Regulating inflammatory cytokines in the diabetic heart

Diabetes mellitus (DM) is an independent cause of cardiomyopathy. It increases the risk of heart failure and mortality, which is not alleviated by intensive glycemic control in clinical trials. Since diabetic cardiomyopathy (DMCM) can not be cured and glycemic control has limited effects on it, novel therapeutic strategies for DMCM are warranted. One of the hallmarks of the DM heart is increased inflammation that contributes to pyroptosis, an inflamamtory cell death mechanism. Pyroptosis results in release of interleukin-1β (IL-1β) and IL-18 inflamamtory cytokines that further increase inflamamtion. Thus, a vicious cycle of inflammation-induced inflammatory cell death continues leading to DMCM. Inflammation also promotes adverse cardiac remodeling leading to DMCM. Thus, the regulation of DM-induced inflammatory cytokines is important. This chapter focuses on the key regulators of inflammatory cytokines in the DM heart and their potential roles as atherapeutic target for DMCM.