Insulin therapy for pre-hyperglycemic beta-cell endoplasmic reticulum crowding.

Insulin therapy for pre-hyperglycemic beta-cell endoplasmic reticulum crowding.
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DOI:
10.1371/journal.pone.0054351
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发表时间:
2013
期刊:
影响因子:
3.7
通讯作者:
Hodish I
Hodish I
中科院分区:
综合性期刊3区
文献类型:
--
作者:
Absood A;Gandomani B;Zaki A;Nasta V;Michail A;Habib PM;Hodish I

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胰岛素治疗通过可能超过减轻葡萄糖毒性的机制改善糖尿病早期阶段的β细胞功能。在晚期2型糖尿病中,高血糖导致β细胞损伤并最终导致β细胞损失。在这种晚期阶段,治疗方式往往是不够的。越来越多的证据表明,在2型糖尿病和与内质网(ER)功能障碍相关的某些类型的单基因糖尿病的早期阶段,β细胞ER一旦过载就无法加工足够的胰岛素原。这些变化表现为ER扩张(ER拥挤)和分泌颗粒不足。我们推测胰岛素治疗可能通过减轻ER拥挤来改善β细胞功能。为了支持这一假设,我们研究了hProC(A7)Y-CpepGFP转基因小鼠的糖尿病前期β细胞变化,这些小鼠由于胰岛素原不成熟和ER拥挤而发展为长期的糖尿病前期。我们通过靶向胰岛素治疗减弱了β细胞ER胰岛素原的合成,同时避免了低血糖和体重增加。ER拥挤的缓解导致胰岛素原成熟、胰岛素分泌和糖耐量的暂时改善。我们的观察结果表明,使用靶向胰岛素治疗缓解糖尿病前期ER拥挤可能会改善β细胞功能,并可能防止进一步的代谢恶化。
Insulin therapy improves β-cell function in early stages of diabetes by mechanisms that may exceed alleviation of glucotoxicity. In advance type 2 diabetes, hyperglycemia causes β-cell damage and ultimately β-cell loss. At such an advanced stage, therapeutic modalities are often inadequate. Growing evidence indicates that in early stages of type-2 diabetes and some types of monogenic diabetes linked with malfunctioning endoplasmic-reticulum (ER), the β-cell ER fails to process sufficient proinsulin once it becomes overloaded. These changes manifest with ER distention (ER-crowding) and deficiency of secretory granules. We hypothesize that insulin therapy may improves β-cell function by alleviating ER-crowding. To support this hypothesis, we investigated pre-diabetic β-cell changes in hProC(A7)Y-CpepGFP transgenic mice that develop prolonged pre-diabetes due to proinsulin dysmaturation and ER-crowding. We attenuated the β-cell ER proinsulin synthesis with a treat-to-target insulin therapy while avoiding hypoglycemia and weight gain. Alleviation of ER-crowding resulted in temporary improvement in proinsulin maturation, insulin secretion and glucose tolerance. Our observations suggest that alleviation of pre-diabetic ER-crowding using a treat-to-target insulin therapy may improve β-cell function and may prevent further metabolic deterioration.
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