Metformin Modulates Oxidative Stress via Activation of AMPK/NF-κB Signaling in Trisomy 21 Fibroblasts: an in vitro study

Angelika Buczyńska^*Piotr MalinowskiArkadiusz ŻbikowskiAdam KrętowskiMonika Zbucka

• Medical University of Bialystok, Bialystok, Poland

Oxidative stress and impaired antioxidant defenses are key contributors to cellular dysfunction in Trisomy 21 (T21), highlighting the need for targeted therapeutic strategies. This study explores the modulatory ef-fects of metformin on oxidative stress and antioxidant capacity in T21. An in vitro model was employed using human fibroblast cells with T21 (CCL-54 – Detroit 532 and Detroit 539 – CCL-84; ATCC) alongside normal fibroblasts as a control group (PCS-201-012; ATCC). These cells were treated with varying doses of metformin (10 μM, 30 μM, and 50 μM) for 48 hours to assess its pleiotropic protective effects and their impact on oxidative-metabolic cellular profiles. Our results demonstrate that metformin treatment signif-icantly reduced total oxidative capacity (TOC) and levels of oxidative DNA/RNA damage products in T21 cell lines (CCL-84 and CCL-54). Additionally, metformin markedly increased total antioxidant capacity (TAC) in these fibroblasts. Furthermore, metformin influenced key signaling pathways, as evidenced by increased levels of nuclear factor kappa B (NF-κB) and enhanced activity of protein kinase AMP-activated alpha 1 (PRKAA1) and AMP-activated protein kinase (AMPK) in T21 cell lines. These findings highlight metformin's significant role in modulating oxidative stress and inflammation-related mechanisms in T21. Given the growing interest in managing oxidative stress during pregnancies affected by T21, this study presents potential clinical implications for therapeutic intervention.