1
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McGlone ER, Tan TMM. Glucagon-based therapy for people with diabetes and obesity: What is the sweet spot? Peptides 2024; 176:171219. [PMID: 38615717 DOI: 10.1016/j.peptides.2024.171219] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/06/2024] [Revised: 04/09/2024] [Accepted: 04/10/2024] [Indexed: 04/16/2024]
Abstract
People with obesity and type 2 diabetes have a high prevalence of metabolic-associated steatotic liver disease, hyperlipidemia and cardiovascular disease. Glucagon increases hepatic glucose production; it also decreases hepatic fat accumulation, improves lipidemia and increases energy expenditure. Pharmaceutical strategies to antagonize the glucagon receptor improve glycemic outcomes in people with diabetes and obesity, but they increase hepatic steatosis and worsen dyslipidemia. Co-agonism of the glucagon and glucagon-like peptide-1 (GLP-1) receptors has emerged as a promising strategy to improve glycemia in people with diabetes and obesity. Addition of glucagon receptor agonism enhances weight loss, reduces liver fat and ameliorates dyslipidemia. Prior to clinical use, however, further studies are needed to investigate the safety and efficacy of glucagon and GLP-1 receptor co-agonists in people with diabetes and obesity and related conditions, with specific concerns regarding a higher prevalence of gastrointestinal side effects, loss of muscle mass and increases in heart rate. Furthermore, co-agonists with differing ratios of glucagon:GLP-1 receptor activity vary in their clinical effect; the optimum balance is yet to be identified.
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Affiliation(s)
- Emma Rose McGlone
- Department of Surgery and Cancer, Imperial College London, London, UK; Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK
| | - Tricia M-M Tan
- Department of Metabolism, Digestion and Reproduction, Imperial College London, London, UK.
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2
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Yu X, Wen X, Xu J, Zhou Q, Chen Y, Qu F, He M, Chang H, Zheng C. Rapid Correction of the Hypoglycemia State in Nonhuman Primates Using a Glucagon Long-Dissolving Microneedle Patch. ACS Biomater Sci Eng 2024; 10:3086-3096. [PMID: 38588325 DOI: 10.1021/acsbiomaterials.3c01962] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/10/2024]
Abstract
The timely administration of glucagon is a standard clinical practice for the treatment of severe hypoglycemia. However, the process involves cumbersome steps, including the reconstitution of labile glucagon and filling of the syringe, which cause considerable delays in emergency situations. Moreover, multiple dosages are often required to prevent the recurrence of the hypoglycemic episode because of the short half-life of glucagon in plasma. Herein, we develop a glucagon-loaded long-dissolving microneedle (GLMN) patch that exhibits the properties of fast onset and sustained activity for the effective treatment of severe hypoglycemia. Three types of MN patches were fabricated with different dimensions (long, medium, and short). The longer MN patch packaged a higher dosage of glucagon and exhibited supreme mechanical strength compared to the shorter one. Additionally, the longer MN patch could insert more deeply into the skin, resulting in higher permeability of glucagon across the skin tissue and more rapid systemic absorption as compared with the shorter MN patch. The GLMN patch was observed to reverse the effects of hypoglycemia within 15 min of application in animal models (specifically, rat and rhesus monkey models) and maintained long-term glycemic control, owing to highly efficient drug permeation and the drug reservoir effect of the MN base. The current study presents a promising strategy for the rapid reversal of severe hypoglycemia that exhibits the desirable properties of easy use, high efficiency, and sustained action.
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Affiliation(s)
- Xiang Yu
- Affiliated Huzhou Hospital, School of Medicine, Zhejiang University, Huzhou Central Hospital, Huzhou, Zhejiang 313000, China
| | - Xueyu Wen
- Hangzhou Institute of Medicine, Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
| | - Jianchen Xu
- Department of Endocrinology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Qiao Zhou
- Department of Endocrinology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China
| | - Yingrong Chen
- Affiliated Huzhou Hospital, School of Medicine, Zhejiang University, Huzhou Central Hospital, Huzhou, Zhejiang 313000, China
| | - Fengli Qu
- Hangzhou Institute of Medicine, Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
| | - Min He
- Hangzhou Institute of Medicine, Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
| | - Hao Chang
- Hangzhou Institute of Medicine, Chinese Academy of Sciences, Hangzhou, Zhejiang 310022, China
| | - Chao Zheng
- Affiliated Huzhou Hospital, School of Medicine, Zhejiang University, Huzhou Central Hospital, Huzhou, Zhejiang 313000, China
- Department of Endocrinology, The Second Affiliated Hospital, School of Medicine, Zhejiang University, Hangzhou, Zhejiang 310058, China
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3
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Quiroz-Aldave JE, Gamarra-Osorio ER, Durand-Vásquez MDC, Rafael-Robles LDP, Gonzáles-Yovera JG, Quispe-Flores MA, Concepción-Urteaga LA, Román-González A, Paz-Ibarra J, Concepción-Zavaleta MJ. From liver to hormones: The endocrine consequences of cirrhosis. World J Gastroenterol 2024; 30:1073-1095. [PMID: 38577191 PMCID: PMC10989500 DOI: 10.3748/wjg.v30.i9.1073] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/04/2023] [Revised: 01/02/2024] [Accepted: 02/06/2024] [Indexed: 03/06/2024] Open
Abstract
Hepatocrinology explores the intricate relationship between liver function and the endocrine system. Chronic liver diseases such as liver cirrhosis can cause endocrine disorders due to toxin accumulation and protein synthesis disruption. Despite its importance, assessing endocrine issues in cirrhotic patients is frequently neglected. This article provides a comprehensive review of the epidemiology, pathophysiology, diagnosis, and treatment of endocrine disturbances in liver cirrhosis. The review was conducted using the PubMed/Medline, EMBASE, and Scielo databases, encompassing 172 articles. Liver cirrhosis is associated with endocrine disturbances, including diabetes, hypoglycemia, sarcopenia, thyroid dysfunction, hypogonadotropic hypogonadism, bone disease, adrenal insufficiency, growth hormone dysfunction, and secondary hyperaldosteronism. The optimal tools for diagnosing diabetes and detecting hypoglycemia are the oral glucose tolerance test and continuous glucose monitoring system, respectively. Sarcopenia can be assessed through imaging and functional tests, while other endocrine disorders are evaluated using hormonal assays and imaging studies. Treatment options include metformin, glucagon-like peptide-1 analogs, sodium-glucose co-transporter-2 inhibitors, and insulin, which are effective and safe for diabetes control. Established standards are followed for managing hypoglycemia, and hormone replacement therapy is often necessary for other endocrine dysfunctions. Liver transplantation can address some of these problems.
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Affiliation(s)
| | | | | | | | | | | | | | - Alejandro Román-González
- Department of Endocrinology, Hospital Universitario de San Vicente Fundación, Medellin 050010, Colombia
- Internal Medicine, Universidad de Antioquia, Medellín 050010, Colombia
| | - José Paz-Ibarra
- School of Medicine, Universidad Nacional Mayor de San Marcos, Lima 15081, Peru
- Department of Endocrinology, Hospital Nacional Edgardo Rebagliati Martins, Lima 15072, Peru
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4
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Monfeuga T, Norlin J, Bugge A, Gaalsgaard ED, Prada-Medina CA, Latta M, Veidal SS, Petersen PS, Feigh M, Holst D. Evaluation of long acting GLP1R/GCGR agonist in a DIO and biopsy-confirmed mouse model of NASH suggest a beneficial role of GLP-1/glucagon agonism in NASH patients. Mol Metab 2024; 79:101850. [PMID: 38065435 PMCID: PMC10772820 DOI: 10.1016/j.molmet.2023.101850] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/04/2023] [Revised: 11/28/2023] [Accepted: 12/02/2023] [Indexed: 12/18/2023] Open
Abstract
OBJECTIVE The metabolic benefits of GLP-1 receptor (GLP-1R) agonists on glycemic and weight control are well established as therapy for type 2 diabetes and obesity. Glucagon's ability to increase energy expenditure is well described, and the combination of these mechanisms-of-actions has the potential to further lower hepatic steatosis in metabolic disorders and could therefore be attractive for the treatment for non-alcoholic steatohepatitis (NASH). Here, we have investigated the effects of a dual GLP-1/glucagon receptor agonist NN1177 on hepatic steatosis, fibrosis, and inflammation in a preclinical mouse model of NASH. Having observed strong effects on body weight loss in a pilot study with NN1177, we hypothesized that direct engagement of the hepatic glucagon receptor (GCGR) would result in a superior effect on steatosis and other liver related parameters as compared to the GLP-1R agonist semaglutide at equal body weight. METHODS Male C57Bl/6 mice were fed a diet high in trans-fat, fructose, and cholesterol (Diet-Induced Obese (DIO)-NASH) for 36 weeks. Following randomization based on the degree of fibrosis at baseline, mice were treated once daily with subcutaneous administration of a vehicle or three different doses of NN1177 or semaglutide for 8 weeks. Hepatic steatosis, inflammation and fibrosis were assessed by immunohistochemistry and morphometric analyses. Plasma levels of lipids and liver enzymes were determined, and hepatic gene expression was analyzed by RNA sequencing. RESULTS NN1177 dose-dependently reduced body weight up to 22% compared to vehicle treatment. Plasma levels of ALT, a measure of liver injury, were reduced in all treatment groups with body weight loss. The dual agonist reduced hepatic steatosis to a greater extent than semaglutide at equal body weight loss, as demonstrated by three independent methods. Both the co-agonist and semaglutide significantly decreased histological markers of inflammation such as CD11b and Galectin-3, in addition to markers of hepatic stellate activation (αSMA) and fibrosis (Collagen I). Interestingly, the maximal beneficial effects on above mentioned clinically relevant endpoints of NN1177 treatment on hepatic health appear to be achieved with the middle dose tested. Administering the highest dose resulted in a further reduction of liver fat and accompanied by a massive induction in genes involved in oxidative phosphorylation and resulted in exaggerated body weight loss and a downregulation of a module of co-expressed genes involved in steroid hormone biology, bile secretion, and retinol and linoleic acid metabolism that are also downregulated due to NASH itself. CONCLUSIONS These results indicate that, in a setting of overnutrition, the liver health benefits of activating the fasting-related metabolic pathways controlled by the glucagon receptor displays a bell-shaped curve. This observation is of interest to the scientific community, due to the high number of ongoing clinical trials attempting to leverage the positive effects of glucagon biology to improve metabolic health.
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Affiliation(s)
- Thomas Monfeuga
- AI & Digital Research, Research & Early Development, Novo Nordisk Research Centre Oxford, UK
| | - Jenny Norlin
- Novo Nordisk A/S, Novo Park, DK-2750 Maaloev, Denmark
| | - Anne Bugge
- Novo Nordisk A/S, Novo Park, DK-2750 Maaloev, Denmark
| | | | - Cesar A Prada-Medina
- AI & Digital Research, Research & Early Development, Novo Nordisk Research Centre Oxford, UK
| | - Markus Latta
- Novo Nordisk A/S, Novo Park, DK-2750 Maaloev, Denmark
| | - Sanne S Veidal
- Gubra A/S, Hørsholm Kongevej 11, B, DK-2970 Hørsholm, Denmark
| | - Pia S Petersen
- Gubra A/S, Hørsholm Kongevej 11, B, DK-2970 Hørsholm, Denmark
| | - Michael Feigh
- Gubra A/S, Hørsholm Kongevej 11, B, DK-2970 Hørsholm, Denmark
| | - Dorte Holst
- Novo Nordisk A/S, Novo Park, DK-2750 Maaloev, Denmark.
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Wang YP, Bernatchez F, Chouinard-Castonguay S, Tremblay MC, Vanasse A, Kinnard N, Mégalli M, Millette M, Boulet G, Henderson M, Simoneau-Roy J, Brazeau AS, Rabasa-Lhoret R, Gagnon C. Comparison of Intranasal and Injectable Glucagon Administration Among Pediatric Population Responders. Diabetes Technol Ther 2023; 25:808-816. [PMID: 37751153 DOI: 10.1089/dia.2023.0290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 09/27/2023]
Abstract
Aims: Ease of use and acceptability of nasal versus injectable glucagon (IG) among pediatric responders have been little investigated. This study compared the performance of administering nasal and IG in parents of youth with type 1 diabetes (T1D) and in school workers. Enablers and barriers associated with each glucagon and preferred glucagon administration learning modality were also evaluated. Methods: Three months after watching short pedagogical videos, 30 parents and 30 school workers performed simulated scenarios where they administered both glucagon. Completion time and successful execution of critical steps were collected. Interviews assessed preferred learning modalities, barriers, and enablers associated with each glucagon. Results: Both groups administered nasal glucagon faster than IG (median [interquartile range]: parents 19 [12-29] vs. 97 [71-117] s, P < 0.001; school workers 24 [16-33] vs. 129 [105-165] s, P < 0.001). A lower proportion of participants successfully executed all critical steps for injectable versus nasal glucagon (significant difference for school workers [53% vs. 90%; P = 0.007] but not for parents [68% vs. 83%; P = 0.227]). Nasal glucagon was preferred for ease of use and acceptability. Preferred learning modalities were a combination of videos and workshops, but videos alone could suffice for nasal glucagon. Conclusions: Nasal glucagon is faster to use, more likely to be successfully administered, and more acceptable than IG for parents of children with T1D and school workers. Nasal glucagon training with videos could improve school workers' involvement in severe hypoglycemia management. Clinical Trial number, URL to the registration: NCT05395000, https://clinicaltrials.gov/ct2/show/NCT05395000.
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Affiliation(s)
- Yue-Pei Wang
- CHU de Québec-Université Laval Research Centre, Centre Hospitalier de l'Université Laval, Quebec, Canada
| | - Francesca Bernatchez
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, Canada
| | - Sarah Chouinard-Castonguay
- CHU de Québec-Université Laval Research Centre, Centre Hospitalier de l'Université Laval, Quebec, Canada
| | - Marie-Claude Tremblay
- Department of Family Medicine and Emergency Medicine, Université Laval, Quebec, Canada
- VITAM, Sustainable Health Research Centre, Quebec, Canada
| | - Andréane Vanasse
- Patient Partners of the BETTER Registry for Type 1 Diabetes, Quebec, Canada
| | - Nathalie Kinnard
- Patient Partners of the BETTER Registry for Type 1 Diabetes, Quebec, Canada
| | - Mélissa Mégalli
- CHU de Québec-Université Laval Research Centre, Centre Hospitalier de l'Université Laval, Quebec, Canada
| | - Maude Millette
- Department of Pediatrics, Université Laval, Quebec, Canada
| | | | - Mélanie Henderson
- Department of Pediatrics, Université de Montréal, Montreal, Canada
- CHU Ste-Justine Research Center, Montreal, Canada
- Department of Social and Preventive Medicine, School of Public Health, Université de Montréal, Montreal, Canada
| | - Judith Simoneau-Roy
- Department of Pediatrics, Endocrinology Division, Faculty of Medicine and Health Sciences, CIUSSS-Estrie CHUS, Université de Sherbooke, Sherbrooke, Canada
| | | | - Rémi Rabasa-Lhoret
- Faculty and Department of Medicine, Clinical Research Institute of Montreal, Université de Montréal, Montreal, Canada
| | - Claudia Gagnon
- CHU de Québec-Université Laval Research Centre, Centre Hospitalier de l'Université Laval, Quebec, Canada
- Department of Medicine, Université Laval, Quebec, Canada
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6
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Stuckey HL, Desai U, Mitchell BD, Pearson TL. 'Didn't See the Need': Misperceptions about glucagon from the perspectives of people with diabetes and their caregivers. Diabet Med 2023; 40:e15084. [PMID: 36924085 DOI: 10.1111/dme.15084] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/14/2022] [Revised: 02/28/2023] [Accepted: 03/09/2023] [Indexed: 03/18/2023]
Abstract
AIMS Severe hypoglycaemia among people with diabetes who use insulin can be a life-threatening complication if left untreated. Although glucagon has been approved for treatment of hypoglycaemia since the 1960s, it has been underutilized. We aimed to understand the perceptions of people with diabetes and their caregivers about glucagon. METHODS We conducted in-depth, one-on-one telephone interviews with people with diabetes and their caregivers in the United States. The interviews included questions around general awareness of glucagon, reasons for owning or not owning glucagon, and suggestions for improving understanding of glucagon as treatment for severe hypoglycaemia. Initial synopsis and inductive codebook schema were used to analyse the responses by two independent researchers. Themes were developed from the codes, and codes were re-mapped back to the themes. RESULTS There were 60 dyads of people with diabetes and their caregivers (N = 120). Four themes developed from the interviews: (1) for most participants, the stated reasons for not owning or renewing a prescription for glucagon included unawareness of the medication, its advantages and its value; (2) misperceptions about glucagon occurred frequently; (3) caregivers often lacked confidence in administering reconstituted injectable glucagon; and (4) education and training from healthcare providers about glucagon would be welcomed. CONCLUSIONS This study emphasizes the need for healthcare providers to discuss hypoglycaemia prevention and events at each clinical visit, including the use of glucagon in the case of severe hypoglycaemia. Healthcare providers are encouraged to assess the knowledge of people with diabetes and their caregivers regarding treatment and prevention of hypoglycaemia.
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Affiliation(s)
- Heather L Stuckey
- Department of Medicine, Pennsylvania State University College of Medicine, Hershey, Pennsylvania, 17033, USA
| | - Urvi Desai
- Analysis Group, Boston, Massachusetts, 02199, USA
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7
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Kim CR, Han JH, Kim MJ, Kim MJ, Kim S, Cho YC, Ji HB, Min CH, Lee C, Choy YB. Implantable device with magnetically rotating disk for needle‐free administrations of emergency drug. Bioeng Transl Med 2023; 8:e10479. [DOI: 10.1002/btm2.10479] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/06/2022] [Revised: 12/07/2022] [Accepted: 12/13/2022] [Indexed: 02/04/2023] Open
Affiliation(s)
- Cho Rim Kim
- Interdisciplinary Program in Bioengineering College of Engineering, Seoul National University Seoul Republic of Korea
| | - Jae Hoon Han
- Interdisciplinary Program in Bioengineering College of Engineering, Seoul National University Seoul Republic of Korea
| | - Min Ji Kim
- Interdisciplinary Program in Bioengineering College of Engineering, Seoul National University Seoul Republic of Korea
| | - Myoung Ju Kim
- Interdisciplinary Program in Bioengineering College of Engineering, Seoul National University Seoul Republic of Korea
| | - Se‐Na Kim
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University Seoul Republic of Korea
| | - Yong Chan Cho
- Interdisciplinary Program in Bioengineering College of Engineering, Seoul National University Seoul Republic of Korea
| | - Han Bi Ji
- Interdisciplinary Program in Bioengineering College of Engineering, Seoul National University Seoul Republic of Korea
| | - Chang Hee Min
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University Seoul Republic of Korea
| | - Cheol Lee
- Department of Pathology Seoul National University College of Medicine Seoul Republic of Korea
| | - Young Bin Choy
- Interdisciplinary Program in Bioengineering College of Engineering, Seoul National University Seoul Republic of Korea
- Institute of Medical and Biological Engineering, Medical Research Center, Seoul National University Seoul Republic of Korea
- Department of Biomedical Engineering Seoul National University College of Medicine Seoul Republic of Korea
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8
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Wang Z, Fu R, Han X, Wen D, Wu Y, Li S, Gu Z. Shrinking Fabrication of a Glucose-Responsive Glucagon Microneedle Patch. ADVANCED SCIENCE (WEINHEIM, BADEN-WURTTEMBERG, GERMANY) 2022; 9:e2203274. [PMID: 35957510 PMCID: PMC9534970 DOI: 10.1002/advs.202203274] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 06/08/2022] [Indexed: 05/19/2023]
Abstract
A microdevice that offers glucagon supplements in a safe, non-invasive, and glucose-responsive manner is ideal for avoiding fatal hypoglycemia consequences from insulin overdosage during daily diabetes treatment. However, mold-assisted microfabrication of biomedical materials or devices typically needs high-resolution laser ablation to scale down structural design. In addition, the majority of the polymeric drug delivery materials being used to fabricate devices are dissolvable or deformable in aqueous environments, which restricts washing-based cleaning and purification procedures post shape fixation. This study leverages the design flexibility of 3D printing-assisted mold casting and presents a shrinking microfabrication approach that allows subsequent washing procedures to remove toxic monomer residues during polymerization. The feasibility of this approach is demonstrated by developing a glucose-responsive transdermal glucagon microneedle patch through matrix volume change-mediated release kinetic control. Shown in the type 1 diabetic mouse model, this transdermal patch can reverse the occurrence of hypoglycemia while lowering the risk of monomer residue-induced irritation during treatment. Freeing from the restrain of molding resolution for microstructure design, this shrinking methodology further provides an insight into post-fabrication purifications of biomedical materials.
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Affiliation(s)
- Zejun Wang
- Department of BioengineeringUniversity of CaliforniaLos AngelesCA90095USA
- Department of ChemistryCollege of SciencesNortheastern UniversityShenyang110819China
| | - Ruxing Fu
- Department of BioengineeringUniversity of CaliforniaLos AngelesCA90095USA
| | - Xiao Han
- Department of BioengineeringUniversity of CaliforniaLos AngelesCA90095USA
| | - Di Wen
- Department of BioengineeringUniversity of CaliforniaLos AngelesCA90095USA
| | - Yifan Wu
- Department of BioengineeringUniversity of CaliforniaLos AngelesCA90095USA
| | - Song Li
- Department of BioengineeringUniversity of CaliforniaLos AngelesCA90095USA
| | - Zhen Gu
- Department of BioengineeringUniversity of CaliforniaLos AngelesCA90095USA
- College of Pharmaceutical SciencesZhejiang UniversityHangzhou310058China
- Liangzhu LaboratoryZhejiang University Medical CenterSir Run Run Shaw HospitalHangzhou310058China
- Jinhua Institute of Zhejiang UniversityJinhua321299China
- Department of General Surgery, Sir Run Run Shaw Hospital, School of MedicineZhejiang UniversityHangzhou310016China
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9
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Grant JS, Talley MH. Glucagon Nasal Powder: Treating Hypoglycemia in Individuals With Diabetes Mellitus. J Nurse Pract 2022. [DOI: 10.1016/j.nurpra.2022.08.009] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/14/2022]
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10
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Liu L, Dattaroy D, Simpson KF, Barella LF, Cui Y, Xiong Y, Jin J, König GM, Kostenis E, Roman JC, Kaestner KH, Doliba NM, Wess J. α-cell Gq signaling is critical for maintaining euglycemia. JCI Insight 2021; 6:152852. [PMID: 34752420 PMCID: PMC8783673 DOI: 10.1172/jci.insight.152852] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2021] [Accepted: 11/04/2021] [Indexed: 11/17/2022] Open
Abstract
Glucagon, a hormone released from pancreatic α cells, plays a key role in maintaining euglycemia. New insights into the signaling pathways that control glucagon secretion may stimulate the development of novel therapeutic agents. In this study, we investigated the potential regulation of α cell function by G proteins of the Gq family. The use of a chemogenetic strategy allowed us to selectively activate Gq signaling in mouse α cells in vitro and in vivo. Acute stimulation of α cell Gq signaling led to elevated plasma glucagon levels, accompanied by increased insulin release and improved glucose tolerance. Moreover, chronic activation of this pathway greatly improved glucose tolerance in obese mice. We also identified an endogenous Gq-coupled receptor (vasopressin 1b receptor; V1bR) that was enriched in mouse and human α cells. Agonist-induced activation of the V1bR strongly stimulated glucagon release in a Gq-dependent fashion. In vivo studies indicated that V1bR-mediated glucagon release played a key role in the counterregulatory hyperglucagonemia under hypoglycemic and glucopenic conditions. These data indicate that α cell Gq signaling represents an important regulator of glucagon secretion, resulting in multiple beneficial metabolic effects. Thus, drugs that target α cell–enriched Gq-coupled receptors may prove useful to restore euglycemia in various pathophysiological conditions.
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Affiliation(s)
- Liu Liu
- Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, United States of America
| | - Diptadip Dattaroy
- Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, United States of America
| | - Katherine F Simpson
- Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, United States of America
| | - Luiz F Barella
- Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, United States of America
| | - Yinghong Cui
- Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, United States of America
| | - Yan Xiong
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Jian Jin
- Department of Pharmacological Sciences, Icahn School of Medicine at Mount Sinai, New York, United States of America
| | - Gabriele M König
- Institute of Pharmaceutical Biology, University of Bonn, Bonn, Germany
| | - Evi Kostenis
- Institute for Pharmaceutical Biology, University of Bonn, Bonn, Germany
| | - Jefferey C Roman
- Institute of Diabetes, Obesity, and Metabolism, The University of Pennsylvania, Philadelphia, United States of America
| | - Klaus H Kaestner
- Institute of Diabetes, Obesity, and Metabolism, Perelman School of Medicine, The University of Pennsylvania, Philadeplhia, United States of America
| | - Nicolai M Doliba
- Institute of Diabetes, Obesity, and Metabolism, Perelman School of Medicine, The University of Pennsylvania, Philadeplhia, United States of America
| | - Jürgen Wess
- Laboratory of Bioorganic Chemistry, National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, United States of America
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