GLUT4 localisation with the plasma membrane is unaffected by an increase in plasma free fatty acid availability

BACKGROUND

Insulin-stimulated glucose uptake into skeletal muscle occurs via translocation of GLUT4 from intracellular storage vesicles to the plasma membrane. Elevated free fatty acid (FFA) availability via a lipid infusion reduces glucose disposal, but this occurs in the absence of impaired proximal insulin signalling. Whether GLUT4 localisation to the plasma membrane is subsequently affected by elevated FFA availability is not known.

METHODS

Trained (n = 11) and sedentary (n = 10) individuals, matched for age, sex and body mass index, received either a 6 h lipid or glycerol infusion in the setting of a concurrent hyperinsulinaemic-euglycaemic clamp. Sequential muscle biopsies (0, 2 and 6 h) were analysed for GLUT4 membrane localisation and microvesicle size and distribution using immunofluorescence microscopy.

RESULTS

At baseline, trained individuals had more small GLUT4 spots at the plasma membrane, whereas sedentary individuals had larger GLUT4 spots. GLUT4 localisation with the plasma membrane increased at 2 h (P = 0.04) of the hyperinsulinemic-euglycemic clamp, and remained elevated until 6 h, with no differences between groups or infusion type. The number of GLUT4 spots was unchanged at 2 h of infusion. However, from 2 to 6 h there was a decrease in the number of small GLUT4 spots at the plasma membrane (P = 0.047), with no differences between groups or infusion type.

CONCLUSION

GLUT4 localisation with the plasma membrane increases during a hyperinsulinemic-euglycemic clamp, but this is not altered by elevated FFA availability. GLUT4 appears to disperse from small GLUT4 clusters located at the plasma membrane to support glucose uptake during a hyperinsulinaemic-euglycaemic clamp.

In Obese Patients Without Diabetes, 12 Weeks of Time-Restricted Eating (TRE) Does Not Alter β-Cell Function: A Randomized Pilot Study

Impairment of β-cell function is a precursor to impaired glucose tolerance, which is a pathophysiological basis for the development of Type 2 Diabetes Mellitus (T2DM). Previous literature has reported varying effects of TRE on metabolic measures in different populations, yet the effect of TRE on β-cell function has not been well-characterized. We hypothesized that in obese patients without diabetes, 12 weeks of TRE (8-hour eating window) would improve β-cell function relative to baseline and the unrestricted eating group (non-TRE). Participants (17 women and 3 men; (mean ± SD); 45.5±12.1 years; BMI 34.1±7.5 kg/m2) with a prolonged eating window (15.4±0.9 hours) were randomized to either TRE (n=11) or non-TRE (n=9) for 12 weeks. Weight and 2-hour oral glucose tolerance (OGTT) were measured during at baseline and end-intervention. Β-cell function was assessed by multiple OGTT-based measures, including Glucose AUC, Insulin AUC, insulinogenic index, disposition index, QUICKI index, Matsuda index, Stumvoll index, and Avignon index. At baseline, these measures are within normal range across both groups. We found that TRE did not significantly alter these measures relative to baseline or the non-TRE group. In addition, the degree of eating window restriction did not correlate with any observed changes in β-cell function. We concluded that in obese patients without diabetes, TRE did not significantly alter β cell function; whether TRE may be beneficial in patients with dysglycemia warrants further investigation.

MON-606 Changes in Eating Frequency but Not in Food Quality During Time Restricted Eating: Analysis from the See Food Study

Time-restricted eating (TRE) is a form of intermittent fasting that has gained interest in nutrition research and interventions as one of the dietary patterns to promote weight loss and other metabolic benefits. TRE is an eating pattern in which all nutrient intakes occur within a few hours (< 12 hours) every day, with no overt attempt to alter nutrient quality or quantity. The “See Food” study was a randomized, unblinded, controlled, behavioral interventional pilot clinical trial conducted from 2017-2018, that aimed to study the effect of a TRE intervention on metabolic health of overweight and obese participants, using the help of novel digital mobile technology. The objective of the current study is to analyze changes in diet quality among participants of the “See Food” study. Specifically, food intake patterns (frequency and type of meals, snacks and beverages) were compared between subjects in the 8-hour TRE intervention group, versus the unrestricted intake control group. Inclusion criteria included age 18-65, BMI >25 kg/m², had stable sleep and work schedule and owned a smartphone. Participants with diabetes, cardiovascular disease, uncontrolled pulmonary disease, pregnancy and nursing were excluded. A total of 20 participants with overweight or obesity (9 in control group and 11 in TRE group) were enrolled. Participants were instructed to use the “myCircadianClock” smartphone application to document their time of eating, type of meal and food images at baseline and during the intervention period of 14 weeks. The TRE group was instructed to consume calories within 8 hours each day. We compared the data between 14 days at baseline and 14 days at the end of the intervention. An eating occasion (EO) as defined as an occasion when a food or beverage (other than water) was consumed, and was separate from another EO by at least 15 minutes. Compared to baseline, both the TRE (3.8±0.4 vs 5.3±0.4, p<0.0001) and control group (4.9±0.4 vs 5.6±0.5, p=0.007) had less eating frequency. The TRE group had less eating frequency compared to control group (-1.5±0.2 vs -0.6±0.2, p=0.01) at the end of the study. Meal quality was classified by meal or snack type using a food-based classification system, and included 6 Eos ranging from a complete meal, to a low-quality snack. Beverages were classified separately by type. There were no differences in meal quality between the TRE and control group. The TRE group had less frequency of high-quality snack (-0.5±0.1 vs 0.05±0.1, p=0.008), mixed quality snack (-0.03±0.06 vs -0.3±0.07, p=0.01) and caffeinated beverage (-0.6±0.09 vs -0.008±0.1) compared to the control group. Conclusions: There was a reduction in eating frequency but no change in food quality when following an 8-hour TRE. Estimation of calories intake was limited in this study. A strength of the study is the use of a novel mobile app to track timing of meals. This would be feasible to implement in a real life setting.

Training alters the distribution of perilipin proteins in muscle following acute free fatty acid exposure

KEY POINTS

The lipid droplet (LD)-associated perilipin (PLIN) proteins promote intramuscular triglyceride (IMTG) storage, although whether the abundance and association of the PLIN proteins with LDs is related to the diverse lipid storage in muscle between trained and sedentary individuals is unknown. We show that lipid infusion augments IMTG content in type I fibres of both trained and sedentary individuals. Most importantly, despite there being no change in PLIN protein content, lipid infusion did increase the number of LDs connected with PLIN proteins in trained individuals only. We conclude that trained individuals are able to redistribute the pre-existing pool of PLIN proteins to an expanded LD pool during lipid infusion and, via this adaptation, may support the storage of fatty acids in IMTG.

ABSTRACT

Because the lipid droplet (LD)-associated perilipin (PLIN) proteins promote intramuscular triglyceride (IMTG) storage, we investigated the hypothesis that differential protein content of PLINs and their distribution with LDs may be linked to the diverse lipid storage in muscle between trained and sedentary individuals. Trained (n = 11) and sedentary (n = 10) subjects, matched for age, sex and body mass index, received either a 6 h lipid or glycerol infusion in the setting of a concurrent hyperinsulinaemic-euglycaemic clamp. Sequential muscle biopsies (0, 2 and 6 h) were analysed using confocal immunofluorescence microscopy for fibre type-specific IMTG content and PLIN associations with LDs. In both groups, lipid infusion increased IMTG content in type I fibres (trained: +62%, sedentary: +79%; P < 0.05) but did not affect PLIN protein content. At baseline, PLIN2 (+65%), PLIN3 (+105%) and PLIN5 (+53%; all P < 0.05) protein content was higher in trained compared to sedentary individuals. In trained individuals, lipid infusion increased the number of LDs associated with PLIN2 (+27%), PLIN3 (+73%) and PLIN5 (+40%; all P < 0.05) in type I fibres. By contrast, in sedentary individuals, lipid infusion only increased the number of LDs not associated with PLIN proteins. Acute free fatty acid elevation therefore induces a redistribution of PLIN proteins to an expanded LD pool in trained individuals only and this may be part of the mechanism that enables fatty acids to be stored in IMTG.

Biomarkers associated with severe hypoglycaemia and death in ACCORD

AIMS AND HYPOTHESIS

In patients with Type 2 diabetes, intensive glycaemic control is associated with hypoglycaemia and possibly increased mortality. However, no blood biomarkers exist to predict these outcomes. Using participants from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study, we hypothesized that insulin deficiency and islet autoantibodies in patients with clinically diagnosed Type 2 diabetes would be associated with severe hypoglycaemia and death.

METHODS

A nested case-control study design was used. A case (n = 86) was a participant who died with at least one episode of severe hypoglycaemia, defined as hypoglycaemia requiring assistance, at any point during ACCORD follow-up. A control (n = 344) was a participant who did not die and did not have severe hypoglycaemia during follow-up. Each case was matched to four controls (glycaemic intervention arm, race, age and BMI). Baseline insulin deficiency (fasting C-peptide ≤ 0.15 nmol/l) and islet autoantibodies [glutamic acid decarboxylase (GAD), tyrosine phosphatase-related islet antigen 2 (IA2), insulin (IAA) and zinc transporter (ZnT8)] were measured. Conditional logistic regression with and without adjustment for age, BMI and diabetes duration was used.

RESULTS

Death during ACCORD in those who experienced at least one episode of severe hypoglycaemia was associated with insulin deficiency [OR 4.8 (2.1, 11.1): P < 0.0001], GAD antibodies [OR 2.3 (1.1, 5.1): P = 0.04], the presence of IAA or baseline insulin use [OR 6.1 (3.5,10.7): P < 0.0001], which remained significant after adjusting for age, BMI, and diabetes duration. There was no significant association with IA2 or ZnT8 antibodies.

CONCLUSIONS

In patients with Type 2 diabetes, C-peptide or GAD antibodies may serve as blood biomarkers predicting higher odds of subsequent severe hypoglycaemia and death. (Clinical Trial Registry No: NCT00000620, www.clinicaltrials.gov for original ACCORD study).

Nondiagnostic thyroid fine-needle aspiration cytology: management dilemmas

Approximately 10% to 20% of thyroid biopsies by fine-needle aspiration (FNA) are nondiagnostic. The management of thyroid nodules in which FNA is nondiagnostic remains controversial because few studies have addressed this issue. We retrospectively reviewed the medical records of 153 patients with nondiagnostic FNAs of the thyroid performed in 1994. Sixty patients had reaspiration biopsies performed. Thirty-seven specimens (62%) were diagnostic and 23 (38%) remained nondiagnostic. Of the 27 patients who had a thyroid operation, 10 (37%) had a malignancy. Preoperative information about physical examination, ultrasound imaging, or nondiagnostic FNA did not predict outcome. Nondiagnostic FNAs of the thyroid may be associated with a high probability of thyroid malignancy. Nondiagnostic FNAs should not be considered benign. Reaspiration followed by selective surgical treatment is recommended.

High frequency of promoter hypermethylation of RASSF1A in nasopharyngeal carcinoma

We have investigated the genetic and epigenetic changes of a newly isolated tumor suppressor gene on 3p21.3, RASSF1A, in nasopharyngeal carcinoma (NPC). Four xenografts, four cell lines and 21 primary tumors were examined. Promoter hypermethylation of the 5'CpG island of RASSF1A was detected in 4 of 4 (100%) xenografts, in 3 of 4 (75%) cell lines, and in 14 of 21 (66.7%) primary tumors but not in the normal nasopharyngeal epithelia. Mutations were found in 2 of 21 (9.5%) primary tumors. In the cell lines and xenografts with extensive methylation, no RASSF1A gene expression was found. After treatment with 5'-aza-2'deoxycytidine, reexpression and demethylation of the RASSF1A gene were detected in a NPC cell line. These findings suggest that promoter hypermethylation may participate in the transcriptional inactivation of the RASSF1A gene in NPC. The high incidence of RASSF1A alterations suggest that it is the critical target gene on chromosome 3p21.3 involved in the development of NPC.

Cytotoxic effect of gossypol on colon carcinoma cells

Gossypol, a male contraceptive drug extracted from cottonseeds, has been found to have antiproliferative activity on tumour cells and is thought to be a potential anticancer drug. The aim of this study was to investigate the mechanisms of gossypol-induced cell death on two colon carcinoma cell lines, HT29 and LoVo. Firstly, we studied the effect of gossypol on the colony forming ability of these tumour cells, which is the main target of chemotherapeutic drugs. Using clonogenic assays, flow cytometry and DNA gel electrophoresis techniques, we have found that gossypol not only inhibited colony forming ability of these tumour cells, but we also observed cellular internucleosomal DNA fragmentation in the cells treated with 3 doses of gossypol and this was accompanied by the appearance of a sub-G1 apoptotic peak and morphological characteristics of apoptosis. Our results suggest that the gossypol induced cell death is via an apoptotic pathway and the effect of gossypol may not be cell cycle specific. Using Western blotting analysis, we found that the gossypol-induced apoptosis may not be involved in the regulation of p53 but possibly associated with the regulation of bcl-2 and Bax expression. Our evidence indicates that gossypol may provide a potential therapeutic benefit for the treatment of colon carcinoma and understanding the mechanisms of gossypol-induced cytotoxicity on tumour cells is essential for including this drug in clinical use.

Effect of p16INK4a on chemosensitivity in nasopharyngeal carcinoma cells

The p16INK4a tumor suppressor gene is frequently inactivated in nasopharyngeal carcinoma (NPC) and hence it may play an important role in the suppression of this tumor. In order to study the effect of p16INK4a restoration in NPC cells, full-length human p16INK4a gene was transfected into a NPC cell line, CNE1. Four individual clones with differential levels of p16INK4a protein expression, were selected for further studies. The introduction of p16INK4a into CNE1 cells induced growth suppression through G0/G1 cell cycle arrest; however, the cell growth rate was not correlated to the levels of p16INK4a protein expression. To study whether transfection of p16INK4a could protect NPC cells from radiation, cisplatin and 5-fluorouracil (5FU), the cellular sensitivity of p16INK4a transfectants and vector control were investigated. An increase in sensitivity to 5FU was observed (2-fold compared to IC50) in all 4 clones compared to vector-transfected control. P16INK4a transfection also resulted in increased sensitivity to cisplatin (1.5-1.8-fold) in 3 out of 4 cell lines. However, no difference in radiosensitivity was found between the p16INK4a transfectants and the control. These findings indicate that p16INK4a suppresses NPC cell growth through G0/G1 arrest and modulating cellular response to chemotherapeutic drugs in NPC cells. Therefore, restoration of p16INK4a may have a therapeutic purpose in the treatment of NPC.

Regulation of telomerase activity by gamma-radiation in nasopharyngeal carcinoma cells

Since telomerase has been suggested to play a role in radiation response, the effect of radiation on the regulation of telomerase activity was studied on two NPC cell lines, CNE1 and 915. In order to investigate the correlation between cell survival and telomerase activity, three low doses (0.25, 0.5 and 1 Gy) and three high doses (2, 4 and 8 Gy) of gamma-radiation were used. We found that low doses of radiation induced telomerase activity (up to 250% of untreated controls) followed by a cell cycle G1 arrest, suggesting that the up-regulation of telomerase may play a role in initiating radiation induced cell cycle arrest. High doses of radiation resulted in decreased telomerase activity (down to 30% of untreated controls) and this was followed by an increased cell death. Our results indicate that the up-regulation of telomerase activity is an important response to radiation induced sub-lethal DNA damage. Our results also suggest that inhibition of telomerase activity by high doses of radiation may play a role radiation-induced cell death.

Cisplatin-induced p53-independent growth arrest and cell death in cancer cells

In a recent study, it was shown that DNA damaging agent cisplatin-induced growth arrest and cell death in cancer cells by a pathway sharing some of the characteristics of replicative senescence. The aim of this study was to determine the role of p53, p21WAF1 and p16INK4A proteins in this alternative route to cancer cell death in additional human cancer cell lines. After exposure to cisplatin, all the cell lines underwent growth arrest and expressed the senescence marker senescence-associated beta-galactosidase, but showed none of the features of apoptosis. However, there was no change in p53 protein expression, and neither p21WAF1 nor p16INK4A was expressed before or up to 4 days after cisplatin exposure. These findings provide further evidence that cells carrying mutations resulting in loss of function in the p53 gene can be killed by cisplatin via a p53-independent route with some similarities to replicative senescence, but not apoptosis.

Functional studies of a glucagon receptor isolated from frog Rana tigrina rugulosa: implications on the molecular evolution of glucagon receptors in vertebrates

In this report, the first amphibian glucagon receptor (GluR) cDNA was characterized from the liver of the frog Rana tigrina rugulosa. Functional expression of the frog GluR in CHO and COS-7 cells showed a high specificity of the receptor towards human glucagon with an EC(50) value of 0.8+/-0.5 nM. The binding of radioiodinated human glucagon to GluR was displaced in a dose-dependent manner only with human glucagon and its antagonist (des-His(1)-[Nle(9)-Ala(11)-Ala(16)]) with IC(50) values of 12.0+/-3. 0 and 7.8+/-1.0 nM, respectively. The frog GluR did not display any affinity towards fish and human GLP-1s, and towards glucagon peptides derived from two species of teleost fishes (goldfish, zebrafish). These fish glucagons contain substitutions in several key residues that were previously shown to be critical for the binding of human glucagon to its receptor. By RT-PCR, mRNA transcripts of frog GluR were located in the liver, brain, small intestine and colon. These results demonstrate a conservation of the functional characteristics of the GluRs in frog and mammalian species and provide a framework for a better understanding of the molecular evolution of the GluR and its physiological function in vertebrates.

Recipient bed vascularity and the survival of ischaemic flaps

The purpose of this study was to identify the length of the ischaemic period required to induce the 'no-reflow' phenomenon in a rat epigastric flap on an avascular recipient site. The vascularity of the recipient bed may affect flap survival in the early postischaemic stage after flap transfer. Initially, we designed epigastric flaps in 300-350 g Sprague-Dawley rats and separated the rats into four groups of 5 rats each (total 20 rats). In groups 1, 2, 3, the flaps were made ischaemic for 1 hour, 6 hours and 10 hours, respectively, by temporarily clipping the epigastric artery and vein. In group 4, the epigastric artery and vein were divided to create permanent ischaemia. In groups 1, 2 and 3, ischaemia was ended by removing the clips. After the ischaemic flaps were reperfused, their viability was studied by measuring the flap survival rate at postoperative day 7. Flap survival was studied by direct observations, laser Doppler flowmeter measurement of flap blood flow, histopathology, and carbon particle perfusion of the flap vasculature. Ischaemic flaps of groups 1 and 2 recovered almost completely after reperfusion due to the short period of ischaema. In a second series of experiments, in order to evaluate the contribution to flap survival of the recipient vascularised bed, another four groups of epigastric flaps (of 5 animals each, using the same time periods as above) were raised and a piece of Biobrane was interposed between the flap and the recipient bed before the flap wound was closed, to eliminate all nutrient supply from the recipient bed. THe results showed that the combined effect of the reperfused flap vasculature plus the metabolic contribution of the recipient bed significantly (P < 0.01) increased the extent of flap survival of the 6- and 10-hour ischaemic flaps as well as the divided pedicle flaps, which were never reperfused. An absolute 'no-reflow' rat model flap for further flap salvage studies was also developed.