Upregulation of TNF-alpha and Receptors Contribute to Endothelial Dysfunction in Zucker Diabetic Rats

Diabetes mellitus is a major risk factor to impair endothelial function and induce cardiovascular diseases. TNF-alpha (TNF) is expressed during a variety of inflammatory conditions. We hypothesized that impairment in coronary endothelial function in type 2 diabetes is due to the overexpression of TNF and TNF receptors (TNFRs). Endothelium-dependent (acetylcholine, ACh) and -independent vasodilation (sodium nitroprusside, SNP) of isolated, pressurized (60 cmH(2)O) coronary arteries (50-100 microm) from lean control and Zucker diabetic fatty (ZDF, the model of type 2 diabetes) rats were determined. In lean rats, SNP and ACh induced dose-dependent vasodilation, but dilation to only ACh was blocked by the NOS inhibitor N(G)-monomethyl-L-arginine (L-NMMA, 10 microM). In ZDF rats, dilation to ACh was blunted compared to lean rats, but SNP-induced dilation was comparable. Neutralizing antibodies to TNF, or blockade of NAD(P)H and xanthine oxidase, partially restored endothelium-dependent, NO-mediated vasodilation in isolated coronary arteries in ZDF rats, but anti-TNF did not alter endothelium-dependent vasodilation in lean rats. The mRNA expression of TNF receptor 1 (TNFR1, but not TNFR2) significantly increased in coronary arteries in ZDF rats. Protein expression of TNF and N-Tyr (ONOO(-)) were higher in coronary arteries in ZDF than those in lean rats. Production of H(2)O(2), NAD(P)H oxidase and xanthine oxidase activity were all higher in ZDF rats than those in lean controls; anti-TNF reduces the production of H(2)O(2), N-Tyr expression, NAD(P)H oxidase and xanthine oxidase activity in ZDF rats. These results demonstrate the endothelial dysfunction occurring in type 2 diabetes is the result of effects of the inflammatory cytokine TNF that activates NAD(P)H oxidase and xanthine oxidase; and perhaps acts mainly through the overexpression of TNFR1.