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Miskelly MG, Berggren J, Svensson M, Koffert J, Honka H, Kauhanen S, Nuutila P, Hedenbro J, Lindqvist A, Melander O, Wierup N. The effects of Calorie restriction and Bariatric surgery on Circulating Proneurotensin levels. J Clin Endocrinol Metab 2024:dgae147. [PMID: 38477483 DOI: 10.1210/clinem/dgae147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2023] [Revised: 03/05/2024] [Accepted: 03/05/2024] [Indexed: 03/14/2024]
Abstract
CONTEXT Proneurotensin (pNT) is associated with obesity and T2D, but the effects of Roux-en-Y gastric bypass (RYGB) on postprandial pNT levels are not well studied. OBJECTIVE Assess effects of RYGB versus very low-energy diet (VLED) on pNT levels in response to mixed-meal tests (MMT), and long-term effects of RYGB on fasting pNT.Study participants: Cohort 1: Nine normoglycemic (NG) and ten T2D patients underwent MMT before and after VLED, immediately post-RYGB and six weeks post-RYGB. Cohort 2: Ten controls with normal weight and ten patients with obesity and T2D, who underwent RYGB or vertical sleeve gastrectomy (VSG), were subjected to MMTs and GIP infusions pre-surgery and three months post-surgery. GLP-1 infusions were performed in normal weight participants. Cohort 3: Fasting pNT was assessed pre-RYGB (n=161), two months post-RYGB (n=92) and 1-year post-RYGB (n=118) in NG and T2D patients. pNT levels were measured using ELISA. RESULTS Reduced fasting and postprandial pNT were evident after VLED and immediately following RYGB. Reintroduction of solid food post-RYGB increased fasting and postprandial pNT. Prior to RYGB, all patients lacked a meal response in pNT, but this was evident post-RYGB/VSG. GIP- or GLP-1 infusion had no effect on pNT levels. Fasting pNT were higher 1-year post-RYGB regardless of glycemic status. CONCLUSION RYGB causes a transient reduction in pNT as a consequence of caloric restriction. The RYGB/VSG-induced rise in postprandial pNT is independent of GIP and GLP-1 and higher fasting pNT are maintained one year post-surgically.
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Affiliation(s)
- Michael G Miskelly
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | - Johan Berggren
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | - Malin Svensson
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Jukka Koffert
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Gastroenterology, Turku University Hospital, Turku, Finland
| | - Henri Honka
- Turku PET Centre, University of Turku, Turku, Finland
| | - Saila Kauhanen
- Division of Digestive Surgery and Urology, Turku University Hospital, Finland
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | - Jan Hedenbro
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | - Andreas Lindqvist
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | - Olle Melander
- Department of Clinical Sciences, Lund University, Malmö, Sweden
| | - Nils Wierup
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
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Miskelly MG, Lindqvist A, Piccinin E, Hamilton A, Cowan E, Nergård BJ, Del Giudice R, Ngara M, Cataldo LR, Kryvokhyzha D, Volkov P, Engelking L, Artner I, Lagerstedt JO, Eliasson L, Ahlqvist E, Moschetta A, Hedenbro J, Wierup N. RNA sequencing unravels novel L cell constituents and mechanisms of GLP-1 secretion in human gastric bypass-operated intestine. Diabetologia 2024; 67:356-370. [PMID: 38032369 PMCID: PMC10789678 DOI: 10.1007/s00125-023-06046-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/22/2023] [Accepted: 09/15/2023] [Indexed: 12/01/2023]
Abstract
AIMS/HYPOTHESIS Roux-en-Y gastric bypass surgery (RYGB) frequently results in remission of type 2 diabetes as well as exaggerated secretion of glucagon-like peptide-1 (GLP-1). Here, we assessed RYGB-induced transcriptomic alterations in the small intestine and investigated how they were related to the regulation of GLP-1 production and secretion in vitro and in vivo. METHODS Human jejunal samples taken perisurgically and 1 year post RYGB (n=13) were analysed by RNA-seq. Guided by bioinformatics analysis we targeted four genes involved in cholesterol biosynthesis, which we confirmed to be expressed in human L cells, for potential involvement in GLP-1 regulation using siRNAs in GLUTag and STC-1 cells. Gene expression analyses, GLP-1 secretion measurements, intracellular calcium imaging and RNA-seq were performed in vitro. OGTTs were performed in C57BL/6j and iScd1-/- mice and immunohistochemistry and gene expression analyses were performed ex vivo. RESULTS Gene Ontology (GO) analysis identified cholesterol biosynthesis as being most affected by RYGB. Silencing or chemical inhibition of stearoyl-CoA desaturase 1 (SCD1), a key enzyme in the synthesis of monounsaturated fatty acids, was found to reduce Gcg expression and secretion of GLP-1 by GLUTag and STC-1 cells. Scd1 knockdown also reduced intracellular Ca2+ signalling and membrane depolarisation. Furthermore, Scd1 mRNA expression was found to be regulated by NEFAs but not glucose. RNA-seq of SCD1 inhibitor-treated GLUTag cells identified altered expression of genes implicated in ATP generation and glycolysis. Finally, gene expression and immunohistochemical analysis of the jejunum of the intestine-specific Scd1 knockout mouse model, iScd1-/-, revealed a twofold higher L cell density and a twofold increase in Gcg mRNA expression. CONCLUSIONS/INTERPRETATION RYGB caused robust alterations in the jejunal transcriptome, with genes involved in cholesterol biosynthesis being most affected. Our data highlight SCD as an RYGB-regulated L cell constituent that regulates the production and secretion of GLP-1.
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Affiliation(s)
- Michael G Miskelly
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Andreas Lindqvist
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Elena Piccinin
- Department of Translational Biomedicine and Neuroscience, University of Bari 'Aldo Moro', Bari, Italy
- Department of Interdisciplinary Medicine, University of Bari 'Aldo Moro', Bari, Italy
| | - Alexander Hamilton
- Molecular Metabolism, Lund University Diabetes Centre, Lund University, Malmö, Sweden
- Islet Cell Exocytosis, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Elaine Cowan
- Islet Cell Exocytosis, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | | | - Rita Del Giudice
- Department of Experimental Medical Science, Lund University, Lund, Sweden
- Department of Biomedical Science and Biofilms - Research Center for Biointerfaces, Malmö University, Malmö, Sweden
| | - Mtakai Ngara
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Luis R Cataldo
- Molecular Metabolism, Lund University Diabetes Centre, Lund University, Malmö, Sweden
- Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Dmytro Kryvokhyzha
- Bioinformatics Unit, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Petr Volkov
- Bioinformatics Unit, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Luke Engelking
- Internal Medicine, University of Texas Southwestern Medical Center, Dallas, TX, USA
- Department of Molecular Genetics, University of Texas Southwestern Medical Center, Dallas, TX, USA
| | - Isabella Artner
- Endocrine Cell Differentiation and Function, Stem Cell Centre, Lund University, Malmö, Sweden
| | - Jens O Lagerstedt
- Islet Cell Exocytosis, Lund University Diabetes Centre, Lund University, Malmö, Sweden
- Department of Experimental Medical Science, Lund University, Lund, Sweden
| | - Lena Eliasson
- Islet Cell Exocytosis, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Emma Ahlqvist
- Genomics, Diabetes and Endocrinology, Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Antonio Moschetta
- Department of Interdisciplinary Medicine, University of Bari 'Aldo Moro', Bari, Italy
- INBB National Institute for Biostructure and Biosystems, Rome, Italy
| | - Jan Hedenbro
- Department of Surgery, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Nils Wierup
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Lund University, Malmö, Sweden.
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Rogova O, Herzog K, Al-Majdoub M, Miskelly M, Lindqvist A, Bennet L, Hedenbro JL, Wierup N, Spégel P. Metabolic remission precedes possible weight regain after gastric bypass surgery. Obesity (Silver Spring) 2023; 31:2530-2542. [PMID: 37587639 DOI: 10.1002/oby.23864] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/09/2023] [Revised: 05/24/2023] [Accepted: 06/15/2023] [Indexed: 08/18/2023]
Abstract
OBJECTIVE Some patients regain weight to a variable extent from 1 year after Roux-en-Y gastric bypass surgery (RYGB), though rarely reaching preoperative values. The aim of the present study was to investigate whether, when, and to what extent metabolic remission occurs. METHODS Fasting metabolite and lipid profiles were determined in blood plasma collected from a nonrandomized intervention study involving 148 patients before RYGB and at 2, 12, and 60 months post RYGB. Both short-term and long-term alterations in metabolism were assessed. Anthropometric and clinical variables were assessed at all study visits. RESULTS This study found that the vast majority of changes in metabolite levels occurred during the first 2 months post RYGB. Notably, thereafter the metabolome started to return toward the presurgical state. Consequently, a close-to-presurgical metabolome was observed at the time when patients reached their lowest weight and glucose level. Lipids with longer acyl chains and a higher degree of unsaturation were altered more dramatically compared with shorter and more saturated lipids, suggesting a systematic and reversible lipid remodeling. CONCLUSIONS Remission of the metabolic state was observed prior to notable weight regain. Further and more long-term studies are required to assess whether the extent of metabolic remission predicts future weight regain and glycemic deterioration.
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Affiliation(s)
- Oksana Rogova
- Department of Chemistry, Centre for Analysis and Synthesis, Lund University, Lund, Sweden
| | - Katharina Herzog
- Department of Chemistry, Centre for Analysis and Synthesis, Lund University, Lund, Sweden
| | - Mahmoud Al-Majdoub
- Unit of Molecular Metabolism, Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
| | - Michael Miskelly
- Neuroendocrine Cell Biology, Department of Experimental Medical Science, Lund University Diabetes Centre, Malmö, Sweden
| | - Andreas Lindqvist
- Neuroendocrine Cell Biology, Department of Experimental Medical Science, Lund University Diabetes Centre, Malmö, Sweden
| | - Louise Bennet
- Department of Clinical Sciences Malmö, Lund University, Malmö, Sweden
- Clinical Research and Trial Centre, Lund University Hospital, Lund, Sweden
| | - Jan L Hedenbro
- Neuroendocrine Cell Biology, Department of Experimental Medical Science, Lund University Diabetes Centre, Malmö, Sweden
- Department of Surgery, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Nils Wierup
- Neuroendocrine Cell Biology, Department of Experimental Medical Science, Lund University Diabetes Centre, Malmö, Sweden
| | - Peter Spégel
- Department of Chemistry, Centre for Analysis and Synthesis, Lund University, Lund, Sweden
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Bacos K, Perfilyev A, Karagiannopoulos A, Cowan E, Ofori JK, Bertonnier-Brouty L, Rönn T, Lindqvist A, Luan C, Ruhrmann S, Ngara M, Nilsson Å, Gheibi S, Lyons CL, Lagerstedt JO, Barghouth M, Esguerra JL, Volkov P, Fex M, Mulder H, Wierup N, Krus U, Artner I, Eliasson L, Prasad RB, Cataldo LR, Ling C. Type 2 diabetes candidate genes, including PAX5, cause impaired insulin secretion in human pancreatic islets. J Clin Invest 2023; 133:163612. [PMID: 36656641 PMCID: PMC9927941 DOI: 10.1172/jci163612] [Citation(s) in RCA: 7] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2022] [Accepted: 01/05/2023] [Indexed: 01/20/2023] Open
Abstract
Type 2 diabetes (T2D) is caused by insufficient insulin secretion from pancreatic β cells. To identify candidate genes contributing to T2D pathophysiology, we studied human pancreatic islets from approximately 300 individuals. We found 395 differentially expressed genes (DEGs) in islets from individuals with T2D, including, to our knowledge, novel (OPRD1, PAX5, TET1) and previously identified (CHL1, GLRA1, IAPP) candidates. A third of the identified expression changes in islets may predispose to diabetes, as expression of these genes associated with HbA1c in individuals not previously diagnosed with T2D. Most DEGs were expressed in human β cells, based on single-cell RNA-Seq data. Additionally, DEGs displayed alterations in open chromatin and associated with T2D SNPs. Mouse KO strains demonstrated that the identified T2D-associated candidate genes regulate glucose homeostasis and body composition in vivo. Functional validation showed that mimicking T2D-associated changes for OPRD1, PAX5, and SLC2A2 impaired insulin secretion. Impairments in Pax5-overexpressing β cells were due to severe mitochondrial dysfunction. Finally, we discovered PAX5 as a potential transcriptional regulator of many T2D-associated DEGs in human islets. Overall, we have identified molecular alterations in human pancreatic islets that contribute to β cell dysfunction in T2D pathophysiology.
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Affiliation(s)
- Karl Bacos
- Epigenetics and Diabetes Unit, Department of Clinical Sciences and
| | | | - Alexandros Karagiannopoulos
- Unit of Islet Cell Exocytosis, Department of Clinical Sciences, Lund University Diabetes Centre, Scania University Hospital, Malmö, Scania, Sweden
| | - Elaine Cowan
- Unit of Islet Cell Exocytosis, Department of Clinical Sciences, Lund University Diabetes Centre, Scania University Hospital, Malmö, Scania, Sweden
| | - Jones K. Ofori
- Epigenetics and Diabetes Unit, Department of Clinical Sciences and
| | - Ludivine Bertonnier-Brouty
- Endocrine Cell Differentiation, Department of Laboratory Medicine, Lund Stem Cell Center, Malmö, Scania, Sweden
| | - Tina Rönn
- Epigenetics and Diabetes Unit, Department of Clinical Sciences and
| | - Andreas Lindqvist
- Neuroendocrine Cell Biology, Department of Experimental Medical Science
| | - Cheng Luan
- Unit of Islet Pathophysiology, Department of Clinical Sciences
| | - Sabrina Ruhrmann
- Epigenetics and Diabetes Unit, Department of Clinical Sciences and
| | - Mtakai Ngara
- Neuroendocrine Cell Biology, Department of Experimental Medical Science
| | - Åsa Nilsson
- Human Tissue Lab, Department of Clinical Sciences
| | - Sevda Gheibi
- Molecular Metabolism Unit, Department of Clinical Sciences, and
| | - Claire L. Lyons
- Molecular Metabolism Unit, Department of Clinical Sciences, and
| | - Jens O. Lagerstedt
- Unit of Islet Cell Exocytosis, Department of Clinical Sciences, Lund University Diabetes Centre, Scania University Hospital, Malmö, Scania, Sweden
| | | | - Jonathan L.S. Esguerra
- Unit of Islet Cell Exocytosis, Department of Clinical Sciences, Lund University Diabetes Centre, Scania University Hospital, Malmö, Scania, Sweden
| | - Petr Volkov
- Epigenetics and Diabetes Unit, Department of Clinical Sciences and
| | - Malin Fex
- Molecular Metabolism Unit, Department of Clinical Sciences, and
| | - Hindrik Mulder
- Molecular Metabolism Unit, Department of Clinical Sciences, and
| | - Nils Wierup
- Neuroendocrine Cell Biology, Department of Experimental Medical Science
| | - Ulrika Krus
- Human Tissue Lab, Department of Clinical Sciences
| | - Isabella Artner
- Endocrine Cell Differentiation, Department of Laboratory Medicine, Lund Stem Cell Center, Malmö, Scania, Sweden
| | - Lena Eliasson
- Unit of Islet Cell Exocytosis, Department of Clinical Sciences, Lund University Diabetes Centre, Scania University Hospital, Malmö, Scania, Sweden
| | - Rashmi B. Prasad
- Genomics, Diabetes and Endocrinology, Department of Clinical Sciences, Lund University Diabetes Centre, Scania University Hospital, Malmö, Scania, Sweden.,Institute of Molecular Medicine (FIMM), Helsinki University, Helsinki, Finland
| | - Luis Rodrigo Cataldo
- Molecular Metabolism Unit, Department of Clinical Sciences, and,The Novo Nordisk Foundation Centre for Basic Metabolic Research, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Charlotte Ling
- Epigenetics and Diabetes Unit, Department of Clinical Sciences and
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Saari T, Koffert J, Honka H, Kauhanen S, U-Din M, Wierup N, Lindqvist A, Groop L, Virtanen KA, Nuutila P. Obesity-associated Blunted Subcutaneous Adipose Tissue Blood Flow After Meal Improves After Bariatric Surgery. J Clin Endocrinol Metab 2022; 107:1930-1938. [PMID: 35363252 PMCID: PMC9202692 DOI: 10.1210/clinem/dgac191] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Indexed: 11/19/2022]
Abstract
CONTEXT Glucose-dependent insulinotropic peptide (GIP) and meal ingestion increase subcutaneous adipose tissue (SAT) perfusion in healthy individuals. The effects of GIP and a meal on visceral adipose tissue (VAT) perfusion are unclear. OBJECTIVE Our aim was to investigate the effects of meal and GIP on VAT and SAT perfusion in obese individuals with type 2 diabetes mellitus (T2DM) before and after bariatric surgery. METHODS We recruited 10 obese individuals with T2DM scheduled for bariatric surgery and 10 control individuals. Participants were studied under 2 stimulations: meal ingestion and GIP infusion. SAT and VAT perfusion was measured using 15O-H2O positron emission tomography-magnetic resonance imaging at 3 time points: baseline, 20 minutes, and 50 minutes after the start of stimulation. Obese individuals were studied before and after bariatric surgery. RESULTS Before bariatric surgery the responses of SAT perfusion to meal (P = .04) and GIP-infusion (P = .002) were blunted in the obese participants compared to controls. VAT perfusion response did not differ between obese and control individuals after a meal or GIP infusion. After bariatric surgery SAT perfusion response to a meal was similar to that of controls. SAT perfusion response to GIP administration remained lower in the operated-on than control participants. There was no change in VAT perfusion response after bariatric surgery. CONCLUSION The vasodilating effects of GIP and meal are blunted in SAT but not in VAT in obese individuals with T2DM. Bariatric surgery improves the effects of a meal on SAT perfusion, but not the effects of GIP. Postprandial increase in SAT perfusion after bariatric surgery seems to be regulated in a GIP-independent manner.
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Affiliation(s)
- Teemu Saari
- Turku PET Centre, University of Turku, 20520 Turku, Finland
- Turku PET Centre, Turku University Hospital, 20520 Turku, Finland
| | - Jukka Koffert
- Turku PET Centre, University of Turku, 20520 Turku, Finland
- Department of Gastroenterology, Turku University Hospital, 20520 Turku, Finland
| | - Henri Honka
- Turku PET Centre, University of Turku, 20520 Turku, Finland
| | - Saila Kauhanen
- Division of Digestive Surgery and Urology, Turku University Hospital, 20520 Turku, Finland
| | - Mueez U-Din
- Turku PET Centre, University of Turku, 20520 Turku, Finland
- Turku PET Centre, Turku University Hospital, 20520 Turku, Finland
| | - Nils Wierup
- Department of Clinical Sciences, Lund University Diabetes Centre, 20213 Malmö, Sweden
| | - Andreas Lindqvist
- Department of Clinical Sciences, Lund University Diabetes Centre, 20213 Malmö, Sweden
| | - Leif Groop
- Department of Clinical Sciences, Lund University Diabetes Centre, 20213 Malmö, Sweden
| | - Kirsi A Virtanen
- Correspondence: Kirsi A. Virtanen, MD, PhD, Turku PET Centre, University of Turku, Department of Endocrinology, Kiinamyllynkatu 4-8, 2052 Turku, Finland. ,
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, 20520 Turku, Finland
- Turku PET Centre, Turku University Hospital, 20520 Turku, Finland
- Department of Endocrinology, Turku University Hospital, 20520 Turku, Finland
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Abels M, Riva M, Shcherbina L, Fischer AHT, Banke E, Degerman E, Lindqvist A, Wierup N. Overexpressed beta cell CART increases insulin secretion in mouse models of insulin resistance and diabetes. Peptides 2022; 151:170747. [PMID: 35065097 DOI: 10.1016/j.peptides.2022.170747] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 01/14/2022] [Accepted: 01/14/2022] [Indexed: 12/15/2022]
Abstract
Impaired beta cell function and beta cell death are key features of type 2 diabetes (T2D). Cocaine- and amphetamine-regulated transcript (CART) is necessary for normal islet function in mice. CART increases glucose-stimulated insulin secretion in vivo in mice and in vitro in human islets and CART protects beta cells against glucotoxicity-induced cell death in vitro in rats. Furthermore, beta cell CART is upregulated in T2D patients and in diabetic rodent models as a consequence of hyperglycaemia. The aim of this study was to assess the impact of upregulated beta cell CART on islet hormone secretion and glucose homeostasis in a transgenic mouse model. To this end, mice with beta cell-specific overexpression of CART (CARTtg mice) were generated. CARTtg mice challenged by aging, high fat diet feeding or streptozotocin treatment were phenotyped with respect to in vivo and in vitro insulin and glucagon secretion, glucose homeostasis, and beta cell mass. In addition, the impact of adenoviral overexpression of CART on insulin secretion was studied in INS-1 832/13 cells. CARTtg mice had a normal metabolic phenotype under basal conditions. On the other hand, with age CARTtg mice displayed increased insulin secretion and improved glucose elimination, compared with age-matched WT mice. Furthermore, compared with WT controls, CARTtg mice had increased insulin secretion after feeding a high fat diet, as well as lower glucose levels and higher insulin secretion after streptozotocin treatment. Viral overexpression of CART in INS-1 832/13 cells resulted in increased glucose-stimulated insulin secretion. Together, these results imply that beta cell CART acts to increase insulin secretion when beta cell function is challenged. We propose that the increase in beta cell CART is part of a compensatory mechanisms trying to counteract the hyperglycaemia in T2D.
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Affiliation(s)
- Mia Abels
- Lund University Diabetes Centre, Malmö, Sweden
| | - Matteo Riva
- Lund University Diabetes Centre, Malmö, Sweden
| | | | | | - Elin Banke
- Lund University Diabetes Centre, Malmö, Sweden
| | | | | | - Nils Wierup
- Lund University Diabetes Centre, Malmö, Sweden.
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7
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Wierup N, Abels M, Shcherbina L, Lindqvist A. The role of CART in islet biology. Peptides 2022; 149:170708. [PMID: 34896575 DOI: 10.1016/j.peptides.2021.170708] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/07/2021] [Revised: 12/03/2021] [Accepted: 12/03/2021] [Indexed: 10/19/2022]
Abstract
Cocaine- and amphetamine-regulated transcript (CART) is mostly known for its appetite regulating effects in the central nervous system. However, CART is also highly expressed in the peripheral nervous system as well as in certain endocrine cells. Our group has dedicated more than 20 years to understand the role of CART in the pancreatic islets and in this review we summarize what is known to date about CART expression and function in the islets. CART is expressed in both islet cells and nerve fibers innervating the islets. Large species differences are at hand and CART expression is highly dynamic and increased during development, as well as in Type 2 Diabetes and certain endocrine tumors. In the human islets CART is expressed in alpha cells and beta cells and the expression is increased in T2D patients. CART increases insulin secretion, reduces glucagon secretion, and protects against beta cell death by reducing apoptosis and increasing proliferation. It is still not fully understood how CART mediates its effects or which receptors that are involved. Nevertheless, CART is endowed with several properties that are beneficial in a T2D perspective. Many of the described effects of CART resemble those of GLP-1, and interestingly CART has been found to potentiate some of the effects of GLP-1, paving the way for CART-based treatments in combination with GLP-1-based drugs.
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Affiliation(s)
- Nils Wierup
- Lund University Diabetes Centre, Malmö, Sweden.
| | - Mia Abels
- Lund University Diabetes Centre, Malmö, Sweden
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8
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Lindqvist A, Hacking D, Wright L, Cowie B, D'Orsa K, Gregory M, Foulkes S, Janssens K, La Gerche A. Swimming Induced Pulmonary Oedema is Not Cardiogenic in Long-Distance Open-Water Swimmers. Heart Lung Circ 2022. [DOI: 10.1016/j.hlc.2022.06.291] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/16/2022]
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9
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Chriett S, Lindqvist A, Shcherbina L, Edlund A, Abels M, Asplund O, Martínez López JA, Ottosson-Laakso E, Hatem G, Prasad RB, Groop L, Eliasson L, Hansson O, Wierup N. SCRT1 is a novel beta cell transcription factor with insulin regulatory properties. Mol Cell Endocrinol 2021; 521:111107. [PMID: 33309639 DOI: 10.1016/j.mce.2020.111107] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/05/2020] [Revised: 11/13/2020] [Accepted: 11/30/2020] [Indexed: 01/06/2023]
Abstract
Here we show that scratch family transcriptional repressor 1 (SCRT1), a zinc finger transcriptional regulator, is a novel regulator of beta cell function. SCRT1 was found to be expressed in beta cells in rodent and human islets. In human islets, expression of SCRT1 correlated with insulin secretion capacity and the expression of the insulin (INS) gene. Furthermore, SCRT1 mRNA expression was lower in beta cells from T2D patients. siRNA-mediated Scrt1 silencing in INS-1832/13 cells, mouse- and human islets resulted in impaired glucose-stimulated insulin secretion and decreased expression of the insulin gene. This is most likely due to binding of SCRT1 to E-boxes of the Ins1 gene as shown with ChIP. Scrt1 silencing also reduced the expression of several key beta cell transcription factors. Moreover, Scrt1 mRNA expression was reduced by glucose and SCRT1 protein was found to translocate between the nucleus and the cytosol in a glucose-dependent fashion in INS-1832/13 cells as well as in a rodent model of T2D. SCRT1 was also regulated by a GSK3β-dependent SCRT1-serine phosphorylation. Taken together, SCRT1 is a novel beta cell transcription factor that regulates insulin secretion and is affected in T2D.
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Affiliation(s)
- S Chriett
- Lund University Diabetes Centre, Malmö, Sweden
| | - A Lindqvist
- Lund University Diabetes Centre, Malmö, Sweden
| | | | - A Edlund
- Lund University Diabetes Centre, Malmö, Sweden
| | - M Abels
- Lund University Diabetes Centre, Malmö, Sweden
| | - O Asplund
- Lund University Diabetes Centre, Malmö, Sweden
| | - J A Martínez López
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | | | - G Hatem
- Lund University Diabetes Centre, Malmö, Sweden
| | - R B Prasad
- Lund University Diabetes Centre, Malmö, Sweden
| | - L Groop
- Lund University Diabetes Centre, Malmö, Sweden; Finnish Institute of Molecular Medicine, Helsinki, Finland
| | - L Eliasson
- Lund University Diabetes Centre, Malmö, Sweden
| | - O Hansson
- Lund University Diabetes Centre, Malmö, Sweden; Finnish Institute of Molecular Medicine, Helsinki, Finland
| | - N Wierup
- Lund University Diabetes Centre, Malmö, Sweden.
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10
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Miskelly MG, Shcherbina L, Thorén Fischer AH, Abels M, Lindqvist A, Wierup N. GK-rats respond to gastric bypass surgery with improved glycemia despite unaffected insulin secretion and beta cell mass. Peptides 2021; 136:170445. [PMID: 33197511 DOI: 10.1016/j.peptides.2020.170445] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/26/2020] [Revised: 11/09/2020] [Accepted: 11/09/2020] [Indexed: 02/07/2023]
Abstract
Roux-en-Y gastric bypass (RYGB) is the most effective treatment for morbid obesity and results in rapid remission of type 2 diabetes (T2D), before significant weight loss occurs. The underlying mechanisms for T2D remission are not fully understood. To gain insight into these mechanisms we used RYGB-operated diabetic GK-rats and Wistar control rats. Twelve adult male Wistar- and twelve adult male GK-rats were subjected to RYGB- or sham-operation. Oral glucose tolerance tests (OGTT) were performed six weeks after surgery. RYGB normalized fasting glucose levels in GK-rats, without affecting fasting insulin levels. In both rat strains, RYGB caused increased postprandial responses in glucose, GLP-1, and GIP. RYGB caused elevated postprandial insulin secretion in Wistar-rats, but had no effect on insulin secretion in GK-rats. In agreement with this, RYGB improved HOMA-IR in GK-rats, but had no effect on HOMA-β. RYGB-operated GK-rats had an increased number of GIP receptor and GLP-1 receptor immunoreactive islet cells, but RYGB had no major effect on beta or alpha cell mass. Furthermore, in RYGB-operated GK-rats, increased Slc5a1, Pck2 and Pfkfb1 and reduced Fasn hepatic mRNA expression was observed. In summary, our data shows that RYGB induces T2D remission and enhanced postprandial incretin hormone secretion in GK-rats, without affecting insulin secretion or beta cell mass. Thus our data question the dogmatic view of how T2D remission is achieved and instead point at improved insulin sensitivity as the main mechanism of remission.
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MESH Headings
- Animals
- Diabetes Mellitus, Type 2/genetics
- Diabetes Mellitus, Type 2/metabolism
- Diabetes Mellitus, Type 2/pathology
- Diabetes Mellitus, Type 2/surgery
- Disease Models, Animal
- Gastric Bypass
- Gastric Inhibitory Polypeptide/genetics
- Glucagon-Like Peptide 1/genetics
- Glucose Tolerance Test
- Humans
- Insulin/genetics
- Insulin/metabolism
- Insulin Secretion/genetics
- Insulin-Secreting Cells/metabolism
- Insulin-Secreting Cells/pathology
- Islets of Langerhans/metabolism
- Islets of Langerhans/pathology
- Obesity, Morbid/genetics
- Obesity, Morbid/metabolism
- Obesity, Morbid/pathology
- Obesity, Morbid/surgery
- Rats
- Rats, Wistar
- Weight Loss/genetics
- Weight Loss/physiology
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Affiliation(s)
- Michael G Miskelly
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | - Liliya Shcherbina
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | | | - Mia Abels
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | - Andreas Lindqvist
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden
| | - Nils Wierup
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö, Sweden.
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11
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Costello B, Ross L, Lindqvist A, Brown Z, Hansen D, Stevens W, Burns A, Prior D, Nikpour M, La Gerche A. Significant and Early Cardiac Involvement in Systemic Sclerosis Detected by Cardiac Magnetic Resonance. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.243] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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12
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Ross L, Lindqvist A, Hansen D, Brown Z, Costello B, Burns A, Prior D, Stevens W, Nikpour M, La Gerche A. Characterising Breathlessness in Systemic Sclerosis: Peak Exercise Performance is Linked to Workload-Indexed Blood Pressure Response. Heart Lung Circ 2021. [DOI: 10.1016/j.hlc.2021.06.057] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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13
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Janssens K, Paratz E, Brosnan M, Lindqvist A, Mitchell A, Afridi A, Orchard J, Prior D, La Gerche A. You've got to be in it to win it: the importance of including female athletes in screening ECG cohorts. Eur Heart J 2020. [DOI: 10.1093/ehjci/ehaa946.3136] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
Abstract
Background
ECG screening is widely employed in athletic populations with the aim of identifying cardiac conditions associated with sudden death. Recommendations for athlete ECG interpretation are disproportionately reliant on data from male athletes and sex-specific differences have not been adequately elucidated.
Purpose
The aim of this study is to identify any different patterns in female athletic training response on ECG screening.
Methods
444 elite athletes (156 male rowers, 135 female rowers, 117 male cricketers, 36 female cricketers) underwent electrocardiogram (ECG) screening. Standard definitions were used to characterize abnormalities identified on ECG. Comparisons were made according to sex and endurance (rowing) vs skill-based (cricket) athletes (EA and SBA respectively).
Results
“Potentially pathological” T-wave inversion extending to V3 was more prevalent in female athletes (9.9% vs. 2.9%, P=0.002), especially amongst endurance athletes (11.9% female EA vs. 2.8% female SBA, P=0.004) (Figure 1). As compared with males, the QTc interval was longer in female athletes (418 vs. 402ms), the QRS duration was shorter (90 vs. 100 ms) and left ventricular hypertrophy on voltage criteria were less prevalent (9.9% vs. 33.3%, P<0.001 for all). First-degree heart block and incomplete right bundle branch block were more prevalent amongst male athletes.
Conclusion
Female athletes exhibit different training-related cardiac remodelling responses to exercise compared to males. A greater proportion of ostensibly healthy female athletes, especially female endurance athletes, have ECG changes that would be deemed “potentially pathological” according to current sex-agnostic guidelines.
Figure 1
Funding Acknowledgement
Type of funding source: None
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Affiliation(s)
- K Janssens
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - E Paratz
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - M Brosnan
- St Vincent's Hospital, National Centre for Sports Cardiology, Melbourne, Australia
| | - A Lindqvist
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - A Mitchell
- Baker Heart and Diabetes Institute, Melbourne, Australia
| | - A Afridi
- Harvard Medical School, Boston, United States of America
| | - J Orchard
- University of Sydney, Heart Research Institute, Sydney, Australia
| | - D Prior
- St Vincent's Hospital, National Centre for Sports Cardiology, Melbourne, Australia
| | - A La Gerche
- Baker Heart and Diabetes Institute, Melbourne, Australia
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14
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Herzog K, Berggren J, Al Majdoub M, Balderas Arroyo C, Lindqvist A, Hedenbro J, Groop L, Wierup N, Spégel P. Metabolic Effects of Gastric Bypass Surgery: Is It All About Calories? Diabetes 2020; 69:2027-2035. [PMID: 32527768 DOI: 10.2337/db20-0131] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/07/2020] [Accepted: 06/08/2020] [Indexed: 11/13/2022]
Abstract
Bariatric surgery is an efficient method to induce weight loss and also, frequently, remission of type 2 diabetes (T2D). Unpaired studies have shown bariatric surgery and dietary interventions to differentially affect multiple hormonal and metabolic parameters, suggesting that bariatric surgery causes T2D remission at least partially via unique mechanisms. In the current study, plasma metabolite profiling was conducted in patients with (n = 10) and without T2D (n = 9) subjected to Roux-en-Y gastric bypass surgery (RYGB). Mixed-meal tests were conducted at baseline, after the presurgical very-low-calorie diet (VLCD) intervention, immediately after RYGB, and after a 6-week recovery period. Thereby, we could compare fasted and postprandial metabolic consequences of RYGB and VLCD in the same patients. VLCD yielded a pronounced increase in fasting acylcarnitine levels, whereas RYGB, both immediately and after a recovery period, resulted in a smaller but opposite effect. Furthermore, we observed profound changes in lipid metabolism following VLCD but not in response to RYGB. Most changes previously associated with RYGB were found to be consequences of the presurgical dietary intervention. Overall, our results question previous findings of unique metabolic effects of RYGB and suggest that the effect of RYGB on the metabolite profile is mainly attributed to caloric restriction.
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Affiliation(s)
- Katharina Herzog
- Department of Chemistry, Centre for Analysis and Synthesis, Lund University, Lund, Sweden
| | - Johan Berggren
- Department of Surgery and Urology, Kalmar Hospital, Kalmar, Sweden
- Neuroendocrine Cell Biology, Department of Experimental Medical Science, Lund University Diabetes Centre, Malmö, Sweden
| | - Mahmoud Al Majdoub
- Unit of Molecular Metabolism, Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden
| | | | - Andreas Lindqvist
- Neuroendocrine Cell Biology, Department of Experimental Medical Science, Lund University Diabetes Centre, Malmö, Sweden
| | - Jan Hedenbro
- Neuroendocrine Cell Biology, Department of Experimental Medical Science, Lund University Diabetes Centre, Malmö, Sweden
| | - Leif Groop
- Diabetes and Endocrinology, Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden
| | - Nils Wierup
- Neuroendocrine Cell Biology, Department of Experimental Medical Science, Lund University Diabetes Centre, Malmö, Sweden
| | - Peter Spégel
- Department of Chemistry, Centre for Analysis and Synthesis, Lund University, Lund, Sweden
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15
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Morgenroth T, Sendén MG, Lindqvist A, Renström EA, Ryan MK, Morton TA. Defending the Sex/Gender Binary: The Role of Gender Identification and Need for Closure. Social Psychological and Personality Science 2020. [DOI: 10.1177/1948550620937188] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
In the Western world, gender/sex is traditionally viewed as binary, with people falling into one of two categories: male or female. This view of gender/sex has started to change, triggering some resistance. This research investigates psychological mechanisms underlying that resistance. Study 1 ( N = 489, UK) explored the role of individual gender identification in defense of, and attempts to reinforce, the gender/sex binary. Study 2 ( N = 415, Sweden) further considered the role of individual differences in need for closure. Both gender identification and need for closure were associated with binary views of gender/sex, prejudice against nonbinary people, and opposition to the use of gender-neutral pronouns. Policies that aim to abolish gender/sex categories, but not policies that advocate for a third gender/sex category, were seen as particularly unfair among people high in gender identification. These findings are an important step in understanding the psychology of resistance to change around binary systems of gender/sex.
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Affiliation(s)
- Thekla Morgenroth
- Washington Singer Laboratories, University of Exeter, United Kingdom
| | | | - A. Lindqvist
- Stockholm University, Sweden
- Lund University, Sweden
| | | | - M. K. Ryan
- Washington Singer Laboratories, University of Exeter, United Kingdom
- University of Groningen, the Netherlands
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16
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Lindqvist A, Shcherbina L, Prasad RB, Miskelly MG, Abels M, Martínez-Lopéz JA, Fred RG, Nergård BJ, Hedenbro J, Groop L, Hjerling-Leffler J, Wierup N. Ghrelin suppresses insulin secretion in human islets and type 2 diabetes patients have diminished islet ghrelin cell number and lower plasma ghrelin levels. Mol Cell Endocrinol 2020; 511:110835. [PMID: 32371087 DOI: 10.1016/j.mce.2020.110835] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/12/2020] [Revised: 04/07/2020] [Accepted: 04/21/2020] [Indexed: 01/22/2023]
Abstract
It is not known how ghrelin affects insulin secretion in human islets from patients with type 2 diabetes (T2D) or whether islet ghrelin expression or circulating ghrelin levels are altered in T2D. Here we sought out to identify the effect of ghrelin on insulin secretion in human islets and the impact of T2D on circulating ghrelin levels and on islet ghrelin cells. The effect of ghrelin on insulin secretion was assessed in human T2D and non-T2D islets. Ghrelin expression was assessed with RNA-sequencing (n = 191) and immunohistochemistry (n = 21). Plasma ghrelin was measured with ELISA in 40 T2D and 40 non-T2D subjects. Ghrelin exerted a glucose-dependent insulin-suppressing effect in islets from both T2D and non-T2D donors. Compared with non-T2D donors, T2D donors had reduced ghrelin mRNA expression and 75% less islet ghrelin cells, and ghrelin mRNA expression correlated negatively with HbA1c. T2D subjects had 25% lower fasting plasma ghrelin levels than matched controls. Thus, ghrelin has direct insulin-suppressing effects in human islets and T2D patients have lower fasting ghrelin levels, likely as a result of reduced number of islet ghrelin cells. These findings support inhibition of ghrelin signaling as a potential therapeutic avenue for stimulation of insulin secretion in T2D patients.
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Affiliation(s)
- A Lindqvist
- Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - L Shcherbina
- Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - R B Prasad
- Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - M G Miskelly
- Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - M Abels
- Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - J A Martínez-Lopéz
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - R G Fred
- Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | | | - J Hedenbro
- Lund University Diabetes Centre, Lund University, Malmö, Sweden; Aleris Obesitas, Lund, Sweden
| | - L Groop
- Lund University Diabetes Centre, Lund University, Malmö, Sweden; Finnish Institute of Molecular Medicine, Helsinki, Finland
| | - J Hjerling-Leffler
- Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - N Wierup
- Lund University Diabetes Centre, Lund University, Malmö, Sweden.
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17
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Shcherbina L, Lindqvist A, Thorén Fischer AH, Ahlqvist E, Zhang E, Falkmer SE, Renström E, Koffert J, Honka H, Wierup N. Intestinal CART is a regulator of GIP and GLP-1 secretion and expression. Mol Cell Endocrinol 2018; 476:8-16. [PMID: 29627317 DOI: 10.1016/j.mce.2018.04.002] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/10/2017] [Revised: 03/26/2018] [Accepted: 04/05/2018] [Indexed: 12/20/2022]
Abstract
Impaired incretin effect is a culprit in Type 2 Diabetes. Cocaine- and amphetamine-regulated transcript (CART) is a regulatory peptide controlling pancreatic islet hormone secretion and beta-cell survival. Here we studied the potential expression of CART in enteroendocrine cells and examined the role of CART as a regulator of incretin secretion and expression. CART expression was found in glucose-dependent insulinotropic polypeptide (GIP)-producing K-cells and glucagon-like peptide-1 (GLP-1)-producing L-cells in human duodenum and jejunum and circulating CART levels were increased 60 min after a meal in humans. CART expression was increased by fatty acids and GIP, but unaffected by glucose in GLUTag and STC-1 cells. Exogenous CART had no effect on GIP and GLP-1 expression and secretion in GLUTag or STC-1 cells, but siRNA-mediated silencing of CART reduced GLP-1 expression and secretion. Furthermore, acute intravenous administration of CART increased GIP and GLP-1 secretion during an oral glucose-tolerance test in mice. We conclude that CART is a novel constituent of human K- and L-cells with stimulatory actions on incretin secretion and that interfering with the CART system may be a therapeutic avenue for T2D.
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Affiliation(s)
| | - A Lindqvist
- Lund University Diabetes Centre, Malmö, Sweden
| | | | - E Ahlqvist
- Lund University Diabetes Centre, Malmö, Sweden
| | - E Zhang
- Lund University Diabetes Centre, Malmö, Sweden
| | - S E Falkmer
- Department of Clinical Pathology, Ryhov Hospital, Jönköping, Sweden
| | - E Renström
- Lund University Diabetes Centre, Malmö, Sweden
| | - J Koffert
- Turku PET Centre, University of Turku, Turku, Finland
| | - H Honka
- Turku PET Centre, University of Turku, Turku, Finland
| | - N Wierup
- Lund University Diabetes Centre, Malmö, Sweden.
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18
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Honka H, Koffert J, Kauhanen S, Kudomi N, Hurme S, Mari A, Lindqvist A, Wierup N, Parkkola R, Groop L, Nuutila P. Liver blood dynamics after bariatric surgery: the effects of mixed-meal test and incretin infusions. Endocr Connect 2018; 7:888-896. [PMID: 29941634 PMCID: PMC6063878 DOI: 10.1530/ec-18-0234] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/19/2018] [Accepted: 06/25/2018] [Indexed: 01/18/2023]
Abstract
AIMS/HYPOTHESIS The mechanisms for improved glycemic control after bariatric surgery in subjects with type 2 diabetes (T2D) are not fully known. We hypothesized that dynamic hepatic blood responses to a mixed-meal are changed after bariatric surgery in parallel with an improvement in glucose tolerance. METHODS A total of ten morbidly obese subjects with T2D were recruited to receive a mixed-meal and a glucose-dependent insulinotropic polypeptide (GIP) infusion before and early after (within a median of less than three months) bariatric surgery, and hepatic blood flow and volume (HBV) were measured repeatedly with combined positron emission tomography/MRI. Ten lean non-diabetic individuals served as controls. RESULTS Bariatric surgery leads to a significant decrease in weight, accompanied with an improved β-cell function and glucagon-like peptide 1 (GLP-1) secretion, and a reduction in liver volume. Blood flow in portal vein (PV) was increased by 1.65-fold (P = 0.026) in response to a mixed-meal in subjects after surgery, while HBV decreased in all groups (P < 0.001). When the effect of GIP infusion was tested separately, no change in hepatic arterial and PV flow was observed, but HBV decreased as seen during the mixed-meal test. CONCLUSIONS/INTERPRETATION Early after bariatric surgery, PV flow response to a mixed-meal is augmented, improving digestion and nutrient absorption. GIP influences the post-prandial reduction in HBV thereby diverting blood to the extrahepatic sites.
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Affiliation(s)
- Henri Honka
- Turku PET CentreUniversity of Turku, Turku, Finland
| | - Jukka Koffert
- Turku PET CentreUniversity of Turku, Turku, Finland
- Department of GastroenterologyTurku University Hospital, Turku, Finland
| | - Saila Kauhanen
- Division of Digestive Surgery and UrologyTurku University Hospital, Turku, Finland
| | | | - Saija Hurme
- Department of BiostatisticsUniversity of Turku, Turku, Finland
| | - Andrea Mari
- Institute of NeuroscienceNational Research Council, Padua, Italy
| | - Andreas Lindqvist
- Department of Clinical SciencesLund University Diabetes Centre, Malmö, Sweden
| | - Nils Wierup
- Department of Clinical SciencesLund University Diabetes Centre, Malmö, Sweden
| | - Riitta Parkkola
- Department of RadiologyUniversity of Turku and Turku University Hospital, Turku, Finland
| | - Leif Groop
- Department of Clinical SciencesLund University Diabetes Centre, Malmö, Sweden
| | - Pirjo Nuutila
- Turku PET CentreUniversity of Turku, Turku, Finland
- Department of EndocrinologyTurku University Hospital, Turku, Finland
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19
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Gao X, Lindqvist A, Sandberg M, Groop L, Wierup N, Jansson L. Effects of GIP on regional blood flow during normoglycemia and hyperglycemia in anesthetized rats. Physiol Rep 2018; 6:e13685. [PMID: 29673130 PMCID: PMC5907939 DOI: 10.14814/phy2.13685] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/07/2017] [Revised: 03/13/2018] [Accepted: 03/15/2018] [Indexed: 12/22/2022] Open
Abstract
The incretin hormone glucose-dependent insulinotropic polypeptide (GIP) potentiates glucose-stimulated insulin secretion, and affects β-cell turnover. This study aimed at evaluating if some of the beneficial effects of GIP on glucose homeostasis can be explained by modulation of islet blood flow. Anesthetized Sprague-Dawley rats were infused intravenously with different doses of GIP (10, 20, or 60 ng/kg*min) for 30 min. Subsequent organ blood flow measurements were performed with microspheres. In separate animals, islets were perfused ex vivo with GIP (10-6 -10-12 mol/L) during normo- and hyperglycemia and arteriolar responsiveness was recorded. The highest dose of GIP potentiated insulin secretion during hyperglycemia, but had no effect in normoglycemic rats. The highest GIP concentration decreased blood perfusion of whole pancreas, pancreatic islets, duodenum, colon, liver and kidneys. The decrease in blood flow was unaffected by ganglion blockade or adenosine receptor inhibition. In contrast to this, in single perfused islets GIP induced a dose-dependent arteriolar dilation. Thus, high doses of GIP exert a direct dilatory effect on islet arterioles in isolated islets, but induce a generalized vasoconstriction in splanchnic organs, including the whole pancreas and islets, in vivo. The latter effect is unlikely to be mediated by adenosine, the autonomic nervous system, or endothelial mediators.
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Affiliation(s)
- Xiang Gao
- Department of Medical Cell BiologyUppsala UniversityUppsalaSweden
| | - Andreas Lindqvist
- Department of Clinical SciencesLund University Diabetes CentreLund UniversityMalmöSweden
| | - Monica Sandberg
- Department of Medical Cell BiologyUppsala UniversityUppsalaSweden
| | - Leif Groop
- Department of Clinical SciencesLund University Diabetes CentreLund UniversityMalmöSweden
| | - Nils Wierup
- Department of Clinical SciencesLund University Diabetes CentreLund UniversityMalmöSweden
| | - Leif Jansson
- Department of Medical Cell BiologyUppsala UniversityUppsalaSweden
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20
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Almgren P, Lindqvist A, Krus U, Hakaste L, Ottosson-Laakso E, Asplund O, Sonestedt E, Prasad RB, Laurila E, Orho-Melander M, Melander O, Tuomi T, Holst JJ, Nilsson PM, Wierup N, Groop L, Ahlqvist E. Genetic determinants of circulating GIP and GLP-1 concentrations. JCI Insight 2017; 2:93306. [PMID: 29093273 DOI: 10.1172/jci.insight.93306] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2017] [Accepted: 09/29/2017] [Indexed: 12/19/2022] Open
Abstract
The secretion of insulin and glucagon from the pancreas and the incretin hormones glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) from the gastrointestinal tract is essential for glucose homeostasis. Several novel treatment strategies for type 2 diabetes (T2D) mimic GLP-1 actions or inhibit incretin degradation (DPP4 inhibitors), but none is thus far aimed at increasing the secretion of endogenous incretins. In order to identify new potential therapeutic targets for treatment of T2D, we performed a meta-analysis of a GWAS and an exome-wide association study of circulating insulin, glucagon, GIP, and GLP-1 concentrations measured during an oral glucose tolerance test in up to 7,828 individuals. We identified 6 genome-wide significant functional loci associated with plasma incretin concentrations in or near the SLC5A1 (encoding SGLT1), GIPR, ABO, GLP2R, F13A1, and HOXD1 genes and studied the effect of these variants on mRNA expression in pancreatic islet and on metabolic phenotypes. Immunohistochemistry showed expression of GIPR, ABO, and HOXD1 in human enteroendocrine cells and expression of ABO in pancreatic islets, supporting a role in hormone secretion. This study thus provides candidate genes and insight into mechanisms by which secretion and breakdown of GIP and GLP-1 are regulated.
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Affiliation(s)
- Peter Almgren
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Andreas Lindqvist
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Ulrika Krus
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Liisa Hakaste
- Endocrinology, Abdominal Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Diabetes and Obesity Research Program, University of Helsinki and Folkhälsan Research Center, Helsinki, Finland
| | - Emilia Ottosson-Laakso
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Olof Asplund
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Emily Sonestedt
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Rashmi B Prasad
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Esa Laurila
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Marju Orho-Melander
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Olle Melander
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Tiinamaija Tuomi
- Endocrinology, Abdominal Centre, University of Helsinki and Helsinki University Hospital, Helsinki, Finland; Diabetes and Obesity Research Program, University of Helsinki and Folkhälsan Research Center, Helsinki, Finland.,Finnish Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Jens Juul Holst
- Novo Nordisk Foundation Center for Basic Metabolic Research and Department of Biomedical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Peter M Nilsson
- Clinical Research Unit Medicine, Department of Internal Medicine, and Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Nils Wierup
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
| | - Leif Groop
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden.,Finnish Institute for Molecular Medicine, University of Helsinki, Helsinki, Finland
| | - Emma Ahlqvist
- Lund University Diabetes Centre, Department of Clinical Sciences, Malmö, Lund University, Skåne University Hospital, Malmö, Sweden
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Johansson BB, Fjeld K, Solheim MH, Shirakawa J, Zhang E, Keindl M, Hu J, Lindqvist A, Døskeland A, Mellgren G, Flatmark T, Njølstad PR, Kulkarni RN, Wierup N, Aukrust I, Bjørkhaug L. Nuclear import of glucokinase in pancreatic beta-cells is mediated by a nuclear localization signal and modulated by SUMOylation. Mol Cell Endocrinol 2017. [PMID: 28648619 DOI: 10.1016/j.mce.2017.06.020] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/26/2022]
Abstract
The localization of glucokinase in pancreatic beta-cell nuclei is a controversial issue. Although previous reports suggest such a localization, the mechanism for its import has so far not been identified. Using immunofluorescence, subcellular fractionation and mass spectrometry, we present evidence in support of glucokinase localization in beta-cell nuclei of human and mouse pancreatic sections, as well as in human and mouse isolated islets, and murine MIN6 cells. We have identified a conserved, seven-residue nuclear localization signal (30LKKVMRR36) in the human enzyme. Substituting the residues KK31,32 and RR35,36 with AA led to a loss of its nuclear localization in transfected cells. Furthermore, our data indicates that SUMOylation of glucokinase modulates its nuclear import, while high glucose concentrations do not significantly alter the enzyme nuclear/cytosolic ratio. Thus, for the first time, we provide data in support of a nuclear import of glucokinase mediated by a redundant mechanism, involving a nuclear localization signal, and which is modulated by its SUMOylation. These findings add new knowledge to the functional role of glucokinase in the pancreatic beta-cell.
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Affiliation(s)
- Bente Berg Johansson
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Norway; Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway; Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Karianne Fjeld
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Norway; Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Marie Holm Solheim
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Norway; Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway; Section on Integrative Physiology and Metabolism, Joslin Diabetes Center and Harvard Medical School, Boston, MA, USA
| | - Jun Shirakawa
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School and Harvard Stem Cell Institute, Boston, MA, USA; Department of Endocrinology and Metabolism, Yokohama City University, Yokohama, Japan
| | | | - Magdalena Keindl
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Norway; Hormone Laboratory, Haukeland University Hospital, Bergen, Norway
| | - Jiang Hu
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School and Harvard Stem Cell Institute, Boston, MA, USA
| | | | - Anne Døskeland
- Proteomics Unit (PROBE), Department of Biomedicine, University of Bergen, Norway
| | - Gunnar Mellgren
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Norway; Hormone Laboratory, Haukeland University Hospital, Bergen, Norway; Department of Clinical Science, University of Bergen, Bergen, Norway
| | | | - Pål Rasmus Njølstad
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Norway; Department of Pediatrics, Haukeland University Hospital, Bergen, Norway
| | - Rohit N Kulkarni
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Department of Medicine, Brigham and Women's Hospital, Harvard Medical School and Harvard Stem Cell Institute, Boston, MA, USA
| | - Nils Wierup
- Lund University Diabetes Centre, Malmö, Sweden
| | - Ingvild Aukrust
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Norway; Center for Medical Genetics and Molecular Medicine, Haukeland University Hospital, Bergen, Norway
| | - Lise Bjørkhaug
- KG Jebsen Center for Diabetes Research, Department of Clinical Science, University of Bergen, Norway; Department of Biomedicine, University of Bergen, Bergen, Norway; Department of Biomedical Laboratory Sciences and Chemical Engineering, Western Norway University of Applied Sciences, Bergen, Norway.
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Lundberg M, Lindqvist A, Wierup N, Krogvold L, Dahl-Jørgensen K, Skog O. The density of parasympathetic axons is reduced in the exocrine pancreas of individuals recently diagnosed with type 1 diabetes. PLoS One 2017. [PMID: 28628651 PMCID: PMC5476281 DOI: 10.1371/journal.pone.0179911] [Citation(s) in RCA: 19] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/08/2023] Open
Abstract
To elucidate the etiology of type 1 diabetes, the affected pancreas needs to be thoroughly characterized. Pancreatic innervation has been suggested to be involved in the pathology of the disease and a reduction of sympathetic innervation of the islets was recently reported. In the present study, we hypothesized that parasympathetic innervation would be altered in the type 1 diabetes pancreas. Human pancreatic specimens were obtained from a unique cohort of individuals with recent onset or long standing type 1 diabetes. Density of parasympathetic axons was assessed by immunofluorescence and morphometry. Our main finding was a reduced density of parasympathetic axons in the exocrine, but not endocrine compartment of the pancreas in individuals with recent onset type 1 diabetes. The reduced density of parasympathetic axons in the exocrine compartment could have functional implications, e.g. be related to the exocrine insufficiency reported in type 1 diabetes patients. Further studies are needed to understand whether reduced parasympathetic innervation is a cause or consequence of type 1 diabetes.
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Affiliation(s)
- Marcus Lundberg
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
- * E-mail:
| | | | - Nils Wierup
- Lund University Diabetes Centre, Lund University, Malmö, Sweden
| | - Lars Krogvold
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Knut Dahl-Jørgensen
- Division of Paediatric and Adolescent Medicine, Oslo University Hospital, Oslo, Norway
- Faculty of Medicine, University of Oslo, Oslo, Norway
| | - Oskar Skog
- Department of Immunology, Genetics and Pathology, Uppsala University, Uppsala, Sweden
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Bajc M, Chen Y, Wang J, Li XY, Shen WM, Wang CZ, Huang H, Lindqvist A, He XY. Identifying the heterogeneity of COPD by V/P SPECT: a new tool for improving the diagnosis of parenchymal defects and grading the severity of small airways disease. Int J Chron Obstruct Pulmon Dis 2017; 12:1579-1587. [PMID: 28603413 PMCID: PMC5457181 DOI: 10.2147/copd.s131847] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/22/2022] Open
Abstract
Introduction Airway obstruction and possible concomitant pulmonary diseases in COPD cannot be identified conventionally with any single diagnostic tool. We aimed to diagnose and grade COPD severity and identify pulmonary comorbidities associated with COPD with ventilation/perfusion single-photon emission computed tomography (V/P SPECT) using Technegas as the functional ventilation imaging agent. Methods 94 COPD patients (aged 43–86 years, Global Initiative for Chronic Obstructive Lung Disease (GOLD) stages I–IV) were examined with V/P SPECT and spirometry. Ventilation and perfusion defects were analyzed blindly according to the European guidelines. Penetration grade of Technegas in V SPECT measured the degree of obstructive small airways disease. Total preserved lung function and penetration grade of Technegas in V SPECT were assessed by V/P SPECT and compared to GOLD stages and spirometry. Results Signs of small airway obstruction in the ventilation SPECT images were found in 92 patients. Emphysema was identified in 81 patients. Two patients had no signs of COPD, but both of them had a pulmonary embolism, and in one of them we also suspected a lung tumor. The penetration grade of Technegas in V SPECT and total preserved lung function correlated significantly to GOLD stages (r=0.63 and −0.60, respectively, P<0.0001). V/P SPECT identified pulmonary embolism in 30 patients (32%). A pattern typical for heart failure was present in 26 patients (28%). Parenchymal changes typical for pneumonia or lung tumor were present in several cases. Conclusion V/P SPECT, using Technegas as the functional ventilation imaging agent, is a new tool to diagnose COPD and to grade its severity. Additionally, it revealed heterogeneity of COPD caused by pulmonary comorbidities. The characteristics of these comorbidities suggest their significant impact in clarifying symptoms, and also their influence on the prognosis.
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Affiliation(s)
- M Bajc
- Department of Clinical Science Physiology and Nuclear Medicine, Skåne University Hospital, Lund, Sweden
| | - Y Chen
- Respiratory Department, Changzheng Hospital, Shanghai
| | - J Wang
- Respiratory Department, Xinqiao Hospital, Chongqing
| | - X Y Li
- Respiratory Department, Huadong Hospital, Shanghai, China
| | - W M Shen
- Respiratory Department, Huadong Hospital, Shanghai, China
| | - C Z Wang
- Respiratory Department, Xinqiao Hospital, Chongqing
| | - H Huang
- Respiratory Department, Changzheng Hospital, Shanghai
| | - A Lindqvist
- Department of Pulmonary Medicine, Heart and Lung Center, Helsinki University Hospital and Helsinki University, Helsinki, Finland
| | - X Y He
- Suzhou University Affiliated Tumor Hospital, Wuxi, China
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Honka H, Koffert J, Kauhanen S, Teuho J, Hurme S, Mari A, Lindqvist A, Wierup N, Groop L, Nuutila P. Bariatric Surgery Enhances Splanchnic Vascular Responses in Patients With Type 2 Diabetes. Diabetes 2017; 66:880-885. [PMID: 28096259 DOI: 10.2337/db16-0762] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/23/2016] [Accepted: 01/11/2017] [Indexed: 11/13/2022]
Abstract
Bariatric surgery results in notable weight loss and alleviates hyperglycemia in patients with type 2 diabetes (T2D). We aimed to characterize the vascular effects of a mixed meal and infusion of exogenous glucose-dependent insulinotropic polypeptide (GIP) in the splanchnic region in 10 obese patients with T2D before and after bariatric surgery and in 10 lean control subjects. The experiments were carried out on two separate days. Pancreatic and intestinal blood flow (BF) were measured at baseline, 20 min, and 50 min with 15O-water by using positron emission tomography and MRI. Before surgery, pancreatic and intestinal BF responses to a mixed meal did not differ between obese and lean control subjects. Compared with presurgery, the mixed meal induced a greater increase in plasma glucose, insulin, and GIP concentrations after surgery, which was accompanied by a marked augmentation of pancreatic and intestinal BF responses. GIP infusion decreased pancreatic but increased small intestinal BF similarly in all groups both before and after surgery. Taken together, these results demonstrate that bariatric surgery leads to enhanced splanchnic vascular responses as a likely consequence of rapid glucose appearance and GIP hypersecretion.
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Affiliation(s)
- Henri Honka
- Turku PET Centre, University of Turku, Turku, Finland
| | - Jukka Koffert
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Gastroenterology, Turunmaa Hospital, Turku, Finland
| | - Saila Kauhanen
- Division of Digestive Surgery and Urology, Turku University Hospital, Turku, Finland
| | - Jarmo Teuho
- Turku PET Centre, University of Turku, Turku, Finland
| | - Saija Hurme
- Department of Biostatistics, University of Turku, Turku, Finland
| | - Andrea Mari
- Institute of Neuroscience, National Research Council, Padua, Italy
| | - Andreas Lindqvist
- Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden
| | - Nils Wierup
- Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden
| | - Leif Groop
- Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden
| | - Pirjo Nuutila
- Turku PET Centre, University of Turku, Turku, Finland
- Department of Endocrinology, Turku University Hospital, Turku, Finland
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Koffert J, Honka H, Teuho J, Kauhanen S, Hurme S, Parkkola R, Oikonen V, Mari A, Lindqvist A, Wierup N, Groop L, Nuutila P. Effects of meal and incretins in the regulation of splanchnic blood flow. Endocr Connect 2017; 6:179-187. [PMID: 28258126 PMCID: PMC5428912 DOI: 10.1530/ec-17-0015] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/20/2017] [Accepted: 03/03/2017] [Indexed: 01/19/2023]
Abstract
OBJECTIVE Meal ingestion is followed by a redistribution of blood flow (BF) within the splanchnic region contributing to nutrient absorption, insulin secretion and glucose disposal, but factors regulating this phenomenon in humans are poorly known. The aim of the present study was to evaluate the organ-specific changes in BF during a mixed-meal and incretin infusions. DESIGN A non-randomized intervention study of 10 healthy adults to study splanchnic BF regulation was performed. METHODS Effects of glucose-dependent insulinotrophic polypeptide (GIP) and glucagon-like peptide 1 (GLP-1) infusions and mixed-meal were tested in 10 healthy, glucose tolerant subjects using PET-MRI multimodal imaging technology. Intestinal and pancreatic BF and blood volume (BV) were measured with 15O-water and 15O-carbon monoxide, respectively. RESULTS Ingestion of a mixed-meal led to an increase in pancreatic and jejunal BF, whereas duodenal BF was unchanged. Infusion of GIP and GLP-1 reduced BF in the pancreas. However, GIP infusion doubled blood flow in the jejunum with no effect of GLP-1. CONCLUSION Together, our data suggest that meal ingestion leads to increases in pancreatic BF accompanied by a GIP-mediated increase in jejunal but not duodenal blood flow.
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Affiliation(s)
- Jukka Koffert
- Department of GastroenterologyTurunmaa Hospital, Turku, Finland
- Turku PET CentreUniversity of Turku, Turku, Finland
| | - Henri Honka
- Turku PET CentreUniversity of Turku, Turku, Finland
| | - Jarmo Teuho
- Department of GastroenterologyTurunmaa Hospital, Turku, Finland
| | - Saila Kauhanen
- Division of Digestive Surgery and UrologyTurku University Hospital, Turku, Finland
| | - Saija Hurme
- Institute of BiostatisticsUniversity of Turku, Turku, Finland
| | - Riitta Parkkola
- Turku PET CentreUniversity of Turku, Turku, Finland
- Department of RadiologyUniversity of Turku and Turku University Hospital, Turku, Finland
| | - Vesa Oikonen
- Turku PET CentreUniversity of Turku, Turku, Finland
| | - Andrea Mari
- Institute of NeuroscienceNational Research Council, Padua, Italy
| | - Andreas Lindqvist
- Department of Clinical SciencesLund University Diabetes Centre, Malmö, Sweden
| | - Nils Wierup
- Department of Clinical SciencesLund University Diabetes Centre, Malmö, Sweden
| | - Leif Groop
- Department of Clinical SciencesLund University Diabetes Centre, Malmö, Sweden
| | - Pirjo Nuutila
- Turku PET CentreUniversity of Turku, Turku, Finland
- Department of EndocrinologyTurku University Hospital, Turku, Finland
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Lindqvist A, Ekelund M, Pierzynowski S, Groop L, Hedenbro J, Wierup N. Gastric bypass in the pig increases GIP levels and decreases active GLP-1 levels. Peptides 2017; 90:78-82. [PMID: 28242256 DOI: 10.1016/j.peptides.2017.02.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/22/2016] [Revised: 02/17/2017] [Accepted: 02/21/2017] [Indexed: 01/06/2023]
Abstract
Gastric bypass surgery results in remission of type 2 diabetes in the majority of patients. The incretin hormones glucagon-like peptide 1 (GLP-1) and glucose-dependent insulinotropic polypeptide (GIP) have been implicated in the observed remission. Most knowledge so far has been generated in obese subjects. To isolate the surgical effects of gastric bypass on metabolism and hormone responses from the confounding influence of obesity, T2D, or food intake, we performed gastric bypass in lean pigs, using sham-operated and pair-fed pigs as controls. Thus, pigs were subjected to Roux-en-Y gastric bypass (RYGB) or sham surgery and oral glucose tolerance tests (OGTT). RYGB pigs and sham pigs exhibited similar basal and 120-min glucose levels in response to the OGTT. However, RYGB pigs had approximately 1.6-fold higher 30-min glucose (p<0.01). Early insulin release (EIR) was enhanced approximately 3.5-fold in the RYGB pigs (p<0.01). Furthermore, GIP release, both acute and sustained release (p<0.001 and p<0.01, respectively), was increased approximately 2.5-fold and 1.4-fold, respectively, in RYGB pigs. Although total GLP-1 release increased approximately 2.1-fold after RYGB (p<0.001), active GLP-1 was 33% lower (p<0.01). Interestingly basal DPP4-activity was approximately 3.2-fold higher in RYGB pigs (p<0.001). In conclusion, RYGB in lean pigs increases the response of GIP, total GLP-1, and insulin, but reduces levels of active GLP-1 in response to an oral glucose load. These data challenge the role of active GLP-1 as a contributor to remission from diabetes after RYGB.
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Affiliation(s)
| | | | | | - Leif Groop
- Lund University Diabetes Centre, Malmö, Sweden
| | - Jan Hedenbro
- Department of Surgery, Lund University, Lund, Sweden
| | - Nils Wierup
- Lund University Diabetes Centre, Malmö, Sweden.
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Lindqvist A, Ekelund M, Garcia-Vaz E, Ståhlman M, Pierzynowski S, Gomez MF, Rehfeld JF, Groop L, Hedenbro J, Wierup N, Spégel P. The impact of Roux-en-Y gastric bypass surgery on normal metabolism in a porcine model. PLoS One 2017; 12:e0173137. [PMID: 28257455 PMCID: PMC5336237 DOI: 10.1371/journal.pone.0173137] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Accepted: 02/15/2017] [Indexed: 12/14/2022] Open
Abstract
BACKGROUND A growing body of literature on Roux-en-Y gastric bypass surgery (RYGB) has generated inconclusive results on the mechanism underlying the beneficial effects on weight loss and glycaemia, partially due to the problems of designing clinical studies with the appropriate controls. Moreover, RYGB is only performed in obese individuals, in whom metabolism is perturbed and not completely understood. METHODS In an attempt to isolate the effects of RYGB and its effects on normal metabolism, we investigated the effect of RYGB in lean pigs, using sham-operated pair-fed pigs as controls. Two weeks post-surgery, pigs were subjected to an intravenous glucose tolerance test (IVGTT) and circulating metabolites, hormones and lipids measured. Bile acid composition was profiled after extraction from blood, faeces and the gallbladder. RESULTS A similar weight development in both groups of pigs validated our experimental model. Despite similar changes in fasting insulin, RYGB-pigs had lower fasting glucose levels. During an IVGTT RYGB-pigs had higher insulin and lower glucose levels. VLDL and IDL were lower in RYGB- than in sham-pigs. RYGB-pigs had increased levels of most amino acids, including branched-chain amino acids, but these were more efficiently suppressed by glucose. Levels of bile acids in the gallbladder were higher, whereas plasma and faecal bile acid levels were lower in RYGB- than in sham-pigs. CONCLUSION In a lean model RYGB caused lower plasma lipid and bile acid levels, which were compensated for by increased plasma amino acids, suggesting a switch from lipid to protein metabolism during fasting in the immediate postoperative period.
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Affiliation(s)
- Andreas Lindqvist
- Neuroendocrine Cell Biology, Department of Clinical Sciences Malmö, Lund University Diabetes Centre, Malmö, Sweden
| | - Mikael Ekelund
- Department of Surgery, Department of Clinical Sciences Malmö, Lund University, Lund, Sweden
| | - Eliana Garcia-Vaz
- Vascular ET-coupling, Department of Clinical Sciences Malmö, Lund University Diabetes Centre, Malmö, Sweden
| | - Marcus Ståhlman
- Sahlgrenska Academy, Institute of Medicine, Department of Molecular and Clinical Medicine and Wallenberg Laboratory, University of Gothenburg, Gothenburg, Sweden
| | - Stefan Pierzynowski
- Department of Cell and Organism Biology, Lund University, Lund, Sweden
- Innovation Center STB, Tczew, Poland
| | - Maria F. Gomez
- Vascular ET-coupling, Department of Clinical Sciences Malmö, Lund University Diabetes Centre, Malmö, Sweden
| | - Jens F. Rehfeld
- Department of Clinical Biochemistry, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark
| | - Leif Groop
- Diabetes and Endocrinology, Department of Clinical Sciences Malmö, Lund University Diabetes Centre, Malmö, Sweden
| | - Jan Hedenbro
- Neuroendocrine Cell Biology, Department of Clinical Sciences Malmö, Lund University Diabetes Centre, Malmö, Sweden
- Surgery, Department of Clinical Sciences Lund, Lund University, Lund, Sweden
| | - Nils Wierup
- Neuroendocrine Cell Biology, Department of Clinical Sciences Malmö, Lund University Diabetes Centre, Malmö, Sweden
| | - Peter Spégel
- Molecular Metabolism, Department of Clinical Sciences Malmö, Lund University Diabetes Centre, Malmö, Sweden
- Centre for Analysis and Synthesis, Department of Chemistry, Lund University, Lund, Sweden
- * E-mail:
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28
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Berggren J, Lindqvist A, Hedenbro J, Groop L, Wierup N. Roux-en-Y gastric bypass versus calorie restriction: support for surgery per se as the direct contributor to altered responses of insulin and incretins to a mixed meal. Surg Obes Relat Dis 2017; 13:234-242. [DOI: 10.1016/j.soard.2016.09.017] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2016] [Revised: 08/22/2016] [Accepted: 09/15/2016] [Indexed: 12/19/2022]
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Lindqvist A, Shcherbina L, Fischer AHT, Wierup N. Ghrelin Is a Regulator of Glucagon-Like Peptide 1 Secretion and Transcription in Mice. Front Endocrinol (Lausanne) 2017; 8:135. [PMID: 28674521 PMCID: PMC5475379 DOI: 10.3389/fendo.2017.00135] [Citation(s) in RCA: 15] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/20/2017] [Accepted: 06/01/2017] [Indexed: 01/23/2023] Open
Abstract
The gut hormones ghrelin, glucagon-like peptide 1 (GLP-1), and glucose-dependent insulinotropic peptide (GIP) have been intensively studied for their role in metabolism. It is, however, not well known whether the hormones interplay and regulate the secretion of each other. In this study, we studied the effect of ghrelin on GLP-1, GIP, and insulin secretion during an oral glucose tolerance test (OGTT) in mice. Intravenous administration of ghrelin caused increased GLP-1 secretion during the OGTT. On the other hand, ghrelin had no effect on circulating levels of glucose, insulin, and GIP. Furthermore, ghrelin treatment reduced proglucagon mRNA expression in GLUTag cells. The effect of ghrelin on GLP-1 secretion and proglucagon transcription was reinforced by the presence of GHS-R1a in human and mouse ileal L-cells, as well as in GLUTag cells. In summary, ghrelin is a regulator of GLP-1 secretion and transcription, and interfering with GHS-R1a signaling may be a way forward to enhance endogenous GLP-1 secretion in subjects with type 2 diabetes.
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Affiliation(s)
- Andreas Lindqvist
- Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden
| | - Liliya Shcherbina
- Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden
| | | | - Nils Wierup
- Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden
- *Correspondence: Nils Wierup,
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Warpman Berglund U, Sanjiv K, Gad H, Kalderén C, Koolmeister T, Pham T, Gokturk C, Jafari R, Maddalo G, Seashore-Ludlow B, Chernobrovkin A, Manoilov A, Pateras IS, Rasti A, Jemth AS, Almlöf I, Loseva O, Visnes T, Einarsdottir BO, Gaugaz FZ, Saleh A, Platzack B, Wallner OA, Vallin KSA, Henriksson M, Wakchaure P, Borhade S, Herr P, Kallberg Y, Baranczewski P, Homan EJ, Wiita E, Nagpal V, Meijer T, Schipper N, Rudd SG, Bräutigam L, Lindqvist A, Filppula A, Lee TC, Artursson P, Nilsson JA, Gorgoulis VG, Lehtiö J, Zubarev RA, Scobie M, Helleday T. Validation and development of MTH1 inhibitors for treatment of cancer. Ann Oncol 2016; 27:2275-2283. [PMID: 27827301 DOI: 10.1093/annonc/mdw429] [Citation(s) in RCA: 94] [Impact Index Per Article: 11.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/18/2016] [Accepted: 09/01/2016] [Indexed: 12/11/2022] Open
Abstract
BACKGROUND Previously, we showed cancer cells rely on the MTH1 protein to prevent incorporation of otherwise deadly oxidised nucleotides into DNA and we developed MTH1 inhibitors which selectively kill cancer cells. Recently, several new and potent inhibitors of MTH1 were demonstrated to be non-toxic to cancer cells, challenging the utility of MTH1 inhibition as a target for cancer treatment. MATERIAL AND METHODS Human cancer cell lines were exposed in vitro to MTH1 inhibitors or depleted of MTH1 by siRNA or shRNA. 8-oxodG was measured by immunostaining and modified comet assay. Thermal Proteome profiling, proteomics, cellular thermal shift assays, kinase and CEREP panel were used for target engagement, mode of action and selectivity investigations of MTH1 inhibitors. Effect of MTH1 inhibition on tumour growth was explored in BRAF V600E-mutated malignant melanoma patient derived xenograft and human colon cancer SW480 and HCT116 xenograft models. RESULTS Here, we demonstrate that recently described MTH1 inhibitors, which fail to kill cancer cells, also fail to introduce the toxic oxidized nucleotides into DNA. We also describe a new MTH1 inhibitor TH1579, (Karonudib), an analogue of TH588, which is a potent, selective MTH1 inhibitor with good oral availability and demonstrates excellent pharmacokinetic and anti-cancer properties in vivo. CONCLUSION We demonstrate that in order to kill cancer cells MTH1 inhibitors must also introduce oxidized nucleotides into DNA. Furthermore, we describe TH1579 as a best-in-class MTH1 inhibitor, which we expect to be useful in order to further validate the MTH1 inhibitor concept.
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Affiliation(s)
- U Warpman Berglund
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - K Sanjiv
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - H Gad
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - C Kalderén
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - T Koolmeister
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - T Pham
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - C Gokturk
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - R Jafari
- Clinical Proteomics Mass Spectrometry, Department of Oncology-Pathology
| | - G Maddalo
- Clinical Proteomics Mass Spectrometry, Department of Oncology-Pathology
| | - B Seashore-Ludlow
- Chemical Biology Consortium Sweden, Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - A Chernobrovkin
- Division of Physiological Chemistry I, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - A Manoilov
- Division of Physiological Chemistry I, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - I S Pateras
- Molecular Carcinogenesis Group, Department of Histology and Embryology, School of Medicine, National and Kapodistrian University of Athens, Athens, Greece
| | - A Rasti
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - A-S Jemth
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - I Almlöf
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - O Loseva
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - T Visnes
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - B O Einarsdottir
- Sahlgrenska Translational Melanoma Group (SATMEG), Sahlgrenska Cancer Center, Department of Surgery, Institute of Clinical Sciences, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg
| | - F Z Gaugaz
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics.,Department of Pharmacy and
| | - A Saleh
- Science for Life Laboratory Drug Discovery and Development Platform, ADME of Therapeutics facility, Department of Phamracy, Uppsala University, Uppsala, Sweden
| | - B Platzack
- Swedish Toxicology Sciences Research Center, Södertälje, Sweden
| | - O A Wallner
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - K S A Vallin
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - M Henriksson
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - P Wakchaure
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - S Borhade
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - P Herr
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - Y Kallberg
- National Bioinformatics Infrastructure Sweden (NBIS), Science for Life Laboratory, Department of Medicine Solna, Karolinska Institutet, Stockholm
| | - P Baranczewski
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics.,Science for Life Laboratory Drug Discovery and Development Platform, ADME of Therapeutics facility, Department of Phamracy, Uppsala University, Uppsala, Sweden
| | - E J Homan
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - E Wiita
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - V Nagpal
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics.,SP Process Development, Södertälje, Sweden
| | - T Meijer
- SP Process Development, Södertälje, Sweden
| | - N Schipper
- SP Process Development, Södertälje, Sweden
| | - S G Rudd
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - L Bräutigam
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - A Lindqvist
- Science for Life Laboratory Drug Discovery and Development Platform, ADME of Therapeutics facility, Department of Phamracy, Uppsala University, Uppsala, Sweden
| | - A Filppula
- Uppsala Drug Optimisation and Pharmaceutical Profiling Platform (UDOPP), Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - T-C Lee
- Institute of biomedical sciences, Academia Sinica, Taipei-115, Taiwan
| | - P Artursson
- Department of Pharmacy and.,Science for Life Laboratory Drug Discovery and Development Platform, ADME of Therapeutics facility, Department of Phamracy, Uppsala University, Uppsala, Sweden.,Uppsala Drug Optimisation and Pharmaceutical Profiling Platform (UDOPP), Department of Pharmacy, Uppsala University, Uppsala, Sweden
| | - J A Nilsson
- Sahlgrenska Translational Melanoma Group (SATMEG), Sahlgrenska Cancer Center, Department of Surgery, Institute of Clinical Sciences, University of Gothenburg and Sahlgrenska University Hospital, Gothenburg
| | - V G Gorgoulis
- Biomedical Research Foundation of the Academy of Athens, Athens, Greece.,Faculty Institute for Cancer Sciences, Manchester Academic Health Sciences Centre, University of Manchester, Manchester, UK
| | - J Lehtiö
- Clinical Proteomics Mass Spectrometry, Department of Oncology-Pathology
| | - R A Zubarev
- Division of Physiological Chemistry I, Department of Medical Biochemistry and Biophysics, Karolinska Institutet, Stockholm, Sweden
| | - M Scobie
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
| | - T Helleday
- Science for Life Laboratory, Division of Translational Medicine and Chemical Biology, Department of Medical Biochemistry and Biophysics
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Abels M, Riva M, Bennet H, Ahlqvist E, Dyachok O, Nagaraj V, Shcherbina L, Fred RG, Poon W, Sörhede-Winzell M, Fadista J, Lindqvist A, Kask L, Sathanoori R, Dekker-Nitert M, Kuhar MJ, Ahrén B, Wollheim CB, Hansson O, Tengholm A, Fex M, Renström E, Groop L, Lyssenko V, Wierup N. CART is overexpressed in human type 2 diabetic islets and inhibits glucagon secretion and increases insulin secretion. Diabetologia 2016; 59:1928-37. [PMID: 27338624 DOI: 10.1007/s00125-016-4020-6] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/17/2016] [Accepted: 05/23/2016] [Indexed: 11/30/2022]
Abstract
AIMS/HYPOTHESIS Insufficient insulin release and hyperglucagonaemia are culprits in type 2 diabetes. Cocaine- and amphetamine-regulated transcript (CART, encoded by Cartpt) affects islet hormone secretion and beta cell survival in vitro in rats, and Cart (-/-) mice have diminished insulin secretion. We aimed to test if CART is differentially regulated in human type 2 diabetic islets and if CART affects insulin and glucagon secretion in vitro in humans and in vivo in mice. METHODS CART expression was assessed in human type 2 diabetic and non-diabetic control pancreases and rodent models of diabetes. Insulin and glucagon secretion was examined in isolated islets and in vivo in mice. Ca(2+) oscillation patterns and exocytosis were studied in mouse islets. RESULTS We report an important role of CART in human islet function and glucose homeostasis in mice. CART was found to be expressed in human alpha and beta cells and in a subpopulation of mouse beta cells. Notably, CART expression was several fold higher in islets of type 2 diabetic humans and rodents. CART increased insulin secretion in vivo in mice and in human and mouse islets. Furthermore, CART increased beta cell exocytosis, altered the glucose-induced Ca(2+) signalling pattern in mouse islets from fast to slow oscillations and improved synchronisation of the oscillations between different islet regions. Finally, CART reduced glucagon secretion in human and mouse islets, as well as in vivo in mice via diminished alpha cell exocytosis. CONCLUSIONS/INTERPRETATION We conclude that CART is a regulator of glucose homeostasis and could play an important role in the pathophysiology of type 2 diabetes. Based on the ability of CART to increase insulin secretion and reduce glucagon secretion, CART-based agents could be a therapeutic modality in type 2 diabetes.
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Affiliation(s)
- Mia Abels
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Matteo Riva
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Hedvig Bennet
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Emma Ahlqvist
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Oleg Dyachok
- Department of Medical Cell Biology, Uppsala University Biomedical Centre, Uppsala, Sweden
| | - Vini Nagaraj
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Liliya Shcherbina
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Rikard G Fred
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Wenny Poon
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | | | - Joao Fadista
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Andreas Lindqvist
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Lena Kask
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Ramasri Sathanoori
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | | | - Michael J Kuhar
- The Yerkes Research Center of Emory University, Atlanta, GA, USA
| | - Bo Ahrén
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Claes B Wollheim
- Department of Cell Physiology and Metabolism, University Medical Centre, Geneva, Switzerland
| | - Ola Hansson
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Anders Tengholm
- Department of Medical Cell Biology, Uppsala University Biomedical Centre, Uppsala, Sweden
| | - Malin Fex
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Erik Renström
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Leif Groop
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
| | - Valeriya Lyssenko
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden
- Steno Diabetes Center A/S, Gentofte, Denmark
| | - Nils Wierup
- Lund University Diabetes Centre, Skåne University Hospital, Lund and Malmö, Sweden.
- Lund University Diabetes Centre, Skåne University Hospital, Department of Clinical Sciences in Malmö, Unit of Neuroendocrine Cell Biology, Lund University, Clinical Research Centre 91:12, Jan Waldenströms gata 35, 20502, Malmö, Sweden.
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32
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Nordin L, Nordlund A, Lindqvist A, Gislason H, Hedenbro JL. Corticosteroids or Not for Postoperative Nausea: A Double-Blinded Randomized Study. J Gastrointest Surg 2016; 20:1517-22. [PMID: 27216406 DOI: 10.1007/s11605-016-3166-3] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2016] [Accepted: 05/06/2016] [Indexed: 01/31/2023]
Abstract
BACKGROUND Postoperative nausea and vomiting (PONV) is common after general anaesthesia, and corticosteroids are used in many protocols for enhanced recovery after surgery (ERAS). However, surgical techniques are developing, and ERAS protocols need to be reevaluated from time to time. PATIENTS AND METHOD In this study, we compared the effects of oral vs. parenteral corticosteroid administration on postoperative nausea. Elective Roux-y-gastric bypass (RYGB) patients were randomly assigned to either 8 mg betamethasone orally (n = 50) or parentally (n = 25) or as controls (n = 25), in a double-blind design. PONV risk factors were noted. All patients had the same anaesthetic technique. Data were collected at baseline, on arrival to the recovery room (RR) and at five more time points during the first 24 h. Nausea and tiredness were patient assessed using visual analogue scales; rescue drug consumption was recorded. RESULTS Operation time was 30-40 min. Neither demographics nor risk factors for nausea differed between groups. Neither peak values for nor total amount of nausea differed between groups. The number of supplemental injections was the same for all groups. COMMENTS In a setting of modern laparoscopic RYGB, the value of betamethasone in preventing PONV seems to be limited. ERAS protocols may need re-evaluation.
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Affiliation(s)
- L Nordin
- Aleris Obesity Academy, St Lars v 45B, SE 222 70, Lund, Sweden
| | - A Nordlund
- Aleris Obesity Academy, St Lars v 45B, SE 222 70, Lund, Sweden
| | - A Lindqvist
- Lund University Diabetes Centre, Malmö, Sweden
| | - H Gislason
- Aleris Obesity Academy, St Lars v 45B, SE 222 70, Lund, Sweden
| | - J L Hedenbro
- Aleris Obesity Academy, St Lars v 45B, SE 222 70, Lund, Sweden. .,Department of Surgery, Clinical Sciences, Lund University, Lund, Sweden.
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33
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Lozinska L, Weström B, Prykhodko O, Lindqvist A, Wierup N, Ahrén B, Szwiec K, Pierzynowski SG. Decreased insulin secretion and glucose clearance in exocrine pancreas-insufficient pigs. Exp Physiol 2015; 101:100-12. [PMID: 26663041 DOI: 10.1113/ep085431] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/15/2015] [Accepted: 10/30/2015] [Indexed: 12/26/2022]
Abstract
The effect of exocrine pancreatic function on the glucose-mediated insulin response and glucose utilization were studied in an exocrine pancreas-insufficient (EPI) pig model. Five 10-week-old EPI pigs after pancreatic duct ligation and 6 age-matched, non-operated control pigs were used in the study. Blood glucose, plasma insulin and C-peptide concentrations were monitored during meal (MGTT), oral (OGTT) and intravenous (IVGTT) glucose tolerance tests. Upon post-mortem examination, the pancreatic remnants of the EPI pigs showed acinar fibrotic atrophy but normal islets and β-cell morphology. The EPI pigs displayed increased fasting glucose concentrations compared with control animals (6.4 ± 0.4 versus 4.8 ± 0.1 mmol l(-1) , P < 0.0001) but unchanged insulin concentrations (2.4 ± 0.6 versus 2.1 ± 0.2 pmol l(-1) ). During the OGTT and IVGTT, the EPI pigs showed slower, impaired glucose utilization, with the disruption of a well-timed insulin response. Plasma C-peptide concentrations confirmed the delayed insulin response during the IVGTT in EPI pigs. Oral pancreatic enzyme supplementation (PES) of EPI pigs improved glucose clearance during IVGTT [AUC(glucose) 1295 ± 70 mmol l(-1) × (120 min) in EPI versus 1044 ± 32 mmol l(-1) × (120 min) in EPI + PES, P < 0.0001] without reinforcing the release of insulin [AUC(C-peptide) 14.4 ± 3.8 nmol l(-1) × (120 min) in EPI versus 6.4 ± 1.3 nmol l(-1) × (120 min) in EPI + PES, P < 0.002]. The results suggest the existence of an acino-insular axis regulatory communication. The presence of pancreatic enzymes in the gut facilitates glucose utilization in an insulin-independent manner, indicating the existence of a gut-derived pancreatic enzyme-dependent mechanism involved in peripheral glucose utilization.
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Affiliation(s)
| | - Björn Weström
- Department of Biology, Lund University, Lund, Sweden
| | | | - Andreas Lindqvist
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Nils Wierup
- Department of Clinical Sciences in Malmö, Lund University, Malmö, Sweden
| | - Bo Ahrén
- Department of Clinical Sciences, Lund University, Lund, Sweden
| | | | - Stefan G Pierzynowski
- Department of Biology, Lund University, Lund, Sweden.,Department of Medical Biology, Institute of Rural Health, Lublin, Poland
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34
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Begic A, Opankovic E, Cukic V, Lindqvist A, Miniati M, Bajc M. Ancillary findings assessed by ventilation/perfusion tomography. Impact and clinical outcome in patients with suspected pulmonary embolism. Nuklearmedizin 2015; 54:223-30. [PMID: 26227225 DOI: 10.3413/nukmed-0748-15-06] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/05/2015] [Accepted: 07/20/2015] [Indexed: 11/20/2022]
Abstract
UNLABELLED Ventilation/perfusion tomography (V/P SPECT) is a recommended method for diagnosing and follow-up of pulmonary embolism (PE). Moreover, it is possible to recognize other pathologies in addition to PE, such as pneumonia, COPD and left heart failure (LHF). The objective of this prospective study was to identify frequency of ancillary findings among patients with suspected PE. Patients, material, method: 331 consecutive patients with suspected PE were examined and classified with V/P SPECT. Patients were followed up clinically and by means of other laboratory tests. RESULTS 80 patients had a normal V/P SPECT and no clinical consequences in the follow-up. PE had 104 patients: 23 of them had also additional findings. Among the remaining 147 patients, pneumonias were shown in 82, acute in 75 patients and 7 had chronic post inflammatory state. COPD was present in 42 patients, in 3 combined with pneumonia. Sign of LHF was observed in 10: in 7 the acute LHF diagnosis was established, 3 were classified as having a chronic cardiopulmonary disease. Furthermore, in 16 patients, the V/P pattern was suggestive of a tumour. The clinical outcomes were 6 lung tumours, 3 empyema, one sarcoidosis, 2 were unclarified and 4 were lost in the follow-up. CONCLUSION V/P SPECT identifies a high prevalence of other cardiopulmonary diseases among patients with a clinical suspicion of PE. Ancillary findings with V/P SPECT clarified patients' symptoms and had an impact on the treatment. These findings were verified by a clinical outcome by the follow-up over three months.
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Affiliation(s)
| | | | | | | | | | - M Bajc
- Marika Bajc MD, PhD, Department of clinical sciences Lund, 221 85 Lund, Sweden, Tel. +46/46 17 33 03,
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35
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Nergård BJ, Lindqvist A, Gislason HG, Groop L, Ekelund M, Wierup N, Hedenbro JL. Mucosal glucagon-like peptide-1 and glucose-dependent insulinotropic polypeptide cell numbers in the super-obese human foregut after gastric bypass. Surg Obes Relat Dis 2015; 11:1237-46. [PMID: 26143297 DOI: 10.1016/j.soard.2015.03.021] [Citation(s) in RCA: 40] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/20/2014] [Revised: 03/26/2015] [Accepted: 03/30/2015] [Indexed: 12/25/2022]
Abstract
BACKGROUND Super-obesity, a body mass index>50 kg/m(2), is difficult to treat. Many studies have focused on the anatomic changes of the intestines; the physiologic background is not clearly identified. It is established that Roux-en-Y gastric bypass (RYGB) augments secretion of glucagon-like peptide-1 (GLP-1), peptide tyrosine tyrosine (PYY), and insulin, but other aspects of gut hormone cell function in the alimentary limb are unknown. OBJECTIVE To study the effects of laparoscopic RYGB on enteroendocrine cells. SETTING University-affiliated, high-volume bariatric surgery center. METHODS Eighteen nondiabetic patients were drawn from the present study (NCT 01514799), randomizing between biliopancreatic (BP) limbs of either 60 cm (BP60) or 200 cm (BP200). Demographic characteristics did not differ at baseline or 12 months. Pouch and jejunal biopsies were obtained intraoperatively and using endoscopy at 12 months. Mucosal height and density of hormone-producing cell populations were assessed and mRNA expression measured with real-time polymerase chain reaction. RESULTS In perianastomotic jejunum, a 4.9-fold increase in GLP-1 cell density was evident 12 months after RYGB, most pronounced in the BP200-group. The densities of glucose-dependent insulinotropic polypeptide (GIP) cells and PYY immunoreactive cells were doubled after 12 months. GIP mRNA was unaffected, but GLP-1 and PYY mRNA were lower 12 months after RYGB. RYGB had no impact on villi length or density of ghrelin-, cholecystokinin-, neurotensin-, secretin-, or serotonin-producing cells after 12 months. Pouch mucosal height and cell densities of ghrelin-, histamine-, serotonin-, and somatostatin-producing cells remained unaffected by RYGB in both groups. CONCLUSIONS RYGB selectively increased the density of incretin-producing cell populations in the jejunum. This may provide anatomic explanation for the observed increased plasma levels of incretins.
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Affiliation(s)
| | | | | | - Leif Groop
- Lund University Diabetes Centre, Malmö, Sweden
| | - Mikael Ekelund
- Department of Surgery, Clinical Sciences, Lund University, Lund, Sweden
| | - Nils Wierup
- Lund University Diabetes Centre, Malmö, Sweden
| | - Jan L Hedenbro
- Aleris Obesity, Lund, Sweden; Department of Surgery, Clinical Sciences, Lund University, Lund, Sweden.
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36
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Kainu A, Timonen KL, Toikka J, Qaiser B, Pitkäniemi J, Kotaniemi JT, Lindqvist A, Vanninen E, Länsimies E, Sovijärvi ARA. Reference values of spirometry for Finnish adults. Clin Physiol Funct Imaging 2015; 36:346-58. [PMID: 25817817 DOI: 10.1111/cpf.12237] [Citation(s) in RCA: 48] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/13/2014] [Accepted: 01/27/2015] [Indexed: 12/01/2022]
Abstract
BACKGROUND Diagnostic assessment of lung function necessitates up-to-date reference values. The aim of this study was to estimate reference values for spirometry for the Finnish population between 18 and 80 years and to compare them with the existing Finnish, European and the recently published global GLI2012 reference values. METHODS Spirometry was performed for 1380 adults in the population-based FinEsS studies and for 662 healthy non-smoking volunteer adults. Detailed predefined questionnaire screening of diseases and symptoms, and quality control of spirometry yielded a sample of 1000 native Finns (387 men) healthy non-smokers aged 18-83 years. Sex-specific reference values, which are estimated using the GAMLSS method and adjusted for age and height, are provided. RESULTS The predicted values for lung volumes are larger than those obtained by GLI2012 prediction for the Caucasian subgroup for forced vital capacity (FVC) by an average 6·2% and 5·1% and forced expiratory volume in 1 s (FEV1) by an average 4·2% and 3·0% in men and women, respectively. GLI2012 slightly overestimated the ratio FEV1/FVC with an age-dependent trend. Most reference equations from other European countries, with the exception of the Swiss SAPALDIA study, showed an underestimation of FVC and FEV1 to varying degrees, and a slight overestimation of FEV1/FVC. CONCLUSION This study offers up-to-date reference values of spirometry for native Finns with a wide age range. The GLI2012 predictions seem not to be suitable for clinical use for native Finns due to underestimation of lung volumes.
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Affiliation(s)
- A Kainu
- Department of Pulmonary Medicine, HUCH Heart and Lung Center, Peijas Hospital, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - K L Timonen
- Department of Clinical Physiology, Central Hospital of Central Finland, Jyväskylä, Finland.,Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - J Toikka
- Department of Clinical Physiology, Turku University Hospital, Turku, Finland.,Department of Clinical Physiology, Tampere University Hospital, Tampere, Finland
| | - B Qaiser
- Department of Public Health, Hjelt -institute, University of Helsinki, Helsinki, Finland
| | - J Pitkäniemi
- Department of Public Health, Hjelt -institute, University of Helsinki, Helsinki, Finland
| | - J T Kotaniemi
- Department of Respiratory Diseases, Tampere University Hospital, Tampere, Finland
| | - A Lindqvist
- Research Unit of Pulmonary Diseases, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
| | - E Vanninen
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - E Länsimies
- Department of Clinical Physiology and Nuclear Medicine, Kuopio University Hospital and University of Eastern Finland, Kuopio, Finland
| | - A R A Sovijärvi
- Department of Clinical Physiology and Nuclear Medicine, HUS Medical Imaging Center, University of Helsinki and Helsinki University Hospital, Helsinki, Finland
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Wierup N, Lindqvist A, Spégel P, Groop L, Hedenbro J, Ekelund M. Short- and Long-Term Hormonal and Metabolic Consequences of Reversing Gastric Bypass to Normal Anatomy in a Type 2 Diabetes Patient. Obes Surg 2014; 25:180-5. [DOI: 10.1007/s11695-014-1459-8] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
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Lindqvist A, Spégel P, Ekelund M, Garcia Vaz E, Pierzynowski S, Gomez MF, Mulder H, Hedenbro J, Groop L, Wierup N. Gastric bypass improves β-cell function and increases β-cell mass in a porcine model. Diabetes 2014; 63:1665-71. [PMID: 24487021 DOI: 10.2337/db13-0969] [Citation(s) in RCA: 58] [Impact Index Per Article: 5.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
Abstract
The most frequently used and effective treatment for morbid obesity is Roux-en-Y gastric bypass surgery (RYGB), which results in rapid remission of type 2 diabetes in most cases. To what extent this is accounted for by weight loss or other factors remains elusive. To gain insight into these mechanisms, we investigated the effects of RYGB on β-cell function and β-cell mass in the pig, a species highly reminiscent of the human. RYGB was performed using linear staplers during open surgery. Sham-operated pigs were used as controls. Both groups were fed a low-calorie diet for 3 weeks after surgery. Intravenous glucose tolerance tests were performed 2 weeks after surgery. Body weight in RYGB pigs and sham-operated, pair-fed control pigs developed similarly. RYGB pigs displayed improved glycemic control, which was attributed to increases in β-cell mass, islet number, and number of extraislet β-cells. Pancreatic expression of insulin and glucagon was elevated, and cells expressing the glucagon-like peptide 1 receptor were more abundant in RYGB pigs. Our data from a pig model of RYGB emphasize the key role of improved β-cell function and β-cell mass to explain the improved glucose tolerance after RYGB as food intake and body weight remained identical.
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Affiliation(s)
- Andreas Lindqvist
- Department of Clinical Sciences, Lund University Diabetes Centre, Malmö, Sweden
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39
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Spégel P, Lindqvist A, Sandberg M, Wierup N. Glucose-dependent insulinotropic polypeptide lowers branched chain amino acids in hyperglycemic rats. ACTA ACUST UNITED AC 2014; 189:11-6. [PMID: 24412429 DOI: 10.1016/j.regpep.2013.12.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/30/2013] [Revised: 12/28/2013] [Accepted: 12/31/2013] [Indexed: 10/25/2022]
Abstract
Hypersecretion of the incretin hormone glucose-dependent insulinotropic polypeptide (GIP) has been associated with obesity and glucose intolerance. This condition has been suggested to be linked to GIP resistance. Besides its insulinotropic effect, GIP also directly affects glucose uptake and lipid metabolism. This notwithstanding, effects of GIP on other circulating metabolites than glucose have not been thoroughly investigated. Here, we examined effects of infusion of various concentrations of GIP in normo- and hyperglycemic rats on serum metabolite profiles. We found that, despite a decrease in serum glucose levels (-26%, p<0.01), the serum metabolite profile was largely unaffected by GIP infusion in normoglycemic rats. Interestingly, levels of branched chain amino acids and the ketone body β-hydroxybutyrate were decreased by 21% (p<0.05) and 27% (p<0.001), respectively, in hyperglycemic rats infused with 60 ng/ml GIP. Hence, our data suggest that GIP provokes a decrease in BCAA levels and ketone body production. Increased concentrations of these metabolites have been associated with obesity and T2D.
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Affiliation(s)
- Peter Spégel
- Molecular Metabolism, Lund University Diabetes Centre, Malmö, Sweden.
| | | | - Monica Sandberg
- Department of Medical Cell Biology, Uppsala University, Uppsala, Sweden
| | - Nils Wierup
- Neuroendocrine Cell Biology, Lund University Diabetes Centre, Malmö Sweden
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Koskela J, Kupiainen H, Kilpeläinen M, Lindqvist A, Sintonen H, Pitkäniemi J, Laitinen T. Longitudinal HRQoL shows divergent trends and identifies constant decliners in asthma and COPD. Respir Med 2013; 108:463-71. [PMID: 24388549 DOI: 10.1016/j.rmed.2013.12.001] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/28/2013] [Revised: 09/18/2013] [Accepted: 12/05/2013] [Indexed: 01/31/2023]
Abstract
BACKGROUND/AIM Monitoring of lung function alone does not adequately identify the high-risk patients among elderly asthma and COPD cohorts. The additional value of Health-Related Quality of Life (HRQoL) development in the detection of patients with a disabling disease in clinical practice is unclear. The aim of this study was to statistically examine the individual development of HRQoL measured using respiratory-specific AQ20 and generic 15D questionnaires. MATERIALS AND METHODS The HRQoL of COPD (N = 739) and asthma (N = 1329) patients was evaluated at 0, 1, 2, and 4 years after recruitment. To determine a five-year HRQoL change for each patient we used mixed-effects modelling for linear trend. RESULTS In COPD, the majority (60-80%) of the individuals showed declining trend, whereas in asthma, the majority (46-71%) showed no attenuation in HRQoL. The proportion of constant decliners was estimated higher with the 15D both in asthma (6.3%) and COPD (6.3%) than with AQ20 (3.5 and 4.5%, respectively). The first measurement of HRQoL was found to predict future development of HRQoL. In asthma, obesity-related diseases such as hypertension, diabetes and gastro-esophageal reflux disease best explained the decline, whereas in COPD, age and the level of bronchial obstruction were the main determinants. CONCLUSION Based on the five-year follow-up, the HRQoL trends significantly diverging from each other could be identified both among the asthma and COPD patients. Compared to cross-sectional HRQoL, the HRQoL trend over a clinically relevant period of time allows us to ignore, to a great extent, the random error of self-assessed HRQoL and thus, it may offer a more accurate measure to describe the disease process.
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Affiliation(s)
- J Koskela
- Clinical Research Unit for Pulmonary Diseases and Division of Pulmonology, Helsinki University Central Hospital, Finland.
| | - H Kupiainen
- Clinical Research Unit for Pulmonary Diseases and Division of Pulmonology, Helsinki University Central Hospital, Finland
| | - M Kilpeläinen
- Division of Medicine, Dept. of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, Finland
| | - A Lindqvist
- Clinical Research Unit for Pulmonary Diseases and Division of Pulmonology, Helsinki University Central Hospital, Finland
| | - H Sintonen
- Department of Public Health, University of Helsinki, Finland
| | - J Pitkäniemi
- Department of Public Health, University of Helsinki, Finland
| | - T Laitinen
- Division of Medicine, Dept. of Pulmonary Diseases and Clinical Allergology, Turku University Hospital and University of Turku, Finland
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Lindqvist A, Spégel P, Ekelund M, Mulder H, Groop L, Hedenbro J, Wierup N. Effects of ingestion routes on hormonal and metabolic profiles in gastric-bypassed humans. J Clin Endocrinol Metab 2013; 98:E856-61. [PMID: 23633201 DOI: 10.1210/jc.2012-3996] [Citation(s) in RCA: 33] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/06/2023]
Abstract
CONTEXT Gastric bypass surgery (GBP) results in the rapid resolution of type 2 diabetes. Most studies aiming to explain the underlying mechanisms are limited to data obtained after a postsurgical recovery period, making assessment of confounding influences from, for example, weight loss and altered nutrient intake difficult. OBJECTIVE To examine the impact of GBP on hormonal and metabolite profiles under conditions of identical nutrient intake independent of weight loss, we studied GBP patients fitted with a gastrostomy tube to enable the administration of nutrients to bypassed segments of the gut. Thus, this model allowed us to simulate partially the preoperative condition and compare this with the postoperative situation in the same patient. DESIGN Patients (n = 4) were first given a mixed meal test (MMT) orally and then via the gastrostomy tube, preceded by overnight and 2-hour fasting, respectively. Blood samples were assessed for hormones and metabolites. RESULTS The oral MMT yielded 4.6-fold increase in plasma insulin (P < .05), 2-fold in glucagon-like peptide-1 (P < .05), and 2.5-fold in glucose-dependent insulinotropic peptide (P < .05) plasma levels, compared with the gastrostomy MMT. The changes in hormone levels were accompanied by elevated branched-chain amino acid levels (1.4-2-fold, P < .05) and suppressed fatty acid levels (∼50%, P < .05). CONCLUSIONS These data, comparing identical nutrient delivery, demonstrate markedly higher incretin and insulin responses after oral MMT than after gastric MMT, thereby providing a potential explanation for the rapid remission of type 2 diabetes observed after GBP. The simultaneous increase in branched-chain amino acid questions its role as a marker for insulin resistance.
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Affiliation(s)
- Andreas Lindqvist
- Department of Clinical Sciences, Lund University Diabetes Centre, Lund University, SE-205 02 Malmö, Sweden
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Poukkula A, Alanko K, Kilpiö K, Knuuttila A, Koskinen S, Laitinen J, Lehtonen K, Liippo K, Lindqvist A, Lähelmä S, Paananen M, Ruotsalainen EM, Salomaa ER, Silvasti M, Suuronen U, Toivanen P, Vilkka V. Comparison of a Multidose Powder Inhaler Containing Beclomethasone Dipropionate (BDP) with a BDP Metered Dose Inhaler with Spacer in the Treatment of Asthmatic Patients. Clin Drug Investig 2012; 16:101-10. [PMID: 18370527 DOI: 10.2165/00044011-199816020-00002] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/02/2022]
Abstract
OBJECTIVE The clinical efficacy, tolerability and acceptability of a new multidose powder inhaler (MDPI) [Easyhaler((R)), Orion Pharma, Finland] containing a high dose (500 microg/dose) of beclomethasone dipropionate (BDP) were compared with those of BDP metered dose inhaler administered with a large volume spacer (MDI-spacer). PATIENTS AND STUDY DESIGN Recruited patients were adult asthmatics currently receiving 800 to 1000 microg/day of inhaled corticosteroid. The dose of BDP during the study was 1000 mg/day. The study was an open, randomised, parallel-group multicentre study and included a 2-week run-in period followed by a 12-week treatment period. RESULTS 74 patients were randomised to both groups. During the run-in period the mean morning peak expiratory flow (PEF) was 489 and 478 L/min in the MDPI and MDI-spacer groups, respectively. During the last 2 weeks of the study the morning PEF was 485 L/min in the MDPI group and 477 L/min in the MDI-spacer group. Asthma symptom scores and use of rescue medication were low in both groups. The median dose of histamine required to decrease forced expiratory volume in 1 second (FEV(1)) by 15% was 1.05mg in the MDPI group and 0.64mg in the MDI-spacer group. The most frequent adverse events were hoarseness and sore throat. Mean serum cortisol levels were not affected in either treatment group. Patients' personal opinion regarding acceptability of the devices clearly favoured the MDPI. CONCLUSION In conclusion, the novel powder inhaler was well tolerated and at least equally effective compared with the conventional MDI-spacer combination in the treatment of asthma with BDP. However, in everyday use the patients clearly favoured the powder inhaler.
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Riva M, Nitert MD, Voss U, Sathanoori R, Lindqvist A, Ling C, Wierup N. Nesfatin-1 stimulates glucagon and insulin secretion and beta cell NUCB2 is reduced in human type 2 diabetic subjects. Cell Tissue Res 2011; 346:393-405. [DOI: 10.1007/s00441-011-1268-5] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/21/2011] [Accepted: 10/20/2011] [Indexed: 12/15/2022]
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Pallasaho P, Juusela M, Lindqvist A, Sovijärvi A, Lundbäck B, Rönmark E. Allergic rhinoconjunctivitis doubles the risk for incident asthma--results from a population study in Helsinki, Finland. Respir Med 2011; 105:1449-56. [PMID: 21600752 DOI: 10.1016/j.rmed.2011.04.013] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/14/2010] [Revised: 04/09/2011] [Accepted: 04/22/2011] [Indexed: 11/30/2022]
Abstract
OBJECTIVE To examine the incidence of allergic rhinoconjunctivitis and asthma, and to assess allergic rhinoconjunctivitis as a risk factor for incident asthma, we performed a 11-year follow-up postal survey. METHODS The original study population was a random population sample of 8000 inhabitants of Helsinki aged 20-69 years in 1996. Participants in the first postal questionnaire survey, 6062 subjects, were invited to this follow-up study, and provided 4302 (78%) answers out of 5484 traced subjects in 2007. RESULTS Cumulative incidence of asthma from 1996 to 2007 was 4.0% corresponding to an annual incidence rate of 3.7/1000/year. After exclusion of those with asthma medication or physician-diagnosed chronic bronchitis or COPD at baseline in 1996, the cumulative incidence decreased to 3.5% (incidence rate 3.2/1000/year), and further to 2.7% (2.5/1000/year) when also those reporting recurrent wheeze or shortness of breath during the last year in 1996 were omitted from the population at risk. Remission of asthma occurred in 43 subjects and was 16.9% over 11 years. Cumulative 11-year incidence of allergic rhinoconjunctivitis was 16.9% corresponding to 16.8/1000/year, and cumulative remission was 18.1%. Incidence of allergic rhinoconjunctivitis was significantly lower among those who had lived in the countryside or on a farm during the first 5 years of life, but this was not true for asthma. In multivariate analysis, farm living during the first 5 years of life was protective for the development of allergic rhinoconjunctivitis, OR 0.75 (95%CI 0.57-0.99). Allergic rhinoconjunctivitis was a significant independent risk factor for incident asthma, OR 2.15 (95%CI 1.54-3.02). In the cohort, the prevalence of rhinoconjunctivitis increased from 38.0% in 1996 to 40.9% in 2007, physician-diagnosed asthma from 6.8% to 9.4%, while current smoking decreased from 31.3% to 23.3%. CONCLUSION Incidence of allergic rhinoconjunctivitis was higher than in earlier studies, while asthma incidence remained on similar level, both being significantly higher in women. Allergic rhinoconjunctivitis doubled the risk for incident asthma.
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Affiliation(s)
- P Pallasaho
- Division of Allergology, Skin and Allergy Hospital, Department of Medicine, Helsinki University Central Hospital, Helsinki, Finland.
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Abstract
The purpose of the study was to describe the outcome after hand injury from powered wood splitters, and to investigate the relation between injury severity and outcome. Injury severity was rated according to the Hand Injury Severity Scoring System (HISS system) and the Injury Severity Score method. The patients were evaluated with the Disabilities of the Arm Shoulder and Hand outcome questionnaire (DASH), and 26 of the most severely injured patients were evaluated with the Sollerman test. The mean DASH score was moderately elevated at 15, indicating that many of these patients have sequelae. A statistically significant correlation between HISS and DASH scores was found, implying that initial injury severity is of importance for outcome. The mean Sollerman score in the injured hand was 66, which amounts to a significantly impaired hand function.
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Affiliation(s)
- A Lindqvist
- Department of Surgical Sciences, Uppsala University, Uppsala, Sweden.
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Svensson E, Millet J, Lindqvist A, Olsson M, Ridell M, Rastogi N. Impact of immigration on tuberculosis epidemiology in a low-incidence country. Clin Microbiol Infect 2010; 17:881-7. [PMID: 20825440 DOI: 10.1111/j.1469-0691.2010.03358.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
Mycobacterium tuberculosis strains from 349 patients were isolated in western Sweden during the years 2001-2005. Only 26% of the tuberculosis (TB) patients were born in Sweden. All the others were born in any of 42 different countries; 17% in other European countries, 28% in Africa, 16% in Asia, 11% in the Middle East, and 2% in South America. The mean age of the Swedish-born patients was 67 years, while the mean age among the foreign-born patients was 37 years. The male/female ratio was 1.6 among the Swedes and 0.9 among those born abroad. Extrapulmonary manifestations of TB were most common among patients born in Africa while lung infections without extrapulmonary manifestations were most common in patients born in Europe, including Sweden. Spoligotyping showed that patients with T or Beijing strains had more pulmonary TB than extrapulmonary TB, while patients with EAI and CAS strains had a high proportion of extrapulmonary TB. The ancestral and/or evolutionary older PGG1 strains were more often isolated from the foreign-born patients than from the Swedish-born patients, who had strains generally being of the evolutionary recent genogroups PGG2/PGG3. We conclude that immigration from countries with a high incidence of TB has a strong impact on the TB epidemiology in western Sweden, a finding that should be taken into account by TB control strategists when developing programmes for eradication of TB in low prevalence settings.
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Affiliation(s)
- E Svensson
- Institute for Biomedicine, University of Gothenburg, Gothenburg, Sweden.
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Itoh H, Keller P, Mogami H, Lindqvist A, Word R. Progesterone and transforming growth factor beta 1 (TGFB1) regulate matrix metalloproteinases (MMPS) in human endometrium. Fertil Steril 2010. [DOI: 10.1016/j.fertnstert.2010.07.830] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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48
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Macůrek L, Lindqvist A, Voets O, Kool J, Vos HR, Medema RH. Wip1 phosphatase is associated with chromatin and dephosphorylates γH2AX to promote checkpoint inhibition. Oncogene 2010; 29:2281-91. [DOI: 10.1038/onc.2009.501] [Citation(s) in RCA: 116] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
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Erlanson-Albertsson C, Lindqvist A. Fructose affects enzymes involved in the synthesis and degradation of hypothalamic endocannabinoids. ACTA ACUST UNITED AC 2010; 161:87-91. [PMID: 20085790 DOI: 10.1016/j.regpep.2010.01.003] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/20/2009] [Revised: 01/07/2010] [Accepted: 01/10/2010] [Indexed: 11/26/2022]
Abstract
Endocannabinoids have been implicated in the regulation of consumption of palatable food, sugar in particular. In this study, we investigated how palatable solutions would affect the hypothalamic mRNA expression of enzymes involved in the synthesis and degradation of the two main endocannabinoids, anandamide and 2-arachidonoyl-glycerol. Rats were offered sugar solutions to drink for one week, during which daily food and drink intake, and body weight gain was monitored. Rats offered sugar solutions to drink consumed less solid food but drank more of their respective sugar solution than did water-drinking control rats, resulting in increased total calorie intake. However, this increase in caloric intake did not result in increased body weight or adiposity in the rats. The mRNA expression of fatty acid amid hydrolase was up-regulated by sucrose and fructose. N-acyl phospatidyl ethanolamine phospholipase D mRNA was up-regulated by sucrose, whereas phospholipase C was down-regulated by all forms of sugar tested. The mRNA expression of monoglyceride lipase was down-regulated by all three forms of sugar. Also, the mRNA expression of diacylglycerol lipase 1alpha was down-regulated by sucrose and fructose, whereas the mRNA expression of diacylglycerol lipase 1beta was up-regulated by fructose. In this study, we show that sugars in liquid form affect enzymes involved in the degradation and synthesis of endocannabinoids in the hypothalamus and that this effect predates obesity.
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Köhnke R, Lindbo A, Larsson T, Lindqvist A, Rayner M, Emek SC, Albertsson PA, Rehfeld JF, Landin-Olsson M, Erlanson-Albertsson C. Thylakoids promote release of the satiety hormone cholecystokinin while reducing insulin in healthy humans. Scand J Gastroenterol 2009; 44:712-9. [PMID: 19308799 DOI: 10.1080/00365520902803499] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/04/2023]
Abstract
OBJECTIVE The effects of a promising new appetite suppressor named "thylakoids" (membrane proteins derived from spinach leaves) were examined in a single meal in man. Thylakoids inhibit the lipase/colipase hydrolysis of triacylglycerols in vitro and suppress food intake, decrease body-weight gain and raise the satiety hormone cholecystokinin (CCK) in rats, but their effects in man remain unclear. The aim of this study was to investigate whether thylakoids, when added to a test meal, affect appetite regulation and blood parameters in healthy individuals. MATERIAL AND METHODS In an intervention crossover study, healthy individuals of normal weight (n=11) were offered a high-fat meal with and without the addition of thylakoids. Blood samples were taken 0 (prior to meal), 30, 60, 120, 180, 240, 300 and 360 min after the start of the meal. Blood samples were analysed for satiety and hunger hormones (CCK, leptin and ghrelin), insulin and blood metabolites (glucose and free fatty acids). RESULTS The CCK level increased, in particular between the 120 min time-point and onwards, the ghrelin level was reduced at 120 min and leptin level increased at 360 min after intake of the thylakoid-enriched meal. The insulin level was reduced, whereas glucose concentrations were unchanged. Free fatty acids were reduced between time-point 120 min and onwards after the thylakoid meal. CONCLUSIONS The addition of thylakoids to energy-dense food promotes satiety signals and reduces insulin response during a single meal in man.
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Affiliation(s)
- Rickard Köhnke
- Department of Experimental Medical Science, Appetite Control Unit, BMC B11, Lund University, Lund, Sweden
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