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Li Y, Lu Z, Kirkwood CL, Kirkwood KL, Wank SA, Li AJ, Lopes-Virella MF, Huang Y. GPR40 deficiency worsens metabolic syndrome-associated periodontitis in mice. J Periodontal Res 2023; 58:575-587. [PMID: 36807310 PMCID: PMC10182248 DOI: 10.1111/jre.13107] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/12/2022] [Revised: 01/13/2023] [Accepted: 01/30/2023] [Indexed: 02/20/2023]
Abstract
BACKGROUND AND OBJECTIVE G protein-coupled receptor 40 (GPR40) is a receptor for medium- and long-chain free fatty acids (FFAs). GPR40 activation improves type 2 diabetes mellitus (T2DM), metabolic syndrome (MetS), and the complications of T2DM and MetS. Periodontitis, a common oral inflammatory disease initiated by periodontal pathogens, is another complication of T2DM and MetS. Since FFAs play a key role in the pathogenesis of MetS which exacerbates periodontal inflammation and GPR40 is a FFA receptor with anti-inflammatory properties, it is important to define the role of GPR40 in MetS-associated periodontitis. MATERIALS AND METHODS We induced MetS and periodontitis by high-fat diet and periodontal injection of lipopolysaccharide (LPS), respectively, in wild-type and GPR40-deficient mice and determined alveolar bone loss and periodontal inflammation using micro-computed tomography, histology, and osteoclast staining. We also performed in vitro study to determine the role of GPR40 in the expression of proinflammatory genes. RESULTS The primary outcome of the study is that GPR40 deficiency increased alveolar bone loss and enhanced osteoclastogenesis in control mice and the mice with both MetS and periodontitis. GPR40 deficiency also augmented periodontal inflammation in control mice and the mice with both MetS and periodontitis. Furthermore, GPR40 deficiency led to increased plasma lipids and insulin resistance in control mice but had no effect on the metabolic parameters in mice with MetS alone. For mice with both MetS and periodontitis, GPR40 deficiency increased insulin resistance. Finally, in vitro studies with macrophages showed that deficiency or inhibition of GPR40 upregulated proinflammatory genes while activation of GPR40 downregulated proinflammatory gene expression stimulated synergistically by LPS and palmitic acid. CONCLUSION GPR40 deficiency worsens alveolar bone loss and periodontal inflammation in mice with both periodontitis and MetS, suggesting that GPR40 plays a favorable role in MetS-associated periodontitis. Furthermore, GPR40 deficiency or inhibition in macrophages further upregulated proinflammatory and pro-osteoclastogenic genes induced by LPS and palmitic acid, suggesting that GPR40 has anti-inflammatory and anti-osteoclastogenic properties.
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Affiliation(s)
- Yanchun Li
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Zhongyang Lu
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
| | - Cameron L. Kirkwood
- Departments of Oral Biology, School of Dental Medicine, University at Buffalo
| | - Keith L. Kirkwood
- Departments of Oral Biology, School of Dental Medicine, University at Buffalo
- Department of Head & Neck/Plastic & Reconstructive Surgery, Roswell Park Comprehensive Cancer Center, Buffalo, New York
| | - Stephen A. Wank
- National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, Maryland
| | - Ai-Jun Li
- Integrative Physiology and Neuroscience, Washington State University, Pullman, Washington
| | - Maria F. Lopes-Virella
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
| | - Yan Huang
- Division of Endocrinology, Diabetes and Metabolic Diseases, Department of Medicine, College of Medicine, Medical University of South Carolina, Charleston, South Carolina
- Ralph H. Johnson Veterans Affairs Medical Center, Charleston, South Carolina
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Ademola SA, Bamikole OJ, Amodu OK. Is TNF alpha a mediator in the co-existence of malaria and type 2 diabetes in a malaria endemic population? Front Immunol 2023; 14:1028303. [PMID: 37215099 PMCID: PMC10196125 DOI: 10.3389/fimmu.2023.1028303] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/25/2022] [Accepted: 04/25/2023] [Indexed: 05/24/2023] Open
Abstract
Malaria remains a disease of public health importance globally, especially in sub-Saharan Africa. Malaria deaths reduced globally steadily between 2000-2019, however there was a 10% increase in 2020 due to disruptions in medical service during the COVID-19 pandemic. Globally, about 96% of malaria deaths occurred in 29 countries; out of which, four countries (Nigeria, the Democratic Republic of the Congo, the Niger, and the United Republic of Tanzania) accounted for just over half of the malaria deaths. Nigeria leads the four countries with the highest malaria deaths (accounting for 31% globally). Parallelly, sub-Saharan Africa is faced with a rise in the incidence of Type 2 diabetes (T2D). Until recently, T2D was a disease of adulthood and old age. However, this is changing as T2D in children and adolescents is becoming an increasingly important public health problem. Nigeria has been reported to have the highest burden of diabetes in Africa with a prevalence of 5.77% in the country. Several studies conducted in the last decade investigating the interaction between malaria and T2D in developing countries have led to the emergence of the intra-uterine hypothesis. The hypothesis has arisen as a possible explanation for the rise of T2D in malaria endemic areas; malaria in pregnancy could lead to intra-uterine stress which could contribute to low birth weight and may be a potential cause of T2D later in life. Hence, previous, and continuous exposure to malaria infection leads to a higher risk of T2D. Current and emerging evidence suggests that an inflammation-mediated link exists between malaria and eventual T2D emergence. The inflammatory process thus, is an important link for the co-existence of malaria and T2D because these two diseases are inflammatory-related. A key feature of T2D is systemic inflammation, characterized by the upregulation of inflammatory cytokines such as tumor necrosis factor alpha (TNF-α) which leads to impaired insulin signaling. Malaria infection is an inflammatory disease in which TNF-α also plays a major role. TNF-α plays an important role in the pathogenesis and development of malaria and T2D. We therefore hypothesize that TNF-α is an important link in the increasing co-existence of T2D.
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Krivosova M, Gondas E, Murin R, Dohal M, Ondrejka I, Tonhajzerova I, Hutka P, Ferencova N, Visnovcova Z, Hrtanek I, Mokry J. The Plasma Levels of 3-Hydroxybutyrate, Dityrosine, and Other Markers of Oxidative Stress and Energy Metabolism in Major Depressive Disorder. Diagnostics (Basel) 2022; 12:diagnostics12040813. [PMID: 35453861 PMCID: PMC9025710 DOI: 10.3390/diagnostics12040813] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2022] [Revised: 03/20/2022] [Accepted: 03/24/2022] [Indexed: 02/01/2023] Open
Abstract
Major depressive disorder (MDD) is a serious mental disease with a pathophysiology that is not yet fully clarified. An increasing number of studies show an association of MDD with energy metabolism alteration and the presence of oxidative stress. We aimed to evaluate plasma levels of 3-hydroxybutyrate (3HB), NADH, myeloperoxidase, and dityrosine (di-Tyr) in adolescent and adult patients with MDD, compare them with healthy age-matched controls, and assess the effect of antidepressant treatment during hospitalisation on these levels. In our study, plasmatic levels of 3HB were elevated in both adolescents (by 55%; p = 0.0004) and adults (by 88%; p < 0.0001) with MDD compared to controls. Levels of dityrosine were increased in MDD adults (by 19%; p = 0.0092) but not adolescents. We have not found any significant effect of antidepressants on the selected parameters during the short observation period. Our study supports the findings suggesting altered energy metabolism in MDD and demonstrates its presence independently of the age of the patients.
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Affiliation(s)
- Michaela Krivosova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (M.K.); (N.F.); (Z.V.)
| | - Eduard Gondas
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (E.G.); (R.M.)
| | - Radovan Murin
- Department of Medical Biochemistry, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (E.G.); (R.M.)
| | - Matus Dohal
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia;
| | - Igor Ondrejka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (I.O.); (P.H.); (I.H.)
| | - Ingrid Tonhajzerova
- Department of Physiology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia;
| | - Peter Hutka
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (I.O.); (P.H.); (I.H.)
| | - Nikola Ferencova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (M.K.); (N.F.); (Z.V.)
| | - Zuzana Visnovcova
- Biomedical Centre Martin, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia; (M.K.); (N.F.); (Z.V.)
| | - Igor Hrtanek
- Psychiatric Clinic, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, University Hospital Martin, 03659 Martin, Slovakia; (I.O.); (P.H.); (I.H.)
| | - Juraj Mokry
- Department of Pharmacology, Jessenius Faculty of Medicine in Martin, Comenius University in Bratislava, 03601 Martin, Slovakia;
- Correspondence:
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Wu L, Jiao Y, Li Y, Jiang J, Zhao L, Li M, Li B, Yan Z, Chen X, Li X, Lu Y. Hepatic Gadd45β promotes hyperglycemia and glucose intolerance through DNA demethylation of PGC-1α. J Exp Med 2021; 218:e20201475. [PMID: 33688917 PMCID: PMC7953268 DOI: 10.1084/jem.20201475] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2020] [Revised: 08/05/2020] [Accepted: 01/14/2021] [Indexed: 11/15/2022] Open
Abstract
Although widely used for their potent anti-inflammatory and immunosuppressive properties, the prescription of glucocorticoid analogues (e.g., dexamethasone) has been associated with deleterious glucose metabolism, compromising their long-term therapeutic use. However, the molecular mechanism remains poorly understood. In the present study, through transcriptomic and epigenomic analysis of two mouse models, we identified a growth arrest and DNA damage-inducible β (Gadd45β)-dependent pathway that stimulates hepatic glucose production (HGP). Functional studies showed that overexpression of Gadd45β in vivo or in cultured hepatocytes activates gluconeogenesis and increases HGP. In contrast, liver-specific Gadd45β-knockout mice were resistant to high-fat diet- or steroid-induced hyperglycemia. Of pathophysiological significance, hepatic Gadd45β expression is up-regulated in several mouse models of obesity and diabetic patients. Mechanistically, Gadd45β promotes DNA demethylation of PGC-1α promoter in conjunction with TET1, thereby stimulating PGC-1α expression to promote gluconeogenesis and hyperglycemia. Collectively, these findings unveil an epigenomic signature involving Gadd45β/TET1/DNA demethylation in hepatic glucose metabolism, enabling the identification of pathogenic factors in diabetes.
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Affiliation(s)
- Ling Wu
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
- Department of Laboratory Animal Science, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Yang Jiao
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yao Li
- Department of Laboratory Animal Science, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Jingjing Jiang
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Lin Zhao
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Menghui Li
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Bin Li
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Zheng Yan
- Department of Assisted Reproduction, Shanghai Ninth People’s Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xuejin Chen
- Department of Laboratory Animal Science, Shanghai Jiao Tong University School of Medicine, Shanghai, China
| | - Xiaoying Li
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
| | - Yan Lu
- Key Laboratory of Metabolism and Molecular Medicine, Ministry of Education, Department of Endocrinology and Metabolism, Zhongshan Hospital, Fudan University, Shanghai, China
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Mantravadi S, George M, Brensinger C, Du M, Baker JF, Ogdie A. Impact of tumor necrosis factor inhibitors and methotrexate on diabetes mellitus among patients with inflammatory arthritis. BMC Rheumatol 2020; 4:39. [PMID: 32905192 PMCID: PMC7466800 DOI: 10.1186/s41927-020-00138-3] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/11/2020] [Accepted: 05/06/2020] [Indexed: 01/03/2023] Open
Abstract
Background To determine whether initiation of a tumor necrosis factor inhibitor (TNFi) or methotrexate improves hemoglobin A1c in patients with psoriatic arthritis (PsA), rheumatoid arthritis (RA), or ankylosing spondylitis (AS) who also have diabetes mellitus (DM). Methods A retrospective cohort study was conducted in Optum's de-identified Clinformatics® Data Mart Database, an administrative claims database, using data from 2000 to 2014. Patients with PsA, RA, or AS, with DM (defined by ICD-9-CM codes) and/or HbA1c ≥7%, who newly initiated either a TNFi, MTX, or metformin (positive control) were identified. The change in HbA1c after drug initiation was calculated. Statistical differences in the change in HbA1c between drugs were assessed using the Wilcoxon rank sum test and linear regression models adjusting for potential confounders. Results Among 10,389 drug initiations in 9541 patients with PsA, RA, or AS, and available HbA1c values, HbA1c was ≥7 at baseline in 254 (35%) TNFi initiations, 361(37%) MTX initiations, and 2144 (50%) metformin initiations. Median HbA1c change was - 0.35 (IQR -1.10, 0.30) after TNFi initiation, - 0.40 (IQR -1.20, 0.30) after MTX initiation, and - 0.80 (IQR -1.60, - 0.10) after metformin initiation. In adjusted analyses, TNFi initiators had less of a decrease in HbA1c compared to MTX initiators (β 0.22, 95% CI: 0.004, 0.43), p = 0.046. Metformin initiators had a significantly greater decrease in HbA1c than MTX, β - 0.38 (95% CI: - 0.52, - 0.23), p < 0.001. Glucocorticoid use was not accounted for in the models. Conclusion HbA1c decreased with TNFi initiation or MTX initiation. Reductions in HbA1c after initiation of a TNFi or MTX are about half (~ 0.4 units) the decrease observed after initiation of metformin.
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Affiliation(s)
- Santhi Mantravadi
- Department of Pharmacology and Experimental Therapeutics, Thomas Jefferson University, 132 South 10th Street, 1170 Main Building, Philadelphia, PA 19107-5244 USA.,Department of Medicine, Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania, White Building Rm 5023, 3400 Spruce St, Philadelphia, PA 19104 USA
| | - Michael George
- Department of Medicine, Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania, White Building Rm 5023, 3400 Spruce St, Philadelphia, PA 19104 USA.,Department of Biostatistics, Epidemiology, and Informatics, Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Dr, Philadelphia, PA 19104 USA
| | - Colleen Brensinger
- Department of Biostatistics, Epidemiology, and Informatics, Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Dr, Philadelphia, PA 19104 USA
| | - Min Du
- Department of Biostatistics, Epidemiology, and Informatics, Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Dr, Philadelphia, PA 19104 USA
| | - Joshua F Baker
- Department of Medicine, Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania, White Building Rm 5023, 3400 Spruce St, Philadelphia, PA 19104 USA.,Department of Biostatistics, Epidemiology, and Informatics, Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Dr, Philadelphia, PA 19104 USA
| | - Alexis Ogdie
- Department of Medicine, Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania, White Building Rm 5023, 3400 Spruce St, Philadelphia, PA 19104 USA.,Department of Biostatistics, Epidemiology, and Informatics, Division of Rheumatology, Perelman School of Medicine, University of Pennsylvania, 423 Guardian Dr, Philadelphia, PA 19104 USA
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Abstract
Chronic low-grade inflammation has been observed in major depression and other major psychiatric disorders and has been implicated in metabolic changes that are commonly associated with these disorders. This raises the possibility that the effects of dysfunctional metabolism may facilitate changes in neuronal structure and function which contribute to neuroprogression. Such changes may have implications for the progress from major depression to dementia in the elderly patient. The purpose of this review is to examine the contribution of inflammation and hypercortisolaemia, which are frequently associated with major depression, to neurodegeneration and how they detrimentally impact on brain energy metabolism. A key factor in these adverse events is insulin insensitivity caused by pro-inflammatory cytokines in association with desensitised glucocorticoid receptors. Identifying the possible metabolic changes initiated by inflammation opens new targets to ameliorate the adverse metabolic changes. This has resulted in the identification of dietary and drug targets which are of interest in the development of a new generation of psychotropic drugs.
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Bedi O, Aggarwal S, Trehanpati N, Ramakrishna G, Krishan P. Molecular and Pathological Events Involved in the Pathogenesis of Diabetes-Associated Nonalcoholic Fatty Liver Disease. J Clin Exp Hepatol 2019; 9:607-618. [PMID: 31695251 PMCID: PMC6823706 DOI: 10.1016/j.jceh.2018.10.004] [Citation(s) in RCA: 39] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/27/2018] [Accepted: 10/30/2018] [Indexed: 12/12/2022] Open
Abstract
Diabetes mellitus is a rising epidemic in most part of the world and is often associated with multiple organ disorders such as kidney, liver, and cardiovascular diseases. Liver is a major metabolic hub, and the metabolic disorders associated with diabetes result in liver dysfunctions culminating in spectrum of liver diseases such as fatty liver disorders, cirrhosis, and hepatocellular carcinoma. The intervention strategies to prevent diabetes-associated liver injury require an overall understanding of the key factors and molecular pathways which can be strategically targeted. The present review focuses on some of the key aspects of fatty acid metabolism, fetuin-A regulation, inflammatory pathways, and genetic factors associated with insulin resistance, dyslipidemia, hyperglycemia, oxidative stress, and so on involved in the nexus between diabetes and liver injury. Further recent interventions, pharmacological target, and newer therapeutic agents are discussed briefly for the better clinical management of diabetes-associated hepatic disorders.
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Key Words
- AP-1, Activator protein 1
- DLI, diabetic liver injury
- DM, diabetes mellitus
- DMPs, Damage-associated molecular patterns
- FFA, free fatty acid
- FOXO1, Forkhead box protein O1
- FetA, fetuin-A
- G6Pase, Glucose-6-phosphatase
- HCC, hepatocellular carcinoma
- IKK, IκB kinase
- IL, interleukin
- IRS2, Insulin receptor substrate-2
- IκB, Inhibitor of Kb
- LPS, Lipopolysaccharide
- MD2, Myeloid differentiation protein-2
- MMP, matrix metalloproteinase
- MyD88, Myeloid differentiation factor 88
- NAFLD, nonalcoholic fatty liver disease
- NASH, nonalcoholic steatohepatitis
- NFe κB, Nuclear factor-κB
- NIDDM, noninsulin dependent diabetes mellitus
- PC, Pyruvate carboxylase
- PEPCK, Phosphoenolpyruvate carboxykinase
- PIP3, Phosphatidyl inositol (3, 4, 5)-triphosphate
- T2DM, type 2 diabetes mellitus
- TLR4, Toll-like receptor
- TNF, tumor necrosis factor
- Th 17, T helper 17 cells
- VLDL, very low–density lipoprotein
- diabetes mellitus
- diabetic liver injury
- fetuin-A
- free fatty acid
- inflammatory mediators
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Affiliation(s)
- Onkar Bedi
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, India
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Savera Aggarwal
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Nirupma Trehanpati
- Department of Molecular and Cellular Medicine, Institute of Liver and Biliary Sciences, New Delhi, India
| | - Gayatri Ramakrishna
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, India
| | - Pawan Krishan
- Department of Pharmaceutical Sciences and Drug Research, Punjabi University, Patiala, Punjab, India
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Wynn A, Vacheron A, Zuber J, Solomon SS. Metformin Associated With Increased Survival in Type 2 Diabetes Patients With Pancreatic Cancer and Lymphoma. Am J Med Sci 2019; 358:200-203. [PMID: 31324361 DOI: 10.1016/j.amjms.2019.06.002] [Citation(s) in RCA: 17] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2019] [Revised: 05/03/2019] [Accepted: 06/06/2019] [Indexed: 01/01/2023]
Abstract
BACKGROUND The biguanide drug metformin is one of the most commonly used medications for the treatment of type 2 diabetes mellitus. Diabetics are at an increased risk for cancer. Previous studies have demonstrated improved outcomes in patients taking metformin suffering from prostate, colon, lung, thyroid, and esophageal cancers. Metformin's main antineoplastic mechanism of action is thought to be mediated through inhibition of mammalian target of rapamycin, inhibition of hypoxia-inducible factor 1 (HIF-1) alpha, and activation of p53. We investigated the overall survival of type 2 diabetic patients on metformin with pancreatic cancer and lymphoma using the Computerized Patient Record System at the Veterans Affairs Medical Center, Memphis TN. METHODS Lymphoma and pancreatic cancer patients with type 2 diabetes were sorted into an experimental (metformin) group and a control (nonmetformin) group. Patients were compared on baseline characteristics including race, body mass index, and age. Cancer outcomes including overall survival, metastasis, recurrences, and incidence of new malignancies were recorded. Hemoglobin A1C, creatinine and cancer treatment modalities were recorded and compared. Statistical analyses used included unpaired t tests and Chi-squared tests. RESULTS There was significantly greater overall long-term survival in the metformin group compared to the nonmetformin group for lymphoma (5.89 vs 1.29 years, P < 0.001) and for pancreatic cancer (0.68 vs 0.22 years, P = 0.016). Cancer treatment modalities in both groups were comparable. CONCLUSIONS Metformin is associated with a significant, positive effect of increased overall survival in type 2 diabetes patients with pancreatic cancer and lymphoma. These results are encouraging, and prospective studies should be done to further investigate metformin's effects in cancer.
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Affiliation(s)
- Anne Wynn
- Department of Medicine/Endocrinology, Division of Endocrinology, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Albert Vacheron
- Department of Medicine/Endocrinology, Division of Endocrinology, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Jeffrey Zuber
- Department of Research Services, Veterans Affairs Medical Center, Memphis, Tennessee; Department of Preventive Medicine, University of Tennessee Health Science Center, Memphis, Tennessee
| | - Solomon S Solomon
- Department of Medicine/Endocrinology, Division of Endocrinology, University of Tennessee Health Science Center, Memphis, Tennessee; Department of Research Services, Veterans Affairs Medical Center, Memphis, Tennessee.
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Kawano A, Shigematsu H, Miki K, Ichiki Y, Morita C, Yanagita K, Takahashi K, Dohmen K, Nomura H, Ishibashi H, Shimoda S. Diabetes Mellitus Prevents an Improvement in the Serum Albumin Level During Interferon-free Sofosbuvir-based Therapy for Chronic Hepatitis C Patients: A Multi-institutional Joint Study. Intern Med 2018; 57:1533-1542. [PMID: 29321441 PMCID: PMC6028685 DOI: 10.2169/internalmedicine.9857-17] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/20/2017] [Accepted: 09/28/2017] [Indexed: 11/06/2022] Open
Abstract
Objective Interferon-free regimens of direct-acting antiviral agents have improved the treatment response for chronic hepatitis C virus (HCV) infection, and improvement in the serum albumin level during interferon-free therapy has been reported. The aim of this study was to identify the factors that influence the improvement in the serum albumin level in patients receiving interferon-free antiviral therapy. Methods This retrospective, multicenter study consisted of 471 Japanese patients with chronic hepatitis and compensated liver cirrhosis infected with HCV who completed 12-week interferon-free sofosbuvir (SOF)-based therapy [SOF plus ledipasvir for genotype 1 (n=276) and SOF with ribavirin for genotype 2 (n=195)]. We evaluated the changes in the serum albumin level from baseline to the end of treatment (ΔAlb). Results When compared with the normal-albumin group (baseline serum albumin >35 g/L, n=406), the low-albumin group (baseline serum albumin ≤35 g/L, n=65) showed a significant increase in the mean ΔAlb (5.5 g/L vs. 1.0 g/L, p<0.001). In the low-albumin group, a multivariate logistic regression analysis extracted diabetes mellitus as a negative predictive factor of median ΔAlb >5.0 g/L (odds ratio: 0.19, 95% confidence interval: 0.048-0.79, p=0.020). In the low-albumin group, the mean ΔAlb was significantly lower in the diabetic patients (n=14) than in the non-diabetic patients (n=51) (3.9 g/L and 5.7 g/L, p=0.049). Conclusion Interferon-free SOF-based therapy significantly improved the serum albumin in the low-albumin group patients with chronic HCV infection. However, the improvement in the serum albumin level was significantly lower in the diabetic patients than in the non-diabetic patients.
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Affiliation(s)
- Akira Kawano
- Department of Internal Medicine, Kitakyushu Municipal Medical Center, Japan
| | | | - Koichiro Miki
- Department of Internal Medicine, Kitakyushu Municipal Medical Center, Japan
| | - Yasunori Ichiki
- Department of Internal Medicine, Japan Community Health care Organization Kyushu Hospital, Japan
| | - Chie Morita
- Department of Internal Medicine, JR Kyushu Hospital, Japan
| | | | | | | | | | - Hiromi Ishibashi
- Department of Hepato-Biliary-Pancreatic Medicine, Fukuoka Sanno Hospital, Japan
| | - Shinji Shimoda
- Department of Medicine and Biosystemic Science, Graduate School of Medical Sciences, Kyushu University, Japan
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Jia B, Yu D, Yu G, Cheng Y, Wang Y, Yi X, Li X, Wang Y. Naringenin improve hepatitis C virus infection induced insulin resistance by increase PTEN expression via p53-dependent manner. Biomed Pharmacother 2018; 103:746-754. [PMID: 29684853 DOI: 10.1016/j.biopha.2018.04.110] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/23/2018] [Revised: 04/13/2018] [Accepted: 04/13/2018] [Indexed: 02/07/2023] Open
Abstract
Hepatitis C virus (HCV) infection may finally lead to hepatocellular carcinoma (HCC), and also associated with insulin resistance (IR). Naringenin (NGEN), a flavonoid found in grapefruit, has anti-virus, anti-inflammation and insulin sensitization effects. In the present study we examined the effects of NGEN on HCV core protein (HCVCP) infection induced IR and investigated the mechanism involved. We found that NGEN ameliorated IR and glucose tolerance in HCVCP infected mice by increase the phosphorylation of Akt at both Ser473 and Thr308 site, and also inhibited the inflammation cytokine production and T-cell immune response. Similar to the in vivo results, NGEN also improved the insulin response and showed anti-inflammation effect in HCVCP infected Huh-7.5.1 cells. In addition, NGEN up-regulated the phosphatase and tensin homolog deleted on chromosome ten (PTEN) both in protein and mRNA levels. Furthermore, overexpress of PTEN abolished the HCVCP-stimulated IR and decreased the inflammation cytokine release. NGEN also blocked the interaction between HCVCP and p53, upregulated the endogenous p21/waf1 expression which indiacting the activation of p53. The p53 wild type could upregulate NGEN-stimulated PTEN expression while R273H mut-p53 showed no similar function. Our data reveals that NGEN increases insulin sensitivity in HCVCP infected liver by up-regulating PTEN in p53-dependent manner.
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Affiliation(s)
- Benli Jia
- Department of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China
| | - Dongsheng Yu
- Department of Chinese Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China; Department of Pharmacology, School of Basic Medical Science, Nanjing Medical University, 101 Longmian Rd, Nanjing, Jiangsu, 211166, China
| | - Gang Yu
- Department of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China
| | - Yunsheng Cheng
- Department of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China
| | - Yang Wang
- Department of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China
| | - Xiaoqiang Yi
- Department of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China
| | - Xiaoping Li
- Department of Chinese Medicine, The First Affiliated Hospital of Zhengzhou University, Zhengzhou, Henan, 450052, China
| | - Yong Wang
- Department of General Surgery, The Second Affiliated Hospital of Anhui Medical University, Hefei, Anhui, 230601, China.
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11
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Paschou SA, Kothonas F, Lafkas A, Myroforidis A, Loi V, Terzi T, Karagianni O, Poulou A, Goumas K, Vryonidou A. Favorable Effect of Anti-TNF Therapy on Insulin Sensitivity in Nonobese, Nondiabetic Patients with Inflammatory Bowel Disease. Int J Endocrinol 2018; 2018:6712901. [PMID: 29576769 PMCID: PMC5859792 DOI: 10.1155/2018/6712901] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/11/2017] [Accepted: 01/17/2018] [Indexed: 12/18/2022] Open
Abstract
BACKGROUND The aim of this study was to investigate the effect of anti-TNF therapy on glucose and lipid metabolism in nondiabetic, nonobese patients with inflammatory bowel disease (IBD). PATIENTS AND METHODS We studied 44 patients with IBD, without a known history of diabetes. Three of the patients were diagnosed with overt diabetes and were excluded. Eighteen of the remaining patients (9 M/9 F, 33.6 ± 8.8 years) were on anti-TNF therapy for longer than 1 year, while 23 patients (16 M/7 F, 38.7 ± 12.5 years) were treated with aminosalicylates (AMSs). Twelve of the patients from the second group were then treated with anti-TNF and reassessed 6 months later. Fasting glucose, insulin, c-peptide, HbA1c, lipid, CRP, and fibrinogen levels were determined, and HOMA-IR index was calculated in all patients. RESULTS Patients from the two therapy groups were matched for age and BMI and were not obese. We did not find any differences between patients from the two therapy groups regarding fasting glucose, c-peptide, HbA1c, total cholesterol, HDL, LDL, triglycerides, CRP, and HOMA-IR index. In patients who were treated for 6 months with anti-TNF, a statistically significant decrease in insulin (before 15.5 ± 5.9 versus after 9.9 ± 2.9 μIU/ml, p = 0.042) and c-peptide (before 2.4 ± 1 versus after 1.3 ± 0.4 ng/ml, p = 0.030) levels as well as the HOMA-IR index (before 4.2 ± 1.9 versus after 2.2 ± 0.9, p = 0.045) was observed, without any changes in weight, BMI, glucose, HbA1c, lipid, CRP, and fibrinogen levels. CONCLUSION Anti-TNF therapy exerts a favorable effect on insulin sensitivity, while it has no effect on lipid levels in nondiabetic, nonobese patients with inflammatory bowel disease.
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Affiliation(s)
- Stavroula A. Paschou
- Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece
| | - Fotios Kothonas
- Department of Gastroenterology, Hellenic Red Cross Hospital, Athens, Greece
| | - Apostolos Lafkas
- Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece
| | | | - Vasiliki Loi
- Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece
| | - Thomais Terzi
- Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece
| | - Olympia Karagianni
- Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece
| | - Androniki Poulou
- Department of Gastroenterology, Hellenic Red Cross Hospital, Athens, Greece
| | | | - Andromachi Vryonidou
- Department of Endocrinology and Diabetes, Hellenic Red Cross Hospital, Athens, Greece
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12
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Akash MSH, Rehman K, Liaqat A. Tumor Necrosis Factor-Alpha: Role in Development of Insulin Resistance and Pathogenesis of Type 2 Diabetes Mellitus. J Cell Biochem 2017; 119:105-110. [PMID: 28569437 DOI: 10.1002/jcb.26174] [Citation(s) in RCA: 328] [Impact Index Per Article: 46.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2017] [Accepted: 05/31/2017] [Indexed: 12/12/2022]
Abstract
Pathogenesis of type 2 diabetes mellitus (T2DM) and development of insulin resistance are characterized by multi-stimuli factors notably glucolipotoxicity, generation of reactive oxygen species (ROS), epigenetic factors, activation of various transcriptional mediated pathways along with the augmented levels of various pro-inflammatory cytokines. Among the various pro-inflammatory cytokines, tumor necrosis factor-alpha (TNF-α) is one the most important pro-inflammatory mediator that is critically involved in the development of insulin resistance and pathogenesis of T2DM. TNF-α is mainly produced in adipocytes and/or peripheral tissues, and induces tissue-specific inflammation through the involvement of generation of ROS and activation of various transcriptional mediated pathways. The raised level of TNF-α induces insulin resistance in adipocytes and peripheral tissues by impairing the insulin signaling through serine phosphorylation that leads to the development of T2DM. Anti-TNF-α treatment strategies have been developed to reduce the incidence of insulin resistance and development of T2DM. In this article, we have briefly described how TNF-α plays crucial role to induce insulin resistance and pathogenesis of T2DM. To block the inflammatory responses by blocking TNF-α and TNF-α signaling may be an effective strategy for the treatment of insulin resistance and T2DM. J. Cell. Biochem. 119: 105-110, 2018. © 2017 Wiley Periodicals, Inc.
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Affiliation(s)
| | - Kanwal Rehman
- Institute of Pharmacy, Physiology and Pharmacology, University of Agriculture, Faisalabad, Pakistan
| | - Aamira Liaqat
- Department of Pharmaceutical Chemistry, Government College University, Faisalabad, Pakistan.,Department of Biochemistry, Government College University, Faisalabad, Pakistan
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13
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Franklin JL, Bennett WL, Messina JL. Insulin attenuates TNFα-induced hemopexin mRNA: An anti-inflammatory action of insulin in rat H4IIE hepatoma cells. Biochem Biophys Rep 2017; 9:211-216. [PMID: 28956007 PMCID: PMC5614554 DOI: 10.1016/j.bbrep.2016.12.013] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/24/2016] [Revised: 11/15/2016] [Accepted: 12/21/2016] [Indexed: 12/20/2022] Open
Abstract
Proinflammatory cytokines, including TNF-α and IL-6, can contribute to insulin resistance. Conversely, insulin has some actions that can be considered anti-inflammatory. Hemopexin is a Class 2 acute phase reactant and control of its transcription is predominantly regulated by IL-6, with TNF-α and IL-1β also inducing hemopexin gene expression. Thus, we asked whether insulin could inhibit the ability of TNF-α to stimulate hemopexin mRNA expression. In cultured rat hepatoma (H4IIE) cells, TNF-α significantly increased hemopexin mRNA accumulation. The TNF-α-induced increase of hemopexin mRNA was dramatically attenuated by insulin, even though TNF-α reduced peak insulin activation of ERK. Thus, even though TNF-α can contribute to insulin resistance, the residual insulin response was still able to counteract TNF-α actions. The TNF-α-induced increase of hemopexin mRNA was dramatically attenuated by insulin. This occurred even though TNF-α significantly decreased insulin activation of ERK. This suggests an additional mechanism for the anti-inflammatory action of insulin. Cytokine-induced insulin resistance does not abolish insulin’s anti-inflammatory effect.
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Affiliation(s)
- J Lee Franklin
- University of Alabama at Birmingham, Department of Pathology, Division of Molecular and Cellular Pathology, Birmingham, AL 35294, United States
| | - William L Bennett
- Yale University, Interventional Cardiology, New Haven, CT 06510, United States
| | - Joseph L Messina
- University of Alabama at Birmingham, Department of Pathology, Division of Molecular and Cellular Pathology, Birmingham, AL 35294, United States.,Veterans Administration Medical Center, Birmingham, AL 35294, United States
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14
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Durmanova AK, Otarbayev NK, Kaiyrlykyzy A, Zhangazieva KK, Ibrayeva ZN, Donenbayeva GB, Zhusupova ZT, Saidakhmetov АS, Temirgaliyeva GS, Salykbayeva ZK, Tazhigulova ZM, Yensebayeva АM, Seksembayeva КK, Vasilenko ОK, Timanova S, Akkozhina B. [Ovarian reserve and adipokine levels in reproductive-aged obese women]. TERAPEVT ARKH 2016; 88:46-50. [PMID: 27801419 DOI: 10.17116/terarkh2016881046-50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022]
Abstract
AIM To investigate the relationship of the ovarian reserve to the levels of adipokines and sex hormones in reproductive-aged women with abdominal obesity. SUBJECTS AND METHODS A total of 157 women aged 18 to 45 years with a body mass index (BMI) of more than 30 kg/m2 were examined (a study group). A control group consisted of 93 women aged 18-45 years with a BMI of less than 25 kg/m2. Anthropometric and carbohydrate and lipid metabolic parameters and the levels of sex hormones, anti-Müllerian hormone, resistin, and adiponectin were investigated. RESULTS The mean age of the participants with a BMI of more than 30 kg/m2 was 33.1±6.1 years and that of those with a BMI of less than 25-30 kg/m2 was 32.8±6.2 years. No statistically significant differences were found in age, ethnicity, and marital status between the participants of both groups; however, there was a statistically significant difference in education levels - 76.3% of the women with a BMI of less than 25 kg/m2 (p<0.0001) had higher education. The obese patients were found to have a statistically significant increase in the levels of insulin, HOMA-IR, glucose, total cholesterol, low-density lipoproteins, thyrotrophic hormone, testosterone, and resistin and a decrease in those of high-density lipoproteins, adiponectin, and anti-Müllerian hormone. Comparative analysis made in the obese patients revealed that there was a statistically significant correlation of anti-Müllerian hormone values and hormonal status with the levels of follicle-stimulating hormone (p=0.0026) and resistin (p=0.0323). CONCLUSION The ovarian reserve decreases and the processes of reproductive system aging accelerate in reproductive-aged women with abdominal obesity in the presence of insulin resistance and hyperinsulinemia.
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Affiliation(s)
- A K Durmanova
- Republican Diagnostic Center, Astana, Republic of Kazakhstan
| | - N K Otarbayev
- National Medical Holding, Astana, Republic of Kazakhstan
| | - A Kaiyrlykyzy
- Republican Diagnostic Center, Astana, Republic of Kazakhstan, National Medical Holding, Astana, Republic of Kazakhstan, Center for Life Sciences, Nazarbaev University, Astana, Republic of Kazakhstan
| | | | - Zh N Ibrayeva
- Republican Diagnostic Center, Astana, Republic of Kazakhstan
| | - G B Donenbayeva
- Republican Diagnostic Center, Astana, Republic of Kazakhstan
| | - Zh T Zhusupova
- Republican Diagnostic Center, Astana, Republic of Kazakhstan
| | | | | | | | | | - А M Yensebayeva
- Republican Diagnostic Center, Astana, Republic of Kazakhstan
| | | | - О K Vasilenko
- Republican Diagnostic Center, Astana, Republic of Kazakhstan
| | - S Timanova
- Republican Diagnostic Center, Astana, Republic of Kazakhstan
| | - B Akkozhina
- Republican Diagnostic Center, Astana, Republic of Kazakhstan
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15
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da Costa RM, Neves KB, Mestriner FL, Louzada-Junior P, Bruder-Nascimento T, Tostes RC. TNF-α induces vascular insulin resistance via positive modulation of PTEN and decreased Akt/eNOS/NO signaling in high fat diet-fed mice. Cardiovasc Diabetol 2016; 15:119. [PMID: 27562094 PMCID: PMC5000486 DOI: 10.1186/s12933-016-0443-0] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2016] [Accepted: 08/18/2016] [Indexed: 12/27/2022] Open
Abstract
BACKGROUND High fat diet (HFD) induces insulin resistance in various tissues, including the vasculature. HFD also increases plasma levels of TNF-α, a cytokine that contributes to insulin resistance and vascular dysfunction. Considering that the enzyme phosphatase and tension homologue (PTEN), whose expression is increased by TNF-α, reduces Akt signaling and, consequently, nitric oxide (NO) production, we hypothesized that PTEN contributes to TNF-α-mediated vascular resistance to insulin induced by HFD. Mechanisms underlying PTEN effects were determined. METHODS Mesenteric vascular beds were isolated from C57Bl/6J and TNF-α KO mice submitted to control or HFD diet for 18 weeks to assess molecular mechanisms by which TNF-α and PTEN contribute to vascular dysfunction. RESULTS Vasodilation in response to insulin was decreased in HFD-fed mice and in ex vivo control arteries incubated with TNF-α. TNF-α receptors deficiency and TNF-α blockade with infliximab abolished the effects of HFD and TNF-α on insulin-induced vasodilation. PTEN vascular expression (total and phosphorylated isoforms) was increased in HFD-fed mice. Treatment with a PTEN inhibitor improved insulin-induced vasodilation in HFD-fed mice. TNF-α receptor deletion restored PTEN expression/activity and Akt/eNOS/NO signaling in HFD-fed mice. CONCLUSION TNF-α induces vascular insulin resistance by mechanisms that involve positive modulation of PTEN and inhibition of Akt/eNOS/NO signaling. Our findings highlight TNF-α and PTEN as potential targets to limit insulin resistance and vascular complications associated with obesity-related conditions.
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Affiliation(s)
- Rafael Menezes da Costa
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil.
| | - Karla Bianca Neves
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Fabíola Leslie Mestriner
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Paulo Louzada-Junior
- Division of Clinical Immunology, Department of Clinical Medicine, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Thiago Bruder-Nascimento
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
| | - Rita C Tostes
- Department of Pharmacology, Ribeirao Preto Medical School, University of Sao Paulo, Ribeirao Preto, SP, Brazil
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16
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Wan Y, Garner J, Wu N, Phillip L, Han Y, McDaniel K, Annable T, Zhou T, Francis H, Glaser S, Huang Q, Alpini G, Meng F. Role of stem cells during diabetic liver injury. J Cell Mol Med 2016; 20:195-203. [PMID: 26645107 PMCID: PMC4727564 DOI: 10.1111/jcmm.12723] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2015] [Accepted: 09/24/2015] [Indexed: 12/18/2022] Open
Abstract
Diabetes mellitus is one of the most severe endocrine metabolic disorders in the world that has serious medical consequences with substantial impacts on the quality of life. Type 2 diabetes is one of the main causes of diabetic liver diseases with the most common being non-alcoholic fatty liver disease. Several factors that may explain the mechanisms related to pathological and functional changes of diabetic liver injury include: insulin resistance, oxidative stress and endoplasmic reticulum stress. The realization that these factors are important in hepatocyte damage and lack of donor livers has led to studies concentrating on the role of stem cells (SCs) in the prevention and treatment of liver injury. Possible avenues that the application of SCs may improve liver injury include but are not limited to: the ability to differentiate into pancreatic β-cells (insulin producing cells), the contribution for hepatocyte regeneration, regulation of lipogenesis, glucogenesis and anti-inflammatory actions. Once further studies are performed to explore the underlying protective mechanisms of SCs and the advantages and disadvantages of its application, there will be a greater understand of the mechanism and therapeutic potential. In this review, we summarize the findings regarding the role of SCs in diabetic liver diseases.
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Affiliation(s)
- Ying Wan
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
- Department of Pathophysiology, Key Lab for Shock and Microcirculation Research, Southern Medical University, Guangzhou, China
| | - Jessica Garner
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Nan Wu
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
| | - Levine Phillip
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Yuyan Han
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
| | - Kelly McDaniel
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Tami Annable
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Tianhao Zhou
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Heather Francis
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
| | - Shannon Glaser
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
| | - Qiaobing Huang
- Department of Pathophysiology, Key Lab for Shock and Microcirculation Research, Southern Medical University, Guangzhou, China
| | - Gianfranco Alpini
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
| | - Fanyin Meng
- Research, Central Texas Veterans Health Care System, Temple, TX, USA
- Department of Internal Medicine, Scott & White Digestive Disease Research Center, Texas A&M University Health Science Center and Baylor Scott & White Healthcare, Temple, TX, USA
- Academic Operations, Baylor Scott & White Healthcare, Temple, TX, USA
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17
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Bulger DA, Conley J, Conner SH, Majumdar G, Solomon SS. Role of PTEN in TNFα induced insulin resistance. Biochem Biophys Res Commun 2015; 461:533-6. [PMID: 25918024 DOI: 10.1016/j.bbrc.2015.04.063] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/06/2015] [Accepted: 04/10/2015] [Indexed: 10/23/2022]
Abstract
AIMS/HYPOTHESIS PTEN may play a reversible role in TNFα induced insulin resistance, which has been linked to obesity-associated insulin resistance (IR). METHODS Western blots for PTEN and p-Akt were performed on H-411E liver cells incubated with insulin, TNFα, and in selected experiments VO-OHpic vanadium complex in the presence and absence of PTEN siRNA. Total PTEN was compared to β-actin loading control and p-Akt was compared to total Akt. RESULTS Western blot and Real Time RT-PCR experiments showed increased PTEN after TNFα treatment (p = 0.04); slightly decreased PTEN after insulin treatment; and slightly increased PTEN after insulin + TNFα treatment. PTEN siRNA markedly inhibited the TNFα-induced increase in PTEN (p < 0.01) without significantly changing the p-Akt levels. The vanadium complex, exhibiting insulin-like effects, also significantly prevented the TNFα-induced increase in PTEN. Combining insulin and VO-OHpic was additive, providing both proof of concept and insight into mechanism. DISCUSSION The PTEN increase due to TNFα treatment was reversible by both PTEN siRNA knockdown and VO-OHpic treatment. Thus, PTEN is identified as a potential new therapeutic target for reducing IR in Type 2 DM.
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Affiliation(s)
- David A Bulger
- Departments of Medicine and Pharmacology, University of Tennessee Health Science Center, Memphis, TN 38163, USA; Medicine and Research Services, Veterans Association Medical Center, Memphis, TN 38104, USA; Wellcome Trust Medical Research Council Institute of Metabolic Science, Cambridge CB2 0QQ, UK; National Institute of Diabetes & Digestive & Kidney Disease, National Institutes of Health, Bethesda, MD 20892, USA
| | - Jermaine Conley
- Medicine and Research Services, Veterans Association Medical Center, Memphis, TN 38104, USA
| | - Spencer H Conner
- Departments of Medicine and Pharmacology, University of Tennessee Health Science Center, Memphis, TN 38163, USA; Medicine and Research Services, Veterans Association Medical Center, Memphis, TN 38104, USA
| | - Gipsy Majumdar
- Departments of Medicine and Pharmacology, University of Tennessee Health Science Center, Memphis, TN 38163, USA; Medicine and Research Services, Veterans Association Medical Center, Memphis, TN 38104, USA
| | - Solomon S Solomon
- Departments of Medicine and Pharmacology, University of Tennessee Health Science Center, Memphis, TN 38163, USA; Medicine and Research Services, Veterans Association Medical Center, Memphis, TN 38104, USA.
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18
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Yoon JW, Kang SM, Vassy JL, Shin H, Lee YH, Ahn HY, Choi SH, Park KS, Jang HC, Lim S. Efficacy and safety of ginsam, a vinegar extract from Panax ginseng, in type 2 diabetic patients: Results of a double-blind, placebo-controlled study. J Diabetes Investig 2014; 3:309-17. [PMID: 24843582 PMCID: PMC4014955 DOI: 10.1111/j.2040-1124.2011.00185.x] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Aims/Introduction: The efficacy, dose–response relationship and safety of ginsam, a vinegar extract from Panax ginseng, were evaluated in an 8‐week, double‐blind, randomized, placebo‐controlled study in drug‐naïve patients with type 2 diabetes. Materials and Methods: A total of 72 diabetic patients were randomized to receive 1500, 2000 or 3000 mg of ginsam, or placebo daily for 8 weeks (n = 18 in each group). The primary end‐point was the changes from the baseline HbA1c level. The secondary end‐points were the changes of fasting and postprandial 2‐h glucose concentration, and the proportion of patients achieving a reduction in HbA1c >0.5%. Results: In the intention‐to‐treat analysis, ginsam treatment reduced HbA1c level significantly: −0.56 ± 0.25% in the 1500 mg group, −0.31 ± 0.12% in the 2000 mg group, and −0.29 ± 0.11% in the 3000 mg group (all P < 0.05), with a significant difference between the 1500 mg ginsam and the placebo group (−0.02 ± 0.12%, P = 0.021). The changes in fasting glucose concentration followed the same pattern: −21.40, −14.27 and −6.76 mg/dL for 1500, 2000, and 3000 mg, respectively, vs −2.25 mg/dL for the placebo. The percentage of patients whose HbA1c level decreased by >0.5% differed significantly between the placebo group (11.1%) and the 1500 mg (27.8%) and 2000 mg (27.8%) groups. No severe adverse events were observed in any group. Conclusions: An 8‐week treatment with ginsam, a vinegar extract from P. ginseng, moderately improved HbA1c level and was well tolerated in type 2 diabetic patients with inadequate glycemic control. This trial was registered with ClinicalTrial.Gov (no. NCT01008163). (J Diabetes Invest, doi: 10.1111/j.2040‐1124.2011.00185.x, 2011)
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Affiliation(s)
- Ji Won Yoon
- Internal Medicine, Seoul National University College of Medicine ; Internal Medicine, Healthcare Research Institute, Seoul National University Hospital Healthcare System Gangnam Center, Seoul
| | - Seon Mee Kang
- Internal Medicine, Seoul National University College of Medicine ; Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Jason L Vassy
- General Medicine Division, Massachusetts General Hospital and Harvard Medical School, Boston, MA
| | - Hayley Shin
- Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, USA
| | - Yun Hee Lee
- Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Hwa Young Ahn
- Internal Medicine, Seoul National University College of Medicine ; Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Sung Hee Choi
- Internal Medicine, Seoul National University College of Medicine ; Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Kyong Soo Park
- Internal Medicine, Seoul National University College of Medicine
| | - Hak Chul Jang
- Internal Medicine, Seoul National University College of Medicine ; Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
| | - Soo Lim
- Internal Medicine, Seoul National University College of Medicine ; Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea
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19
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Nagaishi K, Ataka K, Echizen E, Arimura Y, Fujimiya M. Mesenchymal stem cell therapy ameliorates diabetic hepatocyte damage in mice by inhibiting infiltration of bone marrow-derived cells. Hepatology 2014; 59:1816-29. [PMID: 24375439 DOI: 10.1002/hep.26975] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/13/2013] [Accepted: 12/12/2013] [Indexed: 12/12/2022]
Abstract
UNLABELLED Although mesenchymal stem cells (MSCs) have been implicated in hepatic injury, the mechanism through which they contribute to diabetic liver disease has not been clarified. In this study, we investigated the effects of MSC therapy on diabetic liver damage with a focus on the role of bone-marrow-derived cells (BMDCs), which infiltrate the liver, and elucidated the mechanism mediating this process. Rat bone-marrow (BM)-derived MSCs were administered to high-fat diet (HFD)-induced type 2 diabetic mice and streptozotocin (STZ)-induced insulin-deficient diabetic mice. MSC-conditioned medium (MSC-CM) was also administered to examine the trophic effects of MSCs on liver damage. Therapeutic effects of MSCs were analyzed by assessing serum liver enzyme levels and histological findings. Kinetic and molecular profiles of BMDCs in the liver were evaluated using BM-chimeric mice. Curative effects of MSC and MSC-CM therapies were similar because both ameliorated the aggravation of aspartate aminotransferase and alanine aminotransferase at 8 weeks of treatment, despite persistent hyperlipidemia and hyperinsulinemia in HFD-diabetic mice and persistent hyperglycemia in STZ-diabetic mice. Furthermore, both therapies suppressed the abnormal infiltration of BMDCs into the liver, reversed excessive expression of proinflammatory cytokines in parenchymal cells, and regulated proliferation and survival signaling in the liver in both HFD- and STZ-diabetic mice. In addition to inducing hepatocyte regeneration in STZ-diabetic mice, both therapies also prevented excessive lipid accumulation and apoptosis of hepatocytes and reversed insulin resistance (IR) in HFD-diabetic mice. CONCLUSION MSC therapy is a powerful tool for repairing diabetic hepatocyte damage by inhibiting inflammatory reactions induced by BMDCs and IR. These effects are likely the result of humoral factors derived from MSCs.
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Affiliation(s)
- Kanna Nagaishi
- Second Department of Anatomy, Sapporo Medical University, Sapporo, Japan
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Guan HP, Chen G. Factors affecting insulin-regulated hepatic gene expression. PROGRESS IN MOLECULAR BIOLOGY AND TRANSLATIONAL SCIENCE 2014; 121:165-215. [PMID: 24373238 DOI: 10.1016/b978-0-12-800101-1.00006-5] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/07/2023]
Abstract
Obesity has become a major concern of public health. A common feature of obesity and related metabolic disorders such as noninsulin-dependent diabetes mellitus is insulin resistance, wherein a given amount of insulin produces less than normal physiological responses. Insulin controls hepatic glucose and fatty acid metabolism, at least in part, via the regulation of gene expression. When the liver is insulin-sensitive, insulin can stimulate the expression of genes for fatty acid synthesis and suppress those for gluconeogenesis. When the liver becomes insulin-resistant, the insulin-mediated suppression of gluconeogenic gene expression is lost, whereas the induction of fatty acid synthetic gene expression remains intact. In the past two decades, the mechanisms of insulin-regulated hepatic gene expression have been studied extensively and many components of insulin signal transduction pathways have been identified. Factors that alter these pathways, and the insulin-regulated hepatic gene expression, have been revealed and the underlying mechanisms have been proposed. This chapter summarizes the recent progresses in our understanding of the effects of dietary factors, drugs, bioactive compounds, hormones, and cytokines on insulin-regulated hepatic gene expression. Given the large amount of information and progresses regarding the roles of insulin, this chapter focuses on findings in the liver and hepatocytes and not those described for other tissues and cells. Typical insulin-regulated hepatic genes, such as insulin-induced glucokinase and sterol regulatory element-binding protein-1c and insulin-suppressed cytosolic phosphoenolpyruvate carboxyl kinase and insulin-like growth factor-binding protein 1, are used as examples to discuss the mechanisms such as insulin regulatory element-mediated transcriptional regulation. We also propose the potential mechanisms by which these factors affect insulin-regulated hepatic gene expression and discuss potential future directions of the area of research.
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Affiliation(s)
- Hong-Ping Guan
- Department of Diabetes, Merck Research Laboratories, Kenilworth, New Jersey, USA
| | - Guoxun Chen
- Department of Nutrition, University of Tennessee at Knoxville, Knoxville, Tennessee, USA
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21
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Sullivan TJ, Miao Z, Zhao BN, Ertl LS, Wang Y, Krasinski A, Walters MJ, Powers JP, Dairaghi DJ, Baumgart T, Seitz LC, Berahovich RD, Schall TJ, Jaen JC. Experimental evidence for the use of CCR2 antagonists in the treatment of type 2 diabetes. Metabolism 2013; 62:1623-32. [PMID: 23953944 DOI: 10.1016/j.metabol.2013.06.008] [Citation(s) in RCA: 43] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/27/2013] [Revised: 06/03/2013] [Accepted: 06/11/2013] [Indexed: 01/22/2023]
Abstract
OBJECTIVE CCR2 inhibition has produced promising experimental and clinical anti-hyperglycemic effects. These results support the thesis that insulin resistance and Type 2 diabetes (T2D) are associated with chronic unresolved inflammation. The aim of this study was to provide a broad analysis of the various physiological changes occurring in mouse models of T2D in connection with pharmacological CCR2 inhibition. MATERIALS/METHODS A mouse-active chemical analogue of the clinical candidate CCX140-B was tested in diet-induced obese (DIO) mice and db/db mice. Measurements included: adipose tissue inflammatory macrophage counts; peripheral blood glucose levels at steady-state and after glucose and insulin challenges; peripheral blood insulin and adiponectin levels; 24-h urine output and urinary glucose levels; pancreatic islet number and size; hepatic triglyceride and glycogen content; and hepatic glucose-6-phosphatase levels. RESULTS In DIO mice, the CCR2 antagonist completely blocked the recruitment of inflammatory macrophages to visceral adipose tissue. The mice exhibited reduced hyperglycemia and insulinemia, improved insulin sensitivity, increased circulating adiponectin levels, decreased pancreatic islet size and increased islet number. It also reduced urine output, glucose excretion, hepatic glycogen and triglyceride content and glucose 6-phosphatase levels. Similar effects were observed in the db/db diabetic mice. CONCLUSIONS These data indicate that pharmacological inhibition of CCR2 in models of T2D can reduce inflammation in adipose tissue, alter hepatic metabolism and ameliorate multiple diabetic parameters. These mechanisms may contribute to the promising anti-diabetic effects seen in humans with at least one CCR2 antagonist.
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MESH Headings
- Adiponectin/blood
- Adipose Tissue/pathology
- Animals
- Biomarkers/blood
- Blood Glucose/metabolism
- Diabetes Mellitus, Experimental/blood
- Diabetes Mellitus, Experimental/drug therapy
- Diabetes Mellitus, Experimental/etiology
- Diabetes Mellitus, Experimental/metabolism
- Diabetes Mellitus, Experimental/pathology
- Diabetes Mellitus, Type 2/blood
- Diabetes Mellitus, Type 2/drug therapy
- Diabetes Mellitus, Type 2/etiology
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/pathology
- Diet, High-Fat
- Dose-Response Relationship, Drug
- Glucose-6-Phosphatase/metabolism
- Glycogen/metabolism
- Glycosuria/diagnosis
- Hypoglycemic Agents/pharmacology
- Hypoglycemic Agents/therapeutic use
- Inflammation/metabolism
- Insulin/administration & dosage
- Insulin/blood
- Insulin Resistance
- Insulin-Secreting Cells/pathology
- Liver/metabolism
- Macrophages
- Male
- Mice
- Mice, Inbred C57BL
- Obesity/blood
- Obesity/complications
- Obesity/etiology
- Obesity/metabolism
- Receptors, CCR2/antagonists & inhibitors
- Receptors, CCR2/metabolism
- Triglycerides/metabolism
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Zhao ZQ, Luo R, Li LY, Tian FS, Zheng XL, Xiong HL, Sun LT. Angiotensin II Receptor Blocker Telmisartan Prevents New-Onset Diabetes in Pre-Diabetes OLETF Rats on a High-Fat Diet: Evidence of Anti-Diabetes Action. Can J Diabetes 2013; 37:156-68. [PMID: 24070838 DOI: 10.1016/j.jcjd.2013.03.024] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2012] [Revised: 10/15/2012] [Accepted: 03/06/2013] [Indexed: 11/28/2022]
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Abstract
In recent years, the roles of chronic stress and depression as independent risk factors for decreased insulin sensitivity and the development of diabetes have been increasingly recognized. However, an understanding of the mechanisms linking insulin resistance and acute psychological stress are very limited. We hypothesized that acute psychological stress may cause the development of insulin resistance, which may be a risk factor in developing type 2 diabetes. We tested the hypothesis in a well-established mouse model using 180 episodes of inescapable foot shock (IES) followed by a behavioral escape test. In this study, mice that received IES treatment were tested for acute insulin resistance by measuring glucose metabolism and insulin signaling. When compared with normal and sham mice, mice that were exposed to IES resulting in escape failure (defined as IES with behavioral escape failure) displayed elevated blood glucose levels in both glucose tolerance and insulin tolerance tests. Furthermore, mice with IES exposure and behavioral escape failure exhibited impaired hepatic insulin signaling via the insulin-induced insulin receptor/insulin receptor substrate 1/Akt pathway, without affecting similar pathways in skeletal muscle, adipose tissue, and brain. Additionally, a rise in the murine growth-related oncogene KC/GRO was associated with impaired glucose metabolism in IES mice, suggesting a mechanism by which psychological stress by IES may influence glucose metabolism. The present results indicate that psychological stress induced by IES can acutely alter hepatic responsiveness to insulin and affect whole-body glucose metabolism.
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Affiliation(s)
- Li Li
- Department of Psychiatry and Behavioral Neurobiology, The University of Alabama at Birmingham, 1720 University Boulevard, Birmingham, Alabama 35294, USA.
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Clark JE. An overview of the contribution of fatness and fitness factors, and the role of exercise, in the formation of health status for individuals who are overweight. J Diabetes Metab Disord 2012; 11:19. [PMID: 23497464 PMCID: PMC3602007 DOI: 10.1186/2251-6581-11-19] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2012] [Accepted: 09/27/2012] [Indexed: 01/09/2023]
Abstract
Over the last half century there has been an epidemic of diminished health status induced by what seems as a concurrent rise in a population of individuals that are overfat. During the past few decades, the use of exercise has become a staple in the prevention and treatment options for the retarding the development of health issues pertaining to individuals who are overweight, overfatness or experience obesity. However, there are few studies and reviews look at the global issues surrounding the metabolic and hormone consequences of overfatness and the interaction of exercise with adiposity in humans developing the health status for the individual. This review offers an insight into our current understanding of health issues pertaining to metabolic and hormonal disruption related to overfatness and the treatment effect that exercise, especially resistance exercise, can have on impacting the health status, and overall well-being, for individuals who are overfat, regardless of body compositional changes leading toward a lessening of diseased state, and eventually a return to a normal health status for the individual.
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Affiliation(s)
- James E Clark
- Division of Mathematics, Department of Science, Science and Health Careers, MS 29, PO Box 1046, 60 Bidwell Street, Manchester, CT 06045-1046, USA.
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25
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Toups MS, Trivedi MH. Role of metabolic dysfunction in treatment resistance of major depressive disorder. ACTA ACUST UNITED AC 2011. [DOI: 10.2217/npy.11.49] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/21/2022]
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Gupta-Ganguli M, Cox K, Means B, Gerling I, Solomon SS. Does therapy with anti-TNF-alpha improve glucose tolerance and control in patients with type 2 diabetes? Diabetes Care 2011; 34:e121. [PMID: 21709287 PMCID: PMC3120166 DOI: 10.2337/dc10-1334] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Malini Gupta-Ganguli
- From the Department of Medicine, VA Medical Center, Memphis, Tennessee; the
- Department of Research, VA Medical Center, Memphis, Tennessee; the
- Division of Endocrinology, University of Tennessee Health Science Center, Memphis, Tennessee; the
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; and the
| | - Kyle Cox
- From the Department of Medicine, VA Medical Center, Memphis, Tennessee; the
- Department of Research, VA Medical Center, Memphis, Tennessee; the
- Division of Endocrinology, University of Tennessee Health Science Center, Memphis, Tennessee; the
| | - Blake Means
- From the Department of Medicine, VA Medical Center, Memphis, Tennessee; the
- Department of Research, VA Medical Center, Memphis, Tennessee; the
| | - Ivan Gerling
- From the Department of Medicine, VA Medical Center, Memphis, Tennessee; the
- Department of Research, VA Medical Center, Memphis, Tennessee; the
- Division of Endocrinology, University of Tennessee Health Science Center, Memphis, Tennessee; the
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; and the
| | - Solomon S. Solomon
- From the Department of Medicine, VA Medical Center, Memphis, Tennessee; the
- Department of Research, VA Medical Center, Memphis, Tennessee; the
- Division of Endocrinology, University of Tennessee Health Science Center, Memphis, Tennessee; the
- Department of Medicine, University of Tennessee Health Science Center, Memphis, Tennessee; and the
- Department of Pharmacology, University of Tennessee Health Science Center, Memphis, Tennessee
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Xu X, Yin X, Feng W, Li G, Wang D, Tu L. Telmisartan protects against insulin resistance by attenuating inflammatory response in rats. ACTA ACUST UNITED AC 2011; 31:317-323. [DOI: 10.1007/s11596-011-0374-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/24/2010] [Indexed: 12/29/2022]
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28
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Dietert RR, DeWitt JC, Germolec DR, Zelikoff JT. Breaking patterns of environmentally influenced disease for health risk reduction: immune perspectives. ENVIRONMENTAL HEALTH PERSPECTIVES 2010; 118:1091-9. [PMID: 20483701 PMCID: PMC2920092 DOI: 10.1289/ehp.1001971] [Citation(s) in RCA: 53] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/19/2010] [Accepted: 05/18/2010] [Indexed: 05/19/2023]
Abstract
BACKGROUND Diseases rarely, if ever, occur in isolation. Instead, most represent part of a more complex web or "pattern" of conditions that are connected via underlying biological mechanisms and processes, emerge across a lifetime, and have been identified with the aid of large medical databases. OBJECTIVE We have described how an understanding of patterns of disease may be used to develop new strategies for reducing the prevalence and risk of major immune-based illnesses and diseases influenced by environmental stimuli. FINDINGS Examples of recently defined patterns of diseases that begin in childhood include not only metabolic syndrome, with its characteristics of inflammatory dysregulation, but also allergic, autoimmune, recurrent infection, and other inflammatory patterns of disease. The recent identification of major immune-based disease patterns beginning in childhood suggests that the immune system may play an even more important role in determining health status and health care needs across a lifetime than was previously understood. CONCLUSIONS Focusing on patterns of disease, as opposed to individual conditions, offers two important venues for environmental health risk reduction. First, prevention of developmental immunotoxicity and pediatric immune dysfunction can be used to act against multiple diseases. Second, pattern-based treatment of entryway diseases can be tailored with the aim of disrupting the entire disease pattern and reducing the risk of later-life illnesses connected to underlying immune dysfunction. Disease-pattern-based evaluation, prevention, and treatment will require a change from the current approach for both immune safety testing and pediatric disease management.
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Affiliation(s)
- Rodney R Dietert
- Department of Microbiology and Immunology, College of Veterinary Medicine, Cornell University, Ithaca, New York, USA.
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