Effect of Nonsteroidal Mineralocorticoid Receptor Blocker Esaxerenone on Vasoreactivity to an Endothelial Stimulator in Superior Mesenteric Arteries of Type 2 Diabetic Goto-Kakizaki Rat.

Endothelial dysfunction contributes to cardiometabolic disorders, including hypertension, obesity, and type 2 diabetes. Esaxerenone is a selective, nonsteroidal, high-affinity mineralocorticoid receptor blocker recently approved in Japan for the treatment of hypertension. Although imbalanced signaling between vasorelaxant and vasocontractile factors induced by endothelial stimulation is often observed in type 2 diabetic vessels, the effects of esaxerenone on endothelium-dependent responses in type 2 diabetes remain unclear. The aim of this study was to investigate the effect of esaxerenone on endothelium-dependent responses in superior mesenteric arteries isolated from type 2 diabetic Goto-Kakizaki (GK) rats. It was found that esaxerenone (3 mg/kg/d for 4 weeks, per os (p.o.)) partially ameliorated acetylcholine (ACh)-induced endothelium-derived hyperpolarizing factor (EDHF)-type relaxation and NS309, a potent activator of small- and intermediate-conductance Ca2+-activated K+ channels, -induced relaxation, and reduced ACh-induced endothelium-derived contracting factor (EDCF)-mediated contraction. These results suggest that esaxerenone ameliorates endothelial function through increased EDHF signaling and suppressed EDCF signaling.