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Accili D, Talchai SC, Bouchi R, Lee AY, Du W, Kitamoto T, McKimpson WM, Belvedere S, Lin HV. Diabetes treatment by conversion of gut epithelial cells to insulin-producing cells. J Diabetes Investig 2024; 15:797-804. [PMID: 38426644 PMCID: PMC11215681 DOI: 10.1111/jdi.14175] [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] [Received: 02/01/2024] [Accepted: 02/15/2024] [Indexed: 03/02/2024] Open
Abstract
Insulin-deficient (type 1) diabetes is treated by providing insulin to maintain euglycemia. The current standard of care is a quasi-closed loop integrating automated insulin delivery with a continuous glucose monitoring sensor. Cell replacement technologies are advancing as an alternative treatment and have been tested as surrogates to cadaveric islets in transplants. In addition, immunomodulatory treatments to delay the onset of type 1 diabetes in high-risk (stage 2) individuals have gained regulatory approval. We have pioneered a cell conversion approach to restore insulin production through pharmacological conversion of intestinal epithelial cells into insulin-producing cells. We have advanced this approach along a translational trajectory through the discovery of small molecule forkhead box protein O1 inhibitors. When administered to different rodent models of insulin-deficient diabetes, these inhibitors have resulted in robust glucose-lowering responses and generation of insulin-producing cells in the gut epithelium. We review past work and delineate a path to human clinical trials.
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Affiliation(s)
- Domenico Accili
- Department of Medicine and Naomi Berrie Diabetes CenterVagelos College of Physicians and Surgeons of Columbia UniversityNew York CityNew YorkUSA
| | | | - Ryotaro Bouchi
- Diabetes and Metabolism Information Center, Diabetes Research CenterResearch Institute, National Center for Global Health and MedicineTokyoJapan
| | | | - Wen Du
- School of Biomedical EngineeringGuangzhou Medical UniversityGuangzhouChina
| | - Takumi Kitamoto
- Department of Diabetes, Metabolism and EndocrinologyChiba University HospitalChibaJapan
| | - Wendy M McKimpson
- Department of Medicine and Naomi Berrie Diabetes CenterVagelos College of Physicians and Surgeons of Columbia UniversityNew York CityNew YorkUSA
| | - Sandro Belvedere
- ARMGO Pharma, Inc.ArdsleyNew YorkUSA
- Avicenna Biosciences, Inc.DurhamNorth CarolinaUSA
| | - Hua V Lin
- Render TherapeuticsLincolnMassachusettsUSA
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Liang M, Wang L, Wang W. The 15-hydroxyprostaglandin dehydrogenase inhibitor SW033291 ameliorates abnormal hepatic glucose metabolism through PGE 2-EP4 receptor-AKT signaling in a type 2 diabetes mellitus mouse model. Cell Signal 2023; 108:110707. [PMID: 37164143 DOI: 10.1016/j.cellsig.2023.110707] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/24/2023] [Revised: 04/21/2023] [Accepted: 05/03/2023] [Indexed: 05/12/2023]
Abstract
Type 2 diabetes mellitus (T2DM) is associated with high rates of morbidity and mortality worldwide. Prostaglandin E2 (PGE2) is a lipid signaling molecule that can ameliorate the symptoms of some metabolic diseases, including T2DM, and improve tissue repair and regeneration. Although SW033291 can increase PGE2 levels through its action as a small molecule inhibitor of the PGE2-degrading enzyme 15-hydroxyprostaglandin dehydrogenase, its effects on T2DM remain unclear. In the present study, we evaluated whether SW033291 treatment exerts a protective effect against T2DM and explored the underlying mechanisms. A T2DM mouse model was established using a high-fat diet combined with streptozotocin treatment. Palmitic acid-treated LO2 cells were used as an insulin-resistant cell model. SW033291 treatment reduced body weight and fasting blood glucose levels as well as serum triglyceride, total cholesterol, and low-density lipoprotein cholesterol levels in vivo. In addition to ameliorating glucose and insulin tolerance, SW033291 treatment reversed the T2DM-induced decrease in glycogen synthesis and increase in gluconeogenesis in the liver. Furthermore, SW033291 administration increased hepatic glycogen synthase kinase 3 beta (GSK3β) phosphorylation levels to promote glycogen synthesis. SW033291 treatment also inhibited gluconeogenesis by upregulating AKT serine/threonine kinase (AKT) and forkhead box O1 (FOXO1) phosphorylation and reducing glucose-6-phosphatase and phosphoenolpyruvate carboxykinase 1 expression in the livers of T2DM model mice. Additionally, SW033291 treatment improved abnormal hepatic glucose metabolism through the PGE2-EP4 receptor-AKT-GSK3β/FOXO1 signaling pathway in vitro. These results suggest a novel role of SW033291 in improving T2DM and support its potential as a novel therapeutic agent.
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Affiliation(s)
- Mingjie Liang
- Traditional Chinese Medicine Research Institute, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China; Guangdong Provincial Research Center of Integration of Traditional Chinese Medicine and Western Medicine in Metabolic Diseases, Guangzhou, Guangdong Province, China; Key Laboratory of Glucolipid Metabolic Diseases, Ministry of Education, Guangzhou, Guangdong Province, China; Guangdong Provincial TCM Key Laboratory for Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Lexun Wang
- Traditional Chinese Medicine Research Institute, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China; Guangdong Provincial Research Center of Integration of Traditional Chinese Medicine and Western Medicine in Metabolic Diseases, Guangzhou, Guangdong Province, China; Key Laboratory of Glucolipid Metabolic Diseases, Ministry of Education, Guangzhou, Guangdong Province, China; Guangdong Provincial TCM Key Laboratory for Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China
| | - Weixuan Wang
- Traditional Chinese Medicine Research Institute, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China; Guangdong Provincial Research Center of Integration of Traditional Chinese Medicine and Western Medicine in Metabolic Diseases, Guangzhou, Guangdong Province, China; Key Laboratory of Glucolipid Metabolic Diseases, Ministry of Education, Guangzhou, Guangdong Province, China; Guangdong Provincial TCM Key Laboratory for Metabolic Diseases, Guangdong Pharmaceutical University, Guangzhou, Guangdong Province, China.
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3
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Du W, Wang J, Kuo T, Wang L, McKimpson WM, Son J, Watanabe H, Kitamoto T, Lee Y, Creusot RJ, Ratner LE, McCune K, Chen YW, Grubbs BH, Thornton ME, Fan J, Sultana N, Diaz BS, Balasubramanian I, Gao N, Belvedere S, Accili D. Pharmacological conversion of gut epithelial cells into insulin-producing cells lowers glycemia in diabetic animals. J Clin Invest 2022; 132:e162720. [PMID: 36282594 PMCID: PMC9754100 DOI: 10.1172/jci162720] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/16/2022] [Accepted: 10/18/2022] [Indexed: 01/05/2023] Open
Abstract
As a highly regenerative organ, the intestine is a promising source for cellular reprogramming for replacing lost pancreatic β cells in diabetes. Gut enterochromaffin cells can be converted to insulin-producing cells by forkhead box O1 (FoxO1) ablation, but their numbers are limited. In this study, we report that insulin-immunoreactive cells with Paneth/goblet cell features are present in human fetal intestine. Accordingly, lineage-tracing experiments show that, upon genetic or pharmacologic FoxO1 ablation, the Paneth/goblet lineage can also undergo conversion to the insulin lineage. We designed a screening platform in gut organoids to accurately quantitate β-like cell reprogramming and fine-tune a combination treatment to increase the efficiency of the conversion process in mice and human adult intestinal organoids. We identified a triple blockade of FOXO1, Notch, and TGF-β that, when tested in insulin-deficient streptozotocin (STZ) or NOD diabetic animals, resulted in near normalization of glucose levels, associated with the generation of intestinal insulin-producing cells. The findings illustrate a therapeutic approach for replacing insulin treatment in diabetes.
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Affiliation(s)
- Wen Du
- Department of Medicine and Naomi Berrie Diabetes Center and
| | - Junqiang Wang
- Systems Biology Institute, Vagelos College of Physicians and Surgeons, Columbia University, New York, New York, USA
| | - Taiyi Kuo
- Department of Medicine and Naomi Berrie Diabetes Center and
- Department of Neurobiology, Physiology, & Behavior, College of Biological Sciences, University of California, Davis, California, USA
| | - Liheng Wang
- Department of Medicine and Naomi Berrie Diabetes Center and
| | | | - Jinsook Son
- Department of Medicine and Naomi Berrie Diabetes Center and
| | | | | | - Yunkyoung Lee
- Forkhead BioTherapeutics Corp., New York, New York, USA
| | - Remi J. Creusot
- Columbia Center for Translational Immunology, Department of Medicine, Columbia University Irving Medical Center, New York, New York, USA
| | - Lloyd E. Ratner
- Department of Surgery, Columbia University Medical Center, New York, New York, USA
| | - Kasi McCune
- Department of Surgery, Columbia University Medical Center, New York, New York, USA
| | - Ya-Wen Chen
- Department of Otolaryngology
- Department of Cell, Developmental, and Regenerative Biology, and
- Black Family Stem Cell Institute, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Brendan H. Grubbs
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Matthew E. Thornton
- Department of Obstetrics and Gynecology, Keck School of Medicine, University of Southern California, Los Angeles, California, USA
| | - Jason Fan
- Bascom Palmer Eye Institute, Department of Ophthalmology, Miami, Florida, USA
| | - Nishat Sultana
- Department of Medicine and Naomi Berrie Diabetes Center and
| | - Bryan S. Diaz
- Department of Medicine and Naomi Berrie Diabetes Center and
| | | | - Nan Gao
- Department of Biological Sciences, Rutgers University, Newark, New Jersey, USA
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