Improvement of metabolic control in diabetic patients during mebendazole administration: preliminary studies

Mebendazole is unique among tubulin-active drugs in activating the MEK-ERK pathway

We recently showed that the anti-helminthic compound mebendazole (MBZ) has immunomodulating activity in monocyte/macrophage models and induces ERK signalling. In the present study we investigated whether MBZ induced ERK activation is shared by other tubulin binding agents (TBAs) and if it is observable also in other human cell types. Curated gene signatures for a panel of TBAs in the LINCS Connectivity Map (CMap) database showed a unique strong negative correlation of MBZ with MEK/ERK inhibitors indicating ERK activation also in non-haematological cell lines. L1000 gene expression signatures for MBZ treated THP-1 monocytes also connected negatively to MEK inhibitors. MEK/ERK phosphoprotein activity testing of a number of TBAs showed that only MBZ increased the activity in both THP-1 monocytes and PMA differentiated macrophages. Distal effects on ERK phosphorylation of the substrate P90RSK and release of IL1B followed the same pattern. The effect of MBZ on MEK/ERK phosphorylation was inhibited by RAF/MEK/ERK inhibitors in THP-1 models, CD3/IL2 stimulated PBMCs and a MAPK reporter HEK-293 cell line. MBZ was also shown to increase ERK activity in CD4+ T-cells from lupus patients with known defective ERK signalling. Given these mechanistic features MBZ is suggested suitable for treatment of diseases characterized by defective ERK signalling, notably difficult to treat autoimmune diseases.

Hypoglycemic potential of cyclic guanidine derivatives

Guanidine derivatives are widely used antidiabetic drugs. Metformin (biguanide) is the first-line therapy for the type 2 diabetes mellitus due to its multi-target and pleiotropic effects. Compounds that comprise guanidine moiety integrated in a heterocycle, i.e. cyclic guanidines, represent an increasing area of interest. We have synthesized and studied hypoglycemic effects of a range of cyclic guanidines, namely 2-aminobenzimidazoles and structurally related imidazo[1,2-a]-, pyrimido[1,2-a]-, pyrrolo[1,2-a]-, triazolo[1,5-a]benzimidazole tricyclic derivatives. We have determined the potential of these scaffolds using molecular modeling and QSAR analysis. Experimental studies have shown that N9-(diethylamino)ethyl-2,3-dihydro-imidazo[1,2-a]benzimidazole (RU-254, diabenol) exhibits potent antidiabetic effects along with a low toxicity. We have found that diabenol exerts long-term glucose-lowering effects in prediabetic and diabetic animals, stimulates the first phase of insulin secretion and reduces the rate of liver glycogenolysis. Additionally, diabenol has been shown to exhibit antiplatelet, geroprotective and antitumor activities in animals. Clinical trials confirm that diabenol produces a range of antidiabetogenic effects such as improved glycemia, reduced HbA1c, stimulation of insulin secretion, decreased thrombogenic potential of blood and ameliorated hemorheology.

Large-scale chemical dissection of mitochondrial function

Mitochondrial oxidative phosphorylation (OXPHOS) is under the control of both mitochondrial (mtDNA) and nuclear genomes and is central to energy homeostasis. To investigate how its function and regulation are integrated within cells, we systematically combined four cell-based assays of OXPHOS physiology with multiplexed measurements of nuclear and mtDNA gene expression across 2,490 small-molecule perturbations in cultured muscle. Mining the resulting compendium revealed, first, that protein synthesis inhibitors can decouple coordination of nuclear and mtDNA transcription; second, that a subset of HMG-CoA reductase inhibitors, combined with propranolol, can cause mitochondrial toxicity, yielding potential clues about the etiology of statin myopathy; and, third, that structurally diverse microtubule inhibitors stimulate OXPHOS transcription while suppressing reactive oxygen species, via a transcriptional mechanism involving PGC-1alpha and ERRalpha, and thus may be useful in treating age-associated degenerative disorders. Our screening compendium can be used as a discovery tool both for understanding mitochondrial biology and toxicity and for identifying novel therapeutics.

Mebendazole and insulin secretion from isolated rat islets

In a preliminary communication we reported that mebendazole, a vermicide, decreased plasma glucose and free fatty acid concentrations and increased plasma C peptide concentrations in both type II diabetic patients. Therefore, we suggested that mebendazole was an insulin secretagogue. However, these were uncontrolled studies, and improved metabolic control in these patients due to spontaneous remission rather than drug-induced insulin secretion was a possibility. To investigate the direct effect of mebendazole on insulin secretion we used intact islets isolated from normal rat pancreata. Mebendazole in concentrations as low as 10 to 20 mumol/L caused a twofold to threefold increase in acute-phase insulin release from isolated perifused rat islets. This heightened insulin release occurred in the presence of glucose-stimulated insulin secretion.