Intracerebroventricular administration of galanin antagonist sustains insulin resistance in adipocytes of type 2 diabetic trained rats

Novel hypothalamic pathways for metabolic effects of spexin

One of the main underlying etiologies of type 2 diabetes (T2DM) is insulin resistance, which is most frequently caused by obesity. Notably, the deregulation of adipokine secretion from visceral adiposity has been identified as a crucial characteristic of type 2 diabetes and obesity. Spexin is an adipokine that is released by many different tissues, including white adipocytes and the glandular stomach, and is negatively connected with the state of energy storage. This peptide acts through GALR2/3 receptors to control a wide range of metabolic processes, including inflammation, browning, lipolysis, energy expenditure, and eating behavior. Specifically, spexin can enter the hypothalamus and regulate the hypothalamic melanocortin system, which in turn balances energy expenditure and food intake. This review examines recent advances and the underlying mechanisms of spexin in obesity and T2DM. In particular, we address a range of topics from basic research to clinical findings, such as an analysis of the possible function of spexin in the hypothalamic melanocortin response, which involves reducing energy intake and increasing energy expenditure while also enhancing insulin sensitivity and glucose tolerance. Gaining more insight into the mechanisms that underlie the spexin system's control over energy metabolism and homeostasis may facilitate the development of innovative treatment approaches that focus on combating obesity and diabetes.

Cardioprotective effects of neuropeptide galanin: Focusing on its roles against diabetic heart

Following an unprecedented rise in the number of the aged, the incidence of age-related diseases, such as diabetes and cardiovascular disease, is consequently increasing in the world. Type 2 diabetes mellitus (T2DM) is associated with excess cardiovascular morbidity and mortality. The diabetic heart is characterized by increased cardiomyocyte stiffness and fibrotic changes. Despite many factors resulting in cardiomyocyte injury and dysfunction in diabetes, insulin resistance is still a critical etiology of diabetic cardiomyopathy. Preclinical and clinical studies have revealed an intriguing role for galanin in the pathogenesis of insulin resistance and diabetic heart disease. A significant change in plasma galanin levels occurred in patients suffering from type 2 diabetes or cardiomyocyte injury. In turn, galanin may also distinctly mitigate hyperglycemia and insulin resistance in diabetes as well as increase glucose metabolism and mitochondrial biogenesis in cardiac muscle. Here, we critically review current data about the multivariate relationship among galanin, insulin resistance, and cardiac muscle to comprehensively evaluate the protective role of galanin and its receptors for the diabetic heart and to determine whether galanin receptor 2 agonists potentially represent a feasible way to treat diabetic cardiomyopathy in the future.

Tip 2 diyabetli hastalarda angiopoietin benzeri protein 8 (ANGPTL8) ve Alarin düzeylerinin karşılaştırmalı bir değerlendirmesi

Purpose: Type 2 Diabetes Mellitus (T2DM) is one of the most serious public health problems that affect millions of people worldwide. There are 537 million adults diagnosed with diabetes worldwide and approximately 90% of these adults have type 2 diabetes. The study examined angiopoietin-like protein 8 (ANGPTL8) and Alarin levels of the patients diagnosed with T2DM in comparison with each other and with the healthy control group. Materials and Methods: The study was conducted with a diabetes group consisting of 67 patients who were newly diagnosed with T2DM and who did not use any medication, and the control group consisting of 55 healthy people. ANGPTL8 and Alarin levels were measured using the ELISA (enzyme-linked immunosorbent assay) method. Results: We found a significant increase in alarin and ANGPTL8 levels in the diabetic group compared to the control group. Furthermore, a positive correlation between Alarin levels and ANGPTL8, triglyceride, and insulin levels was found in the patient group. In addition, while both adipokines were higher in males in the patient group, both adipokines levels were lower in males than females in the control group, and there was a significant difference in ANGPTL8 levels. Conclusion: High levels of ANGPTL8 and Alarin may facilitate the development of diabetes through the insulin resistance pathway. If this mechanism is more clearly elucidated, there may be a significant improvement in diabetic treatment projection.

Emerging central and peripheral actions of spexin in feeding behavior, leptin resistance and obesity

Consumption of a high calorie diet with irregular eating and sedentary behavior habits is typical of the current suboptimal lifestyle, contributing to the development of metabolic diseases such as obesity and type 2 diabetes mellitus. Most notably, the disorder of adipokine secretion in visceral adiposity is a major contributor to metabolic diseases with advancing age. In this regard, spexin and leptin are established as anorexigenic adipokines that can modulate adipogenesis and glucose metabolism by suppressing food intake or increasing energy expenditure, respectively. Emerging evidence points out that spexin levels are lower in the serum and adipose tissue of patients with obesity and/or insulin resistance, whereas circulating levels of leptin are higher in obesity and comorbidities. In turn, spexin and leptin pharmacologically induce beneficial effects on the brain's modulation of food intake and energy expenditure. On the other hand, endocrine crosstalk via spexin and leptin has also been reported in patients suffering from obesity and diabetes. Spexin plays a crucial role in the regulation of leptin secretion and leptin resistance. It should therefore be taken into account that studying the role of spexin in leptin regulation will help us combat the pathologies of obesity caused by leptin resistance.

Adipose tissue spexin in physical exercise and age-associated diseases

It is known that a strong association exists between a suboptimal lifestyle (physical inactivity and sedentary behavior and/or high calorie diet) and increased propensity of developing age-associated diseases, such as obesity and T2DM. Physical exercise can alleviate obesity-induced insulin resistance and T2DM, however, the precise mechanism for this outcome is not fully understood. The endocrine disorder of adipose tissue in obesity plays a critical role in the development of insulin resistance. In this regard, spexin has been recently described as an adipokine that plays an important role in the pathophysiology of obesity-induced insulin resistance and T2DM. In obese states, expression of adipose tissue spexin is reduced, inducing the adipose tissue and skeletal muscle more susceptible to insulin resistance. Emerging evidences point out that exercise can increase spexin expression. In return, spexin could exert the exercise-protective roles to ameliorate insulin resistance, suggesting that spexin is a potential mediator for exercise to ameliorate obesity-induced insulin resistance and T2DM, namely, the beneficial effect of exercise on insulin sensitivity is at least partly mediated by spexin. This review summarizes our and others' recent studies regarding the effects of obesity on adipose tissue spexin induction, along with the potential effect of exercise on this response in obese context, and provides a new insight into the multivariate relationship among exercise, spexin and T2DM. It should be therefore taken into account that a combination of spexin and exercise training is an effective therapeutic strategy for age-associated diseases.

Emerging roles of kisspeptin/galanin in age-related metabolic disease

Age is a major risk factor for developing metabolic diseases such as obesity and diabetes. There is an unprecedented rise in obesity and type 2 diabetes in recent decades. A convincing majority of brain-gut peptides are associated with a higher risk to develop metabolic disorders, and may contribute to the pathophysiology of age-related metabolic diseases. Accumulating basic studies revealed an intriguing role of kisspeptin and galanin involved in the amelioration of insulin resistance in different ways. In patients suffered from obesity and diabetes a significant, sex-related changes in the plasma kisspeptin and galanin levels occurred. Kisspeptin is anorexigenic to prevent obesity, its level is negatively correlative with obesity and insulin resistance. While galanin is appetitive to stimulate food intake and body weight, its level is positively correlative with obesity, HOMA-IR and glucose/triglyceride concentration. In turn, kisspeptin and galanin also distinctly increase glucose uptake and utilization as well as energy expenditure. This article reviews recent evidence dealing with the role of kisspeptin and galanin in the pathophysiology of age-related metabolic diseases. It should be therefore taken into account that the targeted modulation of those peptidergic signaling may be potentially helpful in the future treatment of age-related metabolic diseases.

Activation of central galanin receptor 2 mitigated insulin resistance in adipocytes of diabetic rats

PURPOSE

Our and other's studies showed that administration of neuropeptide galanin may mitigate insulin resistance via promoting glucose transporter 4 (GLUT4) expression and translocation in rats. The objective of this study is to investigate whether galanin receptor 2 (GAL2-R) in brain mediates the ameliorative effect of galanin on insulin resistance in adipose tissues of type 2 diabetic rats.

METHODS

In this study galanin, GAL2-R agonist M1145 and GAL2-R antagonist M871 were respectively or cooperatively injected into intracerebroventricles of type 2 diabetic rats once a day for successive fifteen days. Then the plasma and fat tissues of rats were used to estimate the alterations of insulin resistance indexes.

RESULTS

The central administration of galanin enhanced 2-deoxy-[³H]-D-glucose, peroxisome proliferator-activated receptor γ and adiponectin levels, food intake and body weight, GLUT4 mRNA expression and GLUT4 concentration in plasma membranes, as well as homeostasis model assessment-insulin resistance index. Those effects of galanin may be blocked by M817, and imitated by M1145 except for food intake and body weight.

CONCLUSION

Those results suggest that central GAL2-R mediates the beneficial effects of galanin on insulin sensitivity in type 2 diabetic rats. GAL2-R agonist may be taken as a potential antidiabetic agent to treat insulin resistance and type 2 diabetes.

A promising biomarker of elevated galanin level in hypothalamus for osteoporosis risk in type 2 diabetes mellitus

Type 2 diabetes mellitus (T2DM) and osteoporosis are two major healthcare problems worldwide. T2DM is considered to be a risk factor for osteoporosis. Interestingly, several epidemiological studies suggest that bone abnormalities associated with diabetes may differ, at least in part, from those associated with senile or post-menopausal osteoporosis. The growing prevalence that patients with T2DM simultaneously suffer from osteoporosis, puts forward the importance to discuss the relationship between both diseases, as well as to investigate correlative agents to treat them. Emerging evidences demonstrate that neuropeptide galanin is involved in the pathogenesis of T2DM and osteoporosis. Galanin via activation of central GALR2 increases insulin sensitivity as well as bone density and mass in animal models. The disorder of galanin function plays major role in development of both diseases. Importantly, galanin signaling is indispensable for ΔFosB, an AP1 antagonist, to play the bone mass-accruing effects in the ventral hypothalamic neurons of diabetic models. This review summarizes our and other recent studies to provide a new insight into the multivariate relationship among galanin, T2DM and osteoporosis, highlighting the beneficial effect of galanin on the comorbid state of both diseases. These may help us better understanding the pathogenesis of osteoporosis and T2DM and provide useful clues for further inquiry if elevated galanin level may be taken as a biomarker for both conjoint diseases, and GALR2 agonist may be taken as a novel therapeutic strategy to treat both diseases concurrently.

Cooperative effects of galanin and leptin on alleviation of insulin resistance in adipose tissue of diabetic rats

It was reported that either orexigenic neuropeptide galanin or anorexigenic hormone leptin caught benefit insulin sensitivity through increasing the translocation of glucose transporter 4 (GLUT4) in patients with diabetes. To date, it is unknown whether galanin can potentiate the effect of leptin on alleviation of insulin resistance. Therefore, in the current study we sought to assess the combined effect of central leptin and galanin on insulin resistance in the adipose tissues of type 2 diabetic rats. Galanin and leptin were injected into the intracerebroventricle of the diabetic rats, respectively, or cooperatively once a day for 2 weeks. Then, several indexes of insulin resistance were examined. The results showed that glucose infusion rates in the hyperinsulinaemic-euglycaemic clamp test, plasma adiponectin content and GLUT4 translocation, as well as Akt phosphorylation in fat cells, were higher, not GLUT4 protein and GLUT4 mRNA expression, but HOMA index was lower in the galanin + leptin group than either one of them. Furthermore, treatment with MK-2206, an Akt inhibitor, blocked the combined effects of galanin + leptin on alleviation of insulin resistance. These results suggest that galanin can improve the leptin-induced mitigative effects on insulin resistance in the fat cells, and those provided new insights into the potential tactics for prevention and remedy of insulin resistance.

ASSESSMENT OF SERUM ALARIN LEVELS IN PATIENTS WITH TYPE 2 DIABETES MELLITUS

OBJECTIVE

We aimed to investigate the potential relationship between plasma alarin levels and type 2 diabetes mellitus (T2DM).

PATIENTS AND METHOD

We included 154 participants, divided into four groups in a cross-sectional study design. The first group includes patients with T2DM without complications (n=30), the second group patients with T2DM with microvascular complications (T2DM-noC n=32), the third group patients with T2DM with macrovascular complications, T2DM-MV (n=32) and the last group is the healthy control group (n=60).

RESULTS

In our study 94 patients were diabetic; 47 females and 47 males. The control group consists of 60 people, 30 women and 30 men. It was found that these had a significant (p>0.05) variation in serum alarin levels among the T2DM (T2DM-noC=3.1±0.7 ng/mL T2DM-mV=2.8±0.4 ng/mL, T2DM-MV= 3.6±0.4 ng/mL) versus control group (15.6±2.6).We failed to find a significant variation of serum alarin levels (p>0.05) between T2DM subgroups. Serum alarin levels were significantly higher among control patients (p<0.05). There was no difference between diabetic sub-groups.

CONCLUSION

We concluded that serum alarin levels in patients with T2DM are lower than in normal people. Further studies are needed to investigate the possible prognostic value of alarin in clinical practice in T2DM.

Baicalin and its aglycone: a novel approach for treatment of metabolic disorders

BACKGROUND

The current strategies for prevention and treatment of insulin resistance and type 2 diabetes are not fully effective and frequently accompanied by many negative effects. Therefore, novel ways to prevent insulin resistance and type 2 diabetes are urgently needed. The roots of Scutellaria radix are commonly used in traditional Chinese medicines for prevention and treatment of type 2 diabetes, atherosclerosis, hypertension, hyperlipidemia, dysentery, and other respiratory disorders. Baicalin and baicalein are the major and active ingredient extracts from Scutellaria baicalensis.

METHODS

A comprehensive and systematic review of literature on baicalin and baicalein was carried out.

RESULTS

Emerging evidence indicated that baicalin and baicalein possessed hepatoprotective, anti-oxidative, anti-dyslipidemic, anti-lipogenic, anti-obese, anti-inflammatory, and anti-diabetic effects, being effective for treating obesity, insulin resistance, non-alcoholic fatty liver, and dyslipidemia. Besides, baicalin and baicalein are almost non-toxic to epithelial, peripheral, and myeloid cells.

CONCLUSION

The purpose of this study is to focus on the therapeutic applications and accompanying molecular mechanisms of baicalin and baicalein against hyperglycemia, insulin resistance, type 2 diabetes, hyperlipidemia, obesity, and non-alcoholic fatty liver, and trying to establish a novel anti-obese and anti-diabetic strategy.

Galanin peptide family regulation of glucose metabolism

Recent preclinical and clinical studies have indicated that the galanin peptide family may regulate glucose metabolism and alleviate insulin resistance, which diminishes the probability of type 2 diabetes mellitus. The galanin was discovered in 1983 as a gut-derived peptide hormone. Subsequently, galanin peptide family was found to exert a series of metabolic effects, including the regulation of gut motility, body weight and glucose metabolism. The galanin peptide family in modulating glucose metabolism received recently increasing recognition because pharmacological activiation of galanin signaling might be of therapeutic value to improve insuin resistance and type 2 diabetes mellitus. To date, however, few papers have summarized the role of the galanin peptide family in modulating glucose metabolism and insulin resistance. In this review we summarize the metabolic effect of galanin peptide family and highlight its glucoregulatory action and discuss the pharmacological value of galanin pathway activiation for the treatment of glucose intolerance and type 2 diabetes mellitus.

Galanin expression is down-regulated in patients with gastric cancer

Objective

To investigate whether galanin and its three receptors (Gal-R1, Gal-R2, Gal-R3) contribute to development of gastric cancer.

Methods

Preoperative and postoperative fasting venous blood samples were collected from 34 patients with gastric cancer and 13 healthy individuals. Plasma galanin contents, as well as expression levels of galanin and its receptors, were quantitatively examined in a cohort of human gastric cancer tissues and corresponding adjacent tissues.

Results

Statistically significantly lower galanin levels were found in the preoperative samples from patients with gastric cancer, compared with postoperative samples from these same patients, as well as with samples from healthy donors. Furthermore, galanin and Gal-R1 expression levels were dramatically reduced in gastric cancer tissues, compared with corresponding adjacent tissues, whereas Gal-R2 and Gal-R3 levels remained unchanged. Furthermore, galanin mRNA and protein expression levels in the preoperative samples from patients with gastric cancer were significantly correlated with lymph node metastasis, tumor node metastasis stage, and size of the gastric cancer.

Conclusions

Overall levels of galanin and Gal-R1 expression were down-regulated in patients with gastric cancer; local levels were also specifically downregulated in gastric cancer tissues. Galanin and its receptor, Gal-R1, may contribute to development of gastric cancer.

Central galanin receptor 2 mediates galanin action to promote systemic glucose metabolism of type 2 diabetic rats

Although recent results of our and other studies have showed that galanin (GAL) is an antidiabetic and anti-inflammatory neuropeptide, the molecular mechanism how central GAL regulates energy homeostasis and insulin sensitivity is still not fully understood. The aim of this study was to investigate whether central type 2 of GAL receptors (GALR2) are involved in the regulation of systemic glucose metabolism and its underlying mechanisms. In the present study, type 2 diabetic rats were intracerebroventricularly (i.c.v.) given 100 nM/kg/d GALR2 agonist M1145 or GALR2 antagonist M871 in 5 μl artificial cerebrospinal fluid once a day for consecutive 21 days. Then insulin resistance indexes, inflammatory factor and many genes associated with the function of glucose metabolism were examined in peripheral tissues. The present findings showed that the intracerebroventricular injection of M1145 or M871 respectively increased or decreased glucose infusion rates in hyperinsulinemic euglycemic clamp tests, but attenuated or enhanced the plasma inflammatory factors and glucose concentration in type 2 diabetic rats. Moreover, administration of M1145 markedly increased PGC-1α and GLUT4 expression in skeletal muscles and adipocytes of type 2 diabetic rats. In conclusion, activation of central GALR2 promotes glucose metabolism and ameliorates insulin resistance mainly through the PGC-1α/GLUT4 pathways. The central GALR2 is crucial to whole-body insulin sensitivity and energy homeostasis.

Serum Galanin Concentration is Increased in Subjects with Impaired Glucose Tolerance

OBJECTIVES

Although extensive data have shown that galanin can regulate the food intake and glucose metabolism of animals, little is known regarding the galanin concentration in patients with impaired glucose tolerance (IGT). Therefore, the aims of this study were to investigate whether serum galanin levels and other metabolic parameters are changed in patients with IGT compared with controls with normal glucose tolerance (NGT).

METHODS

Data regarding serum galanin levels and relative metabolic parameters were collected in 12 patients with IGT and 12 healthy patients with NGT.

RESULTS

At 1 hour and 2 hours after dinner, serum galanin, insulin and glucose levels were significantly higher in patients with IGT than in controls with NGT. Additionally, the body weights of patients with IGT was higher than those of the controls. Furthermore, a negative correlation was found between galanin levels and 1-hour glucose concentrations (r=-0.580; p=0.048) in patients with IGT.

CONCLUSIONS

The higher serum galanin levels as well as the negative correlation between galanin levels and 1-hour glucose content in patients with IGT may result from the interaction between insulin and galanin in differing conditions, suggesting that the galanin level may be used as a potential biomarker for the prediction of IGT in clinical settings.

Psychological intervention for auxiliary treatment of non-erosive reflux disease

Non-erosive reflux disease (NERD) is an independent subtype of gastroesophageal reflux disease, and it is often concomitant with anxiety and/or depression, which seriously influence the patient's quality of life. This article summarizes the research progress of NERD with regard to the pathogenesis of NERD and NERD with anxiety and/or depression, the effect of common treatments on NERD, and psychological intervention for auxiliary treatment of NERD (including establishing a good relationship between doctors and patients, psychological hints, health education, social support and so on). Some deficiencies in the understanding and treatment of NERD are pointed out. In addition, the following suggestions are put forward: more attention should be paid to the psychological factors of patients and psychological intervention should be adopted in the clinical practice and study of NERD; further research should be made on the mechanism of psychological intervention so as to form a unified understanding; epidemiological research and evidence-based medicine research should be carried out to explore the psychological intervention norms on NERD with anxiety and/or depression, in order to improve the curative effect of NERD and the quality of life of patients.

Serum Galanin Levels in Young Healthy Lean and Obese Non-Diabetic Men during an Oral Glucose Tolerance Test

Galanin (GAL) is a neuropeptide involved in the homeostasis of energy metabolism. The objective of this study was to investigate the serum levels of GAL during an oral glucose tolerance test (OGTT) in lean and obese young men. This cross-sectional study included 30 obese non-diabetic young men (median 22 years; mean BMI 37 kg/m²) and 30 healthy lean men (median 23 years; mean BMI 22 kg/m²). Serum GAL was determined during OGTT. The results of this study include that serum GAL levels showed a reduction during OGTT compared with basal levels in the lean subjects group. Conversely, serum GAL levels increased significantly during OGTT in obese subjects. Serum GAL levels were also higher in obese non-diabetic men compared with lean subjects during fasting and in every period of the OGTT (p < 0.001). Serum GAL levels were positively correlated with BMI, total fat, visceral fat, HOMA–IR, total cholesterol, triglycerides and Leptin. A multiple regression analysis revealed that serum insulin levels at 30, 60 and 120 minutes during the OGTT is the most predictive variable for serum GAL levels (p < 0.001). In conclusion, serum GAL levels are significantly higher in the obese group compared with lean subjects during an OGTT.

Correlation between plasma galanin and 5-hydroxytryptamine and psychological status in patients with gastroesophageal reflux disease

AIM: To investigate the difference in plasma galanin (GAL) and 5-hydroxytryptamine (5-HT) in patients with different subtypes of gastroesophageal reflux disease (GERD) and their relationship with patients' anxiety and depression.

METHODS: The Self-rating Anxiety Scale (SAS) and Self-rating Depression Scale (SDS) were used to assess anxiety and depression in GERD patients and healthy controls. Enzyme linked immunosorbent assay (ELISA) was used to analyze the contents of 5-HT and GAL in plasma of GERD patients and healthy controls.

RESULTS: Compared with the healthy control group, GERD patients without anxiety or depression had increased 5-HT and decreased GAL (t = 1.97, P < 0.05). Compared with reflux esophagitis (RE) patients, non-erosive reflux disease (NERD) patients had more serious anxiety and depression (F = 55.92, 36.51, P < 0.05). Compared with the control group, 5-HT decreased and GAL increased in NERD patients (F = 54.53, 8.00, P < 0.05). 5-HT had a negative correlation with SAS and SDS scores (r = -0.789, -0.787, P < 0.05), but GAL had a positive correlation with SAS and SDS scores (r = 0.688, 0.705, P< 0.05). 5-HT was negatively correlated with GAL (r = -0.744, P < 0.05).

CONCLUSION: In GERD patients without anxiety or depression, 5-HT increases and GAL decreases. NERD patients have more serious anxiety and depression problems than RE patients, and 5-HT decreases and GAL increases. The more serious anxiety and depression problems, the lower 5-HT and the higher GAL.

Galanin and its receptor system promote the repair of injured sciatic nerves in diabetic rats

Various studies have reported that galanin can promote axonal regeneration of dorsal root ganglion neurons in vitro and inhibit neuropathic pain. However, little is known about its effects on diabetic peripheral neuropathy, and in vivo experimental data are lacking. We hypothesized that repeated applications of exogenous galanin over an extended time frame may also repair nerve damage in diabetic peripheral neuropathy, and relieve pain in vivo. We found that neuropathic pain occurred in streptozotocin-induced diabetic rats and was more severe after sciatic nerve pinch injury at 14 and 28 days than in diabetic sham-operated rats. Treatment with exogenous galanin alleviated the neuropathic pain and promoted sciatic nerve regeneration more effectively in diabetic rats than in non-diabetic rats after sciatic nerve pinch injury. This was accompanied by changes in the levels of endogenous galanin, and its receptors galanin receptor 1 and galanin receptor 2 in the dorsal root ganglia and the spinal dorsal horn when compared with nerve pinch normal rats. Our results show that application of exogenous galanin daily for 28 days can promote the regeneration of injured sciatic nerves, and alleviate neuropathic pain in diabetic rats.

Central Administration of Galanin Receptor 1 Agonist Boosted Insulin Sensitivity in Adipose Cells of Diabetic Rats

Our previous studies testified the beneficial effect of central galanin on insulin sensitivity of type 2 diabetic rats. The aim of the study was further to investigate whether central M617, a galanin receptor 1 agonist, can benefit insulin sensitivity. The effects of intracerebroventricular administration of M617 on insulin sensitivity and insulin signaling were evaluated in adipose tissues of type 2 diabetic rats. The results showed that central injection of M617 significantly increased plasma adiponectin contents, glucose infusion rates in hyperinsulinemic-euglycemic clamp tests, GLUT4 mRNA expression levels, GLUT4 contents in plasma membranes, and total cell membranes of the adipose cells but reduced the plasma C-reactive protein concentration in nondiabetic and diabetic rats. The ratios of GLUT4 contents were higher in plasma membranes to total cell membranes in both nondiabetic and diabetic M617 groups than each control. In addition, the central administration of M617 enhanced the ratios of pAkt/Akt and pAS160/AS160, but not phosphorylative cAMP response element-binding protein (pCREB)/CREB in the adipose cells of nondiabetic and diabetic rats. These results suggest that excitation of central galanin receptor 1 facilitates insulin sensitivity via activation of the Akt/AS160 signaling pathway in the fat cells of type 2 diabetic rats.

Association between circulating levels of galanin and pre-pregnancy body mass index in patients with gestational diabetes mellitus

Galanin is an important neuropeptide which induces an increase in obesity and appetite, improving insulin sensitivity and glucose tolerance in experimental animals. Although significantly higher levels of plasma galanin are found in pregnant women with gestational diabetes mellitus (GDM), there is a limited understanding of its precise mechanism underlying this variation. In the present study, concentrations of circulating galanin were determined at baseline in pregnant women with GDM and pregnant women with normal glucose tolerance (NGT). Correlation analyses were performed between galanin and pre-gestational body weight, pre-gestational BMI, and hormone involved in various homeostatic processes. Results showed that plasma galanin level was significantly higher in the patients with GDM than in the NGT subjects (p<0.001). Plasma galanin was positively correlated with pre-gestational body weight (r=0.42, p=0.037), pre-gestational BMI (r=0.643, p=0.001), and fasting blood glucose (r=0.840, p<0.001) in the GDM group. Moreover, a significant negative correlation was shown between galanin and sex hormone binding globulin (SHBG) (r=-0.901, p<0.001) in the GDM group. These data indicate that serum galanin concentration increases markedly in pregnant women with GDM, and this increase seems to be related to the increase of pre-gestational BMI and significantly lower SHBG in patients with GDM. Thus, circulating galanin is affected under conditions of altered pre-gestational BMI with highest levels in GDM patients. The increase of galanin under conditions of GDM may indicate a physiological function to improve glucose tolerance which is often impaired in GDM subjects.

Type 2 diabetes mellitus as a disorder of galanin resistance

The increasing prevalence of type 2 diabetes mellitus with its high morbidity and mortality becomes an important health problem. The multifactorial etiology of type 2 diabetes mellitus is relative to many gene and molecule alterations, and increased insulin resistance. Besides these, however, there are still other predisposing and risk factors accounting for type 2 diabetes mellitus not to be identified and recognized. Emerging evidence indicated that defects in galanin function played a crucial role in development of type 2 diabetes mellitus. Galanin homeostasis is tightly relative to insulin resistance and is regulated by blood glucose. Hyperglycemia, hyperinsulinism, enhanced plasma galanin levels and decreased galanin receptor activities are some of the characters of type 2 diabetes mellitus. The discrepancy between high insulin level and low glucose handling is named as insulin resistance. Similarly, the discrepancy between high galanin level and low glucose handling may be denominated as galanin resistance too. In this review, the characteristic milestones of type 2 diabetes mellitus were condensed as two analogical conceptual models, obesity-hyper-insulin-insulin resistance-type 2 diabetes mellitus and obesity-hyper-galanin-galanin resistance-type 2 diabetes mellitus. Both galanin resistance and insulin resistance are correlative with each other. Conceptualizing the etiology of type 2 diabetes mellitus as a disorder of galanin resistance may inspire a new concept to deepen our knowledge about pathogenesis of type 2 diabetes mellitus, eventually leading to novel preventive and therapeutic interventions for type 2 diabetes mellitus.

Crosstalk between exercise and galanin system alleviates insulin resistance

Studies have demonstrated that aerobic exercise can enhance insulin sensitivity, however, the precise mechanism for this outcome is not entirely identified. Emerging evidences point out that exercise can upregulate galanin protein and mRNA expression, resulting in improvement of insulin sensitivity via an increase in translocation of glucose transporter 4 and subsequent glucose uptake in myocytes and adipocytes of healthy and type 2 diabetic rats, which may be blocked by galanin antagonist. In return, galanin can exert the exercise-protective roles to prevent excessive movement of skeletal muscle and to accelerate exercise trauma repair in exercise-relative tissues. Studies also implicated that combination of aerobic exercise and activation of galanin system may make more significant improvement in insulin sensitivity than that of either one did. These suggest that galanin system is essential for physical activity to alleviate insulin resistance, namely, the beneficial effect of physical activity on glucose uptake is at least partly mediated by galanin system. Besides, co-treatment with galanin and exercise is an effective therapeutic strategy for reducing insulin resistance.

Intracerebroventricular Injection of Alarin Increased Glucose Uptake in Skeletal Muscle of Diabetic Rats

In order to investigate the central effect of alarin on glucose uptake, we administered alarin and/ or its inhibitor, ala6-25Cys into the cerebral ventricles of the type 2 diabetic rats. Then the relative parameters about glucose uptake in skeletal muscles were measured. We found that central treatment with alarin significantly increased the food intake, body weight and glucose infusion rates in hyperinsulinemic euglycemic clamp tests of the animals. Besides, the treatment also enhanced 2-deoxy-[³H]-D-glucose uptake, vesicle-associated membrane protein 2 contents, glucose transporter 4 protein and mRNA expression, as well as pAkt^Thr308, pAkt^Ser473 and total Akt levels in muscle cells, but reduced plasma glucose and insulin levels of the rats. All of the alarin-inducing events may be antagonised by central injection of ala6-25Cys. These results suggest that central administration of alarin stimulates glucose uptake mediated by activation of Akt signal pathway in type 2 diabetic animals.

The regulative effect of galanin family members on link of energy metabolism and reproduction

It is essential for the species survival that an efficient coordination between energy storage and reproduction through endocrine regulation. The neuropeptide galanin, one of the endocrine hormones, can potently coordinate energy metabolism and the activities of hypothalamic-pituitary-gonadal reproductive axis to adjust synthesis and release of metabolic and reproductive hormones in animals and humans. However, few papers have summarized the regulative effect of the galanin family members on the link of energy storage and reproduction as yet. To address this issue, this review attempts to summarize the current information available about the regulative effect of galanin, galanin-like peptide and alarin on the metabolic and reproductive events, with special emphasis on the interactions between galanin and hypothalamic gonadotropin-releasing hormone, pituitary luteinizing hormone and ovarian hormones. This research line will further deepen our understanding of the physiological roles of the galanin family in regulating the link of energy metabolism and reproduction.

Elevated galanin may predict the risk of type 2 diabetes mellitus for development of Alzheimer's disease

Alzheimer's disease is the most common form of dementia among the elderly and is characterized by progressive loss of memory and cognition. Epidemiological and clinical studies demonstrated that type 2 diabetes mellitus is an important risk factor for the development of Alzheimer's disease, i.e., the patients with type 2 diabetes mellitus are frequently companied with Alzheimer's disease symptoms. Despite many studies recently probed into the comorbid state of both diseases, so far the precise mechanism for this association is poorly understood. Emerging evidences suggest that defects in galanin play a central role on type 2 diabetes mellitus and is considered to be a risk factor for Alzheimer's disease development. This review provides a new insight into the multivariate relationship among galanin, type 2 diabetes mellitus and Alzheimer's disease, highlighting the effect of galanin system on the cross-talk between both diseases in human and rodent models. The current data support that activating central GalR2 attenuates insulin resistance and Alzheimer's disease feature in animal models. These may help us better understanding the pathogenesis of both diseases and provide useful hints for the development of novel therapeutic approaches to treat type 2 diabetes mellitus and Alzheimer's disease.

Central alarin ameliorated insulin resistance of adipocytes in type 2 diabetic rats

Alarin, a regulatory peptide, belongs to the galanin family and plays the same regulatory roles as galanin in orexigenic activity and energy metabolism. Our previous studies had found that galanin might facilitate insulin sensitivity via activation of its central receptors. To date, little is known about whether central alarin may exert similar effects on insulin sensitivity. In order to investigate this, alarin and its specific antagonist, alarin 6-25Cys, were administered into the cerebral ventricles of type 2 diabetic rats (T2DR) to evaluate the changes in insulin resistance. The results indicated that central treatment with alarin significantly increased the body weight of animals, the 2-(N-(7-nitrobenz-2-oxa-1,3-diazol-4-yl)amino)-2-deoxyglucose uptake, the plasma adiponectin levels, the glucose infusion rates in hyperinsulinemic-euglycemic clamp tests, the vesicle-associated membrane protein 2 as well as glucose transporter 4 (GLUT4 (SLC2A4)) protein and mRNA levels, and the ratios of GLUT4 contents in plasma membranes to total cell membranes in adipocytes, but reduced blood glucose and plasma retinol-binding protein 4 levels. These effects of alarin may be inhibited by pretreatment with alarin 6-25Cys. The above-mentioned results suggest that the central alarin projective system may facilitate insulin sensitivity and glucose uptake via the increase in GLUT4 content and GLUT4 translocation from intracellular pools to plasma membranes in T2DR.

Effect of endogenous galanin on glucose transporter 4 expression in cardiac muscle of type 2 diabetic rats

Although galanin has been shown to increase glucose transporter 4 (GLUT4) expression in skeletal muscle and adipocytes of rats, there is no literature available about the effect of galanin on GLUT4 expression in cardiac muscle of type 2 diabetic rats. In this study, we investigated the relationship between intracerebroventricular administration of M35, a galanin receptor antagonist, and GLUT4 expression in cardiac muscle of type 2 diabetic rats. The rats tested were divided into four groups: rats from healthy and type 2 diabetic drug groups were injected with 2 μM M35 for three weeks, while both control groups with 2 μl vehicle control. The euglycemic-hyperinsulinemic clamp test was conducted for an index of glucose infusion rates. The cardiac muscle was processed for determination of GLUT4 expression levels. The present study showed that the plasma insulin and retinol binding protein 4 (RBP4) levels were higher in both drug groups than controls respectively. Moreover, the results showed the inhibitive effect of central M35 treatment on glucose infusion rates in the euglycemic-hyperinsulinemic clamp test and GLUT4 expression levels in the cardiac muscle. These results demonstrate that endogenous galanin, acting through its central receptor, has an important attribute to increase GLUT4 expression, leading to enhance insulin sensitivity and glucose uptake in cardiac muscle of type 2 diabetic rats. Galanin and its fragment can play a significant role in regulation of glucose metabolic homeostasis in cardiac muscle and galanin is an important hormone relative to diabetic heart.

Combined galanin with insulin improves insulin sensitivity of diabetic rat muscles

Although administration of galanin or insulin alone may enhance insulin sensitivity and glucose transporter 4 (GLUT4) trafficking, their cooperative effect on insulin sensitivity is still unclear. In the present study, we evaluated the cooperative effect of both reagents compared with solitary treatment with galanin or insulin in type 2 diabetic rats. Galanin and/or insulin were injected singly or together into type 2 diabetic rats once a day for 15 days. The results indicated that coadministration of both reagents compared with treatment with galanin or insulin alone significantly increased glucose infusion rates in euglycemic-hyperinsulinemic clamp tests, 2-deoxy-[(3)H]d-glucose contents, GLUT4 densities, and pAS160 and protein kinase C activity levels, but reduced blood glucose and insulin levels, as well as retinol-binding protein 4 contents, and did not affect Glut4 (Slc2a4) mRNA expression levels in myocytes. The changes in the ratios of GLUT4 immunoreaction in plasma membranes to total cell membranes of myocytes were higher in the coadministrative group compared with either the insulin or the galanin group. These results indicate that cooperation of the two hormones plays a synergic role to improve GLUT4 translocation and insulin sensitivity. This finding indicates the possibility of combining galanin with insulin with the aim of obtaining better antidiabetic efficacy than that of the canonical treatment with insulin alone.

Endogenous galanin as a novel biomarker to predict gestational diabetes mellitus

Although a significantly higher level of plasma galanin was found in patients with gestational diabetes mellitus (GDM) in our previous study, it is unknown whether plasma galanin is biomarker for the prediction of GDM. The present study aims to further evaluate the relationship between endogenous galanin and GDM in pregnant women and to find out the precise mechanism by which galanin plays role in the pathogenesis of GDM. The study registered thirty pregnant women with GDM and thirty pregnant women with normal glucose tolerance (NGT). Demographic and biochemical parameters and fasting venous blood samples of two groups were collected from all cases. Galanin was analyzed by an enzyme-linked immunosorbent assay. Gamma-glutamyl transferase (GGT) was measured by enzymatic methods. The plasma galanin and GGT levels were found higher in GDM compared with NGT (P<0.001). In addition, a significant positive correlation was shown between galanin and fasting glucose (P=0.049), 1-h glucose (P=0.033), body mass index (BMI) (P<0.001) and GGT (P=0.048) in pregnant women with GDM, whereas there was significant positive correlation between galanin and BMI (P=0.030) in NGT group. The plasma galanin and GGT levels are higher in patients with GDM. The plasma galanin levels appear to be related to the changes of blood glucose, BMI and GTT in GDM. The higher level of galanin observed in GDM may represent a adaptation to the rise of glucose, weight, GGT associated with GDM. The higher level of plasma galanin is a novel biomarker for the prediction of GDM.

Silymarin induces insulin resistance through an increase of phosphatase and tensin homolog in Wistar rats

BACKGROUND AND AIMS

Phosphatase and tensin homolog (PTEN) is a phosphoinositide phosphatase that regulates crucial cellular functions, including insulin signaling, lipid and glucose metabolism, as well as survival and apoptosis. Silymarin is the active ingredient in milk thistle and exerts numerous effects through the activation of PTEN. However, the effect of silymarin on the development of insulin resistance remains unknown.

METHODS

Wistar rats fed fructose-rich chow or normal chow were administered oral silymarin to identify the development of insulin resistance using the homeostasis model assessment of insulin resistance and hyperinsulinemic- euglycemic clamping. Changes in PTEN expression in skeletal muscle and liver were compared using western blotting analysis. Further investigation was performed in L6 cells to check the expression of PTEN and insulin-related signals. PTEN deletion in L6 cells was achieved by small interfering ribonucleic acid transfection.

RESULTS

Oral administration of silymarin at a dose of 200 mg/kg once daily induced insulin resistance in normal rats and enhanced insulin resistance in fructose-rich chow-fed rats. An increase of PTEN expression was observed in the skeletal muscle and liver of rats with insulin resistance. A decrease in the phosphorylation of Akt in L6 myotube cells, which was maintained in a high-glucose condition, was also observed. Treatment with silymarin aggravated high-glucose-induced insulin resistance. Deletion of PTEN in L6 cells reversed silymarin-induced impaired insulin signaling and glucose uptake.

CONCLUSIONS

Silymarin has the ability to disrupt insulin signaling through increased PTEN expression. Therefore, silymarin should be used carefully in type-2 diabetic patients.

Endogenous peptides as risk markers to assess the development of insulin resistance

Insulin resistance, the reciprocal of insulin sensitivity, is known to be a characteristic of type 2 diabetes mellitus, and is regarded as an important mechanism in the pathogenesis. The hallmark of insulin resistance is a gradual break-down of insulin-regulative glucose uptake by muscle and adipose tissues in subjects. Insulin resistance is increasingly estimated in various disease conditions to examine and assess their etiology, pathogenesis and consequences. Although our understanding of insulin resistance has tremendously been improved in recent years, certain aspects of its estimation and etiology still remain elusive to clinicians and researchers. There are numerous factors involved in pathogenesis and mechanisms of insulin resistance. Recent studies have provided compelling clues about some peptides and proteins, including galanin, galanin-like peptide, ghrelin, adiponectin, retinol binding protein 4 (RBP4) and CRP, which may be used to simplify and to improve the determination of insulin resistance. And alterations of these peptide levels may be recognized as risk markers of developing insulin resistance and type 2 diabetes mellitus. This review examines the updated information for these peptides, highlighting the relations between these peptide levels and insulin resistance. The plasma high ghrelin, RBP4 and CRP as well as low galanin, GALP and adiponectin levels may be taken as the markers of deteriorating insulin resistance. An increase in the knowledge of these marker proteins and peptides will help us correctly diagnose and alleviate insulin resistance in clinic and study.

Galanin peptide family as a modulating target for contribution to metabolic syndrome

Metabolic syndrome (MetS) is defined as abdominal central obesity, atherogenic dyslipidemia, insulin resistance, glucose intolerance and hypertension. The rapid increasing prevalence of MetS and the consequent diseases, such as type 2 diabetes mellitus and cardiovascular disorder, are becoming a global epidemic health problem. Despite considerable research into the etiology of this complex disease, the precise mechanism underlying MetS and the association of this complex disease with the development of type 2 diabetes mellitus and increased cardiovascular disease remains elusive. Therefore, researchers continue to actively search for new MetS treatments. Recent animal studies have indicated that the galanin peptide family of peptides may increase food intake, glucose intolerance, fat preference and the risk for obesity and dyslipidemia while decreasing insulin resistance and blood pressure, which diminishes the probability of type 2 diabetes mellitus and hypertension. To date, however, few papers have summarized the role of the galanin peptide family in modulating MetS. Through a summary of available papers and our recent studies, this study reviews the updated evidences of the effect that the galanin peptide family has on the clustering of MetS components, including obesity, dyslipidemia, insulin resistance and hypertension. This line of research will further deepen our understanding of the relationship between the galanin peptide family and the mechanisms underlying MetS, which will help develop new therapeutic strategies for this complex disease.

Galanin and its receptors: a novel strategy for appetite control and obesity therapy

The rapid increase in the prevalence of overweight and obesity is becoming an important health problem. Overweight and obesity may cause several metabolic complications, including type 2 diabetes mellitus, hyperlipidemia, high cholesterol, coronary artery disease as well as hypertension. Prevention and treatment of obesity will benefit the treatment of these related diseases. Current strategies for treatment of obesity are not adequately effective and are frequently companied with many side effects. Thus, new ways to treat obesity are urgently needed. Galanin is undoubtedly involved in the regulation of food intake and body weight. The aim of this review is to provide up-to-date knowledge concerning the roles of central and peripheral galanin as well as its receptors in the regulation of metabolism, obesity and appetite. We also highlight the mechanisms of galanin and its receptors in experimental obesity, trying to establish a novel anti-obesity strategy.