Have dipeptidyl peptidase-4 inhibitors ameliorated the vascular complications of type 2 diabetes in large-scale trials? The potential confounding effect of stem-cell chemokines

Effects of dipeptidyl peptidase-4 inhibition are mediated by potentiation of both stromal cell-derived factor-1 and glucagon-like peptide-1. Dipeptidyl peptidase-4 (DPP-4) inhibitors potentiate the actions of both stromal cell-derived factor-1 (SDF-1) and glucagon-like peptide-1 (GLP-1). These two peptides appear to exert opposing effects on atherosclerotic plaque growth and stability as well as on podocyte injury and glomerulosclerosis in the diabetic kidney. The effects of DPP-4 inhibitors on natriuresis as well as on cardiac inflammation, fibrosis and remodeling are primarily mediated by SDF-