrome Rat Heart

J Ankara Univ Fac Med 2021;74(2):245-251
1. Ankara Üniversitesi Tıp Fakültesi, Biyofizik Anabilim Dalı, Ankara, Türkiye
2. Anadolu Üniversitesi Eczacılık Fakültesi, Farmakoloji Anabilim Dalı, Eskişehir, Türkiye
No information available.
No information available
Received Date: 12.08.2020
Accepted Date: 07.09.2020
Publish Date: 25.05.2021
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ABSTRACT

Objectives:

Sibutramine (SBT) has been intensely used for losing weight over the past decades. In addition to the known mode of its action through brown adipose tissue thermogenesis, systemic actions reveal some side effects including alterations in cardiac function. Despite various clinical findings, the effect of SBT on cellular levels remains elusive. This study aimed to investigate the possible effects of sibutramine on the electrical activity of the cardiomyocytes from freshly isolated metabolic syndrome (MetS) rat hearts.

Materials and Methods:

Wistar type 2-month-old male rats were used. The animals were fed (20-22 weeks) with tap water containing 32% sucrose in addition to standard feed (20-22 weeks). MetS were confirmed using higher body weight, higher fasting blood glucose, and impaired glucose tolerance test. Heart tissue sections were stained with Masson Trichrome and examined under light microscopy. All patch-clamp experiments were performed in whole-cell mode, but action potentials were recorded in current-clamp configuration and voltage-gated K+-channel currents in voltage-clamp configuration from freshly isolated MetS cardiomyocytes. Acute SBT treatment was performed in a concentration-dependent manner (10-8-10-5 M) for all cardiomyocytes.

Results:

Histological examinations reveal that MetS hearts are characterized by a marked increase in collagen depositions. Electrophysiological findings show the significant prolongation in action potential duration, indicate pro-arrhythmic action for SBT treatment in a concentration-dependent manner. As voltage-gated K+-channel currents (IK) are responsible for changes in the repolarization of the action potentials (AP) in ventricular cardiomyocytes acute SBT treatment reduced IK channels significantly.

Conclusion:

This study showed that the effects of SBT on prolongation of action potential and reduction in IK channel density include pro-arrhythmic and detrimental outcomes in overweighed MetS hearts.

Keywords: Sibutramine, Electrical Activity, Action Potential, K+- Current, Obesity, Metabolic Syndrome

References

1
Reaven GM. Banting lecture 1988. Role of insulin resistance in human disease. Diabetes. 1988;37:1595-1607.
2
Kahn R, Buse J, Ferrannini E, et al. The metabolic syndrome. Lancet. 2005;366:1921-1922.
3
Alberti KG, Eckel RH, Grundy SM, et al. Harmonizing the metabolic syndrome: a joint interim statement of the International Diabetes Federation Task Force on Epidemiology and Prevention; National Heart, Lung, and Blood Institute; American Heart Association; World Heart Federation; International Atherosclerosis Society; and International Association for the Study of Obesity. Circulation. 2009;120:1640-1645.
4
Chinali M, de Simone G, Roman MJ, et al. Cardiac markers of pre-clinical disease in adolescents with the metabolic syndrome: the strong heart study. J Am Coll Cardiol. 2008;52:932-938.
5
Zannad F, Gille B, Grentzinger A, et al. Effects of sibutramine on ventricular dimensions and heart valves in obese patients during weight reduction. Am Heart J. 2002;144:508-515.
6
Bassuk SS, Manson JE. Epidemiological evidence for the role of physical activity in reducing risk of type 2 diabetes and cardiovascular disease. J Appl Physiol (1985). 2005;99:1193-1204.
7
Sullivan PW, Ghushchyan V, Wyatt HR, et al. Impact of cardiometabolic risk factor clusters on health-related quality of life in the U.S. Obesity (Silver Spring). 2007;15:511-521.
8
Balkau B, Deanfield JE, Després JP, et al. International Day for the Evaluation of Abdominal Obesity (IDEA): a study of waist circumference, cardiovascular disease, and diabetes mellitus in 168,000 primary care patients in 63 countries. Circulation. 2007;116:1942-1951.
9
Cannon CP, Kumar A. Treatment of overweight and obesity: lifestyle, pharmacologic, and surgical options. Clin Cornerstone. 2009;9:55-68.
10
Whaley-Connell A, Sowers JR, McCullough PA, et al. Diabetes mellitus and CKD awareness: the Kidney Early Evaluation Program (KEEP) and National Health and Nutrition Examination Survey (NHANES). Am J Kidney Dis. 2009;53:11-21.
11
Gonçalves FB, Koek M, Verhagen HJ, et al. Body-mass index, abdominal adiposity, and cardiovascular risk. Lancet. 2011;378:227.
12
Grundy SM, Benjamin IJ, Burke GL, et al. Diabetes and cardiovascular disease: a statement for healthcare professionals from the American Heart Association. Circulation. 1999;100:1134-1146.
13
Ren J, Kelley RO. Cardiac health in women with metabolic syndrome: clinical aspects and pathophysiology. Obesity (Silver Spring). 2009;17:1114-1123.
14
Zhou X, Ma L, Habibi J, et al. Nebivolol improves diastolic dysfunction and myocardial remodeling through reductions in oxidative stress in the Zucker obese rat. Hypertension. 2010;55:880-888.
15
Akdas S, Turan B, Durak A, et al. The Relationship Between Metabolic Syndrome Development and Tissue Trace Elements Status and Inflammatory Markers. Biol Trace Elem Res. 2020;198:16-24.
16
Durak A, Olgar Y, Degirmenci S, et al. A SGLT2 inhibitor dapagliflozin suppresses prolonged ventricular-repolarization through augmentation of mitochondrial function in insulin-resistant metabolic syndrome rats. Cardiovasc Diabetol. 2018;17:144.
17
Durak A, Olgar Y, Tuncay E, et al. Onset of decreased heart work is correlated with increased heart rate and shortened QT interval in high-carbohydrate fed overweight rats. Can J Physiol Pharmacol. 2017;95:1335-1342.
18
Okatan EN, Durak AT, Turan B. Electrophysiological basis of metabolic-syndrome-induced cardiac dysfunction. Can J Physiol Pharmacol. 2016;94:1064-1073.
19
Okatan EN, Tuncay E, Hafez G, et al. Profiling of cardiac β-adrenoceptor subtypes in the cardiac left ventricle of rats with metabolic syndrome: Comparison with streptozotocin-induced diabetic rats. Can J Physiol Pharmacol. 2015;93:517-525.
20
Okatan EN, Turan B. The contribution of phosphodiesterases to cardiac dysfunction in rats with metabolic syndrome induced by a high-carbohydrate diet. Can J Physiol Pharmacol. 2019;97:1064-1072.
21
Casis O, Echevarria E. Diabetic cardiomyopathy: electromechanical cellular alterations. Curr Vasc Pharmacol. 2004;2:237-248.
22
Shimoni Y. Inhibition of the formation or action of angiotensin II reverses attenuated K+ currents in type 1 and type 2 diabetes. J Physiol. 2001;537:83-92.
23
Shimoni Y, Ewart HS, Severson D. Insulin stimulation of rat ventricular K+ currents depends on the integrity of the cytoskeleton. J Physiol. 1999;514:735-745.
24
Qin D, Huang B, Deng L, et al. Downregulation of K(+) channel genes expression in type I diabetic cardiomyopathy. Biochem Biophys Res Commun. 2001;283:549-553.
25
Sweeting HN, West PB, Der GJ. Explanations for female excess psychosomatic symptoms in adolescence: evidence from a school-based cohort in the West of Scotland. BMC Public Health. 2007;7:298.
26
Haslam D, Sattar N, Lean M. ABC of obesity. Obesity--time to wake up. BMJ. 2006;333:640-642.
27
Luppino FS, de Wit LM, Bouvy PF, et al. Overweight, obesity, and depression: a systematic review and meta-analysis of longitudinal studies. Arch Gen Psychiatry. 2010;67:220-229.
28
Dibaise JK, Foxx-Orenstein AE. Role of the gastroenterologist in managing obesity. Expert Rev Gastroenterol Hepatol. 2013;7:439-451.
29
Yanovski SZ, Yanovski JA. Long-term drug treatment for obesity: a systematic and clinical review. JAMA. 2014;311:74-86.
30
Van Gaal LF, Wauters MA, De Leeuw IH. Anti-obesity drugs: what does sibutramine offer? An analysis of its potential contribution to obesity treatment. Exp Clin Endocrinol Diabetes. 1998;106:35-40.
31
Bray GA, Blackburn GL, Ferguson JM, et al. Sibutramine produces dose-related weight loss. Obes Res. 1999;7:189-198. 
32
Hazenberg BP. Randomized, double-blind, placebo-controlled, multicenter study of sibutramine in obese hypertensive patients. Cardiology. 2000;94:152-158.
33
Smith IG, Goulder MA; Sibutramine Clinical Study 1047 Team. Randomized placebo-controlled trial of long-term treatment with sibutramine in mild to moderate obesity. J Fam Pract. 2001;50:505-512. 
34
Torp-Pedersen C, Caterson I, Coutinho W, et al. Cardiovascular responses to weight management and sibutramine in high-risk subjects: an analysis from the SCOUT trial. Eur Heart J. 2007;28:2915-2923. 
35
Yun J, Chung E, Choi KH, et al. Cardiovascular Safety Pharmacology of Sibutramine. Biomol Ther (Seoul). 2015;23:386-389.
36
Vasanji Z, Cantor EJ, Juric D, et al. Alterations in cardiac contractile performance and sarcoplasmic reticulum function in sucrose-fed rats is associated with insulin resistance. Am J Physiol Cell Physiol. 2006;291:772-780.
37
Okatan EN, Tuncay E, Hafez G, et al. Profiling of cardiac β-adrenoceptor subtypes in the cardiac left ventricle of rats with metabolic syndrome: Comparison with streptozotocin-induced diabetic rats. Can J Physiol Pharmacol. 2015;93:517-525. 
38
Aguilera AA, Díaz GH, Barcelata ML, et al. Effects of fish oil on hypertension, plasma lipids, and tumor necrosis factor-alpha in rats with sucrose-induced metabolic syndrome. J Nutr Biochem. 2004;15:350-357.
39
Yaras N, Ugur M, Ozdemir S, et al. Effects of diabetes on ryanodine receptor Ca release channel (RyR2) and Ca2+ homeostasis in rat heart. Diabetes. 2005;54:3082-3088.
40
Ozdemir S, Ugur M, Gürdal H, et al. Treatment with AT(1) receptor blocker restores diabetes-induced alterations in intracellular Ca(2+) transients and contractile function of rat myocardium. Arch Biochem Biophys. 2005;435:166-174. 
41
Olgar Y, Tuncay E, Degirmenci S, et al. Ageing-associated increase in SGLT2 disrupts mitochondrial/sarcoplasmic reticulum Ca2+ homeostasis and promotes cardiac dysfunction. J Cell Mol Med. 2020;24:8567-8578. 
42
Degirmenci S, Olgar Y, Durak A, et al. Cytosolic increased labile Zn2+ contributes to arrhythmogenic action potentials in left ventricular cardiomyocytes through protein thiol oxidation and cellular ATP depletion. J Trace Elem Med Biol. 2018;48:202-212.
43
Chang GJ, Wu MH, Wu YC, et al. Electrophysiological mechanisms for antiarrhythmic efficacy and positive inotropy of liriodenine, a natural aporphine alkaloid from Fissistigma glaucescens. Br J Pharmacol. 1996;118:1571-1583. 
44
van der Heyden MA, Wijnhoven TJ, Opthof T. Molecular aspects of adrenergic modulation of cardiac L-type Ca2+ channels. Cardiovasc Res. 2005;65:28-39.
45
Song YJ, Dong PS, Wang HL, et al. Regulatory functions of docosahexaenoic acid on ion channels in rat ventricular myocytes. Eur Rev Med Pharmacol Sci. 2013;17:2632-2638.
46
Durak A, Bitirim CV, Turan B. Titin and CK2α are New Intracellular Targets in Acute Insulin Application-Associated Benefits on Electrophysiological Parameters of Left Ventricular Cardiomyocytes From Insulin-Resistant Metabolic Syndrome Rats. Cardiovasc Drugs Ther. 2020;34:487-501.
47
Chang GJ, Yeh YH, Lin TP, et al. Electromechanical and atrial and ventricular antiarrhythmic actions of CIJ-3-2F, a novel benzyl-furoquinoline vasodilator in rat heart. Br J Pharmacol. 2014;171:3918-3937.
48
Ernest D, Gershenzon A, Corallo CE, et al. Sibutramine-associated QT interval prolongation and cardiac arrest. Ann Pharmacother. 2008;42:1514-1517.
49
Chang GJ, Su MJ, Hung LM, et al. Cardiac electrophysiologic and antiarrhythmic actions of a pavine alkaloid derivative, O-methyl-neocaryachine, in rat heart. Br J Pharmacol. 2002;136:459-471.
50
Skarsfeldt MA, Carstensen H, Skibsbye L, et al. Pharmacological inhibition of IK1 by PA-6 in isolated rat hearts affects ventricular repolarization and refractoriness. Physiol Rep. 2016;4:12734.
51
Tziomalos K, Krassas GE, Tzotzas T. The use of sibutramine in the management of obesity and related disorders: an update. Vasc Health Risk Manag. 2009;5:441-452.
52
Bunya N, Sawamoto K, Uemura S, et al. Cardiac arrest caused by sibutramine obtained over the Internet: a case of a young woman without pre-existing cardiovascular disease successfully resuscitated using extracorporeal membrane oxygenation. Acute Med Surg. 2017;4:334-337.
53
Kim KS, Kim EJ, Lee HA, et al. Effect of sibutramine HCl on cardiac hERG K+ channel. Mol Cell Biochem. 2009;320:125-131.
54
Ding L, Hao X, Huang X, et al. Simultaneous determination of sibutramine and its N-desmethyl metabolites in human plasma by liquid chromatography–electrospray ionization–mass spectrometry: Method and clinical applications. Analytica Chimica Acta. 2003;492:241-248.
55
Jain DS, Subbaiah G, Sanyal M, et al. Liquid chromatography/electrospray ionization tandem mass spectrometry validated method for the simultaneous quantification of sibutramine and its primary and secondary amine metabolites in human plasma and its application to a bioequivalence study. Rapid Commun Mass Spectrom. 2006;20:3509-3521.
56
Kokaçya MH,  Şahpolat M, Kurhan F. Sibutramin içeren reçetesiz zayıflama ürününün indüklediği ilk manik hecme. 2014;4:126-129.
57
Luscombe GP, Hopcroft RH, Thomas PC, et al. The contribution of metabolites to the rapid and potent down-regulation of rat cortical beta-adrenoceptors by the putative antidepressant sibutramine hydrochloride. Neuropharmacology. 1989;28:129-134. 
58
Florentin M, Liberopoulos EN, Elisaf MS. Sibutramine-associated adverse effects: a practical guide for its safe use. Obes Rev. 2008;9:378-387.
59
Waszkiewicz N, Zalewska-Szajda B, Szajda SD, et al. Sibutramine-induced mania as the first manifestation of bipolar disorder. BMC Psychiatry. 2012;12:43. 
60
James WP, Caterson ID, Coutinho W, et al. Effect of sibutramine on cardiovascular outcomes in overweight and obese subjects. N Engl J Med. 2010;363:905-917.
61
Scheen AJ. Sibutramine on cardiovascular outcome. Diabetes Care. 2011;34(Suppl 2):114-119.
62
Scheen AJ. Cardiovascular risk-benefit profile of sibutramine. Am J Cardiovasc Drugs. 2010;10:321-334.
63
Cercato C, Fonseca FA. Cardiovascular risk and obesity. Diabetol Metab Syndr. 2019;11:74.
64
Nathan PJ, O’Neill BV, Napolitano A, et al. Neuropsychiatric adverse effects of centrally acting antiobesity drugs. CNS Neurosci Ther. 2011;17:490-505.
65
T.C. Sağlık Bakanlığı Reductil (Sibutramin) hakkında, Sağlık Bakanlığı İlaç ve Eczacılık Genel Müdürlüğü 22.01.2010 tarih 006064 sayılı yazısı.
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