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Dexmedetomidine protects against myocardial ischemia reperfusion injury by inhibiting the TLR2‑NF‑κB pathway in diabetic mice

  • Authors:
    • Zhengjie Chen
    • Liangyu Zheng
    • Gang Chen
  • View Affiliations / Copyright

    Affiliations: Department of Anesthesiology, Sir Run Run Shaw Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310016, P.R. China
    Copyright: © Chen et al. This is an open access article distributed under the terms of Creative Commons Attribution License.
  • Article Number: 130
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    Published online on: March 6, 2026
       https://doi.org/10.3892/mmr.2026.13840
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Abstract

Myocardial cells in patients with diabetes mellitus (DM) experience more severe reperfusion injury following heart ischemia compared with those in patients without DM. The inflammatory response plays a key role in the process of myocardial ischemia‑reperfusion (I/R) injury in diabetic patients. Dexmedetomidine (DEX) exhibits anti‑inflammatory properties, indicating it is an effective treatment for diabetic myocardial I/R injury. C57BL/6 mice underwent 30 min of myocardial ischemia followed by 2 h of reperfusion. H9c2 cardiomyocytes were subjected to oxygen‑glucose deprivation/reoxygenation (OGD/R) injury. DEX was administered at the onset of myocardial reperfusion in the mice or during reoxygenation of the H9c2 cells. Additionally, in an in vitro experiment, the Toll like receptor (TLR) 2 agonist Pam3CSK4 (PAM) was co‑administered with DEX. Analysis of in vivo data demonstrated that DEX reduced serum inflammatory factor levels, myocardial infarction area and structural tissue damage following myocardial I/R in diabetic mice. Immunohistochemical staining and western blot analysis revealed that DEX decreased TLR2 expression after myocardial I/R in these mice. Western blot analysis also demonstrated that DEX reduced the expression of NF‑κB and TNF‑α. Analysis of in vitro data indicated that DEX increased the viability of H9c2 cells after OGD/R under high‑glucose conditions. DEX achieved this by inhibiting NF‑κB activation through downregulation of TLR2 expression, thereby reducing the inflammatory response. However, the effects of DEX in H9c2 cells were reversed by the application of the TLR2 agonist PAM. DEX may have protected the hearts of diabetic mice from I/R injury by reducing inflammation through the downregulation of the TLR2 signaling pathway.
View Figures

Figure 1

DEX protects against I/R-induced
myocardial injury in diabetic mice. (A) Evans blue/TTC double
staining of the myocardium in diabetic mice. The white part
represents ischaemic infarcted myocardium, the red part represents
ischaemic non-infarcted myocardium and the blue part represents
normal myocardium. (B) Quantification of the area at risk/left
ventricular area. (C) Quantification of the infarct region/area at
risk. (D) Representative images of cardiomyocytes stained with
H&E. Scale bar, 60 µm. Compared with the SHAM group,
***P<0.001; compared with the I/R group, ##P<0.01;
n=6. IR, ischemia-reperfusion.

Figure 2

Effects of DEX on the levels of IL-6,
IL-10 and MCP-1 in diabetic mice. (A-C) Statistical representations
of the serum levels of IL-6, IL-10 and MCP-1, respectively.
Compared with SHAM group, *P<0.05 and ***P<0.001; Compared
with IR group, #P<0.05, ##P<0.01, n=5.
DEX, dexmedetomidine. MCP-1, Monocyte Chemoattractant Protein-1;
IR, ischemia-reperfusion.

Figure 3

Effect of DEX on myocardial
inflammation induced by I/R in diabetic mice. (A) Representative
images and quantitative analysis of TLR2 IHC staining in the
myocardium. Scale bar=60 µm. The yellow area represents the
positive area. (B) Statistical graph of the TLR2-positive area by
IHC staining. ImageJ image analysis software was used to measure
the grey values for semiquantitative analysis. (C) Western blot
analysis of TLR2, NF-κB, TNF-α and β-actin. (D-F) Statistical
representations of the relative expression of TLR2, NF-κB and
TNF-α, respectively. Compared with SHAM group, *P<0.05; Compared
with IR group, #P<0.05 and ##P<0.01;
n=6. DEX, dexmedetomidine; I/R, ischemia reperfusion; IHC,
immunohistochemical.

Figure 4

DEX reduces OGD/R-induced damage to
H9c2 cells under HG conditions. (A) After H9c2 cell modelling, Cell
Counting Kit-8 assays were used to detect cell viability. (B)
Western blot analysis of TLR2, NF-κB, TNF-α and β-actin was carried
out. (C-E) Statistical representations of the relative expression
of TLR2, NF-κB and TNF-α, respectively. Compared with the CON
group, *P<0.05, **P<0.01 and ***P<0.001; compared with the
HG + OGD group, #P<0.05, ##P<0.01 and
###P<0.001; n=5. DEX, dexmedetomidine; OGD/R,
oxygen-glucose deprivation/reoxygenation; HG, high-glucose.

Figure 5

DEX reduces OGD/R-induced damage to
H9c2 cells under HG conditions through the TLR2-NF-κB pathway. (A)
Western blot analysis of TLR2, NF-κB, TNF-α and β-actin. (B-E)
Statistical representations of the relative expression of TLR2,
NF-κB, IκB-α and TNF-α, respectively. Compared with the HG + OGD
group, *P<0.05, **P<0.01 and ***P<0.001; compared with the
HG + OGD + DEX group, #P<0.05 and
##P<0.01; n=5. DEX, dexmedetomidine; OGD/R,
oxygen-glucose deprivation/reoxygenation; TLR, toll like receptor;
HG, high-glucose; PAM, Pam3CSK4.

Figure 6

Effect of DEX on the activation of
NF-κB. (A) Changes in the NF-κB immunofluorescence staining
intensity of H9c2 cells. NF-κB p65 is stained red, and DAPI was
used to stain the nuclei blue. Original magnification, ×400. (B)
Statistical graph of the NF-κB fluorescence intensity in the
nucleus. Compared with the HG + OGD group, ***P<0.001; compared
with the HG + OGD + DEX group, ##P<0.01; n=3. DEX,
dexmedetomidine; HG, high-glucose; OGD/R, oxygen-glucose
deprivation/reoxygenation; PAM, Pam3CSK4.
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Chen Z, Zheng L and Chen G: Dexmedetomidine protects against myocardial ischemia reperfusion injury by inhibiting the TLR2‑NF‑&kappa;B pathway in diabetic mice. Mol Med Rep 33: 130, 2026.
APA
Chen, Z., Zheng, L., & Chen, G. (2026). Dexmedetomidine protects against myocardial ischemia reperfusion injury by inhibiting the TLR2‑NF‑&kappa;B pathway in diabetic mice. Molecular Medicine Reports, 33, 130. https://doi.org/10.3892/mmr.2026.13840
MLA
Chen, Z., Zheng, L., Chen, G."Dexmedetomidine protects against myocardial ischemia reperfusion injury by inhibiting the TLR2‑NF‑&kappa;B pathway in diabetic mice". Molecular Medicine Reports 33.5 (2026): 130.
Chicago
Chen, Z., Zheng, L., Chen, G."Dexmedetomidine protects against myocardial ischemia reperfusion injury by inhibiting the TLR2‑NF‑&kappa;B pathway in diabetic mice". Molecular Medicine Reports 33, no. 5 (2026): 130. https://doi.org/10.3892/mmr.2026.13840
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Spandidos Publications style
Chen Z, Zheng L and Chen G: Dexmedetomidine protects against myocardial ischemia reperfusion injury by inhibiting the TLR2‑NF‑&kappa;B pathway in diabetic mice. Mol Med Rep 33: 130, 2026.
APA
Chen, Z., Zheng, L., & Chen, G. (2026). Dexmedetomidine protects against myocardial ischemia reperfusion injury by inhibiting the TLR2‑NF‑&kappa;B pathway in diabetic mice. Molecular Medicine Reports, 33, 130. https://doi.org/10.3892/mmr.2026.13840
MLA
Chen, Z., Zheng, L., Chen, G."Dexmedetomidine protects against myocardial ischemia reperfusion injury by inhibiting the TLR2‑NF‑&kappa;B pathway in diabetic mice". Molecular Medicine Reports 33.5 (2026): 130.
Chicago
Chen, Z., Zheng, L., Chen, G."Dexmedetomidine protects against myocardial ischemia reperfusion injury by inhibiting the TLR2‑NF‑&kappa;B pathway in diabetic mice". Molecular Medicine Reports 33, no. 5 (2026): 130. https://doi.org/10.3892/mmr.2026.13840
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