Abstract

Cellular signaling associated with cardiac β-adrenergic receptors (β-AR) is composed of coupled mechanism among β ₁-/β₂-AR and Gs proteins with contribution of constitutive β₃-AR coupling to Gi proteins. However, down-regulation of β-ARs in the heart under pathological conditions is mediated with a signaling G proteins-included mechanism. Additionally, there are serious conflicting data on this field in literature yet. Although some of these conflictions are generally related with either experimental protocols for different approaches or different animal models. To treat cardiovascular disorders, generally, various types of β-blockers are used while their action mechanisms are not fully known yet. Furthermore, although β-blockers are generally used to block the activated β-ARs, they can be used to scavenge free radicals under oxidative stress. Studies, in whole-system, organ or cellular levels, showed that some β-blockers, including timolol, have protective-actions against increased oxidative stress in diseased heart via ROSscavenging. Additionally, it has been mentioned that some β-blockers nicely prevented the development of heart failure in both experimental and clinical studies by restoring sarcoplasmic reticulum (SR) Ca²⁺ release channels, RyR2. Since diabetic cardiomyopathy is recognized due to its diminished responsiveness to β₁-AR agonist stimulation in the heart with an up-regulation of β ₃-AR, inducing a strong negative inotropic effect on left ventricular function, it has been shown that treatment of streptozotocin-diabetic rats with timolol provided a marked cardio-protection. Importantly, it has been also documented that timolol treatment-dependent cardio-protection in diabetic rats includes basically prevention of RyR2- hyperphosphorylation, which, in turn, block Ca²⁺-leakage from SR via scavenging oxidative agents to control redox-state of cardiomyocytes. This action of timolol in diabetic heart is very similar to other known antioxidants, such as N-acetylcysteine or selenium compounds. In this review article, antioxidant-like action of timolol in diabetic cardiomyopathy was summarized in way of comparison with the benefits obtained with other antioxidants in the similar animal model.

Keywords: Antioxidants, Beta-adrenoceptors, calcium-homeostasis, cardiac ryanodine receptors, confocal microscopy, diabetes, heart-function, oxidative stress.

Graphical Abstract