This result, which could lead to the development of selective and non-invasive therapies for post-bypass surgery, could also provides a possible molecular explanation contributing to the outcome of the recently presented PROactive Study.
Data from the study, presented today at the 41st Annual Meeting of the European Association For the study of Diabetes (EASD), demonstrated that pioglitazone reduces the risk of heart attacks, strokes and death in high-risk patients with Type 2 diabetes.
The PROactive Study demonstrates that the specific diabetes medication, pioglitazone, normally used to control blood glucose, can also significantly improve patient outcomes associated with cardiovascular disease in patients with Type 2 diabetes.
This means that people with Type 2 diabetes can potentially benefit from longer and healthier lives if they are prescribed pioglitazone.
Pioglitazone is one of a group of drugs belonging to the Thiazolidinediones class. These drugs are used to treat insulin-resistance in patients with type 2 diabetes, inhibit vascular cell proliferation by activating a known cancer suppressor gene: p16.
Thiazolidinediones, which also include Avandia (rosiglitazone) and Avandamet (rosiglitazone and metformin) specifically binds to and activates the nuclear receptor Peroxisome Proliferator-Activated Receptor (PPAR) gamma, a protein that sits in the cell nucleus and, when activated, is able to convey specific messages to the transcriptional machinery.
Nikolaus Marx, the leader of the Ulm University team who carried out the clinical aspects of the study, showed rosiglitazone's effectiveness in inhibiting vascular cell proliferation.
"Our in vitro data shows that, when PPARgamma is activated by rosiglitazone, it calls into the picture a very special gene, p16, which is well known as a cancer suppressor gene. p16 then mediates the anti-proliferative effect of rosiglitazone," he said.
"Surgeries like stent and vein grafts can cause excessive cell proliferation and this in turn might result in the occlusion of the vessels," added Florence Gizard, one of the study's authors.