Genomic insights about the effect of sodium-glucose cotransporter 2 inhibitors: a systematic review

IntroductionHeart failure (HF) is a complex clinical syndrome with high morbidity and mortality, significantly burdening healthcare systems worldwide. Despite advances in therapy, effective treatment options remain limited. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for d...

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Main Authors: Pavitraa Saravana Kumar, Yogapriya Chidambaram, G. Shree Devi, Vettriselvi Venkatesan, Ramesh Sankaran, Nagendra Boopathy Senguttuvan, Thanikachalam Sadagopan, Dorairaj Prabhakaran
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Language:English
Published: Frontiers Media S.A. 2025-05-01
Series:Frontiers in Genetics
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Online Access:https://www.frontiersin.org/articles/10.3389/fgene.2025.1571032/full
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author Pavitraa Saravana Kumar
Yogapriya Chidambaram
G. Shree Devi
Vettriselvi Venkatesan
Ramesh Sankaran
Nagendra Boopathy Senguttuvan
Thanikachalam Sadagopan
Dorairaj Prabhakaran
author_facet Pavitraa Saravana Kumar
Yogapriya Chidambaram
G. Shree Devi
Vettriselvi Venkatesan
Ramesh Sankaran
Nagendra Boopathy Senguttuvan
Thanikachalam Sadagopan
Dorairaj Prabhakaran
author_sort Pavitraa Saravana Kumar
collection DOAJ
description IntroductionHeart failure (HF) is a complex clinical syndrome with high morbidity and mortality, significantly burdening healthcare systems worldwide. Despite advances in therapy, effective treatment options remain limited. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for diabetes management, have demonstrated cardiovascular benefits, including reductions in HF hospitalizations and mortality. This systematic review examines the genomic effects of SGLT2 inhibitors in HF patients, focusing on gene expression, inflammatory biomarkers, and potential personalized treatment pathways.MethodsA systematic literature search of various databases was conducted up to November 2024, following PRISMA guidelines. Studies were included if they explored the genomic or molecular impacts of SGLT2 inhibitors in HF. Data extraction and analysis focused on gene expression changes, circulating biomarkers, and potential genomic mechanisms.ResultsOf the 258 identified studies, three met the inclusion criteria. Key findings include: a) SGLT2 inhibitors downregulate pro-inflammatory genes in adipose tissue, reducing immune cell infiltration and ferroptosis; b) Genetic evidence highlights CXCL10 as a mediator of anti-inflammatory effects, with its inhibition linked to reduced HF risk; c) LRRTM2, a protein associated with synaptic formation, emerged as a critical mediator, with genetic links to reduced HF risk via SGLT2 inhibition.DiscussionThis review underscores the genomic mechanisms through which SGLT2 inhibitors provide cardiovascular benefits. Key insights into gene expression modulation and protein interactions reveal pathways for personalized HF treatment. While findings are promising, further large-scale studies are needed to validate these mechanisms and their clinical implications.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024614674.
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spelling doaj-art-812c66933ee24afa92571d88eef0c4d42025-08-20T03:12:38ZengFrontiers Media S.A.Frontiers in Genetics1664-80212025-05-011610.3389/fgene.2025.15710321571032Genomic insights about the effect of sodium-glucose cotransporter 2 inhibitors: a systematic reviewPavitraa Saravana Kumar0Yogapriya Chidambaram1G. Shree Devi2Vettriselvi Venkatesan3Ramesh Sankaran4Nagendra Boopathy Senguttuvan5Thanikachalam Sadagopan6Dorairaj Prabhakaran7Department of Clinical Research, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, IndiaDepartment of Clinical Research, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, IndiaDepartment of Emergency Medicine, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, IndiaDepartment of Human Genetics, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, IndiaDepartment of Cardiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, IndiaDepartment of Cardiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, IndiaDepartment of Cardiology, Sri Ramachandra Institute of Higher Education and Research (SRIHER), Chennai, Tamil Nadu, IndiaExecutive Director, Centre for Chronic Disease Control (CCDC), Delhi, IndiaIntroductionHeart failure (HF) is a complex clinical syndrome with high morbidity and mortality, significantly burdening healthcare systems worldwide. Despite advances in therapy, effective treatment options remain limited. Sodium-glucose cotransporter 2 (SGLT2) inhibitors, initially developed for diabetes management, have demonstrated cardiovascular benefits, including reductions in HF hospitalizations and mortality. This systematic review examines the genomic effects of SGLT2 inhibitors in HF patients, focusing on gene expression, inflammatory biomarkers, and potential personalized treatment pathways.MethodsA systematic literature search of various databases was conducted up to November 2024, following PRISMA guidelines. Studies were included if they explored the genomic or molecular impacts of SGLT2 inhibitors in HF. Data extraction and analysis focused on gene expression changes, circulating biomarkers, and potential genomic mechanisms.ResultsOf the 258 identified studies, three met the inclusion criteria. Key findings include: a) SGLT2 inhibitors downregulate pro-inflammatory genes in adipose tissue, reducing immune cell infiltration and ferroptosis; b) Genetic evidence highlights CXCL10 as a mediator of anti-inflammatory effects, with its inhibition linked to reduced HF risk; c) LRRTM2, a protein associated with synaptic formation, emerged as a critical mediator, with genetic links to reduced HF risk via SGLT2 inhibition.DiscussionThis review underscores the genomic mechanisms through which SGLT2 inhibitors provide cardiovascular benefits. Key insights into gene expression modulation and protein interactions reveal pathways for personalized HF treatment. While findings are promising, further large-scale studies are needed to validate these mechanisms and their clinical implications.Systematic Review Registrationhttps://www.crd.york.ac.uk/prospero/, identifier CRD42024614674.https://www.frontiersin.org/articles/10.3389/fgene.2025.1571032/fullsodium-glucose cotransporter 2 inhibitorsheart failuregenomicsgene expressioninflammatory biomarker
spellingShingle Pavitraa Saravana Kumar
Yogapriya Chidambaram
G. Shree Devi
Vettriselvi Venkatesan
Ramesh Sankaran
Nagendra Boopathy Senguttuvan
Thanikachalam Sadagopan
Dorairaj Prabhakaran
Genomic insights about the effect of sodium-glucose cotransporter 2 inhibitors: a systematic review
Frontiers in Genetics
sodium-glucose cotransporter 2 inhibitors
heart failure
genomics
gene expression
inflammatory biomarker
title Genomic insights about the effect of sodium-glucose cotransporter 2 inhibitors: a systematic review
title_full Genomic insights about the effect of sodium-glucose cotransporter 2 inhibitors: a systematic review
title_fullStr Genomic insights about the effect of sodium-glucose cotransporter 2 inhibitors: a systematic review
title_full_unstemmed Genomic insights about the effect of sodium-glucose cotransporter 2 inhibitors: a systematic review
title_short Genomic insights about the effect of sodium-glucose cotransporter 2 inhibitors: a systematic review
title_sort genomic insights about the effect of sodium glucose cotransporter 2 inhibitors a systematic review
topic sodium-glucose cotransporter 2 inhibitors
heart failure
genomics
gene expression
inflammatory biomarker
url https://www.frontiersin.org/articles/10.3389/fgene.2025.1571032/full
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