Autophagy in the brains of young patients with poorly controlled T1DM and fatal diabetic ketoacidosis.

Autophagy in the brains of young patients with poorly controlled T1DM and fatal diabetic ketoacidosis.
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DOI:
10.1016/j.yexmp.2011.10.007
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发表时间:
2012-10
影响因子:
3.6
通讯作者:
Andjelkovic AV
Andjelkovic AV
中科院分区:
医学3区
文献类型:
--
作者:
Hoffman WH;Shacka JJ;Andjelkovic AV

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半定量神经放射学研究、定量神经元密度研究以及氧化应激和神经炎症的免疫细胞化学标记物表明患有慢性控制不良的 1 型糖尿病 (T1DM) 的年轻患者存在神经元损伤和缺陷。目前的数据表明,因糖尿病酮症酸中毒(DKA)和脑水肿(BE)而死亡的年轻患者神经元缺陷的发病机制并不涉及细胞凋亡,细胞凋亡是许多疾病状态下受调节的细胞死亡的主要形式。为了进一步解决这个问题,我们研究了巨自噬、内质网 (ER) 应激和细胞凋亡的介质。在所有研究领域中,我们证明 T1DM 中巨自噬相关蛋白(包括轻链 3 (LC3) 和自噬相关蛋白 4 (Atg4))水平升高,以及 ER 相关葡萄糖调节蛋白 78/结合免疫球蛋白 (GRP78/BiP) 水平升高。相比之下,在任何 T1DM 大脑区域中很少检测到裂解的 caspase-3。这些结果表明,慢性代谢不稳定和氧化应激可能会导致自噬-溶酶体途径的改变,但不会导致细胞凋亡,并且巨自噬相关分子可能作为进一步研究 T1DM 早期神经元缺陷发病机制的有用候选分子。
Semi-quantitative neuroradiologic studies, quantitative neuron density studies and immunocytochemistry markers of oxidative stress and neuroinflammation indicate neuronal injury and deficits in young patients with chronic poorly controlled type 1 diabetes mellitus (T1DM). Present data suggest that pathogenesis of the neuronal deficits in young patients, who die as the result of diabetic ketoacidosis (DKA) and brain edema (BE), does not involve apoptosis, a prominent form of regulated cell death in many disease states. To further address this we studied mediators of macroautophagy, endoplasmic reticulum (ER) stress and apoptosis. In all areas studied we demonstrated increased levels of macroautophagy-associated proteins including light chain-3 (LC3) and autophagy related protein-4 (Atg4), as well as increased levels of the ER-associated glucose-regulated protein78/binding immunoglobulin protein (GRP78/BiP) in T1DM. In contrast, cleaved caspase-3 was rarely detected in any T1DM brain regions. These results suggest that chronic metabolic instability and oxidative stress may cause alterations in the autophagy-lysosomal pathway but not apoptosis, and macroautophagy-associated molecules may serve as useful candidates for further study in the pathogenesis of early neuronal deficits in T1DM.
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