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Molecular mechanisms of coronary microvascular endothelial dysfunction in diabetes mellitus: focus on mitochondrial quality surveillance

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Abstract

Coronary microvascular endothelial dysfunction is both a culprit and a victim of diabetes, and can accelerate diabetes-related microvascular and macrovascular complications by promoting vasoconstrictive, pro-inflammatory and pro-thrombotic responses. Perturbed mitochondrial function induces oxidative stress, disrupts metabolism and activates apoptosis in endothelial cells, thus exacerbating the progression of coronary microvascular complications in diabetes. The mitochondrial quality surveillance (MQS) system responds to stress by altering mitochondrial metabolism, dynamics (fission and fusion), mitophagy and biogenesis. Dysfunctional mitochondria are prone to fission, which generates two distinct types of mitochondria: one with a normal and the other with a depolarized mitochondrial membrane potential. Mitochondrial fusion and mitophagy can restore the membrane potential and homeostasis of defective mitochondrial fragments. Mitophagy-induced decreases in the mitochondrial population can be reversed by mitochondrial biogenesis. MQS abnormalities induce pathological mitochondrial fission, delayed mitophagy, impaired metabolism and defective biogenesis, thus promoting the accumulation of unhealthy mitochondria and the activation of mitochondria-dependent apoptosis. In this review, we examine the effects of MQS on mitochondrial fitness and explore the association of MQS disorders with coronary microvascular endothelial dysfunction in diabetes. We also discuss the potential to treat diabetes-related coronary microvascular endothelial dysfunction using novel MQS-altering drugs.

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Authors and Affiliations

  1. The Second Affiliated Hospital of Heilongjiang, University of Chinese Medicine, Harbin, 150001, China

    Danan Sun

  2. Department of Vascular Medicine, Peking University Shougang Hospital, Beijing, 100144, China

    Jin Wang

  3. Department of Chemical Engineering, University of Minnesota-Duluth, Duluth, MN, 55812, USA

    Sam Toan

  4. Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, 19104, USA

    David Muid

  5. Senior Department of Cardiology, The Sixth Medical Center of People’s Liberation Army General Hospital, Beijing, China

    Ruibing Li & Hao Zhou

  6. Guang’anmen Hospital, China Academy of Chinese Medical Sciences, Beijing, 100053, China

    Xing Chang

  7. University of Wyoming College of Health Sciences, Laramie, WY, 82071, USA

    Hao Zhou

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HZ, HZ and XC collected and analyzed all literatures. XC and HZ wrote and revised the original draft. AL, HHW, SW and JR contributed to discussion and revisions of the manuscript. All authors approved the submission of this manuscript.

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Sun, D., Wang, J., Toan, S. et al. Molecular mechanisms of coronary microvascular endothelial dysfunction in diabetes mellitus: focus on mitochondrial quality surveillance. Angiogenesis 25, 307–329 (2022). https://doi.org/10.1007/s10456-022-09835-8

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