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Endocrinology

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The impact of antidiabetic treatment on human hypothalamic infundibular neurons and microglia
Martin J.T. Kalsbeek, … , Elly M. Hol, Chun-Xia Yi
Martin J.T. Kalsbeek, … , Elly M. Hol, Chun-Xia Yi
Published August 20, 2020
Citation Information: JCI Insight. 2020;5(16):e133868. https://doi.org/10.1172/jci.insight.133868.
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The impact of antidiabetic treatment on human hypothalamic infundibular neurons and microglia

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Abstract

Animal studies indicate that hypothalamic dysfunction plays a major role in type 2 diabetes mellitus (T2DM) development, and that insulin resistance and inflammation are important mechanisms involved in this disorder. However, it remains unclear how T2DM and antidiabetic treatments affect the human hypothalamus. Here, we characterized the proopiomelanocortin (POMC) immunoreactive (-ir) neurons, the neuropeptide-Y–ir (NPY-ir) neurons, the ionized calcium-binding adapter molecule 1–ir (iba1-ir) microglia, and the transmembrane protein 119–ir (TMEM119-ir) microglia in the infundibular nucleus (IFN) of human postmortem hypothalamus of 32 T2DM subjects with different antidiabetic treatments and 17 matched nondiabetic control subjects. Compared with matched control subjects, T2DM subjects showed a decrease in the number of POMC-ir neurons, but no changes in NPY-ir neurons or microglia. Interestingly, T2DM subjects treated with the antidiabetic drug metformin had fewer NPY-ir neurons and microglia than T2DM subjects not treated with metformin. We found that the number of microglia correlated with the number of NPY-ir neurons, but only in T2DM subjects. These results indicate that different changes in POMC and NPY neurons and microglial cells in the IFN accompany T2DM. In addition, T2DM treatment modality is associated with highly selective changes in hypothalamic neurons and microglial cells.

Authors

Martin J.T. Kalsbeek, Samantha E.C. Wolff, Nikita L. Korpel, Susanne E. la Fleur, Johannes A. Romijn, Eric Fliers, Andries Kalsbeek, Dick F. Swaab, Inge Huitinga, Elly M. Hol, Chun-Xia Yi

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ANGPTL8 has both endocrine and autocrine effects on substrate utilization
Federico Oldoni, … , Jonathan C. Cohen, Helen H. Hobbs
Federico Oldoni, … , Jonathan C. Cohen, Helen H. Hobbs
Published July 30, 2020
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.138777.
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ANGPTL8 has both endocrine and autocrine effects on substrate utilization

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Abstract

The angiopoietin-like protein ANGPTL8 (A8) is one of three ANGPTLs (A8, A3, A4) that coordinate changes in triglyceride (TG) delivery to tissues by inhibiting lipoprotein lipase (LPL), an enzyme that hydrolyzes TG. Previously we showed that A8, which is expressed in liver and adipose tissue, is required to redirect dietary TG from oxidative to storage tissues following food intake. Here we show that A8 from liver and adipose tissue have different roles in this process. Mice lacking hepatic A8 have no circulating A8, high intravascular LPL activity, low plasma TG levels, and evidence of decreased delivery of dietary lipids to adipose tissue. In contrast, mice lacking A8 in adipose tissue have higher postprandial TG levels and no alteration in fatty acid composition in adipocytes. Expression of A8, together with A4, in cultured cells reduced A4 secretion and A4-mediated LPL inhibition. Thus, hepatic A8 (with A3) acts in an endocrine fashion to inhibit intravascular LPL in oxidative tissues, whereas A8 in adipose tissue enhances LPL activity by autocrine/paracrine inhibition of A4. These combined actions of A8 ensure that TG stores are rapidly replenished and sufficient energy is available until the next meal.

Authors

Federico Oldoni, Haili Cheng, Serena Banfi, Viktoria Gusarova, Jonathan C. Cohen, Helen H. Hobbs

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Hematopoietic vs. enterocyte-derived dipeptidyl peptidase-4 differentially regulates triglyceride excursion in mice
Elodie M. Varin, … , Erin E. Mulvihill, Daniel J. Drucker
Elodie M. Varin, … , Erin E. Mulvihill, Daniel J. Drucker
Published July 14, 2020
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.140418.
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Hematopoietic vs. enterocyte-derived dipeptidyl peptidase-4 differentially regulates triglyceride excursion in mice

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Abstract

Post-prandial triglycerides (TGs) are elevated in people with type 2 diabetes (T2D) and glucoregulatory agents such as Glucagon-like-peptide-1 (GLP-1) receptor agonists and Dipeptidyl Peptidase-4 (DPP-4) inhibitors simultaneously reduce post-prandial TG excursion. Although the glucose-lowering mechanisms of DPP-4 have been extensively studied, how the reduction of DPP-4 activity improves lipid tolerance remains unclear. Here we demonstrate that gut-selective and systemic inhibition of DPP-4 activity reduces post-prandial TG excursion in young mice. Genetic inactivation of Dpp4 simultaneously within endothelial cells (ECs) and hematopoietic cells using Tie2-Cre reduces intestinal lipoprotein secretion under regular chow (RC) diet conditions. Bone marrow transplantation revealed a key role for hematopoietic cells in modulation of lipid responses arising from genetic reduction of DPP-4 activity. Unexpectedly, deletion of Dpp4 in enterocytes increases TG excursion in high fat diet (HFD)-fed mice. Moreover, chemical reduction of DPP-4 activity and increased levels of GLP-1 are uncoupled from triglyceride excursion in older or HFD-fed mice, yet lipid tolerance remains improved in older Dpp4-/- and Dpp4EC-/- mice. Taken together, this study defines new roles for specific DPP-4 compartments, age, and diet as modifiers of DPP-4 activity linked to control of gut lipid metabolism.

Authors

Elodie M. Varin, Antonio Hanson, Jacqueline L. Beaudry, My-Anh Nguyen, Xiemin Cao, Laurie Baggio, Erin E. Mulvihill, Daniel J. Drucker

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Insulin synthesized in the paraventricular nucleus of the hypothalamus regulates pituitary growth hormone production
Jaemeun Lee, … , Yong Chul Bae, Eun-Kyoung Kim
Jaemeun Lee, … , Yong Chul Bae, Eun-Kyoung Kim
Published July 9, 2020
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.135412.
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Insulin synthesized in the paraventricular nucleus of the hypothalamus regulates pituitary growth hormone production

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Abstract

Evidence has mounted that insulin can be synthesized in various brain regions including the hypothalamus. However, the distribution and functions of insulin-expressing cells in the hypothalamus remain elusive. Herein, we show that in the mouse hypothalamus, the perikarya of insulin-positive neurons are located in the paraventricular nucleus (PVN) and their axons project to the median eminence; these findings define parvocellular neurosecretory PVN insulin neurons. Contrary to corticotrophin-releasing hormone expression, insulin expression in the PVN was inhibited by restraint stress (RS) in both adult and young mice. Acute RS–induced inhibition of PVN insulin expression in adult mice decreased both pituitary growth hormone (GH) mRNA level and serum GH concentration, which were attenuated by overexpression of PVN insulin. Notably, PVN insulin knockdown or chronic RS in young mice hindered normal growth via the down-regulation of GH gene expression and secretion, whereas PVN insulin overexpression in young mice prevented chronic RS–induced growth retardation by elevating GH production. Our results suggest that in both normal and stressful conditions, insulin synthesized in the parvocellular PVN neurons plays an important role in the regulation of pituitary GH production and body length, unveiling a physiological function of brain-derived insulin.

Authors

Jaemeun Lee, Kyungchan Kim, Jae Hyun Cho, Jin Young Bae, Timothy P. O’Leary, James D. Johnson, Yong Chul Bae, Eun-Kyoung Kim

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Multiplexing DNA methylation markers to detect circulating cell-free DNA derived from human pancreatic beta-cells
Daniel Neiman, … , Ruth Shemer, Yuval Dor
Daniel Neiman, … , Ruth Shemer, Yuval Dor
Published June 23, 2020
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.136579.
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Multiplexing DNA methylation markers to detect circulating cell-free DNA derived from human pancreatic beta-cells

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Abstract

It has been proposed that unmethylated insulin promoter fragments in plasma derive exclusively from β-cells, reflect their recent demise and can be used to assess β-cell damage in type 1 diabetes. Herein we describe an ultrasensitive assay for detection of a β-cell-specific DNA methylation signature, by simultaneous assessment of six DNA methylation markers, that identifies β-cell DNA in mixtures containing as little as 0.03% β-cell DNA (less than one β-cell genome equivalent). With this assay, plasma from non-diabetic individuals (N=218, aged 4-78 years) contained on average only one β-cell genome equivalent/ml. As expected, β-cell cfDNA was significantly elevated in islet transplant recipients shortly after transplantation. We also detected β-cell cfDNA in a patient with KATP congenital hyperinsulinism where substantial β-cell turnover is thought to occur. Strikingly, in contrast to previous reports, we observed no elevation of β-cell-derived cfDNA in autoantibody positive subjects at-risk for type 1 diabetes (N=32), individuals with recent-onset type 1 diabetes (<4 months, N=92), or those with a long-standing disease (>4 months, N=38). We discuss the utility of sensitive beta-cell cfDNA analysis and potential explanations for the lack of a β-cell cfDNA signal in T1D.

Authors

Daniel Neiman, David Gillis, Sheina Piyanzin, Daniel Cohen, Ori Fridlich, Joshua Moss, Aviad Zick, Tal Oron, Frida Sundberg, Gun Forsander, Oskar Skog, Olle Korsgren, Floris Levy-Khademi, Dan Arbell, Saar Hashavya, A.M. James Shapiro, Cate Speake, Carla Greenbaum, Jennifer Hosford, Amanda Posgai, Mark A. Atkinson, Benjamin Glaser, Desmond Schatz, Ruth Shemer, Yuval Dor

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LGR4 deficiency results in delayed puberty through impaired Wnt/β-catenin signaling
Alessandra Mancini, … , Leonardo Guasti, Leo Dunkel
Alessandra Mancini, … , Leonardo Guasti, Leo Dunkel
Published June 4, 2020
Citation Information: JCI Insight. 2020;5(11):e133434. https://doi.org/10.1172/jci.insight.133434.
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LGR4 deficiency results in delayed puberty through impaired Wnt/β-catenin signaling

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Abstract

The initiation of puberty is driven by an upsurge in hypothalamic gonadotropin-releasing hormone (GnRH) secretion. In turn, GnRH secretion upsurge depends on the development of a complex GnRH neuroendocrine network during embryonic life. Although delayed puberty (DP) affects up to 2% of the population, is highly heritable, and is associated with adverse health outcomes, the genes underlying DP remain largely unknown. We aimed to discover regulators by whole-exome sequencing of 160 individuals of 67 multigenerational families in our large, accurately phenotyped DP cohort. LGR4 was the only gene remaining after analysis that was significantly enriched for potentially pathogenic, rare variants in 6 probands. Expression analysis identified specific Lgr4 expression at the site of GnRH neuron development. LGR4 mutant proteins showed impaired Wnt/β-catenin signaling, owing to defective protein expression, trafficking, and degradation. Mice deficient in Lgr4 had significantly delayed onset of puberty and fewer GnRH neurons compared with WT, whereas lgr4 knockdown in zebrafish embryos prevented formation and migration of GnRH neurons. Further, genetic lineage tracing showed strong Lgr4-mediated Wnt/β-catenin signaling pathway activation during GnRH neuron development. In conclusion, our results show that LGR4 deficiency impairs Wnt/β-catenin signaling with observed defects in GnRH neuron development, resulting in a DP phenotype.

Authors

Alessandra Mancini, Sasha R. Howard, Federica Marelli, Claudia P. Cabrera, Michael R. Barnes, Michael J.E. Sternberg, Morgane Leprovots, Irene Hadjidemetriou, Elena Monti, Alessia David, Karoliina Wehkalampi, Roberto Oleari, Antonella Lettieri, Valeria Vezzoli, Gilbert Vassart, Anna Cariboni, Marco Bonomi, Marie Isabelle Garcia, Leonardo Guasti, Leo Dunkel

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Monounsaturated fat rapidly induces hepatic gluconeogenesis and whole-body insulin resistance
Theresia Sarabhai, … , John Griffith Jones, Michael Roden
Theresia Sarabhai, … , John Griffith Jones, Michael Roden
Published May 21, 2020
Citation Information: JCI Insight. 2020;5(10):e134520. https://doi.org/10.1172/jci.insight.134520.
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Monounsaturated fat rapidly induces hepatic gluconeogenesis and whole-body insulin resistance

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Abstract

BACKGROUND While saturated fat intake leads to insulin resistance and nonalcoholic fatty liver, Mediterranean-like diets enriched in monounsaturated fatty acids (MUFA) may have beneficial effects. This study examined effects of MUFA on tissue-specific insulin sensitivity and energy metabolism.METHODS A randomized placebo-controlled cross-over study enrolled 16 glucose-tolerant volunteers to receive either oil (OIL, ~1.18 g/kg), rich in MUFA, or vehicle (VCL, water) on 2 occasions. Insulin sensitivity was assessed during preclamp and hyperinsulinemic-euglycemic clamp conditions. Ingestion of 2H2O/acetaminophen was combined with [6,6-2H2]glucose infusion and in vivo 13C/31P/1H/ex vivo 2H-magnet resonance spectroscopy to quantify hepatic glucose and energy fluxes.RESULTS OIL increased plasma triglycerides and oleic acid concentrations by 44% and 66% compared with VCL. Upon OIL intervention, preclamp hepatic and whole-body insulin sensitivity markedly decreased by 28% and 27%, respectively, along with 61% higher rates of hepatic gluconeogenesis and 32% lower rates of net glycogenolysis, while hepatic triglyceride and ATP concentrations did not differ from VCL. During insulin stimulation hepatic and whole-body insulin sensitivity were reduced by 21% and 25%, respectively, after OIL ingestion compared with that in controls.CONCLUSION A single MUFA-load suffices to induce insulin resistance but affects neither hepatic triglycerides nor energy-rich phosphates. These data indicate that amount of ingested fat, rather than its composition, primarily determines the development of acute insulin resistance.TRIAL REGISTRATION ClinicalTrials.gov NCT01736202.FUNDING German Diabetes Center, German Federal Ministry of Health, Ministry of Culture and Science of the state of North Rhine-Westphalia, German Federal Ministry of Education and Research, German Diabetes Association, German Center for Diabetes Research, Portugal Foundation for Science and Technology, European Regional Development Fund, and Rede Nacional de Ressonancia Magnética Nuclear.

Authors

Theresia Sarabhai, Sabine Kahl, Julia Szendroedi, Daniel F. Markgraf, Oana-Patricia Zaharia, Cristina Barosa, Christian Herder, Frithjof Wickrath, Pavel Bobrov, Jong-Hee Hwang, John Griffith Jones, Michael Roden

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GCN2 regulates pancreatic β cell mass by sensing intracellular amino acid levels
Ayumi Kanno, … , Masato Kasuga, Yoshiaki Kido
Ayumi Kanno, … , Masato Kasuga, Yoshiaki Kido
Published May 7, 2020
Citation Information: JCI Insight. 2020;5(9):e128820. https://doi.org/10.1172/jci.insight.128820.
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GCN2 regulates pancreatic β cell mass by sensing intracellular amino acid levels

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Abstract

EIF2AK4, which encodes the amino acid deficiency–sensing protein GCN2, has been implicated as a susceptibility gene for type 2 diabetes in the Japanese population. However, the mechanism by which GCN2 affects glucose homeostasis is unclear. Here, we show that insulin secretion is reduced in individuals harboring the risk allele of EIF2AK4 and that maintenance of GCN2-deficient mice on a high-fat diet results in a loss of pancreatic β cell mass. Our data suggest that GCN2 senses amino acid deficiency in β cells and limits signaling by mechanistic target of rapamycin complex 1 to prevent β cell failure during the consumption of a high-fat diet.

Authors

Ayumi Kanno, Shun-ichiro Asahara, Ayuko Furubayashi, Katsuhisa Masuda, Risa Yoshitomi, Emi Suzuki, Tomoko Takai, Maki Kimura-Koyanagi, Tomokazu Matsuda, Alberto Bartolome, Yushi Hirota, Norihide Yokoi, Yuka Inaba, Hiroshi Inoue, Michihiro Matsumoto, Kenichi Inoue, Takaya Abe, Fan-Yan Wei, Kazuhito Tomizawa, Wataru Ogawa, Susumu Seino, Masato Kasuga, Yoshiaki Kido

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GPx3 dysregulation impacts adipose tissue insulin receptor expression and sensitivity
Robert Hauffe, … , Anna P. Kipp, Andre Kleinridders
Robert Hauffe, … , Anna P. Kipp, Andre Kleinridders
Published May 5, 2020
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.136283.
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GPx3 dysregulation impacts adipose tissue insulin receptor expression and sensitivity

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Abstract

Insulin receptor signaling is crucial for white adipose tissue (WAT) function. Consequently, lack of insulin receptor (IR) in WAT results in a diabetes-like phenotype. Yet, causes for IR downregulation in WAT of diabetic patients are not well understood. By using multiple mouse models of obesity and insulin resistance, we identify a common downregulation of the IR with a reduction of mRNA expression of the selenoproteins Txnrd3, Sephs2, and Gpx3. Consistently, GPX3 is also decreased in adipose tissue of insulin resistant and obese patients. Inducing Gpx3 expression via selenite treatment enhances IR expression via activation of the transcription factor Sp1 in 3T3-L1 preadipocytes and improves adipocyte differentiation and function. Feeding mice a selenium-enriched high-fat diet alleviates diet-induced insulin resistance with increased insulin sensitivity, decreased tissue inflammation and elevated IR expression in WAT. Again, IR expression correlates positively with Gpx3 expression, a phenotype which is also conserved in humans. Consequently, decreasing GPx3 using siRNA technique reduces IR expression in 3T3-L1 preadipocytes and insulin sensitivity. Overall our data identify GPx3 as a novel regulator of IR expression and insulin sensitivity in adipose tissue.

Authors

Robert Hauffe, Vanessa Stein, Chantal Chudoba, Tanina Flore, Michaela Rath, Katrin Ritter, Mareike Schell, Kristina Wardelmann, Stefanie Deubel, Johannes F. Kopp, Maria Schwarz, Kai Kappert, Matthias Blüher, Tanja Schwerdtle, Anna P. Kipp, Andre Kleinridders

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Integrated human pseudoislet system and microfluidic platform demonstrates differences in G-protein-coupled-receptor signaling in islet cells
John T. Walker, … , Alvin C. Powers, Marcela Brissova
John T. Walker, … , Alvin C. Powers, Marcela Brissova
Published April 30, 2020
Citation Information: JCI Insight. 2020. https://doi.org/10.1172/jci.insight.137017.
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Integrated human pseudoislet system and microfluidic platform demonstrates differences in G-protein-coupled-receptor signaling in islet cells

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Abstract

Pancreatic islets secrete insulin from β cells and glucagon from α cells and dysregulated secretion of these hormones is a central component of diabetes. Thus, an improved understanding of the pathways governing coordinated β and α cell hormone secretion will provide insight into islet dysfunction in diabetes. However, the three-dimensional multicellular islet architecture, essential for coordinated islet function, presents experimental challenges for mechanistic studies of intracellular signaling pathways in primary islet cells. Here, we developed an integrated approach to study the function of primary human islet cells using genetically modified pseudoislets that resemble native islets across multiple parameters. Further, we developed a microperifusion system that allowed synchronous acquisition of GCaMP6f biosensor signal and hormone secretory profiles. We demonstrate the utility of this experimental approach by studying the effects of Gi and Gq GPCR pathways on insulin and glucagon secretion by expressing the designer receptors exclusively activated by designer drugs (DREADDs) hM4Di or hM3Dq. Activation of Gi signaling reduced insulin and glucagon secretion, while activation of Gq signaling stimulated glucagon secretion but had both stimulatory and inhibitory effects on insulin secretion which occur through changes in intracellular Ca2+. The experimental approach of combining pseudoislets with a microfluidic system, allowed the co-registration of intracellular signaling dynamics and hormone secretion and demonstrated differences in GPCR signaling pathways between human β and α cells.

Authors

John T. Walker, Rachana Haliyur, Heather A. Nelson, Matthew Ishahak, Gregory Poffenberger, Radhika Aramandla, Conrad Reihsmann, Joseph R. Luchsinger, Diane C. Saunders, Peng Wang, Adolfo Garcia-Ocana, Rita Bottino, Ashutosh Agarwal, Alvin C. Powers, Marcela Brissova

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