The influence of acute hyperinsulinemia on the insulin-related material in brain, testis, liver, and kidney

Effect of insulin-induced hypoglycaemia on the central nervous system: evidence from experimental studies

Insulin-induced hypoglycaemia (IIH) is a major acute complication in type 1 as well as in type 2 diabetes, particularly during intensive insulin therapy. The brain plays a central role in the counter-regulatory response by eliciting parasympathetic and sympathetic hormone responses to restore normoglycaemia. Brain glucose concentrations, being approximately 15-20% of the blood glucose concentration in humans, are rigorously maintained during hypoglycaemia through adaptions such as increased cerebral glucose transport, decreased cerebral glucose utilisation and, possibly, by using central nervous system glycogen as a glucose reserve. However, during sustained hypoglycaemia, the brain cannot maintain a sufficient glucose influx and, as the cerebral hypoglycaemia becomes severe, electroencephalogram changes, oxidative stress and regional neuronal death ensues. With particular focus on evidence from experimental studies on nondiabetic IIH, this review outlines the central mechanisms behind the counter-regulatory response to IIH, as well as cerebral adaption to avoid sequelae of cerebral neuroglycopaenia, including seizures and coma.

Increased insulin levels after OGTT load in peripheral blood and cerebrospinal fluid of patients with dementia of Alzheimer type

An investigation was carried out to determine whether a disturbance of glycometabolism is associated with dementia of Alzheimer type (AD). The first part of the study was carried out on 108 AD patients and 57 normal controls (NCs). Neither the plasma level of insulin nor that of glucose differed significantly between the two groups before the oral glucose tolerance test (OGTT), whereas there was a significantly greater increase of the plasma insulin in the AD group than in the NC group after the OGTT. The second part of the study was carried out on 54 AD patients, 44 patients with vascular dementia (VD), and 26 NCs. Early in the morning after overnight fasting, there was no significant difference in the fasting plasma level of either glucose or insulin, or the cerebrospinal fluid (CSF) level of glucose, among the three groups, However, the CSF level of insulin was significantly higher in the AD group than in the other two groups. These results suggest that an abnormally high level of insulin, not only in the peripheral blood after OGTT load but also in the CSF after fasting, may be associated with the pathology of AD.

Insulin in the cerebrospinal fluid

The presence, distribution and specific localization of insulin and its receptors in the central nervous system (CNS) have been described in numerous reports. Insulin in the CNS appears to be similar to pancreatic insulin by biochemical and immunological criteria. While the presence of insulin in the cerebrospinal fluid (CSF)--an essential neurohumoral transport system--has been widely reported, the available information is fragmented and therefore it is difficult to determine the significance of insulin in the CSF and to establish future research directions. This paper presents an integrative view of the studies concerning insulin in the CSF of various species including the human. Evidence suggests that insulin in the CSF and brain may be the result of local synthesis in the CNS, and uptake from the peripheral blood through the blood-brain barrier and circumventricular organs. The passage of insulin from the peripheral blood through the blood-brain barrier may be mediated by a specific transport system coupled to insulin receptors in cerebral microvessels. The transfer of insulin from the peripheral blood through the circumventricular organs is not specific and may depend on simple diffusion. Slow access of insulin to brain interstitial fluid adjacent to the blood-brain barrier and circumventricular organs may be followed by selective transport to other brain sites and into the ventricular-subarachnoideal CSF. It has been hypothesized that the choroid plexuses, which constitute the blood-CSF interface, might be a nonspecific pathway for rapid insulin transport into the CSF. Insulin may also pass from the CSF into the peripheral blood via absorption into the arachnoid villi. This evidence indicates that insulin may be transported in both directions between the CSF-brain and the peripheral blood. Evidence also suggests that the presence of insulin in the CSF is of pivotal importance for its neurophysiological or neuropathophysiological significance.

Influence of low- and high-protein diets on insulin and insulin-like growth factor-1 binding to skeletal muscle and liver in the growing rat

The influence of protein content of the diet on the plasma concentrations and binding to skeletal muscle and liver of insulin and insulin-like growth factor-1 (IGF-1), was studied in growing rats. Animals with a starting body-weight of 80 g received for an 11 d period isoenergetic diets containing (g/kg dry matter) 155 protein as controls (MP), or 55 (LP) or 300 (HP) protein. Food was offered as six equal meals/d. Daily food intakes provided adequate amounts of energy. Total plasma IGF-1 increased linearly as a function of dietary protein intake. Plasma insulin was lower in the LP than in the MP and HP groups. Hormone binding was studied in wheat-germ agglutinin (WGA) partially purified skeletal muscle receptor preparations. Each 125I-labelled hormone binding was competed for by increasing amounts of homologous and heterologous unlabelled hormone; this displacement needed lower concentrations of homologous than heterologous hormone. When compared with MP-diet feeding, the LP diet resulted in an increased ligand concentration for half-maximal binding. In addition the specific 125I-labelled insulin and 125I-labelled IGF-1 binding increased at all hormone concentrations and, as revealed by Scatchard analysis, the hormone binding capacity also rose (only significant for low-affinity insulin receptors and high-affinity IGF-1 receptors). The HP diet had little effect on hormone binding, except to increase insulin binding at very low insulin concentrations. Hormone binding was further studied in WGA partially purified liver receptor preparations. Those preparations did not exhibit any detectable specific 125I-labelled IGF-1 binding. The specific 125I-labelled insulin binding was not altered by dietary protein level. It is concluded that the increase in skeletal muscle insulin and IGF-1 binding along with a decrease in insulin and IGF-1 in the blood from rats fed on the LP diet, is consistent with the concept of an inverse relationship between plasma hormone and hormone binding. The physiological significance with respect to metabolic adaptation of muscle remains to be established.

Insulin binding and receptor tyrosine kinase activity in rat liver and skeletal muscle: effect of starvation

Insulin binding and insulin receptor kinase activity were measured in solubilized and partially purified receptor preparations from liver and skeletal muscles of rats that were either fed a standard diet or subjected to a 72-hour fasting period. Insulin binding capacity was increased in both tissues from fasted rats as determined by Scatchard analysis. The affinity of the receptors was not modified by fasting. Affinity labeling of the alpha-subunit of insulin receptors also suggested an increase in the number of insulin receptors in both tissues. The ability of insulin to stimulate the autophosphorylation of the beta-subunit as well as the phosphorylation of the artificial substrate Glu80-Tyr20 was significantly impaired in liver from fasted rats and by contrast unchanged in skeletal muscles. These findings indicate that in rats, fasting produces changes in insulin receptor kinase activity in liver but not in muscle. The physiological significance of this tissue-specific regulation of receptor kinase activity in relation to insulin action during fasting remains to be established.

Metabolic clearance of insulin from the cerebrospinal fluid in the anesthetized rat

Infusion of 125I-(Tyr A14)-insulin at tracer doses into the cerebrospinal fluid (CSF) resulted in a slow rate of increase in the CSF-labeled insulin during the first 2 hours with a plateau thereafter. Labeled insulin was cleared from the CSF at a higher rate than 3H-inulin, a marker of CSF bulk flow. The labeled insulin was mainly distributed in all the ventricular and periventricular brain regions. Small amounts of degraded insulin appeared in the CSF. Coinfusion with an excess of unlabeled insulin impaired the clearance and degradation of labeled insulin. It also inhibited the labeling in medial hypothalamus, olfactory bulbs and brain stem. In contrast, coinfusion of ribonuclease B (used to test the specificity of uptake) was without any effect. It was concluded that there is an active insulin intake from CSF into brain specific compartments that is presumably essential for the effects of insulin on brain function.

Chronic intracerebroventricular infusion of insulin failed to alter brain insulin-binding sites, food intake, and body weight

The present study was performed to explore the role of exogenous insulin in CSF in the control of energy balance in the rat. For this purpose, adult male Sprague-Dawley rats carrying an indwelling cannula in the right lateral cerebral ventricle were infused for a maximum of 10 days with insulin (Actrapid) at various rates (starting at 0, 45, 85, 170, and 600 ng/day) or anti-insulin antibody (IgG fraction; diluted 1:10 wt/vol) with an osmotic minipump. All those treatments did not modify the growing rates; neither total daily food intake nor the circadian rhythm of food intake was further modified. The chronic insulin infusion starting at 600 ng/day resulted in a chronic significant increase in CSF insulin levels without changing the plasma insulin level. It failed to alter specific insulin binding sites to Triton X-100 solubilized microsomal membranes from various brain areas (cerebral cortex, olfactory bulbs, and lateral and medial hypothalami) at the end of the 5- or 10-day period of insulin infusion. Purification of insulin receptors on a wheat germ agglutinin did not reveal any further effect of insulin. From these results, it seems unlikely that the input to the brain insulin-effector systems could arise from CSF insulin.