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Endocrinologies

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Mineralocorticoid receptor antagonism in diabetes reduces albuminuria by preserving the glomerular endothelial glycocalyx
Michael Crompton, … , Simon C. Satchell, Matthew J. Butler
Michael Crompton, … , Simon C. Satchell, Matthew J. Butler
Published February 7, 2023
Citation Information: JCI Insight. 2023. https://doi.org/10.1172/jci.insight.154164.
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Mineralocorticoid receptor antagonism in diabetes reduces albuminuria by preserving the glomerular endothelial glycocalyx

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Abstract

The glomerular endothelial glycocalyx (GEnGlx) forms the first part of the glomerular filtration barrier. Previously we showed that mineralocorticoid receptor (MR) activation caused GEnGlx damage and albuminuria. Here we investigated whether MR antagonism could limit albuminuria in diabetes and studied the site of action. Streptozotocin-induced diabetic Wistar rats developed albuminuria, increased glomerular albumin permeability (Ps’alb) and increased glomerular matrix metalloproteinase (MMP) activity with corresponding GEnGlx loss. MR antagonism prevented albuminuria progression, restored Ps’alb, preserved GEnGlx and reduced MMP activity. Enzymatic degradation of the GEnGlx negated the benefits of MR antagonism, confirming their dependence on GEnGlx integrity. Exposing human glomerular endothelial cells (GEnC) to diabetic conditions in vitro increased MMPs and caused glycocalyx damage. Amelioration of these effects confirmed a direct effect of MR antagonism on GEnC. To confirm relevance to human disease, we used a novel confocal imaging method to show loss of GEnGlx in renal biopsy specimens from patients with diabetic nephropathy (DN). In addition, DN patients randomised to receive an MR antagonist had reduced urinary MMP2 activity and albuminuria compared with placebo and baseline levels. Taken together our work suggests MR antagonists reduce MMP activity and thereby preserve GEnGlx resulting in reduced glomerular permeability and albuminuria in diabetes.

Authors

Michael Crompton, Joanne K. Ferguson, RainaD. Ramnath, Karen L. Onions, Anna S. Ogier, Monica Gamez, Colin J. Down, Laura J. Skinner, Kitty H.F. Wong, Lauren Kari Dixon, Judit Sutak, Steven J. Harper, Paola Pontrelli, Loreto Gesualdo, Hiddo L. Heerspink, Robert D. Toto, Gavin I. Welsh, Rebecca R. Foster, Simon C. Satchell, Matthew J. Butler

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The different natural estrogens promote endothelial healing through distinct cell targets
Morgane Davezac, … , Raphaël Métivier, Coralie Fontaine
Morgane Davezac, … , Raphaël Métivier, Coralie Fontaine
Published February 2, 2023
Citation Information: JCI Insight. 2023. https://doi.org/10.1172/jci.insight.161284.
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The different natural estrogens promote endothelial healing through distinct cell targets

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Abstract

The main estrogen, estradiol (E2), exerts several beneficial vascular actions through estrogen receptor (ER)α in endothelial cells. However, the impact of other natural estrogens such as estriol (E3) and estetrol (E4) on arteries remains poorly described. In the present study, we reported the effects of E3 and E4 on endothelial healing after carotid artery injuries in vivo. After endovascular injury, that preserves smooth muscle cells (SMCs), E2, E3 and E4 equally stimulated reendothelialization. By contrast, only E2 and E3 accelerated endothelial healing after perivascular injury that destroys both endothelial cells and SMCs, suggesting an important role of this latter cell type in E4 action, which was confirmed using Cre/lox mice inactivating ERα in SMCs. In addition, E4 mediated its action independently of ERα membrane initiated signaling by contrast to E2. Consistently, RNAseq analysis revealed that transcriptomic and cellular signatures in response to E4 profoundly differ from those of E2. Thus, whereas acceleration of endothelial healing by estrogens was viewed as entirely dependent on endothelial ERα, these results highlight the very specific pharmacological profile of the natural estrogen E4, revealing the importance of dialogue between SMCs and endothelial cells in its arterial protection.

Authors

Morgane Davezac, Rana Zahreddine, Melissa Buscato, Natalia F. Smirnova, Chanaelle Febrissy, Henrik Laurell, Silveric Gilardi-Bresson, Marine Adlanmerini, Philippe Liere, Gilles Flouriot, Rachida Guennoun, Muriel Laffargue, Jean-Michel Foidart, Françoise Lenfant, Jean-François Arnal, Raphaël Métivier, Coralie Fontaine

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MRAP2 regulates energy homeostasis by promoting primary cilia localization of MC4R
Adelaide Bernard, … , Jeremy F. Reiter, Christian Vaisse
Adelaide Bernard, … , Jeremy F. Reiter, Christian Vaisse
Published January 24, 2023
Citation Information: JCI Insight. 2023;8(2):e155900. https://doi.org/10.1172/jci.insight.155900.
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MRAP2 regulates energy homeostasis by promoting primary cilia localization of MC4R

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Abstract

The G protein–coupled receptor melanocortin-4 receptor (MC4R) and its associated protein melanocortin receptor–associated protein 2 (MRAP2) are essential for the regulation of food intake and body weight in humans. MC4R localizes and functions at the neuronal primary cilium, a microtubule-based organelle that senses and relays extracellular signals. Here, we demonstrate that MRAP2 is critical for the weight-regulating function of MC4R neurons and the ciliary localization of MC4R. More generally, our study also reveals that GPCR localization to primary cilia can require specific accessory proteins that may not be present in heterologous cell culture systems. Our findings further demonstrate that targeting of MC4R to neuronal primary cilia is essential for the control of long-term energy homeostasis and suggest that genetic disruption of MC4R ciliary localization may frequently underlie inherited forms of obesity.

Authors

Adelaide Bernard, Irene Ojeda Naharros, Xinyu Yue, Francois Mifsud, Abbey Blake, Florence Bourgain-Guglielmetti, Jordi Ciprin, Sumei Zhang, Erin McDaid, Kellan Kim, Maxence V. Nachury, Jeremy F. Reiter, Christian Vaisse

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Heterozygous mutations in SOX2 may cause idiopathic hypogonadotropic hypogonadism via dominant-negative mechanisms
Jessica Cassin, … , Pamela L. Mellon, Ravikumar Balasubramanian
Jessica Cassin, … , Pamela L. Mellon, Ravikumar Balasubramanian
Published January 5, 2023
Citation Information: JCI Insight. 2023. https://doi.org/10.1172/jci.insight.164324.
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Heterozygous mutations in SOX2 may cause idiopathic hypogonadotropic hypogonadism via dominant-negative mechanisms

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Abstract

Pathogenic SOX2 variants typically cause severe ocular defects within a SOX2-disorder spectrum that includes hypogonadotropic hypogonadism (HH). We examined exome sequencing data from a large, well-phenotyped cohort of patients (n=1453) with Idiopathic Hypogonadotropic Hypogonadism (IHH) for pathogenic SOX2 variants to investigate the underlying pathogenic SOX2 spectrum and its associated phenotypes. We identified eight IHH individuals harboring heterozygous pathogenic SOX2 variants with variable ocular phenotypes. These variant proteins were tested in vitro to determine whether a causal relationship between IHH and SOX2 exists. We found that Sox2 is highly expressed in the hypothalamus of adult mice and colocalizes with KISS1 expression in the anteroventral periventricular nucleus of adult female mice. In vitro, shRNA suppression of mouse SOX2 protein in Kiss-expressing cell lines increases the levels of human kisspeptin luciferase transcription (hKISS-luc), while SOX2 overexpression represses hKiss-luc transcription. Further, four of the identified SOX2 variants prevented this SOX2-mediated repression of hKiss-luc. Together these data suggest that pathogenic SOX2 variants contribute to both anosmic and normosmic forms of IHH attesting to hypothalamic defects in the SOX2-disorder spectrum. Our study describes novel mechanisms contributing to SOX2-related disease and highlights the necessity of SOX2 screening in IHH genetic evaluation irrespective of associated ocular defects.

Authors

Jessica Cassin, Maria I. Stamou, Kimberly W. Keefe, Kaitlin Sung, Celine Bojo, Karen J. Tonsfeldt, Rebecca A. Rojas, Vanessa Ferreira Lopes, Lacey Plummer, Kathryn B. Salnikov, David L. Keefe Jr., Metin Ozata, Myron Genel, Neoklis A. Georgopoulos, Janet E. Hall, William F. Crowley Jr., Stephanie B. Seminara, Pamela L. Mellon, Ravikumar Balasubramanian

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Rapamycin improves Graves’ orbitopathy by suppressing CD4+ cytotoxic T lymphocytes
Meng Zhang, … , Bing-yin Shi, Yue Wang
Meng Zhang, … , Bing-yin Shi, Yue Wang
Published December 29, 2022
Citation Information: JCI Insight. 2022. https://doi.org/10.1172/jci.insight.160377.
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Rapamycin improves Graves’ orbitopathy by suppressing CD4+ cytotoxic T lymphocytes

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Abstract

CD4+ cytotoxic T lymphocytes (CTLs) were recently implicated in immune-mediated inflammation and fibrosis progression of Graves’ orbitopathy (GO). However, little is known about therapeutic targeting CD4+ CTLs. Herein, we studied the effect of rapamycin, an approved mTORC1 inhibitor, in GO mouse model, in vitro and in refractory GO patients. In the adenovirus-induced model, rapamycin significantly decreased the incidence of orbitopathy. This was accompanied by reduction of CD4+ CTLs, and improvement of inflammation, adipogenesis and fibrosis in orbits. CD4+CTLs from active GO patients showed upregulation of mTOR pathway, while rapamycin decreased their proportions and cytotoxic function. Low-dose rapamycin treatment substantially improved diplopia and clinical activity score in steroid-refractory GO patients. Single-cell RNA sequencing revealed that eye motility improvement was closely related to suppression of inflammation and chemotaxis in CD4+ CTLs. In conclusion, rapamycin is a promising treatment for CD4+ CTL-mediated inflammation and fibrosis in GO.

Authors

Meng Zhang, Kelvin K.L. Chong, Zi-yi Chen, Hui Guo, Yu-feng Liu, Yong-yong Kang, Yang-jun Li, Ting-ting Shi, Kenneth Ka Hei Lai, Ming-qian He, Kai Ye, George J. Kahaly, Bing-yin Shi, Yue Wang

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RAGE activation in macrophages and development of experimental diabetic polyneuropathy
Sho Osonoi, … , Hiroshi Yamamoto, Soroku Yagihashi
Sho Osonoi, … , Hiroshi Yamamoto, Soroku Yagihashi
Published December 8, 2022
Citation Information: JCI Insight. 2022;7(23):e160555. https://doi.org/10.1172/jci.insight.160555.
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RAGE activation in macrophages and development of experimental diabetic polyneuropathy

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Abstract

It is suggested that activation of receptor for advanced glycation end products (RAGE) induces proinflammatory response in diabetic nerve tissues. Macrophage infiltration is invoked in the pathogenesis of diabetic polyneuropathy (DPN), while the association between macrophage and RAGE activation and the downstream effects of macrophages remain to be fully clarified in DPN. This study explored the role of RAGE in the pathogenesis of DPN through the modified macrophages. Infiltrating proinflammatory macrophages impaired insulin sensitivity, atrophied the neurons in dorsal root ganglion, and slowed retrograde axonal transport (RAT) in the sciatic nerve of type 1 diabetic mice. RAGE-null mice showed an increase in the population of antiinflammatory macrophages, accompanied by intact insulin sensitivity, normalized ganglion cells, and RAT. BM transplantation from RAGE-null mice to diabetic mice protected the peripheral nerve deficits, suggesting that RAGE is a major determinant for the polarity of macrophages in DPN. In vitro coculture analyses revealed proinflammatory macrophage–elicited insulin resistance in the primary neuronal cells isolated from dorsal root ganglia. Applying time-lapse recording disclosed a direct impact of proinflammatory macrophage and insulin resistance on the RAT deficits in primary neuronal cultures. These results provide a potentially novel insight into the development of RAGE-related DPN.

Authors

Sho Osonoi, Hiroki Mizukami, Yuki Takeuchi, Hikari Sugawa, Saori Ogasawara, Shizuka Takaku, Takanori Sasaki, Kazuhiro Kudoh, Koichi Ito, Kazunori Sango, Ryoji Nagai, Yasuhiko Yamamoto, Makoto Daimon, Hiroshi Yamamoto, Soroku Yagihashi

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Minocycline-induced disruption of the intestinal FXR-FGF15 axis impairs osteogenesis in mice
Matthew D. Carson, … , Caroline Westwater, Chad M. Novince
Matthew D. Carson, … , Caroline Westwater, Chad M. Novince
Published November 22, 2022
Citation Information: JCI Insight. 2022. https://doi.org/10.1172/jci.insight.160578.
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Minocycline-induced disruption of the intestinal FXR-FGF15 axis impairs osteogenesis in mice

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Abstract

Antibiotic-induced shifts in the indigenous gut microbiota influence normal skeletal maturation. Current theory implies that gut microbiota actions on bone occur through a direct gut-bone signaling axis. However, our prior work supports that a gut-liver signaling axis contributes to gut microbiota effects on bone. Purpose was to investigate the effects of minocycline, a systemic antibiotic treatment for adolescent acne, on pubertal/post-pubertal skeletal maturation. Sex-matched specific-pathogen-free(SPF) and germ-free(GF) C57BL/6T mice were administered a clinically relevant minocycline dose from age 6-12 weeks. Minocycline caused dysbiotic shifts in the gut bacteriome and impaired skeletal maturation in SPF mice, but did not alter the skeletal phenotype in GF mice. Minocycline administration in SPF mice disrupted the intestinal farnesoid X receptor(FXR)-fibroblast growth factor 15(FGF15) axis, a gut-liver endocrine axis supporting systemic bile acid homeostasis. Minocycline-treated SPF mice had increased serum conjugated bile acids that are FXR antagonists, suppressed osteoblast function, decreased bone mass, impaired bone microarchitecture and fracture resistance. Stimulating osteoblasts with the serum bile acid profile from minocycline-treated SPF mice recapitulated the suppressed osteogenic phenotype found in vivo, which was mediated through attenuated FXR-signaling. This work introduces bile acids as a novel mediator of gut-liver signaling actions contributing to gut microbiota effects on bone.

Authors

Matthew D. Carson, Amy J. Warner, Jessica D. Hathaway-Schrader, Vincenza L. Geiser, Joseph D. Kim, Joy E. Gerasco, William D. Hill, John J. Lemasters, Alexander V. Alekseyenko, Yongren Wu, Hai Yao, Jose I. Aguirre, Caroline Westwater, Chad M. Novince

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Dopamine-inhibited POMCDrd2+ neurons in the ARC acutely regulate feeding and body temperature
Isabella Gaziano, … , Peter Kloppenburg, Jens C. Brüning
Isabella Gaziano, … , Peter Kloppenburg, Jens C. Brüning
Published November 8, 2022
Citation Information: JCI Insight. 2022;7(21):e162753. https://doi.org/10.1172/jci.insight.162753.
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Dopamine-inhibited POMCDrd2+ neurons in the ARC acutely regulate feeding and body temperature

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Abstract

Dopamine acts on neurons in the arcuate nucleus (ARC) of the hypothalamus, which controls homeostatic feeding responses. Here we demonstrate a differential enrichment of dopamine receptor 1 (Drd1) expression in food intake–promoting agouti related peptide (AgRP)/neuropeptide Y (NPY) neurons and a large proportion of Drd2-expressing anorexigenic proopiomelanocortin (POMC) neurons. Owing to the nature of these receptors, this translates into a predominant activation of AgRP/NPY neurons upon dopamine stimulation and a larger proportion of dopamine-inhibited POMC neurons. Employing intersectional targeting of Drd2-expressing POMC neurons, we reveal that dopamine-mediated POMC neuron inhibition is Drd2 dependent and that POMCDrd2+ neurons exhibit differential expression of neuropeptide signaling mediators compared with the global POMC neuron population, which manifests in enhanced somatostatin responsiveness of POMCDrd2+ neurons. Selective chemogenetic activation of POMCDrd2+ neurons uncovered their ability to acutely suppress feeding and to preserve body temperature in fasted mice. Collectively, the present study provides the molecular and functional characterization of POMCDrd2+ neurons and aids our understanding of dopamine-dependent control of homeostatic energy-regulatory neurocircuits.

Authors

Isabella Gaziano, Svenja Corneliussen, Nasim Biglari, René Neuhaus, Linyan Shen, Tamara Sotelo-Hitschfeld, Paul Klemm, Lukas Steuernagel, Alain J. De Solis, Weiyi Chen, F. Thomas Wunderlich, Peter Kloppenburg, Jens C. Brüning

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Autonomic dysfunction and risk of severe hypoglycemia among individuals with type 2 diabetes
Arnaud D. Kaze, … , Michael R. Rickels, Justin B. Echouffo-Tcheugui
Arnaud D. Kaze, … , Michael R. Rickels, Justin B. Echouffo-Tcheugui
Published November 1, 2022
Citation Information: JCI Insight. 2022. https://doi.org/10.1172/jci.insight.156334.
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Autonomic dysfunction and risk of severe hypoglycemia among individuals with type 2 diabetes

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Abstract

There is limited data on the link between cardiac autonomic neuropathy (CAN) and severe hypoglycemia, in type 2 diabetes. We evaluated the associations of CAN with severe hypoglycemia among 7,421 adults with type 2 diabetes from the Action to Control Cardiovascular Risk in Diabetes (ACCORD) study. CAN was defined using electrocardiogram-derived measures. Cox and Andersen-Gill regression models were used to generate hazard ratios (HRs) for first and recurrent severe hypoglycemic episodes, respectively. Over 4.7 years, there were 558 first and 811 recurrent hypoglycemic events. Participants with CAN had increased risks of first (HR 1.23, 95%CI 1.01-1.50) or recurrent (HR: 1.46, 95%CI 1.16-1.84) episodes of severe hypoglycemia. The intensity of glycemic management modified the CAN association with hypoglycemia (P for interaction <0.05). In the standard glycemic management group, compared to participants without CAN, HRs for first severe hypoglycemia and recurrent hypoglycemia were 1.58 (95%CI 1.13-2.23) and 1.96 (1.33-2.90). In the intensive glycemic management group, HRs for first severe hypoglycemia and recurrent hypoglycemia were 1.10 (0.86-1.40) and 1.24 (0.93-1.65). In summary, CAN was independently associated with higher risks of first and recurrent hypoglycemia among adults with type 2 diabetes, with the highest risk observed among those on standard glycemic management.

Authors

Arnaud D. Kaze, Matthew F. Yuyun, Rexford S. Ahima, Michael R. Rickels, Justin B. Echouffo-Tcheugui

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DIO3 protects from thyrotoxicosis-derived cranio-encephalic and cardiac congenital abnormalities
M. Elena Martinez, … , Thomas Gridley, Arturo Hernandez
M. Elena Martinez, … , Thomas Gridley, Arturo Hernandez
Published September 27, 2022
Citation Information: JCI Insight. 2022. https://doi.org/10.1172/jci.insight.161214.
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DIO3 protects from thyrotoxicosis-derived cranio-encephalic and cardiac congenital abnormalities

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Maternal hyperthyroidism is associated with an increased incidence of congenital abnormalities at birth, but it is not clear which of those defects arise from a transient developmental excess of thyroid hormone, and which depend on pregnancy stage, antithyroid drug choice, or unwanted subsequent fetal hypothyroidism. To address this issue we studied a mouse model of comprehensive developmental thyrotoxicosis secondary to a lack of type 3 deiodinase (DIO3). Dio3-/- mice exhibit reduced neonatal viability on most genetic backgrounds and perinatal lethality on a C57BL/6 background. Dio3-/- mice exhibit severe growth retardation during the neonatal period and cartilage loss. Mice surviving after birth manifest brain and cranial dysmorphisms, severe hydrocephalus, choanal atresia, and cleft palate. These abnormalities are noticeable in C57BL/6J Dio3-/- mice at fetal stages, in addition to a thyrotoxic heart with septal defects and thin ventricular walls. Our findings stress the protecting role of DIO3 during development and support the hypothesis that human congenital abnormalities associated with hyperthyroidism during pregnancy are caused by transient thyrotoxicosis before clinical intervention. Our results also suggest thyroid hormone involvement in the etiology of idiopathic pathologies including cleft palate, choanal atresia, Chiari malformations, Kaschin-Beck disease, and Temple and other cranio-encephalic and heart syndromes.

Authors

M. Elena Martinez, Ilka Pinz, Marilena Preda, Christine R. Norton, Thomas Gridley, Arturo Hernandez

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