Metformin and its anti-inflammatory and anti-oxidative effects; new concepts

Abstract

Metformin is one of the oldest and commonly used blood sugar lowering drugs, having limited side effects and used as the first line treatment in patients suffering from diabetes mellitus. Moreover, various studies have emphasized on the anti-inflammatory and antioxidant role of metformin, with multiple mechanisms, which activation of AMPK by metformin has had a key role in many of them. During the searches on the internet websites of PubMed, Elsevier, Google Scholar, and Science Direct, 76 papers related to the anti-inflammatory and antioxidant role of metformin were selected and reviewed since 2003 to 2017. At the cellular level, metformin suppresses the inflammation in many cases and reduces or eliminates inflammatory factors mainly through dependent mechanisms and sometimes independent of AMPK at the cellular level and through other ways at the systematic levels. It is also effective in reducing the level of oxidative stress factors by regulating the antioxidant system of the cell. All evidence suggests the antioxidant and anti-inflammatory role of metformin in various conditions. Metformin can be an appropriate treatment option for many diseases, which inflammatory processes and oxidative stress play a role in their pathogenesis.

The Role of Oxidative Stress in Physiopathology and Pharmacological Treatment with Pro- and Antioxidant Properties in Chronic Diseases

“…Some studies show that metformin treatment can reduce MDA levels, increase GSH levels, and decrease inflammatory status [ 88 , 89 ]. Metformin can decrease the production of ROS AMPK induced by decreasing ATP synthesis and NADPH oxidase activity [ 90 ].…”

Effects of guanylurea, the transformation product of the antidiabetic drug metformin, on the health of brown trout (Salmo trutta f. fario)

“…The structurally similar compound guanidine serves as a scavenger for ROS, so it contributes to reducing oxidative stress (Yildiz et al, 1998). The parent compound metformin was also shown to reduce the production of ROS; its anti-oxidative effect is known for type 2 diabetes patients who are prone to oxidative stress (Bonnefont-Rousselot et al, 2003; Bułdak et al, 2014; Dehkordi et al, 2018). However, in a study with Japanese medaka, metformin increased the ROS level in male fish and the catalase activity in female fish, but it also reduced the glutathione level in male fish (Lee et al, 2019).…”

Potensi Ekstrak Etanol Biji Cucurbita moschata terhadap Kadar Malondehaldehid Mencit Model Diabetes

“…Metformin juga meningkatkan pemakaian glukosa oleh sel usus sehingga menurunkan glukosa darah dan juga diduga menghambat absorbsi glukosa di usus sesudah asupan makan [34]. Secara in vivo metformin juga memiliki aktivitas antioksidan dan mampu menurunkan produksi reacktive oxygen species (ROS) [35].…”