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Handzlik MK, Gengatharan JM, Frizzi KE, McGregor GH, Martino C, Rahman G, Gonzalez A, Moreno AM, Green CR, Guernsey LS, Lin T, Tseng P, Ideguchi Y, Fallon RJ, Chaix A, Panda S, Mali P, Wallace M, Knight R, Gantner ML, Calcutt NA, Metallo CM. Insulin-regulated serine and lipid metabolism drive peripheral neuropathy. Nature 2023; 614:118-124. [PMID: 36697822 PMCID: PMC9891999 DOI: 10.1038/s41586-022-05637-6] [Citation(s) in RCA: 36] [Impact Index Per Article: 36.0] [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] [Subscribe] [Scholar Register] [Received: 12/20/2021] [Accepted: 12/07/2022] [Indexed: 01/26/2023]
Abstract
Diabetes represents a spectrum of disease in which metabolic dysfunction damages multiple organ systems including liver, kidneys and peripheral nerves1,2. Although the onset and progression of these co-morbidities are linked with insulin resistance, hyperglycaemia and dyslipidaemia3-7, aberrant non-essential amino acid (NEAA) metabolism also contributes to the pathogenesis of diabetes8-10. Serine and glycine are closely related NEAAs whose levels are consistently reduced in patients with metabolic syndrome10-14, but the mechanistic drivers and downstream consequences of this metabotype remain unclear. Low systemic serine and glycine are also emerging as a hallmark of macular and peripheral nerve disorders, correlating with impaired visual acuity and peripheral neuropathy15,16. Here we demonstrate that aberrant serine homeostasis drives serine and glycine deficiencies in diabetic mice, which can be diagnosed with a serine tolerance test that quantifies serine uptake and disposal. Mimicking these metabolic alterations in young mice by dietary serine or glycine restriction together with high fat intake markedly accelerates the onset of small fibre neuropathy while reducing adiposity. Normalization of serine by dietary supplementation and mitigation of dyslipidaemia with myriocin both alleviate neuropathy in diabetic mice, linking serine-associated peripheral neuropathy to sphingolipid metabolism. These findings identify systemic serine deficiency and dyslipidaemia as novel risk factors for peripheral neuropathy that may be exploited therapeutically.
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Affiliation(s)
- Michal K Handzlik
- Molecular and Cell Biology Laboratory, The Salk Institute for Biological Studies, La Jolla, CA, USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | - Jivani M Gengatharan
- Molecular and Cell Biology Laboratory, The Salk Institute for Biological Studies, La Jolla, CA, USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | - Katie E Frizzi
- Department of Pathology, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Grace H McGregor
- Molecular and Cell Biology Laboratory, The Salk Institute for Biological Studies, La Jolla, CA, USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | - Cameron Martino
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA, USA
- Bioinformatics and Systems Biology Program, University of California San Diego, La Jolla, CA, USA
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, USA
| | - Gibraan Rahman
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA, USA
- Bioinformatics and Systems Biology Program, University of California San Diego, La Jolla, CA, USA
| | - Antonio Gonzalez
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Ana M Moreno
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | - Courtney R Green
- Molecular and Cell Biology Laboratory, The Salk Institute for Biological Studies, La Jolla, CA, USA
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | - Lucie S Guernsey
- Department of Pathology, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Terry Lin
- Regulatory Biology Laboratory, The Salk Institute for Biological Studies, La Jolla, CA, USA
| | - Patrick Tseng
- Molecular and Cell Biology Laboratory, The Salk Institute for Biological Studies, La Jolla, CA, USA
| | | | | | - Amandine Chaix
- Department of Nutrition and Integrative Physiology, University of Utah, Salt Lake City, UT, USA
| | - Satchidananda Panda
- Regulatory Biology Laboratory, The Salk Institute for Biological Studies, La Jolla, CA, USA
| | - Prashant Mali
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
| | - Martina Wallace
- School of Agriculture and Food Science, University College Dublin, Dublin, Ireland
| | - Rob Knight
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA
- Department of Pediatrics, School of Medicine, University of California San Diego, La Jolla, CA, USA
- Bioinformatics and Systems Biology Program, University of California San Diego, La Jolla, CA, USA
- Center for Microbiome Innovation, University of California San Diego, La Jolla, CA, USA
| | | | - Nigel A Calcutt
- Department of Pathology, School of Medicine, University of California San Diego, La Jolla, CA, USA
| | - Christian M Metallo
- Molecular and Cell Biology Laboratory, The Salk Institute for Biological Studies, La Jolla, CA, USA.
- Department of Bioengineering, University of California San Diego, La Jolla, CA, USA.
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Marquez A, Guernsey LS, Frizzi KE, Cundiff M, Constantino I, Muttalib N, Arenas F, Zhou X, Lim SH, Ferdousi M, Ponirakis G, Silverdale M, Kobylecki C, Jones M, Marshall A, Malik RA, Jolivalt CG. Tau associated peripheral and central neurodegeneration: Identification of an early imaging marker for tauopathy. Neurobiol Dis 2021; 151:105273. [PMID: 33482356 DOI: 10.1016/j.nbd.2021.105273] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [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: 01/04/2021] [Accepted: 01/15/2021] [Indexed: 01/29/2023] Open
Abstract
Pathological hyperphosphorylated tau is a key feature of Alzheimer's disease (AD) and Frontotemporal dementia (FTD). Using transgenic mice overexpressing human non-mutated tau (htau mice), we assessed the contribution of tau to peripheral and central neurodegeneration. Indices of peripheral small and large fiber neuropathy and learning and memory performances were assessed at 3 and 6 months of age. Overexpression of human tau is associated with peripheral neuropathy at 6 months of age. Our study also provides evidence that non-mutated tau hyperphosphorylation plays a critical role in memory deficits. In addition, htau mice had reduced stromal corneal nerve length with preservation of sub-basal corneal nerves, consistent with a somatofugal degeneration. Corneal nerve degeneration occurred prior to any cognitive deficits and peripheral neuropathy. Stromal corneal nerve loss was observed in patients with FTD but not AD. Corneal confocal microscopy may be used to identify early neurodegeneration and differentiate FTD from AD.
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Affiliation(s)
| | - Lucie S Guernsey
- Department of Pathology, University of California San Diego, USA
| | - Katie E Frizzi
- Department of Pathology, University of California San Diego, USA
| | - Morgan Cundiff
- Department of Pathology, University of California San Diego, USA
| | | | - Nabeel Muttalib
- Department of Pathology, University of California San Diego, USA
| | - Fernanda Arenas
- Department of Pathology, University of California San Diego, USA
| | - Xiajun Zhou
- Department of Pathology, University of California San Diego, USA
| | - Sze Hway Lim
- Department of Neurology, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK
| | - Maryam Ferdousi
- Institute of Cardiovascular Sciences, University of Manchester and Central Manchester NHS Foundation Trust, Manchester Academic Health Science Centre, Manchester, UK
| | | | - Monty Silverdale
- Department of Neurology, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK; Manchester Academic Health Sciences Centre, University of Manchester, UK
| | - Christopher Kobylecki
- Department of Neurology, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK; Manchester Academic Health Sciences Centre, University of Manchester, UK
| | - Matthew Jones
- Department of Neurology, Manchester Centre for Clinical Neurosciences, Salford Royal NHS Foundation Trust, Salford, UK
| | - Andrew Marshall
- Department of Clinical Neurophysiology, Salford Royal Hospital, National Health Service Foundation Trust, Institute of Brain, Behaviour and Mental Health, University of Manchester, Manchester, UK
| | - Rayaz A Malik
- Department of Medicine, Weill Cornell Medicine-Qatar, Doha, Qatar and Institute of Cardiovascular Science, University of Manchester, Manchester, UK
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King MR, Anderson NJ, Deciu M, Guernsey LS, Cundiff M, Hajizadeh S, Jolivalt CG. Insulin deficiency, but not resistance, exaggerates cognitive deficits in transgenic mice expressing human amyloid and tau proteins. Reversal by Exendin-4 treatment. J Neurosci Res 2020; 98:2357-2369. [PMID: 32737929 DOI: 10.1002/jnr.24706] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [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: 11/08/2019] [Revised: 06/29/2020] [Accepted: 07/12/2020] [Indexed: 12/24/2022]
Abstract
Epidemiological studies have pointed at diabetes as a risk factor for Alzheimer's disease (AD) and this has been supported by several studies in animal models of both type 1 and type 2 diabetes. However, side-by-side comparison of the two types of diabetes is limited. We investigated the role of insulin deficiency and insulin resistance in the development of memory impairments and the effect of Exendin-4 (Ex4) treatment in a mouse model of AD. Three-4-month-old female wild type (WT) mice and mice overexpressing human tau and amyloid precursor protein (TAPP) were injected with streptozotocin (STZ) or fed a high-fat diet (HFD). A second study was performed in TAPP-STZ mice treated with Ex4, a long-lasting analog of GLP-1. Plasma and brain were collected at study termination for ELISA, Western blot, and immunohistochemistry analysis. Learning and memory deficits were impaired in TAPP transgenic mice compared with WT mice at the end of the study. Deficits were exaggerated by insulin deficiency in TAPP mice but 12 weeks of insulin resistance did not affect memory performances in either WT or TAPP mice. Levels of phosphorylated tau were increased in the brain of WT-STZ and TAPP-STZ mice but not in the brain of WT or TAPP mice on HFD. In the TAPP-STZ mice, treatment with Ex4 initiated after established cognitive deficits ameliorated learning, but not memory, impairments. This was accompanied by the reduction of amyloid β and phosphorylated tau expression. Theses studies support the role of Ex4 in AD, independently from its actions on diabetes.
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Affiliation(s)
- Matthew R King
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Nicholas J Anderson
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Mihaela Deciu
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Lucie S Guernsey
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Morgan Cundiff
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Shohreh Hajizadeh
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
| | - Corinne G Jolivalt
- Department of Pathology, University of California San Diego, La Jolla, CA, USA
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Jolivalt CG, Frizzi KE, Han MM, Mota AJ, Guernsey LS, Kotra LP, Fernyhough P, Calcutt NA. Topical Delivery of Muscarinic Receptor Antagonists Prevents and Reverses Peripheral Neuropathy in Female Diabetic Mice. J Pharmacol Exp Ther 2020; 374:44-51. [PMID: 32327528 DOI: 10.1124/jpet.120.265447] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2020] [Accepted: 04/20/2020] [Indexed: 02/06/2023] Open
Abstract
Muscarinic antagonists promote sensory neurite outgrowth in vitro and prevent and/or reverse multiple indices of peripheral neuropathy in rodent models of diabetes, chemotherapy-induced peripheral neuropathy, and HIV protein-induced neuropathy when delivered systemically. We measured plasma concentrations of the M1 receptor-selective muscarinic antagonist pirenzepine when delivered by subcutaneous injection, oral gavage, or topical application to the skin and investigated efficacy of topically delivered pirenzepine against indices of peripheral neuropathy in diabetic mice. Topical application of 2% pirenzepine to the paw resulted in plasma concentrations 6 hours postdelivery that approximated those previously shown to promote neurite outgrowth in vitro. Topical delivery of pirenzepine to the paw of mice with streptozotocin-induced diabetes dose-dependently (0.1%-10.0%) prevented tactile allodynia, thermal hypoalgesia, and loss of epidermal nerve fibers in the treated paw and attenuated large fiber motor nerve conduction slowing in the ipsilateral limb. Efficacy against some indices of neuropathy was also noted in the contralateral limb, indicating systemic effects following local treatment. Topical pirenzepine also reversed established paw heat hypoalgesia, whereas withdrawal of treatment resulted in a gradual decline in efficacy over 2-4 weeks. Efficacy of topical pirenzepine was muted when treatment was reduced from 5 to 3 or 1 day/wk. Similar local effects were noted with the nonselective muscarinic receptor antagonist atropine when applied either to the paw or to the eye. Topical delivery of muscarinic antagonists may serve as a practical therapeutic approach to treating diabetic and other peripheral neuropathies. SIGNIFICANCE STATEMENT: Muscarinic antagonist pirenzepine alleviates diabetic peripheral neuropathy when applied topically in mice.
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Affiliation(s)
- Corinne G Jolivalt
- Department of Pathology, University of California San Diego, San Diego, California (C.G.J., K.E.F., M.M.H., A.J.M., L.S.G., N.A.C.); Winsantor Inc. (K.E.F). Center for Molecular Design and Preformulations and Krembil Research Institute, University Health Network and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada (L.P.K.); and Department of Pharmacology and Therapeutics and Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Center, University of Manitoba, Winnipeg, Manitoba, Canada (P.F.)
| | - Katie E Frizzi
- Department of Pathology, University of California San Diego, San Diego, California (C.G.J., K.E.F., M.M.H., A.J.M., L.S.G., N.A.C.); Winsantor Inc. (K.E.F). Center for Molecular Design and Preformulations and Krembil Research Institute, University Health Network and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada (L.P.K.); and Department of Pharmacology and Therapeutics and Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Center, University of Manitoba, Winnipeg, Manitoba, Canada (P.F.)
| | - May Madi Han
- Department of Pathology, University of California San Diego, San Diego, California (C.G.J., K.E.F., M.M.H., A.J.M., L.S.G., N.A.C.); Winsantor Inc. (K.E.F). Center for Molecular Design and Preformulations and Krembil Research Institute, University Health Network and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada (L.P.K.); and Department of Pharmacology and Therapeutics and Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Center, University of Manitoba, Winnipeg, Manitoba, Canada (P.F.)
| | - Andre J Mota
- Department of Pathology, University of California San Diego, San Diego, California (C.G.J., K.E.F., M.M.H., A.J.M., L.S.G., N.A.C.); Winsantor Inc. (K.E.F). Center for Molecular Design and Preformulations and Krembil Research Institute, University Health Network and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada (L.P.K.); and Department of Pharmacology and Therapeutics and Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Center, University of Manitoba, Winnipeg, Manitoba, Canada (P.F.)
| | - Lucie S Guernsey
- Department of Pathology, University of California San Diego, San Diego, California (C.G.J., K.E.F., M.M.H., A.J.M., L.S.G., N.A.C.); Winsantor Inc. (K.E.F). Center for Molecular Design and Preformulations and Krembil Research Institute, University Health Network and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada (L.P.K.); and Department of Pharmacology and Therapeutics and Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Center, University of Manitoba, Winnipeg, Manitoba, Canada (P.F.)
| | - Lakshmi P Kotra
- Department of Pathology, University of California San Diego, San Diego, California (C.G.J., K.E.F., M.M.H., A.J.M., L.S.G., N.A.C.); Winsantor Inc. (K.E.F). Center for Molecular Design and Preformulations and Krembil Research Institute, University Health Network and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada (L.P.K.); and Department of Pharmacology and Therapeutics and Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Center, University of Manitoba, Winnipeg, Manitoba, Canada (P.F.)
| | - Paul Fernyhough
- Department of Pathology, University of California San Diego, San Diego, California (C.G.J., K.E.F., M.M.H., A.J.M., L.S.G., N.A.C.); Winsantor Inc. (K.E.F). Center for Molecular Design and Preformulations and Krembil Research Institute, University Health Network and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada (L.P.K.); and Department of Pharmacology and Therapeutics and Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Center, University of Manitoba, Winnipeg, Manitoba, Canada (P.F.)
| | - Nigel A Calcutt
- Department of Pathology, University of California San Diego, San Diego, California (C.G.J., K.E.F., M.M.H., A.J.M., L.S.G., N.A.C.); Winsantor Inc. (K.E.F). Center for Molecular Design and Preformulations and Krembil Research Institute, University Health Network and Leslie Dan Faculty of Pharmacy, University of Toronto, Toronto, Ontario, Canada (L.P.K.); and Department of Pharmacology and Therapeutics and Division of Neurodegenerative Disorders, St. Boniface Hospital Albrechtsen Research Center, University of Manitoba, Winnipeg, Manitoba, Canada (P.F.)
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Chen DK, Frizzi KE, Guernsey LS, Ladt K, Mizisin AP, Calcutt NA. Repeated monitoring of corneal nerves by confocal microscopy as an index of peripheral neuropathy in type-1 diabetic rodents and the effects of topical insulin. J Peripher Nerv Syst 2014; 18:306-15. [PMID: 24147903 DOI: 10.1111/jns5.12044] [Citation(s) in RCA: 54] [Impact Index Per Article: 5.4] [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: 07/04/2013] [Revised: 08/07/2013] [Accepted: 10/11/2013] [Indexed: 02/06/2023]
Abstract
We developed a reliable imaging and quantitative analysis method for in vivo corneal confocal microscopy (CCM) in rodents and used it to determine whether models of type 1 diabetes replicate the depletion of corneal nerves reported in diabetic patients. Quantification was reproducible between observers and stable across repeated time points in two rat strains. Longitudinal studies were performed in normal and streptozotocin (STZ)-diabetic rats, with innervation of plantar paw skin quantified using standard histological methods after 40 weeks of diabetes. Diabetic rats showed an initial increase, then a gradual reduction in occupancy of nerves in the sub-basal plexus so that values were significantly lower at week 40 (68 ± 6%) than age-matched controls (80 ± 2%). No significant loss of stromal or intra-epidermal nerves was detected. In a separate study, insulin was applied daily to the eye of control and STZ-diabetic mice and this treatment prevented depletion of nerves of the sub-basal plexus. Longitudinal studies are viable in rodents using CCM and depletion of distal corneal nerves precedes detectable loss of epidermal nerves in the foot, suggesting that diabetic neuropathy is not length dependent. Loss of insulin-derived neurotrophic support may contribute to the pathogenesis of corneal nerve depletion in type 1 diabetes.
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Affiliation(s)
- Debbie K Chen
- Department of Pathology, School of Medicine, University of California, San Diego, La Jolla, CA, USA
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King MR, Anderson NJ, Guernsey LS, Jolivalt CG. Glycogen synthase kinase-3 inhibition prevents learning deficits in diabetic mice. J Neurosci Res 2013; 91:506-14. [PMID: 23362012 DOI: 10.1002/jnr.23192] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2012] [Revised: 10/29/2012] [Accepted: 11/21/2012] [Indexed: 12/20/2022]
Abstract
There is an increasing awareness that diabetes has an impact on the central nervous system, with reports of impaired learning, memory, and mental flexibility being more common in diabetic subjects than in the general population. Insulin-deficient diabetic mice also display learning deficits associated with defective insulin-signaling in the brain and increased activity of GSK3. In the present study, AR-A014418, a GSK3β inhibitor, and TX14(A), a neurotrophic factor with GSK3 inhibitory properties, were tested against the development of learning deficits in mice with insulin-deficient diabetes. Treatments were started at onset of diabetes and continued for 10 weeks. Treatment with AR-A014418 or TX14(A) prevented the development of learning deficits, assessed by the Barnes maze, but only AR-A014418 prevented memory deficits, as assessed by the object recognition test. Diabetes-induced increased levels of amyloid β protein and phosphorylated tau were not significantly affected by the treatments. However, the diabetes-induced decrease in synaptophysin, a presynaptic protein marker of hippocampal plasticity, was partially prevented by both treatments. These results suggest a role for GSK3 and/or reduced neurotrophic support in the development of cognitive deficits in diabetic mice that are associated with synaptic damage.
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Affiliation(s)
- Matthew R King
- Department of Pathology, School of Medicine, University of California San Diego, La Jolla, California, USA
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