Cardiolipin remodeling in diabetic heart

• The review represents the first one on cardiolipin remodeling in diabetic heart.
• Proposed the mechanism responsible for cardiolipin remodeling in diabetic heart.
• Discussed the relevance of cardiolipin remodeling and cardiac function.
• Summarized the possible manipulations of cardiolipin remodeling and their clinical application.

Cardiolipin, a signature phospholipid of mitochondria, is predominantly present in the mitochondrial inner membrane and plays an important role in keeping optimal mitochondrial function. In addition to the cardiolipin content, the composition of four fatty acid chain is thought determine cardiolipin biological function. These acyl chains of cardiolipin are dynamically remodeled via tafazzin, monolysocardiolipin acyltransferase, and acyl-CoA lysocardiolipin acyltransferase especially in the heart under pathological conditions. The major species of cardiolipin in the normal heart, tetralinoleoyl cardiolipin, is dramatically decreased in the diabetic heart, but other species, typically those containing long fatty acyl chains, are increased. This remodeling of cardiolipin has detrimental effects on mitochondrial function and thereafter cardiac function. Approaches for manipulating cardiolipin acyl chains have been examined including via molecular biology and through supplementation of linoleic acid. The efficiency of cardiolipin remodeling and functional improvement is still under investigation.