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Groarke JD, Crawford J, Collins SM, Lubaczewski SL, Breen DM, Harrington MA, Jacobs I, Qiu R, Revkin J, Rossulek MI, Saxena AR. Phase 2 study of the efficacy and safety of ponsegromab in patients with cancer cachexia: PROACC-1 study design. J Cachexia Sarcopenia Muscle 2024. [PMID: 38500292 DOI: 10.1002/jcsm.13435] [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] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/31/2023] [Revised: 12/06/2023] [Accepted: 12/27/2023] [Indexed: 03/20/2024] Open
Abstract
BACKGROUND Cancer cachexia is a multifactorial metabolic wasting syndrome characterized by anorexia, unintentional loss of weight involving both skeletal muscle and adipose tissues, progressive functional impairment and reduced survival. Therapeutic strategies for this serious condition are very limited. Growth differentiation factor 15 (GDF-15) is a cytokine that is implicated in cancer cachexia and may represent both a biomarker of cancer cachexia and a potential therapeutic target. Ponsegromab is a potent and selective humanized monoclonal antibody that inhibits GDF-15-mediated signalling. Preclinical and preliminary phase 1 data suggest that ponsegromab-mediated inactivation of circulating GDF-15 may lead to improvement in key characteristics of cachexia. The primary objective of this phase 2 study is to assess the effect of ponsegromab on body weight in patients with cancer, cachexia and elevated GDF-15 concentrations. Secondary objectives include assessing physical activity, physical function, actigraphy, appetite, nausea and vomiting, fatigue and safety. Exploratory objectives include evaluating pharmacokinetics, pharmacodynamics, immunogenicity, lumbar skeletal muscle index and Response Evaluation Criteria in Solid Tumors. METHODS Approximately 168 adults with non-small-cell lung, pancreatic or colorectal cancers who have cachexia and elevated GDF-15 concentrations will be randomized in a double-blind, placebo-controlled study (NCT05546476). Participants meeting eligibility criteria will be randomized 1:1:1:1 to one of three dose groups of ponsegromab (100, 200 or 400 mg) or matching placebo administered subcutaneously every 4 weeks for an initial 12-week treatment period. This is followed by optional open-label treatment with ponsegromab of 400 mg administered every 4 weeks for up to 1 year. The primary endpoint is mean change from baseline in body weight at Week 12. A mixed model for repeated measures followed by a Bayesian Emax model will be used for the primary analysis. Secondary endpoints include physical activity, physical function and actigraphy measured by remote digital sensors; patient-reported appetite-related symptoms assessed by Functional Assessment of Anorexia-Cachexia Therapy subscale scores; anorexia/appetite, nausea and vomiting, and fatigue evaluated according to questions from the Cancer-Related Cachexia Symptom Diary; and incidence of adverse events, safety laboratory tests, vital signs and electrocardiogram abnormalities. PERSPECTIVE Cancer-related cachexia is an area of significant unmet medical need. This study will support the clinical development of ponsegromab as a novel inhibitor of GDF-15, which may ameliorate key pathologies of cancer cachexia to improve patient symptoms, functionality and quality of life. TRIAL REGISTRATION ClinicalTrials.gov ID: NCT05546476.
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Affiliation(s)
- John D Groarke
- Internal Medicine Research Unit, Pfizer Inc, Cambridge, MA, USA
| | - Jeffrey Crawford
- Duke Cancer Institute, Duke University Medical Center, Durham, NC, USA
| | - Susie M Collins
- Global Biometrics and Data Management, Pfizer R&D UK Ltd, Sandwich, Kent, UK
| | - Shannon L Lubaczewski
- Early Clinical Development and Biomedicine Artificial Intelligence, Pfizer Inc, Collegeville, PA, USA
| | - Danna M Breen
- Internal Medicine Research Unit, Pfizer Inc, Cambridge, MA, USA
| | | | - Ira Jacobs
- Global Product Development, Pfizer Inc, New York, NY, USA
| | - Ruolun Qiu
- Clinical Pharmacology, Pfizer Inc, Cambridge, MA, USA
| | - James Revkin
- Internal Medicine Research Unit, Pfizer Inc, Cambridge, MA, USA
| | | | - Aditi R Saxena
- Internal Medicine Research Unit, Pfizer Inc, Cambridge, MA, USA
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Al-Sawaf O, Weiss J, Skrzypski M, Lam JM, Karasaki T, Zambrana F, Kidd AC, Frankell AM, Watkins TBK, Martínez-Ruiz C, Puttick C, Black JRM, Huebner A, Bakir MA, Sokač M, Collins S, Veeriah S, Magno N, Naceur-Lombardelli C, Prymas P, Toncheva A, Ward S, Jayanth N, Salgado R, Bridge CP, Christiani DC, Mak RH, Bay C, Rosenthal M, Sattar N, Welsh P, Liu Y, Perrimon N, Popuri K, Beg MF, McGranahan N, Hackshaw A, Breen DM, O'Rahilly S, Birkbak NJ, Aerts HJWL, Jamal-Hanjani M, Swanton C. Body composition and lung cancer-associated cachexia in TRACERx. Nat Med 2023; 29:846-858. [PMID: 37045997 PMCID: PMC7614477 DOI: 10.1038/s41591-023-02232-8] [Citation(s) in RCA: 11] [Impact Index Per Article: 11.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2022] [Accepted: 01/24/2023] [Indexed: 04/14/2023]
Abstract
Cancer-associated cachexia (CAC) is a major contributor to morbidity and mortality in individuals with non-small cell lung cancer. Key features of CAC include alterations in body composition and body weight. Here, we explore the association between body composition and body weight with survival and delineate potential biological processes and mediators that contribute to the development of CAC. Computed tomography-based body composition analysis of 651 individuals in the TRACERx (TRAcking non-small cell lung Cancer Evolution through therapy (Rx)) study suggested that individuals in the bottom 20th percentile of the distribution of skeletal muscle or adipose tissue area at the time of lung cancer diagnosis, had significantly shorter lung cancer-specific survival and overall survival. This finding was validated in 420 individuals in the independent Boston Lung Cancer Study. Individuals classified as having developed CAC according to one or more features at relapse encompassing loss of adipose or muscle tissue, or body mass index-adjusted weight loss were found to have distinct tumor genomic and transcriptomic profiles compared with individuals who did not develop such features. Primary non-small cell lung cancers from individuals who developed CAC were characterized by enrichment of inflammatory signaling and epithelial-mesenchymal transitional pathways, and differentially expressed genes upregulated in these tumors included cancer-testis antigen MAGEA6 and matrix metalloproteinases, such as ADAMTS3. In an exploratory proteomic analysis of circulating putative mediators of cachexia performed in a subset of 110 individuals from TRACERx, a significant association between circulating GDF15 and loss of body weight, skeletal muscle and adipose tissue was identified at relapse, supporting the potential therapeutic relevance of targeting GDF15 in the management of CAC.
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Affiliation(s)
- Othman Al-Sawaf
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Metastasis Laboratory, University College London Cancer Institute, London, UK
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - Jakob Weiss
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Department of Diagnostic and Interventional Radiology, University Freiburg, Freiburg, Germany
| | - Marcin Skrzypski
- Department of Oncology and Radiotherapy, Medical University of Gdańsk, Gdańsk, Poland
| | - Jie Min Lam
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Metastasis Laboratory, University College London Cancer Institute, London, UK
- Department of Oncology, University College London Hospitals, London, UK
| | - Takahiro Karasaki
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Metastasis Laboratory, University College London Cancer Institute, London, UK
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | | | - Andrew C Kidd
- Institute of Infection, Immunity & Inflammation, University of Glasgow, Glasgow, UK
| | - Alexander M Frankell
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - Thomas B K Watkins
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - Carlos Martínez-Ruiz
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Genome Evolution Research Group, Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Clare Puttick
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
- Cancer Genome Evolution Research Group, Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - James R M Black
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Genome Evolution Research Group, Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Ariana Huebner
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
- Cancer Genome Evolution Research Group, Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Maise Al Bakir
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
| | - Mateo Sokač
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Susie Collins
- Early Clinical Development, Pfizer UK Ltd, Cambridge, UK
| | - Selvaraju Veeriah
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Neil Magno
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | | | - Paulina Prymas
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Antonia Toncheva
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Sophia Ward
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK
- Advanced Sequencing Facility, The Francis Crick Institute, London, UK
| | - Nick Jayanth
- Cancer Research UK & UCL Cancer Trials Centre, London, UK
| | - Roberto Salgado
- Department of Pathology, ZAS Hospitals, Antwerp, Belgium
- Division of Research, Peter MacCallum Cancer Centre, Melbourne, Australia
| | | | - David C Christiani
- Department of Medicine, Massachusetts General Hospital/Harvard Medicine School, and Department of Environmental Health, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - Raymond H Mak
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
| | - Camden Bay
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, USA
| | - Michael Rosenthal
- Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, and Harvard Medical School, Boston, MA, USA
| | - Naveed Sattar
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Paul Welsh
- School of Cardiovascular and Metabolic Health, University of Glasgow, Glasgow, UK
| | - Ying Liu
- Department of Genetics, Harvard Medical School, Boston, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, USA
| | - Norbert Perrimon
- Department of Genetics, Harvard Medical School, Boston, USA
- Howard Hughes Medical Institute, Harvard Medical School, Boston, USA
| | - Karteek Popuri
- Department of Computer Science, Memorial University of Newfoundland, St. John's, Newfoundland and Labrador, Burnaby, Canada
| | - Mirza Faisal Beg
- School of Engineering Science, Simon Fraser University, Burnaby, British Colombia, Canada
| | - Nicholas McGranahan
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
- Cancer Genome Evolution Research Group, Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK
| | - Allan Hackshaw
- Cancer Research UK & UCL Cancer Trials Centre, London, UK
| | - Danna M Breen
- Internal Medicine Research Unit, Pfizer, Cambridge, MA, USA
| | - Stephen O'Rahilly
- Wellcome Trust-MRC Institute of Metabolic Science and NIHR Cambridge Biomedical Research Centre, University of Cambridge, Cambridge, UK
| | - Nicolai J Birkbak
- Department of Clinical Medicine, Aarhus University, Aarhus, Denmark
- Department of Molecular Medicine, Aarhus University Hospital, Aarhus, Denmark
- Bioinformatics Research Centre, Aarhus University, Aarhus, Denmark
| | - Hugo J W L Aerts
- Artificial Intelligence in Medicine (AIM) Program, Mass General Brigham, Harvard Medical School, Boston, MA, USA
- Department of Radiation Oncology, Brigham and Women's Hospital, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA, USA
- Radiology and Nuclear Medicine, CARIM & GROW, Maastricht University, Maastricht, The Netherlands
| | - Mariam Jamal-Hanjani
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK.
- Cancer Metastasis Laboratory, University College London Cancer Institute, London, UK.
- Department of Oncology, University College London Hospitals, London, UK.
| | - Charles Swanton
- Cancer Research UK Lung Cancer Centre of Excellence, University College London Cancer Institute, London, UK.
- Cancer Evolution and Genome Instability Laboratory, The Francis Crick Institute, London, UK.
- Department of Oncology, University College London Hospitals, London, UK.
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Bernardo B, Joaquim S, Garren J, Boucher M, Houle C, LaCarubba B, Qiao S, Wu Z, Esquejo RM, Peloquin M, Kim H, Breen DM. Characterization of cachexia in the human fibrosarcoma HT-1080 mouse tumour model. J Cachexia Sarcopenia Muscle 2020; 11:1813-1829. [PMID: 32924335 PMCID: PMC7749621 DOI: 10.1002/jcsm.12618] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.8] [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: 05/27/2020] [Revised: 06/22/2020] [Accepted: 07/07/2020] [Indexed: 01/06/2023] Open
Abstract
BACKGROUND Cancer cachexia is a complex metabolic disease with unmet medical need. Although many rodent models are available, none are identical to the human disease. Therefore, the development of new preclinical models that simulate some of the physiological, biochemical, and clinical characteristics of the human disease is valuable. The HT-1080 human fibrosarcoma tumour cell line was reported to induce cachexia in mice. Therefore, the purpose of this work was to determine how well the HT-1080 tumour model could recapitulate human cachexia and to examine its technical performance. Furthermore, the efficacy of ghrelin receptor activation via anamorelin treatment was evaluated, because it is one of few clinically validated mechanisms. METHODS Female severe combined immunodeficient mice were implanted subcutaneously or heterotopically (renal capsule) with HT-1080 tumour cells. The cachectic phenotype was evaluated during tumour development, including body weight, body composition, food intake, muscle function (force and fatigue), grip strength, and physical activity measurements. Heterotopic and subcutaneous tumour histology was also compared. Energy balance was evaluated at standard and thermoneutral housing temperatures in the subcutaneous model. The effect of anamorelin (ghrelin analogue) treatment was also examined. RESULTS The HT-1080 tumour model had excellent technical performance and was reproducible across multiple experimental conditions. Heterotopic and subcutaneous tumour cell implantation resulted in similar cachexia phenotypes independent of housing temperature. Tumour weight and histology was comparable between both routes of administration with minimal inflammation. Subcutaneous HT-1080 tumour-bearing mice presented with weight loss (decreased fat mass and skeletal muscle mass/fibre cross-sectional area), reduced food intake, impaired muscle function (reduced force and grip strength), and decreased spontaneous activity and voluntary wheel running. Key circulating inflammatory biomarkers were produced by the tumour, including growth differentiation factor 15, Activin A, interleukin 6, and TNF alpha. Anamorelin prevented but did not reverse anorexia and weight loss in the subcutaneous model. CONCLUSIONS The subcutaneous HT-1080 tumour model displays many of the perturbations of energy balance and physical performance described in human cachexia, consistent with the production of key inflammatory factors. Anamorelin was most effective when administered early in disease progression. The HT-1080 tumour model is valuable for studying potential therapeutic targets for the treatment of cachexia.
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Affiliation(s)
- Barbara Bernardo
- Internal Medicine Research Unit, Pfizer Inc., Cambridge, MA, USA
| | | | - Jeonifer Garren
- Biostatistics, Early Clinical Development, Pfizer Inc., Cambridge, MA, USA
| | - Magalie Boucher
- Drug Safety Research and Development, Pfizer Inc., Groton, CT, USA
| | | | | | - Shuxi Qiao
- Internal Medicine Research Unit, Pfizer Inc., Cambridge, MA, USA
| | - Zhidan Wu
- Internal Medicine Research Unit, Pfizer Inc., Cambridge, MA, USA
| | - Ryan M Esquejo
- Internal Medicine Research Unit, Pfizer Inc., Cambridge, MA, USA
| | - Matthew Peloquin
- Internal Medicine Research Unit, Pfizer Inc., Cambridge, MA, USA
| | - Hanna Kim
- Internal Medicine Research Unit, Pfizer Inc., Cambridge, MA, USA
| | - Danna M Breen
- Internal Medicine Research Unit, Pfizer Inc., Cambridge, MA, USA
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4
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Breen DM, Kim H, Bennett D, Calle RA, Collins S, Esquejo RM, He T, Joaquim S, Joyce A, Lambert M, Lin L, Pettersen B, Qiao S, Rossulek M, Weber G, Wu Z, Zhang BB, Birnbaum MJ. GDF-15 Neutralization Alleviates Platinum-Based Chemotherapy-Induced Emesis, Anorexia, and Weight Loss in Mice and Nonhuman Primates. Cell Metab 2020; 32:938-950.e6. [PMID: 33207247 DOI: 10.1016/j.cmet.2020.10.023] [Citation(s) in RCA: 64] [Impact Index Per Article: 16.0] [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: 04/21/2020] [Revised: 08/06/2020] [Accepted: 10/29/2020] [Indexed: 12/28/2022]
Abstract
Platinum-based cancer therapy is restricted by dose-limiting side effects and is associated with elevation of growth differentiation factor 15 (GDF-15). But whether this elevation contributes to such side effects has been unclear. Here, we explored the effects of GDF-15 blockade on platinum-based chemotherapy-induced emesis, anorexia, and weight loss in mice and/or nonhuman primate models. We found that circulating GDF-15 is higher in subjects with cancer receiving platinum-based chemotherapy and is positively associated with weight loss in colorectal cancer (NCT00609622). Further, chemotherapy agents associated with high clinical emetic score induce circulating GDF-15 and weight loss in mice. Platinum-based treatment-induced anorexia and weight loss are attenuated in GDF-15 knockout mice, while GDF-15 neutralization with the monoclonal antibody mAB1 improves survival. In nonhuman primates, mAB1 treatment attenuates anorexia and emesis. These results suggest that GDF-15 neutralization is a potential therapeutic approach to alleviate chemotherapy-induced side effects and improve the quality of life.
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Affiliation(s)
- Danna M Breen
- Internal Medicine Research Unit, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA.
| | - Hanna Kim
- Internal Medicine Research Unit, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Donald Bennett
- Biostatistics, Early Clinical Development, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Roberto A Calle
- Internal Medicine Research Unit, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Susie Collins
- Biostatistics, Early Clinical Development, Pfizer R&D UK Limited, Ramsgate Road, Sandwich, Kent, UK
| | - Ryan M Esquejo
- Internal Medicine Research Unit, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Tao He
- Biomedicine Design, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Stephanie Joaquim
- Internal Medicine Research Unit, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Alison Joyce
- Biomedicine Design, Pfizer Inc., 1 Burtt Road, Andover, MA, USA
| | - Matthew Lambert
- Biomedicine Design, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Laura Lin
- Biomedicine Design, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Betty Pettersen
- Drug Safety Research and Development, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Shuxi Qiao
- Internal Medicine Research Unit, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Michelle Rossulek
- Internal Medicine Research Unit, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Gregory Weber
- Biomedicine Design, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Zhidan Wu
- Internal Medicine Research Unit, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Bei B Zhang
- Internal Medicine Research Unit, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
| | - Morris J Birnbaum
- Internal Medicine Research Unit, Pfizer Inc., 1 Portland Street, Cambridge, MA, USA
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Breen DM, Beaumont K, Bennett D, Brosnan J, Calle R, Chabot JR, Collins S, Cunio T, Esquejo RM, Joaquim S, Joyce A, Kim H, Lin L, Pettersen B, Qiao S, Rossulek M, Tierney B, Walters KM, Weber G, Wu Z, Zhang BB, Birnbaum MJ. Abstract 3056: Growth differentiation factor 15 (GDF-15) inhibition attenuates platinum-based chemotherapy-induced emesis, anorexia and weight loss and increases survival. Cancer Res 2020. [DOI: 10.1158/1538-7445.am2020-3056] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Abstract
Platinum-based chemotherapy is associated with nausea/emesis, anorexia and weight loss which reduce patient quality of life and limit treatment adherence potentially leading to poor treatment outcomes. Cisplatin increases circulating growth differentiation factor 15 (GDF-15), a cytokine that induces conditioned taste aversion, anorexia and weight loss in preclinical models. GDF-15 signals through the hindbrain receptor glial cell-derived neurotrophic factor receptor alpha-like (GFRAL). Cisplatin-induced anorexia/weight loss was attenuated in a GFRAL knockout mouse; therefore, we examined whether GDF-15 inhibition can prevent platinum-based chemotherapy-induced emesis, anorexia and weight loss, and also increase survival using mouse and/or nonhuman primate models. In cancer patients, platinum treatment increased circulating GDF-15 in non small cell lung carcinoma, colorectal, and ovarian cancer (~1.5 fold) compared to those receiving a non-platinum-based therapy. Furthermore, cisplatin, oxaliplatin and carboplatin administered individually all increased circulating GDF-15 in wildtype mice (≥ 5 fold) and induced anorexia, skeletal muscle wasting, and weight loss. GDF-15 mRNA was increased in kidney, liver, brain and white adipose tissue. These effects were prevented in GDF-15 knockout mice, however only a partial blockade was observed in the carboplatin group. In nonhuman primates, cisplatin treatment for 5 days (96% of the daily recommended clinical dose) also increased circulating GDF-15 (> 5 fold), and induced anorexia and emesis. Treatment with the anti-GDF-15 monoclonal antibody (mAB1) resulted in no detectable circulating levels of free GDF-15, and attenuated both cisplatin-induced anorexia and emesis. Furthermore, in a mouse cachectic tumor model (subcutaneous implantation of tumor tissue derived from human non-small cell lung carcinoma adenocarcinoma), cisplatin treatment inhibited tumor growth; however, GDF-15 levels were still elevated and additional weight loss occurred compared to vehicle control. When mAB1 was given in combination with cisplatin, weight loss was reversed and tumor growth inhibition was maintained, resulting in greater survival compared to cisplatin alone. Taken together, these data support the notion that GDF-15 inhibition with mAB1 holds the potential as an effective therapeutic approach to alleviate GDF-15 mediated emesis, anorexia and weight loss with the aim to enable optimal cancer treatment as well as to improve patient quality of life and potentially survival.
Citation Format: Danna M. Breen, Kevin Beaumont, Donald Bennett, Julia Brosnan, Roberto Calle, Jeffrey R. Chabot, Susie Collins, Teresa Cunio, Ryan M. Esquejo, Stephanie Joaquim, Alison Joyce, Hanna Kim, Laura Lin, Betty Pettersen, Shuxi Qiao, Michelle Rossulek, Brendan Tierney, Karen M. Walters, Gregory Weber, Zhidan Wu, Bei B. Zhang, Morris J. Birnbaum. Growth differentiation factor 15 (GDF-15) inhibition attenuates platinum-based chemotherapy-induced emesis, anorexia and weight loss and increases survival [abstract]. In: Proceedings of the Annual Meeting of the American Association for Cancer Research 2020; 2020 Apr 27-28 and Jun 22-24. Philadelphia (PA): AACR; Cancer Res 2020;80(16 Suppl):Abstract nr 3056.
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Guo J, Pereira TJ, Mori Y, Gonzalez Medina M, Breen DM, Dalvi PS, Zhang H, McCole DF, McBurney MW, Heximer SP, Tsiani EL, Dolinsky VW, Giacca A. Resveratrol Inhibits Neointimal Growth after Arterial Injury in High-Fat-Fed Rodents: The Roles of SIRT1 and AMPK. J Vasc Res 2020; 57:325-340. [PMID: 32777783 DOI: 10.1159/000509217] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [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: 03/18/2020] [Accepted: 05/20/2020] [Indexed: 12/12/2022] Open
Abstract
We have shown that both insulin and resveratrol (RSV) decrease neointimal hyperplasia in chow-fed rodents via mechanisms that are in part overlapping and involve the activation of endothelial nitric oxide synthase (eNOS). However, this vasculoprotective effect of insulin is abolished in high-fat-fed insulin-resistant rats. Since RSV, in addition to increasing insulin sensitivity, can activate eNOS via pathways that are independent of insulin signaling, such as the activation of sirtuin 1 (SIRT1) and AMP-activated kinase (AMPK), we speculated that unlike insulin, the vasculoprotective effect of RSV would be retained in high-fat-fed rats. We found that high-fat feeding decreased insulin sensitivity and increased neointimal area and that RSV improved insulin sensitivity (p < 0.05) and decreased neointimal area in high-fat-fed rats (p < 0.05). We investigated the role of SIRT1 in the effect of RSV using two genetic mouse models. We found that RSV decreased neointimal area in high-fat-fed wild-type mice (p < 0.05), an effect that was retained in mice with catalytically inactive SIRT1 (p < 0.05) and in heterozygous SIRT1-null mice. In contrast, the effect of RSV was abolished in AMKPα2-null mice. Thus, RSV decreased neointimal hyperplasia after arterial injury in both high-fat-fed rats and mice, an effect likely not mediated by SIRT1 but by AMPKα2.
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Affiliation(s)
- June Guo
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Troy J Pereira
- Department of Pharmacology and Therapeutics, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Yusaku Mori
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada.,Division of Diabetes, Metabolism and Endocrinology, Showa University School of Medicine, Tokyo, Japan
| | | | - Danna M Breen
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Prasad S Dalvi
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada.,Biology Department, Morosky College of Health Professions and Sciences, Gannon University, Erie, Pennsylvania, USA
| | - Hangjun Zhang
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Declan F McCole
- Division of Biomedical Sciences, School of Medicine, University of California, Riverside, California, USA
| | - Michael W McBurney
- Program in Cancer Therapeutics, Ottawa Hospital Research Institute, Departments of Medicine and Biochemistry, Microbiology and Immunology, University of Ottawa, Ottawa, Ontario, Canada
| | - Scott P Heximer
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Evangelia L Tsiani
- Department of Health Sciences, Brock University, St. Catharines, Ontario, Canada.,Centre for Bone and Muscle Health, Brock University, St. Catharines, Ontario, Canada
| | - Vernon W Dolinsky
- Department of Pharmacology and Therapeutics, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada
| | - Adria Giacca
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada, .,Department of Medicine, University of Toronto, Toronto, Ontario, Canada, .,Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada, .,Banting and Best Diabetes Centre, University of Toronto, Toronto General Hospital, Toronto, Ontario, Canada,
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7
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Guo J, Pereira TJ, Dalvi P, Yeung LSN, Swain N, Breen DM, Lam L, Dolinsky VW, Giacca A. High-dose metformin (420mg/kg daily p.o.) increases insulin sensitivity but does not affect neointimal thickness in the rat carotid balloon injury model of restenosis. Metabolism 2017; 68:108-118. [PMID: 28183442 DOI: 10.1016/j.metabol.2016.12.002] [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] [Received: 05/23/2016] [Revised: 11/27/2016] [Accepted: 12/04/2016] [Indexed: 12/21/2022]
Abstract
OBJECTIVE Our laboratory has shown that insulin's effect to decrease neointimal thickness after arterial injury is greatly diminished in insulin resistant conditions. Thus, in these conditions, a better alternative to insulin could be to use an insulin sensitizing agent. Metformin, the most commonly prescribed insulin sensitizer, has a cardiovascular protective role. Therefore, the objective of this study was to investigate the potential benefit of metformin on neointimal area after arterial injury in a rat model of restenosis. METHODS Rats fed with either normal or high fat diet and treated with or without oral metformin (420mg/kg daily) underwent carotid balloon injury. Effects of metformin on clamp-determined insulin sensitivity, vessel AMPK (AMP-activated protein kinase) phosphorylation (activation marker) and neointimal area were evaluated. RESULTS Metformin increased insulin sensitivity, but did not affect neointimal thickness in either the normal fat or high fat diet-fed rats. Furthermore, metformin activated AMPK in uninjured but not in injured vessels. Similarly, 10mmol/L metformin inhibited proliferation and activated AMPK in smooth muscle cells of uninjured but not injured vessels, whereas 2mmol/L metformin did not have any effect. CONCLUSION In rats, metformin does not decrease neointimal growth after arterial injury, despite increasing whole body insulin sensitivity.
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Affiliation(s)
- June Guo
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada M5S 1A8
| | - Troy J Pereira
- Department of Pharmacology and Therapeutics, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada R3E 3P4
| | - Prasad Dalvi
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada M5S 1A8
| | - Lucy Shu Nga Yeung
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada M5S 1A8
| | - Nathan Swain
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada M5S 1A8
| | - Danna M Breen
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada M5S 1A8
| | - Loretta Lam
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada M5S 1A8
| | - Vernon W Dolinsky
- Department of Pharmacology and Therapeutics, Children's Hospital Research Institute of Manitoba, University of Manitoba, Winnipeg, Manitoba, Canada R3E 3P4
| | - Adria Giacca
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada M5S 1A8; Department of Medicine, University of Toronto, Toronto, Ontario, Canada M5S 1A8; Institute of Medical Science, University of Toronto, Toronto, Ontario, Canada M5S 1A8; Banting and Best Diabetes Centre, University of Toronto, Toronto, Ontario, Canada M5S 1A8.
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8
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Pereira S, Park E, Moore J, Faubert B, Breen DM, Oprescu AI, Nahle A, Kwan D, Giacca A, Tsiani E. Resveratrol prevents insulin resistance caused by short-term elevation of free fatty acids in vivo. Appl Physiol Nutr Metab 2015; 40:1129-36. [PMID: 26455923 DOI: 10.1139/apnm-2015-0075] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
Elevated levels of plasma free fatty acids (FFA), which are commonly found in obesity, induce insulin resistance. FFA activate protein kinases including the proinflammatory IκBα kinase β (IKKβ), leading to serine phosphorylation of insulin receptor substrate 1 (IRS-1) and impaired insulin signaling. To test whether resveratrol, a polyphenol found in red wine, prevents FFA-induced insulin resistance, we used a hyperinsulinemic-euglycemic clamp with a tracer to assess hepatic and peripheral insulin sensitivity in overnight-fasted Wistar rats infused for 7 h with saline, Intralipid plus 20 U·mL(-1) heparin (IH; triglyceride emulsion that elevates FFA levels in vivo; 5.5 μL·min(-1)) with or without resveratrol (3 mg·kg(-1)·h(-1)), or resveratrol alone. Infusion of IH significantly decreased glucose infusion rate (GIR; P < 0.05) and peripheral glucose utilization (P < 0.05) and increased endogenous glucose production (EGP; P < 0.05) during the clamp compared with saline infusion. Resveratrol co-infusion, however, completely prevented the effects induced by IH infusion: it prevented the decreases in GIR (P < 0.05 vs. IH), peripheral glucose utilization (P < 0.05 vs. IH), and insulin-induced suppression of EGP (P < 0.05 vs. IH). Resveratrol alone had no effect. Furthermore, IH infusion increased serine (307) phosphorylation of IRS-1 in soleus muscle (∼30-fold, P < 0.001), decreased total IRS-1 levels, and decreased IκBα content, consistent with activation of IKKβ. Importantly, all of these effects were abolished by resveratrol (P < 0.05 vs. IH). These results suggest that resveratrol prevents FFA-induced hepatic and peripheral insulin resistance and, therefore, may help mitigate the health consequences of obesity.
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Affiliation(s)
- Sandra Pereira
- a Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Edward Park
- a Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Jessy Moore
- b Department of Health Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada
| | - Brandon Faubert
- b Department of Health Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada
| | - Danna M Breen
- a Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Andrei I Oprescu
- c Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Ashraf Nahle
- a Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Denise Kwan
- a Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Adria Giacca
- a Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada.,c Institute of Medical Sciences, University of Toronto, Toronto, ON M5S 1A8, Canada.,d Department of Medicine, University of Toronto, Toronto, ON M5G 2C4, Canada
| | - Evangelia Tsiani
- b Department of Health Sciences, Brock University, St. Catharines, ON L2S 3A1, Canada
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9
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Guo J, Breen DM, Pereira TJ, Dalvi PS, Zhang H, Mori Y, Ghanim H, Tumiati L, Fantus IG, Bendeck MP, Dandona P, Rao V, Dolinsky VW, Heximer SP, Giacca A. The effect of insulin to decrease neointimal growth after arterial injury is endothelial nitric oxide synthase-dependent. Atherosclerosis 2015; 241:111-20. [DOI: 10.1016/j.atherosclerosis.2015.04.799] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/28/2013] [Revised: 04/02/2015] [Accepted: 04/19/2015] [Indexed: 12/01/2022]
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10
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Jackson VM, Breen DM, Fortin JP, Liou A, Kuzmiski JB, Loomis AK, Rives ML, Shah B, Carpino PA. Latest approaches for the treatment of obesity. Expert Opin Drug Discov 2015; 10:825-39. [DOI: 10.1517/17460441.2015.1044966] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022]
Affiliation(s)
- V Margaret Jackson
- 1Cardiovascular and Metabolic Diseases Research Unit, Pfizer PharmaTherapeutics, 610 Main Street, Cambridge, MA 02139, USA
| | - Danna M Breen
- 1Cardiovascular and Metabolic Diseases Research Unit, Pfizer PharmaTherapeutics, 610 Main Street, Cambridge, MA 02139, USA
| | - Jean-Philippe Fortin
- 1Cardiovascular and Metabolic Diseases Research Unit, Pfizer PharmaTherapeutics, 610 Main Street, Cambridge, MA 02139, USA
| | - Alice Liou
- 1Cardiovascular and Metabolic Diseases Research Unit, Pfizer PharmaTherapeutics, 610 Main Street, Cambridge, MA 02139, USA
| | - J Brent Kuzmiski
- 1Cardiovascular and Metabolic Diseases Research Unit, Pfizer PharmaTherapeutics, 610 Main Street, Cambridge, MA 02139, USA
| | - A Katrina Loomis
- 2Clinical Research, Pfizer PharmaTherapeutics, Eastern Point Road, Groton, CT 06340, USA
| | - Marie-Laure Rives
- 1Cardiovascular and Metabolic Diseases Research Unit, Pfizer PharmaTherapeutics, 610 Main Street, Cambridge, MA 02139, USA
| | - Bhavik Shah
- 1Cardiovascular and Metabolic Diseases Research Unit, Pfizer PharmaTherapeutics, 610 Main Street, Cambridge, MA 02139, USA
| | - Philip A Carpino
- 3Cardiovascular and Metabolic Diseases Medicinal Chemistry, Pfizer PharmaTherapeutics, 610 Main Street, Cambridge, MA 02139, USA
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11
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Côté CD, Rasmussen BA, Duca FA, Zadeh-Tahmasebi M, Baur JA, Daljeet M, Breen DM, Filippi BM, Lam TKT. Resveratrol activates duodenal Sirt1 to reverse insulin resistance in rats through a neuronal network. Nat Med 2015; 21:498-505. [PMID: 25849131 DOI: 10.1038/nm.3821] [Citation(s) in RCA: 112] [Impact Index Per Article: 12.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/14/2014] [Accepted: 02/06/2015] [Indexed: 12/12/2022]
Abstract
Resveratrol improves insulin sensitivity and lowers hepatic glucose production (HGP) in rat models of obesity and diabetes, but the underlying mechanisms for these antidiabetic effects remain elusive. One process that is considered a key feature of resveratrol action is the activation of the nicotinamide adenine dinucleotide (NAD(+))-dependent deacetylase sirtuin 1 (SIRT1) in various tissues. However, the low bioavailability of resveratrol raises questions about whether the antidiabetic effects of oral resveratrol can act directly on these tissues. We show here that acute intraduodenal infusion of resveratrol reversed a 3 d high fat diet (HFD)-induced reduction in duodenal-mucosal Sirt1 protein levels while also enhancing insulin sensitivity and lowering HGP. Further, we found that duodenum-specific knockdown of Sirt1 expression for 14 d was sufficient to induce hepatic insulin resistance in rats fed normal chow. We also found that the glucoregulatory role of duodenally acting resveratrol required activation of Sirt1 and AMP-activated protein kinase (Ampk) in this tissue to initiate a gut-brain-liver neuronal axis that improved hypothalamic insulin sensitivity and in turn, reduced HGP. In addition to the effects of duodenally acting resveratrol in an acute 3 d HFD-fed model of insulin resistance, we also found that short-term infusion of resveratrol into the duodenum lowered HGP in two other rat models of insulin resistance--a 28 d HFD-induced model of obesity and a nicotinamide (NA)-streptozotocin (STZ)-HFD-induced model of mild type 2 diabetes. Together, these studies highlight the therapeutic relevance of targeting duodenal SIRT1 to reverse insulin resistance and improve glucose homeostasis in obesity and diabetes.
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Affiliation(s)
- Clémence D Côté
- 1] Toronto General Research Institute and Department of Medicine, University Health Network, Toronto, Ontario, Canada. [2] Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Brittany A Rasmussen
- 1] Toronto General Research Institute and Department of Medicine, University Health Network, Toronto, Ontario, Canada. [2] Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Frank A Duca
- Toronto General Research Institute and Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Melika Zadeh-Tahmasebi
- 1] Toronto General Research Institute and Department of Medicine, University Health Network, Toronto, Ontario, Canada. [2] Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Joseph A Baur
- Department of Physiology, Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania, USA
| | - Mira Daljeet
- Toronto General Research Institute and Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Danna M Breen
- Toronto General Research Institute and Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Beatrice M Filippi
- Toronto General Research Institute and Department of Medicine, University Health Network, Toronto, Ontario, Canada
| | - Tony K T Lam
- 1] Toronto General Research Institute and Department of Medicine, University Health Network, Toronto, Ontario, Canada. [2] Department of Physiology, University of Toronto, Toronto, Ontario, Canada. [3] Department of Medicine, University of Toronto, Toronto, Ontario, Canada. [4] Banting and Best Diabetes Centre, University of Toronto, Toronto, Ontario, Canada
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12
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Pereira S, Breen DM, Naassan AE, Wang PYT, Uchino H, Fantus IG, Carpentier AC, Gutierrez-Juarez R, Brindley DN, Lam TKT, Giacca A. In vivo effects of polyunsaturated, monounsaturated, and saturated fatty acids on hepatic and peripheral insulin sensitivity. Metabolism 2015; 64:315-22. [PMID: 25467844 DOI: 10.1016/j.metabol.2014.10.019] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.2] [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: 03/02/2014] [Revised: 10/21/2014] [Accepted: 10/22/2014] [Indexed: 10/24/2022]
Abstract
OBJECTIVE Free fatty acids (FFAs) cause insulin resistance and are often elevated in obesity. Chronic ingestion of diets rich in saturated fat induces more insulin resistance than diets rich in unsaturated fat, however, it remains unclear whether different FFAs cause distinct levels of insulin resistance in the short-term, which is relevant to the feeding and fasting cycle. Protein kinase C (PKC)-δ is implicated in hepatic insulin resistance. Therefore, we investigated the effects of short-term elevation of fatty acids with different degrees of unsaturation on hepatic insulin action and liver PKC-δ membrane translocation, a marker of activation. MATERIALS/METHODS Triglyceride emulsions of Soybean Oil+Heparin (polyunsaturated (POLY)), Olive Oil+Heparin (monounsaturated (MONO)), Lard Oil+Heparin (saturated (SATU)), or saline (SAL) were infused intravenously for 7h to elevate plasma FFA concentrations ~3-4 fold in rats. During the last 2h of infusion, a hyperinsulinemic-euglycemic clamp with tritiated glucose methodology was performed to examine hepatic and peripheral insulin sensitivity. RESULTS Surprisingly, SATU, MONO, and POLY impaired peripheral insulin sensitivity (glucose utilization divided by insulin) to a similar extent. Furthermore, all lipids induced a similar degree of hepatic insulin resistance compared to SAL. Although there were changes in hepatic content of lipid metabolites, there were no significant differences in liver PKC-δ membrane translocation across fat groups. CONCLUSIONS In summary, in the short-term, FFAs with different degrees of unsaturation impair peripheral insulin sensitivity and induce hepatic insulin resistance as well as hepatic PKC-δ translocation to the same extent.
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MESH Headings
- Animals
- Cell Membrane/enzymology
- Dietary Fats/administration & dosage
- Dietary Fats/adverse effects
- Dietary Fats/analysis
- Dietary Fats/metabolism
- Dietary Fats, Unsaturated/administration & dosage
- Dietary Fats, Unsaturated/adverse effects
- Dietary Fats, Unsaturated/analysis
- Dietary Fats, Unsaturated/metabolism
- Enzyme Activation
- Fat Emulsions, Intravenous
- Fatty Acids/adverse effects
- Fatty Acids/analysis
- Fatty Acids/blood
- Fatty Acids/metabolism
- Fatty Acids, Monounsaturated/adverse effects
- Fatty Acids, Monounsaturated/analysis
- Fatty Acids, Monounsaturated/blood
- Fatty Acids, Monounsaturated/metabolism
- Fatty Acids, Nonesterified/blood
- Fatty Acids, Nonesterified/metabolism
- Fatty Acids, Unsaturated/adverse effects
- Fatty Acids, Unsaturated/analysis
- Fatty Acids, Unsaturated/blood
- Fatty Acids, Unsaturated/metabolism
- Female
- Glucose Clamp Technique
- Insulin Resistance
- Liver/enzymology
- Liver/metabolism
- Olive Oil
- Plant Oils/administration & dosage
- Plant Oils/adverse effects
- Plant Oils/chemistry
- Plant Oils/metabolism
- Protein Kinase C-delta/chemistry
- Protein Kinase C-delta/metabolism
- Protein Transport
- Rats, Wistar
- Soybean Oil/administration & dosage
- Soybean Oil/adverse effects
- Soybean Oil/chemistry
- Soybean Oil/metabolism
- Up-Regulation
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Affiliation(s)
- Sandra Pereira
- Department of Physiology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
| | - Danna M Breen
- Department of Physiology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
| | - Anthony E Naassan
- Department of Physiology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
| | - Penny Y T Wang
- Department of Physiology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
| | - Hiroshi Uchino
- Department of Physiology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
| | - I George Fantus
- Department of Physiology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada; Department of Medicine, University of Toronto, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada.
| | - André C Carpentier
- Department of Medicine, Division of Endocrinology, Université de Sherbrooke, 3001-12(e) Avenue Nord, Sherbrooke, QC, J1H 5N4, Canada.
| | - Roger Gutierrez-Juarez
- Department of Medicine, Diabetes Research Center, Albert Einstein College of Medicine, 1300 Morris Park Avenue, Bronx, NY, 10461, USA.
| | - David N Brindley
- Department of Biochemistry, Signal Transduction Research Group, University of Alberta, 357 Heritage Medical Research Center, Edmonton, AB, T6G 2S2, Canada.
| | - Tony K T Lam
- Department of Physiology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
| | - Adria Giacca
- Department of Physiology, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada; Department of Medicine, University of Toronto, 200 Elizabeth Street, Toronto, ON, M5G 2C4, Canada; Institute of Medical Science, University of Toronto, 1 King's College Circle, Toronto, ON, M5S 1A8, Canada.
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13
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Rasmussen BA, Breen DM, Duca FA, Côté CD, Zadeh-Tahmasebi M, Filippi BM, Lam TKT. Jejunal leptin-PI3K signaling lowers glucose production. Cell Metab 2014; 19:155-61. [PMID: 24361011 DOI: 10.1016/j.cmet.2013.11.014] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [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] [Received: 08/01/2013] [Revised: 10/08/2013] [Accepted: 11/11/2013] [Indexed: 10/25/2022]
Abstract
The fat-derived hormone leptin binds to its hypothalamic receptors to regulate glucose homeostasis. Leptin is also synthesized in the stomach and subsequently binds to its receptors expressed in the intestine, although the functional relevance of such activation remains largely unknown. We report here that intrajejunal leptin administration activates jejunal leptin receptors and signals through a phosphatidylinositol 3-kinase (PI3K)-dependent and signal transducer and activator of transcription 3 (STAT3)-independent signaling pathway to lower glucose production in healthy rodents. Jejunal leptin action is sufficient to lower glucose production in uncontrolled diabetic and high-fat-fed rodents and contributes to the early antidiabetic effect of duodenal-jejunal bypass surgery. These data unveil a glucoregulatory site of leptin action and suggest that enhancing leptin-PI3K signaling in the jejunum lowers plasma glucose concentrations in diabetes.
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Affiliation(s)
- Brittany A Rasmussen
- Toronto General Research Institute, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Danna M Breen
- Toronto General Research Institute, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Frank A Duca
- Toronto General Research Institute, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Clémence D Côté
- Toronto General Research Institute, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Melika Zadeh-Tahmasebi
- Toronto General Research Institute, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Beatrice M Filippi
- Toronto General Research Institute, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
| | - Tony K T Lam
- Toronto General Research Institute, University Health Network, Toronto, ON M5G 1L7, Canada; Department of Physiology, University of Toronto, Toronto, ON M5S 1A8, Canada; Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada; Banting and Best Diabetes Centre, University of Toronto, Toronto, ON M5G 2C4, Canada.
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14
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Chiang S, Breen DM, Guo J, Mori Y, Giacca A. Local insulin application on the carotid artery inhibits neointima formation. Can J Physiol Pharmacol 2013; 91:1086-94. [DOI: 10.1139/cjpp-2013-0038] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/14/2023]
Abstract
Anti-mitogenic agents currently used to prevent restenosis in drug-eluting stents delay re-endothelialization. Delayed re-endothelialization is now considered as the main cause of late stent thrombosis with drug-eluting stents, which emphasizes the need for new treatments. We have shown that systemic insulin treatment decreases neointimal growth and accelerates re-endothelialization after arterial injury in a rat model of restenosis. However, systemic insulin treatment cannot be given to non-diabetic individuals because of the risk of hypoglycemia. Thus, we investigated whether local insulin treatment is also effective in reducing neointimal growth after arterial injury. Rats were given local vehicle or local insulin delivered via Pluronic gel applied around the carotid artery immediately following balloon injury. Plasma glucose and systemic insulin levels were not affected by local insulin treatment. Insulin decreased intimal area at 28 days (P < 0.05) and also inhibited vascular smooth muscle cell migration by 60% at 4 days (P < 0.05). NPH (a longer-lasting insulin) also decreased neointimal area. These results indicate that local insulin treatment can lead to decreased restenosis, suggesting a protective vascular effect of insulin in vivo and that local insulin treatment, possibly via insulin-eluting stents, may be clinically relevant.
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Affiliation(s)
- Simon Chiang
- Department of Physiology, Medical Science Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - Danna M. Breen
- Department of Physiology, Medical Science Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - June Guo
- Department of Physiology, Medical Science Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
| | - Yusaku Mori
- Department of Physiology, Medical Science Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Division of Diabetes, Metabolism and Endocrinology, Showa University, Shinagawa, Tokyo 142-0064, Japan
| | - Adria Giacca
- Department of Physiology, Medical Science Building, 1 King’s College Circle, Toronto, ON M5S 1A8, Canada
- Department of Medicine, University of Toronto, Toronto, ON M5S 1A8, Canada
- Institute of Medical Science, University of Toronto, Toronto, ON M5S 1A8, Canada
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15
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Abstract
The small intestine is traditionally viewed as an organ that mediates nutrient digestion and absorption. This view has recently been revised owing to the ability of the duodenum to sense nutrient influx and trigger negative feedback loops to inhibit glucose production and food intake to maintain metabolic homeostasis. Further, duodenal nutrient-sensing defects are acquired in diabetes and obesity, leading to increased glucose production. In contrast, jejunal nutrient sensing inhibits glucose production and mediates the early antidiabetic effect of bariatric surgery, and gut microbiota composition may alter intestinal nutrient-sensing mechanisms to regain better control of glucose homeostasis in diabetes and obesity in the long term. This perspective highlights nutrient-sensing mechanisms in the gut that regulate glucose homeostasis and the potential of targeting gut nutrient-sensing mechanisms as a therapeutic strategy to lower blood glucose concentrations in diabetes.
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Affiliation(s)
- Danna M. Breen
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Brittany A. Rasmussen
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Clémence D. Côté
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - V. Margaret Jackson
- Department of Cardiovascular, Metabolic and Endocrine Diseases, Pfizer Global Research and Development, Cambridge, Massachusetts
| | - Tony K.T. Lam
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
- Banting and Best Diabetes Centre, University of Toronto, Toronto, Ontario, Canada
- Corresponding author: Tony K.T. Lam,
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16
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Rasmussen BA, Breen DM, Luo P, Cheung GWC, Yang CS, Sun B, Kokorovic A, Rong W, Lam TKT. Duodenal activation of cAMP-dependent protein kinase induces vagal afferent firing and lowers glucose production in rats. Gastroenterology 2012; 142:834-843.e3. [PMID: 22245844 DOI: 10.1053/j.gastro.2011.12.053] [Citation(s) in RCA: 39] [Impact Index Per Article: 3.3] [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] [Received: 09/12/2011] [Revised: 12/23/2011] [Accepted: 12/27/2011] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS The duodenum senses nutrients to maintain energy and glucose homeostasis, but little is known about the signaling and neuronal mechanisms involved. We tested whether duodenal activation of adenosine 3',5'-cyclic monophosphate (cAMP)-dependent protein kinase A (PKA) is sufficient and necessary for cholecystokinin (CCK) signaling to trigger vagal afferent firing and regulate glucose production. METHODS In rats, we selectively activated duodenal PKA and evaluated changes in glucose kinetics during the pancreatic (basal insulin) pancreatic clamps and vagal afferent firing. The requirement of duodenal PKA signaling in glucose regulation was evaluated by inhibiting duodenal activation of PKA in the presence of infusion of the intraduodenal PKA agonist (Sp-cAMPS) or CCK1 receptor agonist (CCK-8). We also assessed the involvement of a neuronal network and the metabolic impact of duodenal PKA activation in rats placed on high-fat diets. RESULTS Intraduodenal infusion of Sp-cAMPS activated duodenal PKA and lowered glucose production, in association with increased vagal afferent firing in control rats. The metabolic and neuronal effects of duodenal Sp-cAMPS were negated by coinfusion with either the PKA inhibitor H89 or Rp-CAMPS. The metabolic effect was also negated by coinfusion with tetracaine, molecular and pharmacologic inhibition of NR1-containing N-methyl-d-aspartate (NMDA) receptors within the dorsal vagal complex, or hepatic vagotomy in rats. Inhibition of duodenal PKA blocked the ability of duodenal CCK-8 to reduce glucose production in control rats, whereas duodenal Sp-cAMPS bypassed duodenal CCK resistance and activated duodenal PKA and lowered glucose production in rats on high-fat diets. CONCLUSIONS We identified a neural glucoregulatory function of duodenal PKA signaling.
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Affiliation(s)
- Brittany A Rasmussen
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
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17
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Abstract
Elevation of lipid levels affects energy and glucose homeostasis. Organs such as the gut, brain and liver detect a rise in lipids and orchestrate a biochemical, molecular, neuronal and physiological network of responses that alters appetite and the rate of hepatic glucose production. The factors involved in these responses are unclear but the formation of esterified lipids (long-chain fatty acyl-CoAs) and subsequent activation of protein kinase Cδ remain a common sensing mechanism in all three organs. In this paper, we discuss the mechanisms underlying lipid sensing within the gut, brain and liver and their physiological impact on the regulation of glucose and energy homeostasis.
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Affiliation(s)
- Brittany A Rasmussen
- Toronto General Research Institute, University of Health Network, Toronto, Canada
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18
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Abstract
OBJECTIVE Metabolism of long-chain fatty acids within the duodenum leads to the activation of duodenal mucosal protein kinase C (PKC)-δ and the cholecystokinin (CCK)-A receptor to lower glucose production through a neuronal network. However, the interfunctional relationship between duodenal PKC-δ and CCK remains elusive. Although long-chain fatty acids activate PKC to stimulate the release of CCK in CCK-secreting cells, CCK has also been found to activate PKC-δ in pancreatic acinar cells. We here evaluate whether activation of duodenal mucosal PKC-δ lies upstream (and/or downstream) of CCK signaling to lower glucose production. RESEARCH DESIGN AND METHODS We first determined with immunofluorescence whether PKC-δ and CCK were colocalized within the duodenal mucosa. We then performed gain- and loss-of-function experiments targeting duodenal PKC-δ and the CCK-A receptor and evaluated the impact on changes in glucose kinetics during pancreatic (basal insulin) clamps in rats in vivo. RESULTS Immunostaining of PKC-δ was found to colocalize with CCK in the duodenal mucosa. Intraduodenal coinfusion of either the CCK-A receptor antagonist MK-329 or CR-1409 with the PKC activator negated the ability of duodenal mucosal PKC-δ activation to lower glucose production during the pancreatic clamps in normal rats. Conversely, molecular and pharmacological inhibition of duodenal PKC-δ did not negate the ability of the duodenal CCK-A receptor agonist CCK-8 to lower glucose production, indicating that activation of duodenal PKC-δ lies upstream (and not downstream) of CCK signaling. Finally, intraduodenal PKC activator infusion failed to lower glucose production in rats with high-fat diet-induced duodenal CCK resistance. CONCLUSIONS In summary, activation of duodenal PKC-δ leads to the stimulation of CCK release and activation of the CCK-A receptor signaling axis to lower glucose production in normal rats, but fails to bypass duodenal CCK-resistance in high fat-fed rats.
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Affiliation(s)
- Danna M. Breen
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Jessica T.Y. Yue
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
| | - Brittany A. Rasmussen
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Andrea Kokorovic
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Grace W.C. Cheung
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
| | - Tony K.T. Lam
- Toronto General Research Institute, University Health Network, Toronto, Ontario, Canada
- Department of Medicine, University of Toronto, Toronto, Ontario, Canada
- Department of Physiology, University of Toronto, Toronto, Ontario, Canada
- Banting and Best Diabetes Centre, University of Toronto, Toronto, Ontario, Canada
- Corresponding author: Tony K.T. Lam,
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19
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Kokorovic A, Cheung GWC, Breen DM, Chari M, Lam CKL, Lam TKT. Duodenal mucosal protein kinase C-δ regulates glucose production in rats. Gastroenterology 2011; 141:1720-7. [PMID: 21704002 DOI: 10.1053/j.gastro.2011.06.042] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [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] [Received: 03/16/2011] [Revised: 05/20/2011] [Accepted: 06/17/2011] [Indexed: 12/02/2022]
Abstract
BACKGROUND & AIMS Activation of protein kinase C (PKC) enzymes in liver and brain alters hepatic glucose metabolism, but little is known about their role in glucose regulation in the gastrointestinal tract. We investigated whether activation of PKC-δ in the duodenum is sufficient and necessary for duodenal nutrient sensing and regulates hepatic glucose production through a neuronal network in rats. METHODS In rats, we inhibited duodenal PKC and evaluated whether nutrient-sensing mechanisms, activated by refeeding, have disruptions in glucose regulation. We then performed gain- and loss-of-function pharmacologic and molecular experiments to target duodenal PKC-δ; we evaluated the impact on glucose production regulation during the pancreatic clamping, while basal levels of insulin were maintained. RESULTS PKC-δ was detected in the mucosal layer of the duodenum; intraduodenal infusion of PKC inhibitors disrupted glucose homeostasis during refeeding, indicating that duodenal activation of PKC-δ is necessary and sufficient to regulate glucose homeostasis. Intraduodenal infusion of the PKC activator 1-oleoyl-2-acetyl-sn-glycerol (OAG) specifically activated duodenal mucosal PKC-δ and a gut-brain-liver neuronal pathway to reduce glucose production. Molecular and pharmacologic inhibition of duodenal mucosal PKC-δ negated the ability of duodenal OAG and lipids to reduce glucose production. CONCLUSIONS In the duodenal mucosa, PKC-δ regulates glucose homeostasis.
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Affiliation(s)
- Andrea Kokorovic
- Toronto General Research Institute, University Health Network, Toronto, Canada
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20
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Abstract
Revascularization procedures used for the treatment of cardiovascular disease can be associated with restenosis, although drug-coated stents have greatly reduced this complication. Both type 2 diabetes (T2DM) and metabolic syndrome (MetS) are associated with a high risk for atherosclerosis and restenosis. Insulin resistance, defined as the inability of insulin to exert its metabolic actions, characterizes both T2DM and MetS. Recent data suggest that insulin resistance is directly implicated in atherosclerosis/restenosis, because of the unresponsiveness to the vasculoprotective action of insulin, including its phosphoinositide 3-kinase (PI3K)-Akt-endothelial nitric oxide synthase mediated enhancement of endothelial function. However, insulin also has 'atherogenic' actions, including enhancement of vascular smooth muscle cell (VSMC) proliferation, which are mitogen-activated protein kinase-mediated. These 'atherogenic' actions are less affected by insulin resistance, which mainly involves the PI3K pathway. The role of insulin in the atherosclerotic disease process is still highly controversial, where some investigators view insulin as a growth factor with pro-atherogenic effects while some others believe insulin resistance to be pro-atherogenic rather than insulin itself. We attempt to produce a balanced review with a focus on the effect of insulin in vivo, in animal models of atherosclerosis and restenosis.
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Affiliation(s)
- Danna M Breen
- Department of Physiology, University of Toronto, Toronto M5S 1A8, Canada
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21
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Abstract
The gut plays a unique role in the metabolic defence against energy excess and glucose imbalance. Nutrients, such as lipids, enter the small intestine and activate sensing mechanisms to maintain energy and glucose homeostasis. It is clear that a lipid-induced gut-brain axis exists and that cholecystokinin and a neuronal network are involved, yet the underlying mechanisms in gut lipid sensing that regulate homeostasis remain largely unknown. In parallel, studies underscore the importance of enzymes involved in lipid metabolism within the brain, such as adenosine monophosphate -activated protein kinase, to maintain homeostasis. In this review, we will first examine what is known regarding the mechanisms involved in this lipid-induced gut-brain neuronal axis that regulate food intake and hepatic glucose production. We will also discuss how enzymes that govern brain lipid metabolism could potentially reveal how lipids trigger the gut, and that both the gut and brain may share common biochemical pathways to sense lipids.
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Affiliation(s)
- Danna M Breen
- Toronto General Research Institute, University Health Network, Toronto, Ontario M5G 1L7, Canada
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22
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Breen DM, Dhaliwall JK, Chan KK, Guo J, Lam L, Bendeck MP, Giacca A. Insulin Inhibits and Oral Sucrose Increases Neointimal Growth after Arterial Injury in Rats. J Vasc Res 2010; 47:412-22. [DOI: 10.1159/000281581] [Citation(s) in RCA: 9] [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] [Received: 09/27/2009] [Accepted: 10/29/2009] [Indexed: 11/19/2022] Open
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23
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Breen DM, Chan KK, Dhaliwall JK, Ward MR, Al Koudsi N, Lam L, De Souza M, Ghanim H, Dandona P, Stewart DJ, Bendeck MP, Giacca A. Insulin increases reendothelialization and inhibits cell migration and neointimal growth after arterial injury. Arterioscler Thromb Vasc Biol 2009; 29:1060-6. [PMID: 19359661 DOI: 10.1161/atvbaha.109.185447] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/27/2022]
Abstract
OBJECTIVE Insulin has both growth-promoting and protective vascular effects in vitro, however the predominant effect in vivo is unclear. We investigated the effects of insulin in vivo on neointimal growth after arterial injury. METHODS AND RESULTS Rats were given subcutaneous control (C) or insulin implants (3U/d;I) 3 days before arterial (carotid or aortic) balloon catheter injury. Normoglycemia was maintained by oral glucose and, after surgery, by intraperitoneal glucose infusion (saline in C). Insulin decreased intimal area (P<0.01) but did not change intimal cell proliferation or apoptosis. However, insulin inhibited cell migration into the intima (P<0.01) and increased expression of smooth muscle cell (SMC) differentiation markers (P<0.05). Insulin also increased reendothelialization (P<0.01) and the number of circulating progenitor cells (P<0.05). CONCLUSIONS These results are the first demonstration that insulin has a protective effect on both SMC and endothelium in vivo, resulting in inhibition of neointimal growth after vessel injury.
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Affiliation(s)
- Danna M Breen
- Department of Physiology, University of Toronto. Ontario, Canada
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Breen DM, Sanli T, Giacca A, Tsiani E. Stimulation of muscle cell glucose uptake by resveratrol through sirtuins and AMPK. Biochem Biophys Res Commun 2008; 374:117-22. [DOI: 10.1016/j.bbrc.2008.06.104] [Citation(s) in RCA: 149] [Impact Index Per Article: 9.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2008] [Accepted: 06/26/2008] [Indexed: 10/21/2022]
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25
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Breen DM, Guo J, Franco C, Mroziewicz M, Bendeck M, Giacca A. Insulin Decreases Atherosclerosis Progression in Apolipoprotein E Knockout Mice. Can J Diabetes 2008. [DOI: 10.1016/s1499-2671(08)24041-4] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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