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Abstract
Fetal programming associated with in utero exposure to maternal stress is thought to alter gene expression, resulting in phenotypes that promote survival in a pathogen-rich and nutrient-poor environment but substantially increase the risk of cardiovascular, metabolic and renal disorders (such as diabetes mellitus) in adults with obesity. These (epi)genetic phenomena are modified by environmental and socioeconomic factors, resulting in multiple subphenotypes and clinical consequences. In individuals from areas undergoing rapid economic development, which is associated with a transition from communicable to noncommunicable diseases, an efficient innate immune response can exaggerate obesity-associated inflammation. By contrast, in individuals with a genetic predisposition to autoimmune or monogenic diabetes mellitus, obesity can lead to atypical presentation of diabetes mellitus, termed 'double diabetes mellitus'. The increasingly young age at diagnosis of diabetes mellitus in developing countries results in prolonged exposure to glucolipotoxicity, low-grade inflammation and increased oxidative stress, which put enormous strain on pancreatic β cells and renal function. These conditions create a metabolic milieu conducive to cancer growth. This Review discusses how rapid changes in technology and human behaviour have brought on the global epidemic of metabolic diseases, and suggests that solutions will be based on using system change, technology and behavioural strategies to combat this societal-turned-medical problem.
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Affiliation(s)
- Alice P S Kong
- Department of Medicine and Therapeutics, Hong Kong Institute of Diabetes and Obesity, Li Ka Shing Institute of Health Sciences, The Chinese University of Hong Kong, Prince of Wales Hospital, Shatin, NT Hong Kong Special Administrative Region, China
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102
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Feraco A, Armani A, Mammi C, Fabbri A, Rosano GMC, Caprio M. Role of mineralocorticoid receptor and renin-angiotensin-aldosterone system in adipocyte dysfunction and obesity. J Steroid Biochem Mol Biol 2013; 137:99-106. [PMID: 23454117 DOI: 10.1016/j.jsbmb.2013.02.012] [Citation(s) in RCA: 36] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/13/2012] [Revised: 02/07/2013] [Accepted: 02/20/2013] [Indexed: 12/13/2022]
Abstract
The mineralocorticoid receptor (MR) classically mediates aldosterone effects on salt homeostasis and blood pressure regulation in epithelial target tissues. In recent years, functional MRs have been identified in non classical targets of aldosterone actions, in particular in adipose tissue, where they mediate the effects of aldosterone and glucocorticoids in the control of adipogenesis, adipose expansion and its pro-inflammatory capacity. In this context, inappropriate MR activation has been demonstrated to be a causal factor in several pathologic conditions such as vascular inflammation, endothelial dysfunction, insulin resistance and obesity. The aim of this review is to summarize the latest developments in this rapidly developing field, and will focus on the role of MR and renin-angiotensin-aldosterone system (RAAS) as potential leading characters in the early steps of adipocyte dysfunction and obesity. Indeed modulation of MR activity in adipose tissue has promise as a novel therapeutic approach to treat obesity and its related metabolic complications. This article is part of a Special Issue entitled 'CSR 2013'.
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103
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Freeman JS. Review of insulin-dependent and insulin-independent agents for treating patients with type 2 diabetes mellitus and potential role for sodium-glucose co-transporter 2 inhibitors. Postgrad Med 2013; 125:214-26. [PMID: 23748522 DOI: 10.3810/pgm.2013.05.2672] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Diabetes, especially type 2 diabetes mellitus (T2DM), continues to be a global health care problem. Although the beneficial effects of glycemic control are well established, in the United States, > 40% of adults with diabetes fail to achieve target glycated hemoglobin levels. Antidiabetic drug classes vary with respect to their mechanisms of action, glucose-lowering potential, and safety and tolerability profiles. Antidiabetic drug classes include some agents that depend on the presence or action of insulin for their therapeutic effect. As the disease state of T2DM progresses, patient pancreatic β-cell function declines, and therapies that stimulate insulin secretion or improve insulin sensitivity become less effective for this population. Therefore, the development of additional antidiabetic agents with novel mechanisms of action that can be used alone or in combination with currently approved medications may help patients achieve glycemic control. Agents that have comparable glucose-lowering capabilities but different mechanisms of action may fill treatment gaps or meet the needs of patient subpopulations. For example, inhibitors of sodium-glucose co-transporter 2 (SGLT2) represent an emerging class of glucose-lowering agents. The SGLT2 inhibitors reduce glucose reabsorption by the kidney, leading to increased urinary glucose excretion and caloric loss. In clinical trials, these agents have been shown to improve glycemic control and to reduce body weight in patients with T2DM. Additionally, SGLT2 inhibitors pose a low risk for hypoglycemia and are generally well tolerated; however, their use has been associated with an increase in the frequency of genital infections and, in some studies, urinary tract infections. Sodium-glucose co-transporter 2 inhibitors may provide an alternative or an addition to existing therapies for the treatment of patients with T2DM.
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Affiliation(s)
- Jeffrey S Freeman
- Division of Endocrinology, Philadelphia College of Osteopathic Medicine, Philadelphia, PA 19131, USA.
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104
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Penno CA, Morgan SA, Vuorinen A, Schuster D, Lavery GG, Odermatt A. Impaired oxidoreduction by 11β-hydroxysteroid dehydrogenase 1 results in the accumulation of 7-oxolithocholic acid. J Lipid Res 2013; 54:2874-83. [PMID: 23933573 DOI: 10.1194/jlr.m042499] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) mediates glucocorticoid activation and is currently considered as therapeutic target to treat metabolic diseases; however, biomarkers to assess its activity in vivo are still lacking. Recent in vitro experiments suggested that human 11β-HSD1 metabolizes the secondary bile acid 7-oxolithocholic acid (7-oxoLCA) to chenodeoxycholic acid (CDCA) and minor amounts of ursodeoxycholic acid (UDCA). Here, we provide evidence from in vitro and in vivo studies for a major role of 11β-HSD1 in the oxidoreduction of 7-oxoLCA and compare its level and metabolism in several species. Hepatic microsomes from liver-specific 11β-HSD1-deficient mice were devoid of 7-oxoLCA oxidoreductase activity. Importantly, circulating and intrahepatic levels of 7-oxoLCA and its taurine conjugate were significantly elevated in mouse models of 11β-HSD1 deficiency. Moreover, comparative enzymology of 11β-HSD1-dependent oxidoreduction of 7-oxoLCA revealed that the guinea-pig enzyme is devoid of 7-oxoLCA oxidoreductase activity. Unlike in other species, 7-oxoLCA and its glycine conjugate are major bile acids in guinea-pigs. In conclusion, the oxidoreduction of 7-oxoLCA and its conjugated metabolites are catalyzed by 11β-HSD1, and the lack of this activity leads to the accumulation of these bile acids in guinea-pigs and 11β-HSD1-deficient mice. Thus, 7-oxoLCA and its conjugates may serve as biomarkers of impaired 11β-HSD1 activity.
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Affiliation(s)
- Carlos A Penno
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
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105
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Gathercole LL, Lavery GG, Morgan SA, Cooper MS, Sinclair AJ, Tomlinson JW, Stewart PM. 11β-Hydroxysteroid dehydrogenase 1: translational and therapeutic aspects. Endocr Rev 2013; 34:525-55. [PMID: 23612224 DOI: 10.1210/er.2012-1050] [Citation(s) in RCA: 125] [Impact Index Per Article: 11.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) interconverts the inactive glucocorticoid cortisone and its active form cortisol. It is widely expressed and, although bidirectional, in vivo it functions predominantly as an oxoreductase, generating active glucocorticoid. This allows glucocorticoid receptor activation to be regulated at a prereceptor level in a tissue-specific manner. In this review, we will discuss the enzymology and molecular biology of 11β-HSD1 and the molecular basis of cortisone reductase deficiencies. We will also address how altered 11β-HSD1 activity has been implicated in a number of disease states, and we will explore its role in the physiology and pathologies of different tissues. Finally, we will address the current status of selective 11β-HSD1 inhibitors that are in development and being tested in phase II trials for patients with the metabolic syndrome. Although the data are preliminary, therapeutic inhibition of 11β-HSD1 is also an exciting prospect for the treatment of a variety of other disorders such as osteoporosis, glaucoma, intracranial hypertension, and cognitive decline.
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Affiliation(s)
- Laura L Gathercole
- School of Clinical and Experimental Medicine, University of Birmingham, Queen Elizabeth Hospital, Edgbaston B15 2TH, United Kingdom
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106
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Shimodaira M, Nakayama T, Sato I, Sato N, Izawa N, Mizutani Y, Furuya K, Yamamoto T. Glucocorticoid synthesis-related genes: HSD11B1 and HSD11B2 in hypertensive disorders in pregnancy. Gynecol Endocrinol 2013; 29:657-61. [PMID: 23659736 DOI: 10.3109/09513590.2013.788623] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
Abstract
OBJECTIVE To determine whether polymorphisms of the maternal glucocorticoid-related genes (HSD11B1 and HSD11B2) are associated with pregnancy-induced hypertension (PIH) in a haplotype-based case-control study. METHODS A total of 166 PIH patients and 222 age-matched controls were genotyped, with two single-nucleotide polymorphisms (SNPs) for the HSD11B1 gene (rs2235543 and rs846910) and three SNPs for the HSD11B2 gene (rs12920590, rs45483293 and rs3743729) used as genetic markers. After separation into preeclampsia (PE) and gestational hypertension (GH) subgroups, PIH patients were assessed. RESULTS Significant differences were noted between PE and control groups (p = 0.022, p = 0.034, respectively) for the frequency of genotypes and alleles for rs846910 of HSD11B1. The frequency of the AA genotype of rs846910 was significantly higher in PIH and PE groups compared to controls. Logistic regression analyses showed that this genotype was a risk factor for PIH and PE (adjusted OR 2.9, 95% CI 1.3-6.5 and adjusted OR 3.2, 95% CI 1.4-7.4, respectively). The frequency of the T-A haplotype established by rs2235543-rs846910 was also significantly higher in PIH and PE groups (p = 0.045, p = 0.042, respectively). CONCLUSION rs846910 in the HSD11B1 gene could be a marker for hypertensive disorders during pregnancy. The T-A haplotype constructed by rs2235543-rs846910 was also a useful susceptibility marker for PIH and PE.
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107
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Lipson VV, Shirobokova MG, Petrova ON. 11β-Hydroxysteroid dehydrogenase type 1, a target for development of oral antidiabetic drugs (Review). Pharm Chem J 2013. [DOI: 10.1007/s11094-013-0900-y] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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108
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Fakhrawi DH, Lammi-Keefe CJ, Beeson WL, Darnell TA, Cordero-MacIntyre ZR. WITHDRAWN: Dairy calcium decreases adiposity, plasma leptin, and glucose in obese postmenopausal women. Nutr Res 2013. [DOI: 10.1016/j.nutres.2013.04.007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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109
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Winnick JJ, Ramnanan CJ, Saraswathi V, Roop J, Scott M, Jacobson P, Jung P, Basu R, Cherrington AD, Edgerton DS. Effects of 11β-hydroxysteroid dehydrogenase-1 inhibition on hepatic glycogenolysis and gluconeogenesis. Am J Physiol Endocrinol Metab 2013; 304:E747-56. [PMID: 23403942 PMCID: PMC3625750 DOI: 10.1152/ajpendo.00639.2012] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
Abstract
The aim of this study was to determine the effect of prolonged 11β-hydroxysteroid dehydrogenase-1 (11β-HSD1) inhibition on basal and hormone-stimulated glucose metabolism in fasted conscious dogs. For 7 days prior to study, either an 11β-HSD1 inhibitor (HSD1-I; n = 6) or placebo (PBO; n = 6) was administered. After the basal period, a 4-h metabolic challenge followed, where glucagon (3×-basal), epinephrine (5×-basal), and insulin (2×-basal) concentrations were increased. Hepatic glucose fluxes did not differ between groups during the basal period. In response to the metabolic challenge, hepatic glucose production was stimulated in PBO, resulting in hyperglycemia such that exogenous glucose was required in HSD-I (P < 0.05) to match the glycemia between groups. Net hepatic glucose output and endogenous glucose production were decreased by 11β-HSD1 inhibition (P < 0.05) due to a reduction in net hepatic glycogenolysis (P < 0.05), with no effect on gluconeogenic flux compared with PBO. In addition, glucose utilization (P < 0.05) and the suppression of lipolysis were increased (P < 0.05) in HSD-I compared with PBO. These data suggest that inhibition of 11β-HSD1 may be of therapeutic value in the treatment of diseases characterized by insulin resistance and excessive hepatic glucose production.
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Affiliation(s)
- J. J. Winnick
- 1Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, Tennessee;
| | - C. J. Ramnanan
- 2Department of Cellular and Molecular Medicine, University of Ottawa School of Medicine, Ottawa, Ontario, Canada;
| | - V. Saraswathi
- 3Department of Medicine, University of Nebraska Medical Center, Omaha, Nebraska;
| | - J. Roop
- 1Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, Tennessee;
| | - M. Scott
- 1Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, Tennessee;
| | - P. Jacobson
- 4Abbott Laboratories, Chicago, Illinois; and
| | - P. Jung
- 4Abbott Laboratories, Chicago, Illinois; and
| | - R. Basu
- 5Department of Endocrinology, Diabetes, Metabolism, and Nutrition, Mayo Clinic College of Medicine, Rochester, Minnesota
| | - A. D. Cherrington
- 1Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, Tennessee;
| | - D. S. Edgerton
- 1Department of Molecular Physiology and Biophysics, Vanderbilt University Medical Center, Nashville, Tennessee;
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110
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Association of estrogen with glucocorticoid levels in visceral fat in postmenopausal women. Menopause 2013; 20:437-42. [DOI: 10.1097/gme.0b013e318271a640] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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111
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Bauman DR, Whitehead A, Contino LC, Cui J, Garcia-Calvo M, Gu X, Kevin N, Ma X, Pai LY, Shah K, Shen X, Stribling S, Zokian HJ, Metzger J, Shevell DE, Waddell ST. Evaluation of selective inhibitors of 11β-HSD1 for the treatment of hypertension. Bioorg Med Chem Lett 2013; 23:3650-3. [PMID: 23659858 DOI: 10.1016/j.bmcl.2013.03.011] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/14/2012] [Revised: 02/23/2013] [Accepted: 03/04/2013] [Indexed: 01/28/2023]
Abstract
In an effort to understand the origin of blood-pressure lowering effects observed in recent clinical trials with 11β-HSD1 inhibitors, we examined a set of 11β-HSD1 inhibitors in a series of relevant in vitro and in vivo assays. Select 11β-HSD1 inhibitors reduced blood pressure in our preclinical models but most or all of the blood pressure lowering may be mediated by a 11β-HSD1 independent pathway.
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Affiliation(s)
- David R Bauman
- Department of Medicinal Chemistry, Merck & Co., Inc., PO Box 2000, Rahway, NJ 07065, USA
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112
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Chronic inhibition of 11 β -hydroxysteroid dehydrogenase type 1 activity decreases hypertension, insulin resistance, and hypertriglyceridemia in metabolic syndrome. BIOMED RESEARCH INTERNATIONAL 2013; 2013:427640. [PMID: 23586038 PMCID: PMC3613092 DOI: 10.1155/2013/427640] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 10/05/2012] [Accepted: 02/18/2013] [Indexed: 01/21/2023]
Abstract
Metabolic syndrome is a constellation of risk factors including hypertension, dyslipidemia, insulin resistance, and obesity that promote the development of cardiovascular disease. Metabolic syndrome has been associated with changes in the secretion or metabolism of glucocorticoids, which have important functions in adipose, liver, kidney, and vasculature. Tissue concentrations of the active glucocorticoid cortisol are controlled by the conversion of cortisone to cortisol by 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1). Because of the various cardiovascular and metabolic activities of glucocorticoids, we tested the hypothesis that 11β-HSD1 is a common mechanism in the hypertension, dyslipidemia, and insulin resistance in metabolic syndrome. In obese and lean SHR/NDmcr-cp (SHR-cp), cardiovascular, metabolic, and renal functions were measured before and during four weeks of administration of vehicle or compound 11 (10 mg/kg/d), a selective inhibitor of 11β-HSD1. Compound 11 significantly decreased 11β-HSD1 activity in adipose tissue and liver of SHR-cp. In obese SHR-cp, compound 11 significantly decreased mean arterial pressure, glucose intolerance, insulin resistance, hypertriglyceridemia, and plasma renin activity with no effect on heart rate, body weight gain, or microalbuminuria. These results suggest that 11β-HSD1 activity in liver and adipose tissue is a common mediator of hypertension, hypertriglyceridemia, glucose intolerance, and insulin resistance in metabolic syndrome.
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113
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Gibbs JP, Emery MG, McCaffery I, Smith B, Gibbs MA, Akrami A, Rossi J, Paweletz K, Gastonguay MR, Bautista E, Wang M, Perfetti R, Daniels O. Population Pharmacokinetic/Pharmacodynamic Model of Subcutaneous Adipose 11β-Hydroxysteroid Dehydrogenase Type 1 (11β-HSD1) Activity After Oral Administration of AMG 221, a Selective 11β-HSD1 Inhibitor. J Clin Pharmacol 2013; 51:830-41. [DOI: 10.1177/0091270010374470] [Citation(s) in RCA: 34] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
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114
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Moon SS, Lee YS, Kim JG, Lee IK. Association of 11β-hydroxysteroid dehydrogenase type 1 gene polymorphisms with serum alanine aminotransferase activity. Diabetes Res Clin Pract 2013; 99:343-50. [PMID: 23375992 DOI: 10.1016/j.diabres.2012.12.020] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/08/2012] [Revised: 11/08/2012] [Accepted: 12/17/2012] [Indexed: 01/11/2023]
Abstract
AIMS 11β-Hydroxysteroid dehydrogenase type 1 (HSD11B1), which converts inactive glucocorticoid to active glucocorticoid, plays a critical role in pathogenesis of non-alcoholic fatty liver disease (NAFLD). Serum alanine aminotransferase (ALT), an indicator of hepatocellular injury, has been suggested as a surrogate marker for NAFLD. To date, no study has specifically examined the relationship between HSD11B1 gene polymorphisms and ALT. METHODS A study was conducted to examine the association of common single nucleotide polymorphisms (SNPs) in HSD11B1 (rs12086634, rs1000283) with serum ALT level in 756 Korean subjects (348 males and 408 females). ALT values were divided into two groups: elevated (>33U/l in males, >25U/l in females) and normal. RESULTS SNPs showed a significant association with elevated ALT. According to results of logistic regression analysis adjusted for confounding variables, the GT+GG genotype for rs12086634 and the GA+AA genotype for rs1000283 showed significantly higher frequencies of elevated ALT, compared with the TT and GG genotypes, respectively (GT/GG vs. TT; OR 1.685, 95% CI 1.175-2.416, P=0.005, GA/AA vs. GG; OR 2.057, 95% CI 1.401-3.020, P<0.001, respectively). CONCLUSIONS HSD11B1 polymorphisms (rs12086634 and rs1000283) are associated with elevated levels of ALT. Findings from this study suggest a possible association between HSD11B1 polymorphisms and hepatocellular injury, such as that seen in patients with NAFLD.
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Affiliation(s)
- Seong-Su Moon
- Department of Internal Medicine, Dongguk University College of Medicine, Gyeongju, South Korea
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115
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Udagawa S, Sakami S, Takemura T, Sato M, Arai T, Nitta A, Aoki T, Kawai K, Iwamura T, Okazaki S, Takahashi T, Kaino M. Discovery of novel 7-membered cyclic amide derivatives that inhibit 11beta-hydroxysteroid dehydrogenase type 1. Bioorg Med Chem Lett 2013; 23:1617-21. [DOI: 10.1016/j.bmcl.2013.01.090] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/28/2012] [Revised: 01/18/2013] [Accepted: 01/22/2013] [Indexed: 11/13/2022]
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116
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Wan ZK, Chenail E, Li HQ, Ipek M, Xiang J, Suri V, Hahm S, Bard J, Svenson K, Xu X, Tian X, Wang M, Li X, Johnson CE, Qadri A, Panza D, Perreault M, Mansour TS, Tobin JF, Saiah E. Discovery of HSD-621 as a Potential Agent for the Treatment of Type 2 Diabetes. ACS Med Chem Lett 2013; 4:118-23. [PMID: 24900572 DOI: 10.1021/ml300352x] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Accepted: 11/23/2012] [Indexed: 12/20/2022] Open
Abstract
11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) catalyzes the conversion of inactive glucocorticoid cortisone to its active form, cortisol. The glucocorticoid receptor (GR) signaling pathway has been linked to the pathophysiology of diabetes and metabolic syndrome. Herein, the structure-activity relationship of a series of piperazine sulfonamide-based 11β-HSD1 inhibitors is described. (R)-3,3,3-Trifluoro-2-(5-(((R)-4-(4-fluoro-2-(trifluoromethyl)phenyl)-2-methylpiperazin-1-yl)sulfonyl)thiophen-2-yl)-2-hydroxypropanamide 18a (HSD-621) was identified as a potent and selective 11β-HSD1 inhibitor and was ultimately selected as a clinical development candidate. HSD-621 has an attractive overall pharmaceutical profile and demonstrates good oral bioavailability in mouse, rat, and dog. When orally dosed in C57/BL6 diet-induced obesity (DIO) mice, HSD-621 was efficacious and showed a significant reduction in both fed and fasting glucose and insulin levels. Furthermore, HSD-621 was well tolerated in drug safety assessment studies.
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Affiliation(s)
- Zhao-Kui Wan
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Eva Chenail
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Huan-Qiu Li
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Manus Ipek
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Jason Xiang
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Vipin Suri
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Seung Hahm
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Joel Bard
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Kristine Svenson
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Xin Xu
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Xianbin Tian
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Mengmeng Wang
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Xiangping Li
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Christian E. Johnson
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Ariful Qadri
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Darrell Panza
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Mylene Perreault
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Tarek S. Mansour
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - James F. Tobin
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
| | - Eddine Saiah
- Worldwide
Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts
02140, United States
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117
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Anagnostis P, Katsiki N, Adamidou F, Athyros VG, Karagiannis A, Kita M, Mikhailidis DP. 11beta-Hydroxysteroid dehydrogenase type 1 inhibitors: novel agents for the treatment of metabolic syndrome and obesity-related disorders? Metabolism 2013; 62:21-33. [PMID: 22652056 DOI: 10.1016/j.metabol.2012.05.002] [Citation(s) in RCA: 70] [Impact Index Per Article: 6.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2012] [Revised: 04/30/2012] [Accepted: 05/01/2012] [Indexed: 12/29/2022]
Abstract
OBJECTIVE Metabolic syndrome (MetS) and Cushing's syndrome share common features. It has been proposed that increased glucocorticoid activity at peripheral tissues may play a role in the pathogenesis of MetS and obesity-related disorders. It is well-known that intracellular cortisol concentrations are determined not only by plasma levels but also by the activity of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) which catalyzes the conversion of inactive cortisone to active cortisol, especially in the liver and adipose tissue. Another isoenzyme exists, the 11β-hydroxysteroid dehydrogenase type 2, which acts in the opposite direction inactivating cortisol to cortisone in the kidney. This review considers the significance of the 11β-HSD1 inhibition in the treatment of several features of MetS and provides current data about the development of 11β-HSD1 inhibitors, as new agents for this purpose. MATERIALS/METHODS Using PubMed, we searched for publications during the last 20years regarding the development of 11β-HSD1 inhibitors. RESULTS Emerging data from animal and human studies indicate an association of 11β-HSD1 over-expression with obesity and disorders in glucose and lipid metabolism. This has led to the hypothesis that selective inhibition of 11β-HSD1 could be used to treat MetS and diabetes. Indeed, natural products and older agents such as thiazolidinediones and fibrates seem to exert an inhibitory effect on 11β-HSD1, ameliorating the cardiometabolic profile. In view of this concept, novel compounds, such as adamantyltriazoles, arylsulfonamidothiazoles, anilinothiazolones, BVT2733, INCB-13739, MK-0916 and MK-0736, are currently under investigation and the preliminary findings from both experimental and human studies show a favourable effect on glucose and lipid metabolism, weight reduction and adipokine levels. CONCLUSIONS Many compounds inhibiting 11β-ΗSD1 are under development and preliminary data about their impact on glucose metabolism and obesity-related disorders are encouraging.
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Affiliation(s)
- Panagiotis Anagnostis
- Department of Endocrinology, Hippokration Hospital, 49 Konstantinoupoleos Str, Thessaloniki, 54 642, Greece.
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Glucocorticoids and type 2 diabetes: from physiology to pathology. J Nutr Metab 2012; 2012:525093. [PMID: 23316348 PMCID: PMC3536319 DOI: 10.1155/2012/525093] [Citation(s) in RCA: 100] [Impact Index Per Article: 8.3] [Reference Citation Analysis] [Abstract] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2012] [Accepted: 11/26/2012] [Indexed: 02/06/2023] Open
Abstract
Type 2 diabetes mellitus is the result of interaction between genetic and environmental factors, leading to heterogeneous and progressive pancreatic β-cell dysfunction. Overweight and obesity are major contributors to the development of insulin resistance and impaired glucose tolerance. The inability of β cells to secrete enough insulin produces type 2 diabetes. Abnormalities in other hormones such as reduced secretion of the incretin glucagon-like peptide 1 (GLP-1), hyperglucagonemia, and raised concentrations of other counterregulatory hormones also contribute to insulin resistance, reduced insulin secretion, and hyperglycaemia in type 2 diabetes. Clinical-overt and experimental cortisol excess is associated with profound metabolic disturbances of intermediate metabolism resulting in abdominal obesity, insulin resistance, and low HDL-cholesterol levels, which can lead to diabetes. It was therefore suggested that subtle abnormalities in cortisol secretion and action are one of the missing links between insulin resistance and other features of the metabolic syndrome. The aim of this paper is to address the role of glucocorticoids on glucose homeostasis and to explain the relationship between hypercortisolism and type 2 diabetes.
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Yu J, Liu H, Xia G, Liu L, Xu Z, Chen Q, Ma C, Sun X, Xu J, Li H, Li P, Shi Y, Xiong B, Liu X, Shen J. Discovery of 2-Alkyl-1-arylsulfonylprolinamides as 11β-Hydroxysteroid Dehydrogenase Type 1 Inhibitors. ACS Med Chem Lett 2012; 3:793-8. [PMID: 24900382 DOI: 10.1021/ml300144n] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/11/2012] [Accepted: 09/18/2012] [Indexed: 11/30/2022] Open
Abstract
On the basis of scaffold hopping, a novel series of 2-alkyl-1-arylsulfonylprolinamides was discovered as 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD-1) inhibitors. A representative compound 4ek, obtained through SAR and structure optimization studies, demonstrates excellent in vitro potency against 11β-HSD-1 and dose-dependent in vivo inhibition of 11β-HSD-1 in a prednisone/prednisolone transformation biomarker study in mice.
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Affiliation(s)
- Jianxin Yu
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
| | - Haiyan Liu
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
| | - Guangxin Xia
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
- State Key Laboratory of Drug Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555
Zuchongzhi Road, Zhangjiang Hi-Tech Park, Shanghai 201203, China
| | - Lin Liu
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
- State Key Laboratory of Drug Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555
Zuchongzhi Road, Zhangjiang Hi-Tech Park, Shanghai 201203, China
| | - Zhenmin Xu
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
| | - Qian Chen
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
| | - Chen Ma
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
| | - Xing Sun
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
| | - Jiajun Xu
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
| | - Hua Li
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
| | - Ping Li
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
| | - Yufang Shi
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
| | - Bing Xiong
- State Key Laboratory of Drug Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555
Zuchongzhi Road, Zhangjiang Hi-Tech Park, Shanghai 201203, China
| | - Xuejun Liu
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
| | - Jingkang Shen
- Central Research Institute, Shanghai Pharmaceutical Holding Co., Ltd., Building 5, 898 Ha Lei Road, Zhangjiang
Hi-Tech Park, Shanghai 201203, China
- State Key Laboratory of Drug Research, Shanghai Institute of Materia
Medica, Chinese Academy of Sciences, 555
Zuchongzhi Road, Zhangjiang Hi-Tech Park, Shanghai 201203, China
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Pereira CD, Azevedo I, Monteiro R, Martins MJ. 11β-Hydroxysteroid dehydrogenase type 1: relevance of its modulation in the pathophysiology of obesity, the metabolic syndrome and type 2 diabetes mellitus. Diabetes Obes Metab 2012; 14:869-81. [PMID: 22321826 DOI: 10.1111/j.1463-1326.2012.01582.x] [Citation(s) in RCA: 76] [Impact Index Per Article: 6.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
Recent evidence strongly argues for a pathogenic role of glucocorticoids and 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) in obesity and the metabolic syndrome, a cluster of risk factors for atherosclerotic cardiovascular disease and type 2 diabetes mellitus (T2DM) that includes insulin resistance (IR), dyslipidaemia, hypertension and visceral obesity. This has been partially prompted not only by the striking clinical resemblances between the metabolic syndrome and Cushing's syndrome (a state characterized by hypercortisolism that associates with metabolic syndrome components) but also from monogenic rodent models for the metabolic syndrome (e.g. the leptin-deficient ob/ob mouse or the leptin-resistant Zucker rat) that display overall increased secretion of glucocorticoids. However, systemic circulating glucocorticoids are not elevated in obese patients and/or patients with metabolic syndrome. The study of the role of 11β-HSD system shed light on this conundrum, showing that local glucocorticoids are finely regulated in a tissue-specific manner at the pre-receptor level. The system comprises two microsomal enzymes that either activate cortisone to cortisol (11β-HSD1) or inactivate cortisol to cortisone (11β-HSD2). Transgenic rodent models, knockout (KO) for HSD11B1 or with HSD11B1 or HSD11B2 overexpression, specifically targeted to the liver or adipose tissue, have been developed and helped unravel the currently undisputable role of the enzymes in metabolic syndrome pathophysiology, in each of its isolated components and in their prevention. In the transgenic HSD11B1 overexpressing models, different features of the metabolic syndrome and obesity are replicated. HSD11B1 gene deficiency or HSD11B2 gene overexpression associates with improvements in the metabolic profile. In face of these demonstrations, research efforts are now being turned both into the inhibition of 11β-HSD1 as a possible pharmacological target and into the role of dietary habits on the establishment or the prevention of the metabolic syndrome, obesity and T2DM through 11β-HSD1 modulation. We intend to review and discuss 11β-HSD1 and obesity, the metabolic syndrome and T2DM and to highlight the potential of its inhibition for therapeutic or prophylactic approaches in those metabolic diseases.
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Affiliation(s)
- C D Pereira
- Department of Biochemistry (U38/FCT), Faculty of Medicine, University of Porto, Portugal
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Hartig SM, He B, Newberg JY, Ochsner SA, Loose DS, Lanz RB, McKenna NJ, Buehrer BM, McGuire SE, Marcelli M, Mancini MA. Feed-forward inhibition of androgen receptor activity by glucocorticoid action in human adipocytes. CHEMISTRY & BIOLOGY 2012; 19:1126-41. [PMID: 22999881 PMCID: PMC4259876 DOI: 10.1016/j.chembiol.2012.07.020] [Citation(s) in RCA: 26] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 03/19/2012] [Revised: 07/05/2012] [Accepted: 07/09/2012] [Indexed: 01/03/2023]
Abstract
We compared transcriptomes of terminally differentiated mouse 3T3-L1 and human adipocytes to identify cell-specific differences. Gene expression and high content analysis (HCA) data identified the androgen receptor (AR) as both expressed and functional, exclusively during early human adipocyte differentiation. The AR agonist dihydrotestosterone (DHT) inhibited human adipocyte maturation by downregulation of adipocyte marker genes, but not in 3T3-L1. It is interesting that AR induction corresponded with dexamethasone activation of the glucocorticoid receptor (GR); however, when exposed to the differentiation cocktail required for adipocyte maturation, AR adopted an antagonist conformation and was transcriptionally repressed. To further explore effectors within the cocktail, we applied an image-based support vector machine (SVM) classification scheme to show that adipocyte differentiation components inhibit AR action. The results demonstrate human adipocyte differentiation, via GR activation, upregulates AR but also inhibits AR transcriptional activity.
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Affiliation(s)
- Sean M. Hartig
- Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Bin He
- Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Justin Y. Newberg
- Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Scott A. Ochsner
- Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - David S. Loose
- Integrative Biology and Pharmacology, University of Texas Health Science Center, Houston, TX, USA
| | - Rainer B. Lanz
- Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Neil J. McKenna
- Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | | | - Sean E. McGuire
- Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
| | - Marco Marcelli
- Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
- Michael E. DeBakey VA Medical Center and Department of Medicine, Baylor College of Medicine, Houston, TX, USA
| | - Michael A. Mancini
- Molecular and Cellular Biology, Baylor College of Medicine, Houston, TX, USA
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Adamantyl carboxamides and acetamides as potent human 11β-hydroxysteroid dehydrogenase type 1 inhibitors. Bioorg Med Chem 2012; 20:6394-402. [PMID: 23040895 PMCID: PMC3510433 DOI: 10.1016/j.bmc.2012.08.056] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/19/2012] [Revised: 08/20/2012] [Accepted: 08/24/2012] [Indexed: 11/23/2022]
Abstract
The modulation of 11β-HSD1 activity with selective inhibitors has beneficial effects on various metabolic disorders including insulin resistance, dyslipidemia and obesity. Here we report the discovery of a series of novel adamantyl carboxamide and acetamide derivatives as selective inhibitors of human 11β-HSD1 in HEK-293 cells transfected with the HSD11B1 gene. Optimization based on an initially identified 11β-HSD1 inhibitor (3) led to the discovery of potent inhibitors with IC(50) values in the 100 nM range. These compounds are also highly selective 11β-HSD1 inhibitors with no activity against 11β-HSD2 and 17β-HSD1. Compound 15 (IC(50)=114 nM) with weak inhibitory activity against the key human cytochrome P450 enzymes and moderate stability in incubation with human liver microsomes is worthy of further development. Importantly, compound 41 (IC(50)=280 nM) provides a new lead that incorporates an adamantyl group surrogate and should enable further series diversification.
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123
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Morris KL, Zemel MB. 1, 25-Dihydroxyvitamin D3Modulation of Adipocyte Glucocorticoid Function. ACTA ACUST UNITED AC 2012; 13:670-7. [PMID: 15897475 DOI: 10.1038/oby.2005.75] [Citation(s) in RCA: 56] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
OBJECTIVE 1,25-Dihydroxyvitamin D3 dose dependently increases intracellular calcium in human adipocytes. We have demonstrated that suppression of circulating 1,25-dihydroxyvitamin D3 levels by increasing dietary calcium reduces adipocyte intracellular calcium and reduces adiposity in both humans and rodents, with preferential loss of trunk fat. Autocrine production of cortisol by adipocytes of mice overexpressing 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD 1) in adipose tissue increases visceral adiposity, whereas knockout of 11beta-HSD 1 appears to attenuate truncal obesity. Accordingly, our objective was to investigate the role of 1,25-dihydroxyvitamin D3 in the modulation of adipocyte glucocorticoid metabolism. RESEARCH METHODS AND PROCEDURES We examined the effect of 1,25-dihydroxyvitamin D3 or angiotensin II on cortisol production and expression using real-time reverse transcriptase-polymerase chain reaction of 11beta-HSD 1, angiotensin II receptor type 1 (AT1), and AT2 receptor in human adipocytes. RESULTS Adipocytes produced negligible cortisol in the absence of substrate (cortisone). In the presence of cortisone (1 to 10 nM), there was significant cortisol production, which was dose dependently augmented (2- to 6-fold, p < 0.001) by 1,25-dihydroxyvitamin D3 (0.1 to 10 nM). 1,25-Dihydroxyvitamin D3 dose dependently increased 11beta-HSD 1 expression up to 2-fold (p < 0.01) in both the presence and absence of cortisone. In contrast, 1,25-dihydroxyvitamin D3 dose dependently decreased adipocyte AT1 expression (by 30% to 50%, p < 0.001) in both the presence and absence of cortisone, suggesting compensatory down-regulation of AT(1). DISCUSSION We conclude that 1,25-dihydroxyvitamin D3 directly regulates adipocyte 11beta-HSD 1 expression and, consequently, local cortisol levels and that this may contribute to the preferential loss of visceral adiposity by high-calcium diets.
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Affiliation(s)
- Kristin L Morris
- Department of Nutrition, University of Tennessee, Room 229, Jessie Harris Building, 1215 West Cumberland Avenue, Knoxville, TN 37996, USA
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Zemel MB, Richards J, Milstead A, Campbell P. Effects of Calcium and Dairy on Body Composition and Weight Loss in African-American Adults. ACTA ACUST UNITED AC 2012; 13:1218-25. [PMID: 16076991 DOI: 10.1038/oby.2005.144] [Citation(s) in RCA: 207] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/22/2023]
Abstract
OBJECTIVE Our objective was to determine the effects of dairy consumption on adiposity and body composition in obese African Americans. RESEARCH METHODS AND PROCEDURES We performed two randomized trials in obese African-American adults. In the first (weight maintenance), 34 subjects were maintained on a low calcium (500 mg/d)/low dairy (<1 serving/d) or high dairy (1200 mg Ca/d diet including 3 servings of dairy) diet with no change in energy or macronutrient intake for 24 weeks. In the second trial (weight loss), 29 subjects were similarly randomized to the low or high dairy diets and placed on a caloric restriction regimen (-500 kcal/d). RESULTS In the first trial, body weight remained stable for both groups throughout the maintenance study. The high dairy diet resulted in decreases in total body fat (2.16 kg, p < 0.01), trunk fat (1.03 kg, p < 0.01), insulin (18.7 pM, p < 0.04), and blood pressure (6.8 mm Hg systolic, p < 0.01; 4.25 mm Hg diastolic, p < 0.01) and an increase in lean mass (1.08 kg, p < 0.04), whereas there were no significant changes in the low dairy group. In the second trial, although both diets produced significant weight and fat loss, weight and fat loss on the high dairy diet were approximately 2-fold higher (p < 0.01), and loss of lean body mass was markedly reduced (p < 0.001) compared with the low dairy diet. DISCUSSION Substitution of calcium-rich foods in isocaloric diets reduced adiposity and improved metabolic profiles in obese African Americans without energy restriction or weight loss and augmented weight and fat loss secondary to energy restriction.
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Affiliation(s)
- Michael B Zemel
- Department of Nutrition, The University of Tennessee, 1215 W. Cumberland Avenue, Room 229, Knoxville, TN 37996-1920, USA.
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125
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Wang YJ, Huang SL, Feng Y, Ning MM, Leng Y. Emodin, an 11β-hydroxysteroid dehydrogenase type 1 inhibitor, regulates adipocyte function in vitro and exerts anti-diabetic effect in ob/ob mice. Acta Pharmacol Sin 2012; 33:1195-203. [PMID: 22922341 DOI: 10.1038/aps.2012.87] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023] Open
Abstract
AIM Emodin (1,3,8-trihydroxy-6-methylanthraquinone) is a potent and selective inhibitor of 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) with the ability to ameliorate metabolic disorders in diet-induced obese mice. In the present study, we investigated the effects of emodin on adipocyte function and the underlying mechanisms in vitro, and its anti-diabetic effects in ob/ob mice. METHODS 3T3-L1 adipocytes were used for in vitro studies. 11β-HSD1A activity was evaluated with a scintillation proximity assay. The adipogenesis, glucose uptake, lipolysis and adiponectin secretion were investigated in 3T3-L1 adipocytes treated with emodin in the presence of active (corticosterone) or inactive glucocorticoid (11-dehydrocorticosterone). For in vivo studies, ob/ob mice were administered emodin (25 and 50 mg·kg⁻¹·d⁻¹, ip) for 26 d. On the last day of administration, the serum was collected and the mesenteric and perirenal fat were dissected for analyses. RESULTS Emodin inhibited the 11β-HSD1 activity in 3T3-L1 adipocytes in concentration- and time-dependent manners (the IC₅₀ values were 7.237 and 4.204 μmol/L, respectively, after 1 and 24 h treatment. In 3T3-L1 adipocytes, emodin (30 μmol/L) suppressed 11-dehydrocorticosterone-induced adipogenesis without affecting corticosterone-induced adipogenesis; emodin (3 μmol/L) reduced 11-dehydrocorticosterone-stimulated lipolysis, but had no effect on corticosterone-induced lipolysis. Moreover, emodin (3 μmol/L) partly reversed the impaired insulin-stimulated glucose uptake and adiponectin secretion induced by 11-dehydrocorticosterone but not those induced by corticosterone. In ob/ob mice, long-term emodin administration decreased 11β-HSD1 activity in mesenteric adipose tissues, lowered non-fasting and fasting blood glucose levels, and improved glucose tolerance. CONCLUSION Emodin improves the inactive glucocorticoid-induced adipose tissue dysfunction by selective inhibition on 11β-HSD1 in adipocyte in vitro and improves glycemic control in ob/ob mice.
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Lavery GG, Zielinska AE, Gathercole LL, Hughes B, Semjonous N, Guest P, Saqib K, Sherlock M, Reynolds G, Morgan SA, Tomlinson JW, Walker EA, Rabbitt EH, Stewart PM. Lack of significant metabolic abnormalities in mice with liver-specific disruption of 11β-hydroxysteroid dehydrogenase type 1. Endocrinology 2012; 153:3236-48. [PMID: 22555437 PMCID: PMC3475725 DOI: 10.1210/en.2012-1019] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Glucocorticoids (GC) are implicated in the development of metabolic syndrome, and patients with GC excess share many clinical features, such as central obesity and glucose intolerance. In patients with obesity or type 2 diabetes, systemic GC concentrations seem to be invariably normal. Tissue GC concentrations determined by the hypothalamic-pituitary-adrenal (HPA) axis and local cortisol (corticosterone in mice) regeneration from cortisone (11-dehydrocorticosterone in mice) by the 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) enzyme, principally expressed in the liver. Transgenic mice have demonstrated the importance of 11β-HSD1 in mediating aspects of the metabolic syndrome, as well as HPA axis control. In order to address the primacy of hepatic 11β-HSD1 in regulating metabolism and the HPA axis, we have generated liver-specific 11β-HSD1 knockout (LKO) mice, assessed biomarkers of GC metabolism, and examined responses to high-fat feeding. LKO mice were able to regenerate cortisol from cortisone to 40% of control and had no discernible difference in a urinary metabolite marker of 11β-HSD1 activity. Although circulating corticosterone was unaltered, adrenal size was increased, indicative of chronic HPA stimulation. There was a mild improvement in glucose tolerance but with insulin sensitivity largely unaffected. Adiposity and body weight were unaffected as were aspects of hepatic lipid homeostasis, triglyceride accumulation, and serum lipids. Additionally, no changes in the expression of genes involved in glucose or lipid homeostasis were observed. Liver-specific deletion of 11β-HSD1 reduces corticosterone regeneration and may be important for setting aspects of HPA axis tone, without impacting upon urinary steroid metabolite profile. These discordant data have significant implications for the use of these biomarkers of 11β-HSD1 activity in clinical studies. The paucity of metabolic abnormalities in LKO points to important compensatory effects by HPA activation and to a crucial role of extrahepatic 11β-HSD1 expression, highlighting the contribution of cross talk between GC target tissues in determining metabolic phenotype.
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Affiliation(s)
- Gareth G Lavery
- Centre for Endocrinology, Diabetes and Metabolism, School of Clinical and Experimental Medicine, University of Birmingham, Birmingham B15 2TT, United Kingdom.
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Affiliation(s)
- In-Kyung Jeong
- Division of Endocrinology & Metabolism, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea
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128
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Esteves CL, Kelly V, Bégay V, Man TY, Morton NM, Leutz A, Seckl JR, Chapman KE. Regulation of adipocyte 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) by CCAAT/enhancer-binding protein (C/EBP) β isoforms, LIP and LAP. PLoS One 2012; 7:e37953. [PMID: 22662254 PMCID: PMC3360670 DOI: 10.1371/journal.pone.0037953] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2012] [Accepted: 04/30/2012] [Indexed: 12/11/2022] Open
Abstract
11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) catalyses intracellular regeneration of active glucocorticoids, notably in liver and adipose tissue. 11β-HSD1 is increased selectively in adipose tissue in human obesity, a change implicated in the pathogenesis of metabolic syndrome. With high fat (HF)-feeding, adipose tissue 11β-HSD1 is down-regulated in mice, plausibly to counteract metabolic disease. Transcription of 11β-HSD1 is directly regulated by members of the CCAAT/enhancer binding protein (C/EBP) family. Here we show that while total C/EBPβ in adipose tissue is unaltered by HF diet, the ratio of the C/EBPβ isoforms liver-enriched inhibitor protein (LIP) and liver-enriched activator protein (LAP) (C/EBPβ-LIP:LAP) is increased in subcutaneous adipose. This may cause changes in 11β-HSD1 expression since genetically modified C/EBPβ(+/L) mice, with increased C/EBPβ-LIP:LAP ratio, have decreased subcutaneous adipose 11β-HSD1 mRNA levels, whereas C/EBPβΔuORF mice, with decreased C/EBPβ-LIP:LAP ratio, show increased subcutaneous adipose 11β-HSD1. C/EBPβ-LIP:LAP ratio is regulated by endoplasmic reticulum (ER) stress and mTOR signalling, both of which are altered in obesity. In 3T3-L1 adipocytes, 11β-HSD1 mRNA levels were down-regulated following induction of ER stress by tunicamycin but were up-regulated following inhibition of mTOR by rapamycin. These data point to a central role for C/EBPβ and its processing to LIP and LAP in transcriptional regulation of 11β-HSD1 in adipose tissue. Down-regulation of 11β-HSD1 by increased C/EBPβ-LIP:LAP in adipocytes may be part of a nutrient-sensing mechanism counteracting nutritional stress generated by HF diet.
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Affiliation(s)
- Cristina L. Esteves
- Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Val Kelly
- Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Valérie Bégay
- Max Delbrüeck Center for Molecular Medicine, Berlin, Germany
| | - Tak Y. Man
- Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Nicholas M. Morton
- Molecular Metabolism Group, University/BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Achim Leutz
- Max Delbrüeck Center for Molecular Medicine, Berlin, Germany
| | - Jonathan R. Seckl
- Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
| | - Karen E. Chapman
- Endocrinology Unit, University/BHF Centre for Cardiovascular Science, Queen’s Medical Research Institute, The University of Edinburgh, Edinburgh, United Kingdom
- * E-mail:
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Czegle I, Csala M, Mandl J, Benedetti A, Karádi I, Bánhegyi G. G6PT-H6PDH-11βHSD1 triad in the liver and its implication in the pathomechanism of the metabolic syndrome. World J Hepatol 2012; 4:129-38. [PMID: 22567185 PMCID: PMC3345537 DOI: 10.4254/wjh.v4.i4.129] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2011] [Revised: 11/16/2011] [Accepted: 04/24/2012] [Indexed: 02/06/2023] Open
Abstract
The metabolic syndrome, one of the most common clinical conditions in recent times, represents a combination of cardiometabolic risk determinants, including central obesity, glucose intolerance, insulin resistance, dyslipidemia, non-alcoholic fatty liver disease and hypertension. Prevalence of the metabolic syndrome is rapidly increasing worldwide as a consequence of common overnutrition and consequent obesity. Although a unifying picture of the pathomechanism is still missing, the key role of the pre-receptor glucocorticoid activation has emerged recently. Local glucocorticoid activation is catalyzed by a triad composed of glucose-6-phosphate-transporter, hexose-6-phosphate dehydrogenase and 11β-hydroxysteroid dehydrogenase type 1 in the endoplasmic reticulum. The elements of this system can be found in various cell types, including adipocytes and hepatocytes. While the contribution of glucocorticoid activation in adipose tissue to the pathomechanism of the metabolic syndrome has been well established, the relative importance of the hepatic process is less understood. This review summarizes the available data on the role of the hepatic triad and its role in the metabolic syndrome, by confronting experimental findings with clinical observations.
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Affiliation(s)
- Ibolya Czegle
- Ibolya Czegle, István Karádi, 3rd Department of Internal Medicine, Semmelweis University, 1125 Budapest, Hungary
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Zhang L, Chen J, Ning M, Zou Q, Leng Y, Shen J. Synthesis and evaluation of piperidine urea derivatives as efficacious 11β-hydroxysteroid dehydrogenase type 1 inhibitors in diabetic ob/ob mice. Bioorg Med Chem Lett 2012; 22:2748-52. [DOI: 10.1016/j.bmcl.2012.02.095] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/01/2011] [Revised: 02/19/2012] [Accepted: 02/28/2012] [Indexed: 10/28/2022]
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Hirata A, Maeda N, Nakatsuji H, Hiuge-Shimizu A, Okada T, Funahashi T, Shimomura I. Contribution of glucocorticoid–mineralocorticoid receptor pathway on the obesity-related adipocyte dysfunction. Biochem Biophys Res Commun 2012; 419:182-7. [DOI: 10.1016/j.bbrc.2012.01.139] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2012] [Accepted: 01/27/2012] [Indexed: 01/01/2023]
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Design, synthesis, and SAR studies of novel polycyclic acids as potent and selective inhibitors of human 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD-1). Bioorg Med Chem Lett 2011; 21:6699-704. [DOI: 10.1016/j.bmcl.2011.09.055] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2011] [Revised: 09/13/2011] [Accepted: 09/15/2011] [Indexed: 01/21/2023]
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133
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Klusoňová P, Pátková L, Ergang P, Mikšík I, Zicha J, Kuneš J, Pácha J. Local metabolism of glucocorticoids in Prague hereditary hypertriglyceridemic rats--effect of hypertriglyceridemia and gender. Steroids 2011; 76:1252-9. [PMID: 21729713 DOI: 10.1016/j.steroids.2011.06.003] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/14/2010] [Revised: 06/06/2011] [Accepted: 06/13/2011] [Indexed: 10/18/2022]
Abstract
11β-Hydroxysteroid dehydrogenase type 1 (11HSD1) is a microsomal NADPH-dependent oxidoreductase which elevates intracellular concentrations of active glucocorticoids. Data obtained from mouse strains with genetically manipulated 11HSD1 showed that local metabolism of glucocorticoids plays an important role in the development of metabolic syndrome. Tissue specific dysregulation of 11HSD1 was also found in other models of metabolic syndrome as well as in a number of clinical studies. Here, we studied local glucocorticoid action in the liver, subcutaneous adipose tissue (SAT) and skeletal muscles of male and female Prague hereditary hypertriglyceridemic rats (HHTg) and their normotriglyceridemic counterpart, the Wistar rats. 11HSD1 bioactivity was measured as a conversion of [(3)H]11-dehydrocorticosterone to [(3)H]corticosterone or vice versa. Additionally to express level of active 11HSD1 protein, enzyme activity was measured in tissue homogenates. mRNA abundance of 11HSD1, hexoso-6-phosphate dehydrogenase (H6PDH) and the glucocorticoid receptor (GR) was measured by real-time PCR. In comparison with normotriglyceridemic animals, female HHTg rats showed enhanced regeneration of glucocorticoids in the liver and the absence of any changes in SAT and skeletal muscle. In contrast to females, the glucocorticoid regeneration in males of HHTg rats was unchanged in liver, but stimulated in SAT and downregulated in muscle. Furthermore, SAT and skeletal muscle exhibited not only 11-reductase but also 11-oxidase catalyzed by 11HSD1. In females of both strains, 11-oxidase activity largely exceeded 11-reductase activity. No dramatic changes were found in the mRNA expression of H6PDH and GR. Our data provide evidence that the relationship between hypertriglyceridemia and glucocorticoid action is complex and gender specific.
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Affiliation(s)
- Petra Klusoňová
- Department of Epithelial Physiology, Institute of Physiology, Academy of Sciences of the Czech Republic, Prague, Czech Republic.
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134
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Li S, Liu W, Wang L, Huang R, Chen Q, Wu Y, Cai Y. Effects of menopause on hepatic 11β-hydroxysteroid dehydrogenase type 1 activity and adrenal sensitivity to adrenocorticotropin in healthy non-obese women. Gynecol Endocrinol 2011; 27:794-9. [PMID: 21736538 DOI: 10.3109/09513590.2010.507288] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Menopause is associated with central obesity, dyslipidemia, hypertension and insulin resistance, which are also shown in the patients with excess of glucocorticoids. However, the interaction of hypothalamic-pituitary-adrenal (HPA) axis activity and menopause has not been fully understood. In this study, 55 healthy non-obese women were recruited, and then divided into two groups, premenopausal group (n = 24) and postmenopausal group (n = 31). HPA axis function was evaluated by using dexamethasone suppression test (DST; 0.25 mg), and adrenocorticotrophic hormone (ACTH)-stimulation test. Moreover, 25 mg cortisone acetate test was applied to evaluate the hepatic 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) activity. We found that hepatic 11β-HSD1 activity and adrenal response to ACTH were increased in the postmenopausal group compared with the premenopausal group, whereas the negative feedback effect of dexamethasone did not show significant difference between pre- and postmenopausal women. These findings suggest that the adrenal sensitivity to ACTH and hepatic 11β-HSD1 activity are increased. The increased cortisol conversion and/or synthesis may be contributed to the dysmetabolic features in the postmenopausal women.
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Affiliation(s)
- Shengxian Li
- Department of Endocrinology, Renji Hospital, Shanghai Jiaotong University School of Medicine, Shanghai 200127, China
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135
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Terao M, Murota H, Kimura A, Kato A, Ishikawa A, Igawa K, Miyoshi E, Katayama I. 11β-Hydroxysteroid dehydrogenase-1 is a novel regulator of skin homeostasis and a candidate target for promoting tissue repair. PLoS One 2011; 6:e25039. [PMID: 21949844 PMCID: PMC3176795 DOI: 10.1371/journal.pone.0025039] [Citation(s) in RCA: 58] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/29/2011] [Accepted: 08/26/2011] [Indexed: 12/30/2022] Open
Abstract
11β-hydroxysteroid dehydrogenase 1 (11β-HSD1) catalyzes the interconversion of cortisone and cortisol within the endoplasmic reticulum. 11β-HSD1 is expressed widely, most notably in the liver, adipose tissue, and central nervous system. It has been studied intensely over the last 10 years because its activity is reported to be increased in visceral adipose tissue of obese people. Epidermal keratinocytes and dermal fibroblasts also express 11β-HSD1. However, the function of the enzymatic activity 11β-HSD1 in skin is not known. We found that 11β-HSD1 was expressed in human and murine epidermis, and this expression increased as keratinocytes differentiate. The expression of 11β-HSD1 by normal human epidermal keratinocytes (NHEKs) was increased by starvation or calcium-induced differentiation in vitro. A selective inhibitor of 11β-HSD1 promoted proliferation of NHEKs and normal human dermal fibroblasts, but did not alter the differentiation of NHEKs. Topical application of selective 11β-HSD1 inhibitor to the dorsal skin of hairless mice caused proliferation of keratinocytes. Taken together, these data suggest that 11β-HSD1 is involved in tissue remodeling of the skin. This hypothesis was further supported by the observation that topical application of the selective 11β-HSD1 inhibitor enhanced cutaneous wound healing in C57BL/6 mice and ob/ob mice. Collectively, we conclude that 11β-HSD1 is negatively regulating the proliferation of keratinocytes and fibroblasts, and cutaneous wound healing. Hence, 11β-HSD1 might maintain skin homeostasis by regulating the proliferation of keratinocytes and dermal fibroblasts. Thus 11β-HSD1 is a novel candidate target for the design of skin disease treatments.
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Affiliation(s)
- Mika Terao
- Department of Dermatology, Graduate School of Medicine, Osaka University, Suita, Osaka, Japan.
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136
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Masuzaki H. [108th Scientific Meeting of the Japanese Society of Internal Medicine: educational lecture: 9. A novel, interdisciplinary approach toward the rapid expansion of obesity and metabolic syndrome in Japan]. NIHON NAIKA GAKKAI ZASSHI. THE JOURNAL OF THE JAPANESE SOCIETY OF INTERNAL MEDICINE 2011; 100:2638-2645. [PMID: 22117365 DOI: 10.2169/naika.100.2638] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/31/2023]
Affiliation(s)
- Hiroaki Masuzaki
- Second Department of Internal Medicine (Endocrinology, Diabetes and Metabolism, Hematology, Rheumatology), Graduate School of Medicine, University of the Ryukyus, Japan
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137
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Su X, Pradaux-Caggiano F, Vicker N, Thomas MP, Halem H, Culler MD, Potter BVL. Adamantyl ethanone pyridyl derivatives: potent and selective inhibitors of human 11β-hydroxysteroid dehydrogenase type 1. ChemMedChem 2011; 6:1616-29. [PMID: 21714097 PMCID: PMC3179844 DOI: 10.1002/cmdc.201100182] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/08/2011] [Indexed: 12/30/2022]
Abstract
Elevated levels of active glucocorticoids have been implicated in the development of several phenotypes of metabolic syndrome, such as type 2 diabetes and obesity. 11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) catalyses the intracellular conversion of inactive cortisone to cortisol. Selective 11β-HSD1 inhibitors have shown beneficial effects in various conditions, including diabetes, dyslipidemia and obesity. A series of adamantyl ethanone pyridyl derivatives has been identified, providing potent and selective inhibitors of human 11β-HSD1. Lead compounds display low nanomolar inhibition against human and mouse 11β-HSD1 and are selective for this isoform, with no activity against 11β-HSD2 and 17β-HSD1. Structure-activity relationship studies reveal that an unsubstituted pyridine tethered to an adamantyl ethanone motif through an ether or sulfoxide linker provides a suitable pharmacophore for activity. The most potent inhibitors have IC₅₀ values around 34-48 nM against human 11β-HSD1, display reasonable metabolic stability in human liver microsomes, and weak inhibition of key human CYP450 enzymes.
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Affiliation(s)
- Xiangdong Su
- Medicinal Chemistry, Department of Pharmacy and Pharmacology, University of BathBath, BA2 7AY (UK), Fax: (+44) 1225 386114
| | - Fabienne Pradaux-Caggiano
- Medicinal Chemistry, Department of Pharmacy and Pharmacology, University of BathBath, BA2 7AY (UK), Fax: (+44) 1225 386114
| | - Nigel Vicker
- Medicinal Chemistry, Department of Pharmacy and Pharmacology, University of BathBath, BA2 7AY (UK), Fax: (+44) 1225 386114
| | - Mark P Thomas
- Medicinal Chemistry, Department of Pharmacy and Pharmacology, University of BathBath, BA2 7AY (UK), Fax: (+44) 1225 386114
| | - Heather Halem
- IPSEN, Biomeasure Inc.27 Maple Street, Milford, MA 01757 (USA)
| | | | - Barry V L Potter
- Medicinal Chemistry, Department of Pharmacy and Pharmacology, University of BathBath, BA2 7AY (UK), Fax: (+44) 1225 386114
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138
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Abstract
Obesity and HTN are on the rise in the world. HTN seems to be the most common obesity-related health problem and visceral obesity seems to be the major culprit. Unfortunately, only 31% of hypertensives are treated to goal. This translates into an increased incidence of CVD and related morbidity and mortality. Several mechanisms have been postulated as the causes of obesity-related HTN. Activation of the RAAS, SNS, insulin resistance, leptin, adiponectin, dysfunctional fat, FFA, resistin, 11 Beta dehydrogenase, renal structural and hemodynamic changes, and OSA are some of the abnormalities in obesity-related HTN. Many of these factors are interrelated. Treatment of obesity should begin with weight loss via lifestyle modifications, medications, or bariatric surgery. According to the mechanisms of obesity-related HTN, it seems that drugs that blockade the RAAS and target the SNS should be ideal for treatment. There is not much evidence in the literature that one drug is better than another in controlling obesity-related HTN. There have only been a few studies specifically targeting the obese hypertensive patient, but recent trials that emphasize the importance of BP control have enrolled both overweight and obese subjects. Until we have further studies with more in-depth information about the mechanisms of obesity-related HTN and what the targeted treatment should be, the most important factor necessary to control the obesity-related HTN pandemic and its CVD and CKD consequences is to prevent and treat obesity and to treat HTN to goal.
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Affiliation(s)
- L Romayne Kurukulasuriya
- Department of Internal Medicine, University of Missouri-Columbia School of Medicine, Columbia, MO 65212, USA.
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139
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Nguyen QT, Thomas KT, Lyons KB, Nguyen LD, Plodkowski RA. Current therapies and emerging drugs in the pipeline for type 2 diabetes. AMERICAN HEALTH & DRUG BENEFITS 2011; 4:303-11. [PMID: 25126358 PMCID: PMC4105725] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Subscribe] [Scholar Register] [Indexed: 06/03/2023]
Abstract
BACKGROUND Diabetes is a global epidemic that affects 347 million people worldwide and 25.8 million adults in the United States. In 2007, the total estimated cost associated with diabetes in the United States in 2007 was $174 billion. In 2009, $16.9 billion was spent on drugs for diabetes. The global sales of diabetes pharmaceuticals totaled $35 billion in 2010, and these are expected to rise to $48 billion by 2015. Despite such considerable expenditures, in 2000 only 36% of patients with type 2 diabetes in the United States achieved glycemic control, defined as hemoglobin A1c <7%. OBJECTIVE To review some of the most important drug classes currently in development for the treatment of type 2 diabetes. DISCUSSION Despite the 13 classes of antidiabetes medications currently approved by the US Food and Drug Administration (FDA) for the treatment of type 2 diabetes, the majority of patients with this chronic disease do not achieve appropriate glycemic control with these medications. Many new drug classes currently in development for type 2 diabetes appear promising in early stages of development, and some of them represent novel approaches to treatment, with new mechanisms of action and a low potential for hypoglycemia. Among these promising pharmacotherapies are agents that target the kidney, liver, and pancreas as a significant focus of treatment in type 2 diabetes. These investigational agents may potentially offer new approaches to controlling glucose levels and improve outcomes in patients with diabetes. This article focuses on several new classes, including the sodium-glucose cotransporter-2 inhibitors (which are furthest along in development); 11beta-hydroxysteroid dehydrogenase (some of which are now in phase 2 trials); glycogen phosphorylase inhibitors; glucokinase activators; G protein-coupled receptor 119 agonists; protein tyrosine phosphatase 1B inhibitors; and glucagon-receptor antagonists. CONCLUSION Despite the abundance of FDA-approved therapeutic options for type 2 diabetes, the majority of American patients with diabetes are not achieving appropriate glycemic control. The development of new options with new mechanisms of action may potentially help improve outcomes and reduce the clinical and cost burden of this condition.
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Affiliation(s)
- Quang T Nguyen
- Endocrinology Department, Carson Tahoe Physician Clinics-Carson City, Assistant Clinical Professor of Endocrinology and Internal Medicine, University of Nevada School of Medicine, Reno, and Adjunct Associate Professor of Endocrinology and Internal Medicine, Touro University Nevada, Henderson, College of Osteopathic Medicine
| | - Karmella T Thomas
- Clinical Registered Dietitian, Carson Tahoe Physician Clinics and University of Nevada, Reno, Department of Endocrinology, Nutrition and Metabolism
| | - Katie B Lyons
- Medical student, University of Nevada School of Medicine, Reno
| | - Loida D Nguyen
- Clinical Pharmacist, Sierra Nevada Healthcare System, Veterans Affairs Medical Center, Reno
| | - Raymond A Plodkowski
- Chief of Endocrinology, University of Nevada, and Veterans Affairs Medical Center, Reno
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140
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Xu Z, Tice CM, Zhao W, Cacatian S, Ye YJ, Singh SB, Lindblom P, McKeever BM, Krosky PM, Kruk BA, Berbaum J, Harrison RK, Johnson JA, Bukhtiyarov Y, Panemangalore R, Scott BB, Zhao Y, Bruno JG, Togias J, Guo J, Guo R, Carroll PJ, McGeehan GM, Zhuang L, He W, Claremon DA. Structure-Based Design and Synthesis of 1,3-Oxazinan-2-one Inhibitors of 11β-Hydroxysteroid Dehydrogenase Type 1. J Med Chem 2011; 54:6050-62. [PMID: 21786805 DOI: 10.1021/jm2005354] [Citation(s) in RCA: 35] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Zhenrong Xu
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Colin M. Tice
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Wei Zhao
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Salvacion Cacatian
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Yuan-Jie Ye
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Suresh B. Singh
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Peter Lindblom
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Brian M. McKeever
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Paula M. Krosky
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Barbara A. Kruk
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Jennifer Berbaum
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Richard K. Harrison
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Judith A. Johnson
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Yuri Bukhtiyarov
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Reshma Panemangalore
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Boyd B. Scott
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Yi Zhao
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Joseph G. Bruno
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Jennifer Togias
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Joan Guo
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Rong Guo
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Patrick J. Carroll
- Department of Chemistry, University of Pennsylvania, 250 South 33rd Street, Philadelphia, Pennsylvania 19104, United States
| | - Gerard M. McGeehan
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Linghang Zhuang
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - Wei He
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
| | - David A. Claremon
- Vitae Pharmaceuticals, 502 West Office Center Drive, Fort Washington, Pennsylvania 19034, United States
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141
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Wan ZK, Chenail E, Li HQ, Kendall C, Wang Y, Gingras S, Xiang J, Massefski WW, Mansour TS, Saiah E. Synthesis of Potent and Orally Efficacious 11β-Hydroxysteroid Dehydrogenase Type 1 Inhibitor HSD-016. J Org Chem 2011; 76:7048-55. [DOI: 10.1021/jo200958a] [Citation(s) in RCA: 27] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/07/2023]
Affiliation(s)
- Zhao-Kui Wan
- Pfizer Worldwide Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts 02140, United States
| | - Eva Chenail
- Pfizer Worldwide Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts 02140, United States
| | - Huan-Qiu Li
- Pfizer Worldwide Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts 02140, United States
| | - Christopher Kendall
- Pfizer Worldwide Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts 02140, United States
| | - Youchu, Wang
- Pfizer Worldwide Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts 02140, United States
| | - Stéphane Gingras
- Pfizer Worldwide Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts 02140, United States
| | - Jason Xiang
- Pfizer Worldwide Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts 02140, United States
| | - Walter W. Massefski
- Pfizer Worldwide Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts 02140, United States
| | - Tarek, S. Mansour
- Pfizer Worldwide Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts 02140, United States
| | - Eddine Saiah
- Pfizer Worldwide Research and Development, Pfizer Inc., 200 Cambridge Park Drive, Cambridge, Massachusetts 02140, United States
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142
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Man TY, Michailidou Z, Gokcel A, Ramage L, Chapman KE, Kenyon CJ, Seckl JR, Morton NM. Dietary manipulation reveals an unexpected inverse relationship between fat mass and adipose 11β-hydroxysteroid dehydrogenase type 1. Am J Physiol Endocrinol Metab 2011; 300:E1076-84. [PMID: 21406612 PMCID: PMC3605916 DOI: 10.1152/ajpendo.00531.2010] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Increased dietary fat intake is associated with obesity, insulin resistance, and metabolic disease. In transgenic mice, adipose tissue-specific overexpression of the glucocorticoid-amplifying enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) exacerbates high-fat (HF) diet-induced visceral obesity and diabetes, whereas 11β-HSD1 gene knockout ameliorates this, favoring accumulation of fat in nonvisceral depots. Paradoxically, in normal mice HF diet-induced obesity (DIO) is associated with marked downregulation of adipose tissue 11β-HSD1 levels. To identify the specific dietary fats that regulate adipose 11β-HSD1 and thereby impact upon metabolic disease, we either fed mice diets enriched (45% calories as fat) in saturated (stearate), monounsaturated (oleate), or polyunsaturated (safflower oil) fats ad libitum or we pair fed them a low-fat (11%) control diet for 4 wk. Adipose and liver mass and glucocorticoid receptor and 11β-HSD1 mRNA and activity levels were determined. Stearate caused weight loss and hypoinsulinemia, partly due to malabsorption, and this markedly increased plasma corticosterone levels and adipose 11β-HSD1 activity. Oleate induced pronounced weight gain and hyperinsulinemia in association with markedly low plasma corticosterone and adipose 11β-HSD1 activity. Weight gain and hyperinsulinemia was less pronounced with safflower compared with oleate despite comparable suppression of plasma corticosterone and adipose 11β-HSD1. However, with pair feeding, safflower caused a selective reduction in visceral fat mass and relative insulin sensitization without affecting plasma corticosterone or adipose 11β-HSD1. The dynamic depot-selective relationship between adipose 11β-HSD1 and fat mass strongly implicates a dominant physiological role for local tissue glucocorticoid reactivation in fat mobilization.
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Affiliation(s)
- Tak Yung Man
- Endocrinology Unit, Centre for Cardiovascular Sciences, Queens Medical Research Institute, University of Edinburgh, Edinburgh, United Kingdom
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143
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Su X, Vicker N, Thomas MP, Pradaux-Caggiano F, Halem H, Culler MD, Potter BVL. Discovery of adamantyl heterocyclic ketones as potent 11β-hydroxysteroid dehydrogenase type 1 inhibitors. ChemMedChem 2011; 6:1439-51. [PMID: 21608132 PMCID: PMC3170876 DOI: 10.1002/cmdc.201100144] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/17/2011] [Indexed: 11/11/2022]
Abstract
11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) plays a key role in converting intracellular cortisone to physiologically active cortisol, which is implicated in the development of several phenotypes of metabolic syndrome. Inhibition of 11β-HSD1 activity with selective inhibitors has beneficial effects on various conditions, including diabetes, dyslipidemia and obesity, and therefore constitutes a promising strategy to discover novel therapies for metabolic and cardiovascular diseases. A series of novel adamantyl heterocyclic ketones provides potent and selective inhibitors of human 11β-HSD1. Lead compounds display low nanomolar inhibition against human and mouse 11β-HSD1 and are selective with no activity against 11β-HSD2 and 17β-HSD1. Selected potent 11β-HSD1 inhibitors show moderate metabolic stability upon incubation with human liver microsomes and weak inhibition of human CYP450 enzymes.
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Affiliation(s)
- Xiangdong Su
- Medicinal Chemistry, Department of Pharmacy and Pharmacology, University of Bath, Claverton Down, Bath BA27AY, UK
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144
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Wamil M, Battle JH, Turban S, Kipari T, Seguret D, de Sousa Peixoto R, Nelson YB, Nowakowska D, Ferenbach D, Ramage L, Chapman KE, Hughes J, Dunbar DR, Seckl JR, Morton NM. Novel fat depot-specific mechanisms underlie resistance to visceral obesity and inflammation in 11 β-hydroxysteroid dehydrogenase type 1-deficient mice. Diabetes 2011; 60:1158-67. [PMID: 21350084 PMCID: PMC3064089 DOI: 10.2337/db10-0830] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2010] [Accepted: 01/20/2011] [Indexed: 12/19/2022]
Abstract
OBJECTIVE The study objective was to determine the key early mechanisms underlying the beneficial redistribution, function, and inflammatory profile of adipose tissue in 11β-hydroxysteroid dehydrogenase type 1 knockout (11β-HSD1(-/-)) mice fed a high-fat (HF) diet. RESEARCH DESIGN AND METHODS By focusing on the earliest divergence in visceral adiposity, subcutaneous and visceral fat depots from 11β-HSD1(-/-) and C57Bl/6J control mice fed an HF diet for 4 weeks were used for comparative microarray analysis of gene expression, and differences were validated with real-time PCR. Key changes in metabolic signaling pathways were confirmed using Western blotting/immunoprecipitation, and fat cell size was compared with the respective chow-fed control groups. Altered adipose inflammatory cell content and function after 4 weeks (early) and 18 weeks (chronic) of HF feeding was investigated using fluorescence (and magnetic)-activated cell sorting analysis, immunohistochemistry, and in situ hybridization. RESULTS In subcutaneous fat, HF-fed 11β-HSD1(-/-) mice showed evidence of enhanced insulin and β-adrenergic signaling associated with accretion of smaller metabolically active adipocytes. In contrast, reduced 11β-HSD1(-/-) visceral fat accumulation was characterized by maintained AMP kinase activation, not insulin sensitization, and higher adipocyte interleukin-6 release. Intracellular glucocorticoid deficiency was unexpectedly associated with suppressed inflammatory signaling and lower adipocyte monocyte chemoattractant protein-1 secretion with strikingly reduced cytotoxic T-cell and macrophage infiltration, predominantly in visceral fat. CONCLUSIONS Our data define for the first time the novel and distinct depot-specific mechanisms driving healthier fat patterning and function as a result of reduced intra-adipose glucocorticoid levels.
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Affiliation(s)
- Malgorzata Wamil
- Endocrinology Unit, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - Jenny H. Battle
- Endocrinology Unit, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
- Molecular Metabolism Group, Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - Sophie Turban
- Molecular Metabolism Group, Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - Tiina Kipari
- Endocrinology Unit, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - David Seguret
- Molecular Metabolism Group, Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - Ricardo de Sousa Peixoto
- Endocrinology Unit, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - Yvonne B. Nelson
- Molecular Metabolism Group, Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - Dominika Nowakowska
- Endocrinology Unit, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
- Molecular Metabolism Group, Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - David Ferenbach
- Centre for Inflammation Research, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - Lynne Ramage
- Molecular Metabolism Group, Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - Karen E. Chapman
- Endocrinology Unit, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - Jeremy Hughes
- Centre for Inflammation Research, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - Donald R. Dunbar
- Bioinformatics Core, CVS, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - Jonathan R. Seckl
- Endocrinology Unit, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
| | - Nicholas M. Morton
- Molecular Metabolism Group, Centre for Cardiovascular Science, University of Edinburgh, Queen’s Medical Research Institute, Edinburgh, Scotland
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Stimson RH, Andrew R, McAvoy NC, Tripathi D, Hayes PC, Walker BR. Increased whole-body and sustained liver cortisol regeneration by 11beta-hydroxysteroid dehydrogenase type 1 in obese men with type 2 diabetes provides a target for enzyme inhibition. Diabetes 2011; 60:720-5. [PMID: 21266326 PMCID: PMC3046832 DOI: 10.2337/db10-0726] [Citation(s) in RCA: 50] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
OBJECTIVE The cortisol-regenerating enzyme 11β-hydroxysteroid dehydrogenase type 1 (11β-HSD1) amplifies glucocorticoid levels in liver and adipose tissue. 11β-HSD1 inhibitors are being developed to treat type 2 diabetes. In obesity, 11β-HSD1 is increased in adipose tissue but decreased in liver. The benefits of pharmacological inhibition may be reduced if hepatic 11β-HSD1 is similarly decreased in obese patients with type 2 diabetes. To examine this, we quantified in vivo whole-body, splanchnic, and hepatic 11β-HSD1 activity in obese type 2 diabetic subjects. RESEARCH DESIGN AND METHODS Ten obese men with type 2 diabetes and seven normal-weight control subjects were infused with 9,11,12,12-[(2)H](4)cortisol (40%) and cortisol (60%) at 1.74 mg/h. Adrenal cortisol secretion was suppressed with dexamethasone. Samples were obtained from the hepatic vein and an arterialized hand vein at steady state and after oral administration of cortisone (5 mg) to estimate whole-body and liver 11β-HSD1 activity using tracer dilution. RESULTS In obese type 2 diabetic subjects, the appearance rate of 9,12,12-[(2)H](3)cortisol in arterialized blood was increased (35 ± 2 vs. 29 ± 1 nmol/min, P < 0.05), splanchnic 9,12,12-[(2)H](3)cortisol production was not reduced (29 ± 6 vs. 29 ± 6 nmol/min), and cortisol appearance in the hepatic vein after oral cortisone was unchanged. CONCLUSIONS Whole-body 11β-HSD1 activity is increased in obese men with type 2 diabetes, whereas liver 11β-HSD1 activity is sustained, unlike in euglycemic obesity. This supports the concept that inhibitors of 11β-HSD1 are likely to be most effective in obese type 2 diabetic subjects.
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Affiliation(s)
- Roland H Stimson
- Endocrinology Unit, Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, Scotland, UK.
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Morgan SA, Tomlinson JW. 11beta-hydroxysteroid dehydrogenase type 1 inhibitors for the treatment of type 2 diabetes. Expert Opin Investig Drugs 2011; 19:1067-76. [PMID: 20707593 DOI: 10.1517/13543784.2010.504713] [Citation(s) in RCA: 40] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/11/2022]
Abstract
IMPORTANCE OF THE FIELD The prevalence of obesity and type 2 diabetes is rising and reaching pandemic proportions. For this reason, identification of novel therapeutic targets is urgently needed. AREAS COVERED IN THIS REVIEW The endoluminal enzyme 11beta-hydroxysteroid dehydrogenase type 1 (11beta-HSD1) catalyzes glucocorticoid activation in key metabolic tissues including skeletal muscle, liver and adipose tissue, and is strongly implicated in the pathogenesis of obesity, type 2 diabetes and the metabolic syndrome. Selective 11beta-HSD1 inhibitors limit local glucocorticoid availability and improve insulin sensitivity, glucose tolerance, lipid profiles and atherosclerosis. To date, there is a paucity of clinical studies using selective 11beta-HSD1 inhibitors; however, early indications show that these compounds have great therapeutic potential. WHAT THE READER WILL GAIN We present a comprehensive overview of the background to the development of selective 11beta-HSD1 inhibitors, the preclinical data supporting 11beta-HSD1 as a therapeutic target, and the current status of clinical trials of these agents. TAKE HOME MESSAGE Selective 11beta-HSD1 inhibitors have the potential to improve insulin sensitivity and may ultimately add to the treatment options available for patients with type 2 diabetes. However, further clinical studies are urgently required.
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Affiliation(s)
- Stuart A Morgan
- University of Birmingham, Centre for Endocrinology, Diabetes & Metabolism, Institute of Biomedical Research, School of Clinical and Experimental Medicine, 2nd floor, Room 230, Birmingham B15 2TH, UK
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147
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Abstract
11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) catalyses the intracellular conversion of inert cortisone to physiologically active cortisol, functioning to enhance local cortisol action beyond what would be predicted based on simple plasma exposures. Adipose tissue overexpression of 11β-HSD1 in rodents to levels observed in human obesity can lead to a near complete metabolic syndrome phenotype, and inhibition of 11β-HSD1 has been proposed to be of potential therapeutic benefit to patients with type 2 diabetes mellitus (T2DM). Recently published clinical results with the selective 11β-HSD1 inhibitor, INCB13739, have, for the first time, provided evidence substantiating this hypothesis, and suggest that 11β-HSD1 activity may be important in regulating glycaemia and cardiometabolic risk. In patients with T2DM failing metformin monotherapy, INCB13739 treatment achieves significant reductions in haemoglobin A1c (HbA1c) and fasting plasma glucose (FPG), and when present improves hyperlipidaemia and hypertriglyceridaemia. Interestingly, these positive effects are observed primarily in subjects categorized as obese (body mass index, BMI > 30 kg/m²) and not in subjects categorized as overweight (BMI ≤ 30 kg/m²), underscoring the likely importance of adipose tissue 11β-HSD1 activity to the cardiometabolic sequelae of obesity. This review summarizes the therapeutic rationale for 11β-HSD1 inhibition, and describes in detail the metabolic and endocrinologic changes observed in patients with T2DM treated with INCB13739.
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Affiliation(s)
- G Hollis
- Incyte Corporation, Wilmington, DE 19880, USA
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148
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Adipose tissue and ceramide biosynthesis in the pathogenesis of obesity. ADVANCES IN EXPERIMENTAL MEDICINE AND BIOLOGY 2011; 721:67-86. [PMID: 21910083 DOI: 10.1007/978-1-4614-0650-1_5] [Citation(s) in RCA: 47] [Impact Index Per Article: 3.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Although obesity is a complex metabolic disorder often associated with insulin resistance, hyperinsulinemia and Type 2 diabetes, as well as with accelerated atherosclerosis, the molecular changes in obesity that promote these disorders are not completely understood. Several mechanisms have been proposed to explain how increased adipose tissue mass affects whole body insulin resistance and cardiovascular risk. One theory is that increased adipose derived inflammatory cytokines induces a chronic inflammatory state that not only increases cardiovascular risk, but also antagonizes insulin signaling and mitochondrial function and thereby impair glucose hemostasis. Another suggests that lipid accumulation in nonadipose tissues not suited for fat storage leads to the buildup of bioactive lipids that inhibit insulin signaling and metabolism. Recent evidence demonstrates that sphingolipid metabolism is dysregulated in obesity and specific sphingolipids may provide a common pathway that link excess nutrients and inflammation to increased metabolic and cardiovascular risk. This chapter will focus primarily on the expression and regulation of adipose and plasma ceramide biosynthesis in obesity and, its potential contribution to the pathogenesis of obesity and the metabolic syndrome.
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Abstract
Glucocorticoid action is mediated by glucocorticoid receptor (GR), which upon cortisol binding is activated and regulates the transcriptional expression of target genes and downstream physiological functions. 11β-Hydroxysteroid dehydrogenase type 1 (11β-HSD1) catalyzes the conversion of inactive cortisone to active cortisol. Since cortisol is also produced through biosynthesis in the adrenal glands, the total cortisol level in a given tissue is determined by both the circulating cortisol concentration and the local 11β-HSD1 activity. 11β-HSD1 is expressed in liver, adipose, brain, and placenta. Since it contributes to the local cortisol levels in these tissues, 11β-HSD1 plays a critical role in glucocorticoid action. The metabolic symptoms caused by glucocorticoid excess in Cushing's syndrome overlap with the characteristics of the metabolic syndrome, suggesting that increased glucocorticoid activity may play a role in the etiology of the metabolic syndrome. Consistent with this notion, elevated adipose expression of 11β-HSD1 induced metabolic syndrome-like phenotypes in mice. Thus, 11β-HSD1 is a proposed therapeutic target to normalize glucocorticoid excess in a tissue-specific manner and mitigate obesity and insulin resistance. Selective inhibitors of 11β-HSD1 are under development for the treatment of type 2 diabetes and other components of the metabolic syndrome.
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Affiliation(s)
- Minghan Wang
- Department of Metabolic Disorders, Amgen Inc., One Amgen Center Drive, Mail Stop 29-1-A, Thousand Oaks, CA 91320, USA.
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150
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Yu CY, Mayba O, Lee JV, Tran J, Harris C, Speed TP, Wang JC. Genome-wide analysis of glucocorticoid receptor binding regions in adipocytes reveal gene network involved in triglyceride homeostasis. PLoS One 2010; 5:e15188. [PMID: 21187916 PMCID: PMC3004788 DOI: 10.1371/journal.pone.0015188] [Citation(s) in RCA: 127] [Impact Index Per Article: 9.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/29/2010] [Accepted: 10/28/2010] [Indexed: 01/19/2023] Open
Abstract
Glucocorticoids play important roles in the regulation of distinct aspects of adipocyte biology. Excess glucocorticoids in adipocytes are associated with metabolic disorders, including central obesity, insulin resistance and dyslipidemia. To understand the mechanisms underlying the glucocorticoid action in adipocytes, we used chromatin immunoprecipitation sequencing to isolate genome-wide glucocorticoid receptor (GR) binding regions (GBRs) in 3T3-L1 adipocytes. Furthermore, gene expression analyses were used to identify genes that were regulated by glucocorticoids. Overall, 274 glucocorticoid-regulated genes contain or locate nearby GBR. We found that many GBRs were located in or nearby genes involved in triglyceride (TG) synthesis (Scd-1, 2, 3, GPAT3, GPAT4, Agpat2, Lpin1), lipolysis (Lipe, Mgll), lipid transport (Cd36, Lrp-1, Vldlr, Slc27a2) and storage (S3-12). Gene expression analysis showed that except for Scd-3, the other 13 genes were induced in mouse inguinal fat upon 4-day glucocorticoid treatment. Reporter gene assays showed that except Agpat2, the other 12 glucocorticoid-regulated genes contain at least one GBR that can mediate hormone response. In agreement with the fact that glucocorticoids activated genes in both TG biosynthetic and lipolytic pathways, we confirmed that 4-day glucocorticoid treatment increased TG synthesis and lipolysis concomitantly in inguinal fat. Notably, we found that 9 of these 12 genes were induced in transgenic mice that have constant elevated plasma glucocorticoid levels. These results suggested that a similar mechanism was used to regulate TG homeostasis during chronic glucocorticoid treatment. In summary, our studies have identified molecular components in a glucocorticoid-controlled gene network involved in the regulation of TG homeostasis in adipocytes. Understanding the regulation of this gene network should provide important insight for future therapeutic developments for metabolic diseases.
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Affiliation(s)
- Chi-Yi Yu
- Department of Nutritional Science & Toxicology, University of California, Berkeley, California, United States of America
| | - Oleg Mayba
- Department of Statistics, University of California, Berkeley, California, United States of America
| | - Joyce V. Lee
- Department of Nutritional Science & Toxicology, University of California, Berkeley, California, United States of America
| | - Joanna Tran
- Department of Nutritional Science & Toxicology, University of California, Berkeley, California, United States of America
| | - Charlie Harris
- Department of Medicine, Gladstone Institute of Cardiovascular Disease, Cardiovascular Research Institute, University of California San Francisco, San Francisco, California, United States of America
| | - Terence P. Speed
- Department of Statistics, University of California, Berkeley, California, United States of America
| | - Jen-Chywan Wang
- Department of Nutritional Science & Toxicology, University of California, Berkeley, California, United States of America
- Department of Medicine, Gladstone Institute of Cardiovascular Disease, Cardiovascular Research Institute, University of California San Francisco, San Francisco, California, United States of America
- * E-mail:
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