Rapid Effects Linagliptin on Monocyte Polarization and Endothelial Progenitor Cells in Type 2 Diabetes
Status:
Completed
Trial end date:
2014-12-01
Target enrollment:
Participant gender:
Summary
Diabetes mellitus is characterized by chronic low grade inflammation, which is worsened by
the co-existence of renal failure.
One key aspect of chronic inflammatory diseases is the alteration in the polarization profile
of circulating monocyte-macrophage cells.
Namely, monocytes-macrophages can exist in a pro-inflammatory (M1) polarized form or an
anti-inflammatory (M2) polarized state. Alterations in the M1/M2 balance is thought to
contribute to inflammation within atherosclerotic lesions and visceral adipose tissue which,
in turn, can worsen cardiovascular disease and metabolic features in type 2 diabetic
patients.
M1 and M2 are regulated by a complex interplay of soluble signaling molecules, many of which
are substrate of the enzyme DPP-4 (dipeptidyl peptidase-4). Therefore, inhibition of DPP-4
can affect the M1/M2 polarization balance.
In this clinical trial, the investigators will test whether the DPP-4 inhibitor Linagliptin,
compared to placebo, modifies the M1/M2 balance in type 2 diabetic patients with and without
chronic renal failure.
In addition, we will test whether DPP-4 inhibition with Linagliptin acutely affects
endothelial progenitor cells (EPCs), which are vasculoprotective cells implicated in the
pathobiology of diabetic complications.