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Yang Y, Lin C, Zheng Q, Zhang L, Li Y, Huang Q, Wu T, Zhao Z, Li L, Luo J, Jiang Y, Zhang Q, Wang X, Xia C, Pang J. L-carnitine attenuated hyperuricemia-associated left ventricular remodeling through ameliorating cardiomyocytic lipid deposition. Front Pharmacol 2023; 14:1016633. [PMID: 36817129 PMCID: PMC9929955 DOI: 10.3389/fphar.2023.1016633] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2022] [Accepted: 01/06/2023] [Indexed: 02/04/2023] Open
Abstract
Hyperuricemia (HUA) is associated with left ventricular remodeling (LVR) and thereby causes the initiation and development of a large number of cardiovascular diseases. LVR is typically accompanied by cardiomyocyte energy metabolic disorder. The energy supply of cardiomyocytes is provided by glucose and fatty acid (FA) metabolism. Currently, the effect of HUA on cardiomyocytic FA metabolism is unclear. In this study, we demonstrate that UA-induced cardiomyocyte injury is associated with cytoplasmic lipid deposition, which can be ameliorated by the FA metabolism-promoting drug L-carnitine (LC). UA suppresses carnitine palmitoyl transferase 1B (CPT1B), thereby inhibiting FA transport into the mitochondrial inner matrix for elimination. LC intervention can ameliorate HUA-associated left ventricular anterior wall thickening in mice. This study showed that FA transport dysfunction plays is a critical mechanism in both cardiomyocytic injury and HUA-associated LVR and promoting cytoplasmic FA transportation through pharmacological treatment by LC is a valid strategy to attenuate HUA-associated LVR.
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Affiliation(s)
- Yang Yang
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, Guangdong, China,School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China,NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Cuiting Lin
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Qiang Zheng
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Leqi Zhang
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Yongmei Li
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Qinghua Huang
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Ting Wu
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Zean Zhao
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Lu Li
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Jian Luo
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Yanqing Jiang
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Qun Zhang
- Good Clinical Practice Development, Guangdong Provincial Key Laboratory of Bone and Joint Degeneration Diseases, The Third Affiliated Hospital of Southern Medical University, Guangzhou, Guangdong, China
| | - Xing Wang
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, Guangdong, China,School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China
| | - Chenglai Xia
- Affiliated Foshan Maternity & Child Healthcare Hospital, Southern Medical University, Foshan, Guangdong, China,School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China,*Correspondence: Jianxin Pang, ; Chenglai Xia,
| | - Jianxin Pang
- NMPA Key Laboratory for Research and Evaluation of Drug Metabolism & Guangdong Provincial Key Laboratory of New Drug Screening, School of Pharmaceutical Sciences, Southern Medical University, Guangzhou, Guangdong, China,*Correspondence: Jianxin Pang, ; Chenglai Xia,
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Cao Y, Dong Z, Yang D, Ma X, Wang X. Alleviation of glucolipotoxicity-incurred cardiomyocyte dysfunction by Z-ligustilide involves in the suppression of oxidative insult, inflammation and fibrosis. Chem Phys Lipids 2021; 241:105138. [PMID: 34547276 DOI: 10.1016/j.chemphyslip.2021.105138] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 09/14/2021] [Accepted: 09/15/2021] [Indexed: 12/24/2022]
Abstract
Diabetes mellitus ranks as a major risk cause for disability and death around the world due to its complications, especially diabetic cardiomyopathy (DCM). Glucolipotoxicity is one of the critical causal factors of DCM. Recent finding confirms the beneficial roles of Z-ligustilide in diabetes mellitus. Nevertheless, its efficacy in DCM remains elusive. Here, Z-ligustilide elevated high glucose/high palmitic acid (HG/P)-inhibited cell viability and attenuated HG/P-induced cell apoptosis, caspase-3 activity, pro-apoptotic Bax and anti-apoptotic Bcl-2 protein expression. Furthermore, Z-ligustilide alleviated HG/P-evoked oxidative damage by decreasing HG/P-induced elevation in ROS, lactate dehydrogenase (LDH) and malondialdehyde (MDA) leakage, but increasing antioxidant enzyme-superoxide dismutase (SOD) and glutathione (GSH) levels suppressed by HG/P. Concomitantly, Z-ligustilide attenuated HG/P-induced cardiomyocyte fibrosis by increasing MMP-14 expression and diminishing HG/P-enhanced fibrotic protein expression, including collagen I, collagen II and TGF-β. Mechanistically, Z-ligustilide offset the adverse effects of HG/P on the activation of the AMPK/GSK-3β/Nrf2 pathway. Importantly, blocking the AMPK signaling overturned the protective efficacy of Z-ligustilide against HG/P-induced cardiomyocyte oxidative damage, inflammation and fibrosis. Together, these findings highlight that Z-ligustilide may alleviate glucolipotoxicity-induced cardiomyocyte dysfunction by regulating cell oxidative injury, inflammation and fibrosis via the AMPK/GSK-3β/Nrf2 pathway. Consequently, Z-ligustilide may represent a promising therapeutic agent against DCM by restoring cardiomyocyte dysfunction.
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Affiliation(s)
- Yiqiu Cao
- Department of cardiac surgery, Hainan General Hospital, Hainan Affiliated Hospital of Hainan Medical University, Haikou 570311, Hainan, PR China; The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, PR China
| | - Zhu Dong
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, PR China; Department of Cardiovascular surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong, PR China
| | - Dongpeng Yang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, PR China; Department of Cardiovascular surgery, Guangzhou Red Cross Hospital, Jinan University, Guangzhou 510515, Guangdong, PR China
| | - Ximiao Ma
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, PR China; Department of cardiothoracic surgery, Haikou people's hospital, Haikou 570208, Hainan, PR China
| | - Xiaowu Wang
- The First School of Clinical Medicine, Southern Medical University, Guangzhou 510515, Guangdong, PR China; Department of Cardiovascular surgery, Zhujiang Hospital, Southern Medical University, Guangzhou 510280, Guangdong, PR China.
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Scheen M, Giraud R, Bendjelid K. Stress hyperglycemia, cardiac glucotoxicity, and critically ill patient outcomes current clinical and pathophysiological evidence. Physiol Rep 2021; 9:e14713. [PMID: 33463901 PMCID: PMC7814494 DOI: 10.14814/phy2.14713] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/10/2020] [Revised: 12/09/2020] [Accepted: 12/12/2020] [Indexed: 01/07/2023] Open
Abstract
Stress hyperglycemia is a transient increase in blood glucose during acute physiological stress in the absence of glucose homeostasis dysfunction. Its's presence has been described in critically ill patients who are subject to many physiological insults. In this regard, hyperglycemia and impaired glucose tolerance are also frequent in patients who are admitted to the intensive care unit for heart failure and cardiogenic shock. The hyperglycemia observed at the beginning of these cardiac disorders appears to be related to a variety of stress mechanisms. The release of major stress and steroid hormones, catecholamine overload, and glucagon all participate in generating a state of insulin resistance with increased hepatic glucose output and glycogen breakdown. In fact, the observed pathophysiological response, which appears to regulate a stress situation, is harmful because it induces mitochondrial impairment, oxidative stress-related injury to cells, endothelial damage, and dysfunction of several cellular channels. Paradigms are now being challenged by growing evidence of a phenomenon called glucotoxicity, providing an explanation for the benefits of lowering glucose levels with insulin therapy in these patients. In the present review, the authors present the data published on cardiac glucotoxicity and discuss the benefits of lowering plasma glucose to improve heart function and to positively affect the course of critical illness.
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Affiliation(s)
- Marc Scheen
- Intensive Care Division, University Hospitals, Geneva, Switzerland.,Geneva Hemodynamic Research Group, Geneva, Switzerland.,Faculty of Medicine, Geneva, Switzerland
| | - Raphael Giraud
- Intensive Care Division, University Hospitals, Geneva, Switzerland.,Geneva Hemodynamic Research Group, Geneva, Switzerland.,Faculty of Medicine, Geneva, Switzerland
| | - Karim Bendjelid
- Intensive Care Division, University Hospitals, Geneva, Switzerland.,Geneva Hemodynamic Research Group, Geneva, Switzerland.,Faculty of Medicine, Geneva, Switzerland
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Song R, Zhao X, Cao R, Liang Y, Zhang DQ, Wang R. Irisin improves insulin resistance by inhibiting autophagy through the PI3K/Akt pathway in H9c2 cells. Gene 2020; 769:145209. [PMID: 33038421 DOI: 10.1016/j.gene.2020.145209] [Citation(s) in RCA: 17] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/20/2020] [Revised: 09/08/2020] [Accepted: 10/02/2020] [Indexed: 12/14/2022]
Abstract
As an important complication of diabetes mellitus, diabetic cardiomyopathy (DCM) is thought to arise as a result of insulin resistance (IR) in cardiomyocytes. Improving IR in cardiomyocytes may therefore be a way to treat DCM. A recently discovered myokine, irisin, has been shown to be significantly associated with increased insulin sensitivity both in clinical and pre-clinical studies of diabetes mellitus. Based on previously research, we hypothesized that irisin may be a potential candidate for increasing the insulin sensitivity of cardiomyocytes. The aim of the present study was to examine the ability of irisin to affect IR induced by treatment of rat cardiomyocyte H9c2 cells with palmitic acid (PA) and to explore its underlying mechanism. Differentiated H9c2 cells were treated with 500 μM PA, 200 ng/mL irisin, and 500 μM PA + 200 ng/mL irisin with or without 100 nM rapamycin (RAP) for 24 h. We found that coincubation with 200 ng/mL irisin for 24 h significantly increased insulin-stimulated glucose consumption compared to the 500 μM PA group alone. Additionally, coincubation with irisin significantly alleviated the degree of autophagy compared to the 500 μM PA group alone as evidenced by monodansylcadaverine (MDC) fluorescence, the LC3II/LC3I protein levels ratio, and the protein levels of Atg5 and Atg7. Coincubation with irisin increased the levels of PI3Kp110α, pAkt and Akt compared to the 500 μM PA group alone. All these effects of irisin were reversed by RAP. Our results indicate that irisin improves IR in H9c2 cells, possibly in part by inhibiting autophagy through activating the PI3K/Akt pathway.
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Affiliation(s)
- Rongjing Song
- Department of Pharmacy, Peking University People's Hospital, Beijing 100044, China
| | - Xuecheng Zhao
- Department of Emergency Medicine, China-Japan Friendship Hospital, Beijing 100029, China
| | - Rong Cao
- Key Laboratory of Tropical Biological Resources of Ministry of Education, Department of Pharmaceutical Sciences, School of Life and Pharmaceutical Sciences, Hainan University, Renmin Road, Haikou City, Hainan Province 570228, China
| | - Yuerun Liang
- Key Laboratory of Tropical Biological Resources of Ministry of Education, Department of Pharmaceutical Sciences, School of Life and Pharmaceutical Sciences, Hainan University, Renmin Road, Haikou City, Hainan Province 570228, China
| | - Da-Qi Zhang
- Department of Neurology, the First Affiliated Hospital of Hainan Medical University, Longhua Road, Haikou City, Hainan Province 570102, China.
| | - Rong Wang
- Key Laboratory of Tropical Biological Resources of Ministry of Education, Department of Pharmaceutical Sciences, School of Life and Pharmaceutical Sciences, Hainan University, Renmin Road, Haikou City, Hainan Province 570228, China.
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Han N, Fang HY, Jiang JX, Xu Q. Downregulation of microRNA-873 attenuates insulin resistance and myocardial injury in rats with gestational diabetes mellitus by upregulating IGFBP2. Am J Physiol Endocrinol Metab 2020; 318:E723-E735. [PMID: 31910027 DOI: 10.1152/ajpendo.00555.2018] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
Gestational diabetes mellitus (GDM) is a metabolic disorder characterized by insulin resistance, and patients with GDM have a higher risk of cardiovascular disease. Multiple microRNAs (miRNAs) are reported to be involved in the regulation of myocardial injury. Moreover, miR-873 was predicted to target insulin-like growth factor binding protein 2 (IGFBP2) through bioinformatic analysis, which was further confirmed using a luciferase assay. Thus, our objective was to assess whether microRNA-873 (miR-873) affects insulin resistance and myocardial injury in an established GDM rat model. The GDM rats were treated with miR-875 mimic or inhibitor or IGFBP2 siRNA. The effects of miR-875 and IGFBP2 on the cardiac function, insulin resistance, and myocardial injury were evaluated by hemodynamic measurements, determination of biochemical indices of myocardium and serum, and insulin homeostatic model assessment. The results indicated that downregulation of miR-873 upregulated the expression of IGFBP2 and promoted the activation of phosphatidylinositol-3 kinase (PI3K)/protein kinase B (AKT)/mammalian target of rapamycin (mTOR) axis. With downregulation of miR-873 in GDM rats, the cardiac function was improved and the myocardial apoptosis was inhibited, coupled with elevated activity of superoxide dismutase, carbon monoxide synthase, and the nitric oxide content. In addition, the inhibition of miR-873 in GDM rats modulated the insulin resistance and reduced myocardial apoptosis. Overall, the data showed that inhibition of miR-873 by targeting IGFBP2 may regulate the insulin resistance and curtail myocardial injury in GDM rats through activating the PI3K/AKT/mTOR axis, thus providing a potential means of impeding the progression of GDM.
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Affiliation(s)
- Na Han
- Department of Obstetrics, Qingdao Women and Children's Hospital, Qingdao, People's Republic of China
| | - Hai-Yan Fang
- Department of Obstetrics, Qingdao Women and Children's Hospital, Qingdao, People's Republic of China
| | - Jie-Xuan Jiang
- Department of Obstetrics, Qingdao Women and Children's Hospital, Qingdao, People's Republic of China
| | - Qian Xu
- Department of Obstetrics, Qingdao Women and Children's Hospital, Qingdao, People's Republic of China
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Liu Z, Xu L, Xu X, Niu Y, Saadeldeen F, Kang W. Effects and mechanisms of iridoid glycosides from Patrinia scabiosaefolia on improving insulin resistance in 3T3-L1 adipocytes. Food Chem Toxicol 2019; 134:110806. [DOI: 10.1016/j.fct.2019.110806] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/09/2019] [Revised: 08/30/2019] [Accepted: 09/05/2019] [Indexed: 11/25/2022]
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Ghrelin Ameliorates Angiotensin II-Induced Myocardial Fibrosis by Upregulating Peroxisome Proliferator-Activated Receptor Gamma in Young Male Rats. BIOMED RESEARCH INTERNATIONAL 2018; 2018:9897581. [PMID: 30175152 PMCID: PMC6098901 DOI: 10.1155/2018/9897581] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 03/28/2018] [Revised: 07/06/2018] [Accepted: 07/25/2018] [Indexed: 01/07/2023]
Abstract
Angiotensin (Ang) II contributes to the formation and development of myocardial fibrosis. Ghrelin, a gut peptide, has demonstrated beneficial effects against cardiovascular disease. In the present study, we explored the effect and related mechanism of Ghrelin on myocardial fibrosis in Ang II-infused rats. Adult Sprague-Dawley (SD) rats were divided into 6 groups: Control, Ang II (200ng/kg/min, microinfusion), Ang II+Ghrelin (100 μg/kg, subcutaneously twice daily), Ang II+Ghrelin+GW9662 (a specific PPAR-γ inhibitor, 1 mg/kg/d, orally), Ang II+GW9662, and Ghrelin for 4 wks. In vitro, adult rat cardiac fibroblasts (CFs) were pretreated with or without Ghrelin, Ghrelin+GW9662, or anti-Transforming growth factor (TGF)-β1 antibody and then stimulated with or without Ang II (100 nmol/L) for 24 h. Ang II infusion significantly increased myocardial fibrosis, expression of collagen I, collagen III, and TGF-β1, as well as TGF-β1 downstream proteins p-Smad2, p-Smad3, TRAF6, and p-TAK1 (all p<0.05). Ghrelin attenuated these effects. Similar results were seen in Ang II-stimulated rat cardiac fibroblasts in vitro. In addition, Ghrelin upregulated PPAR-γ expression in vivo and in vitro, and treatment with GW9662 counteracted the effects of Ghrelin. In conclusion, Ghrelin ameliorated Ang II-induced myocardial fibrosis by upregulating PPAR-γ and in turn inhibiting TGF-β1signaling.
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Blanco AM, Bertucci JI, Ramesh N, Delgado MJ, Valenciano AI, Unniappan S. Ghrelin Facilitates GLUT2-, SGLT1- and SGLT2-mediated Intestinal Glucose Transport in Goldfish (Carassius auratus). Sci Rep 2017; 7:45024. [PMID: 28338019 PMCID: PMC5364492 DOI: 10.1038/srep45024] [Citation(s) in RCA: 22] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/30/2016] [Accepted: 02/17/2017] [Indexed: 12/13/2022] Open
Abstract
Glucose homeostasis is an important biological process that involves a variety of regulatory mechanisms. This study aimed to determine whether ghrelin, a multifunctional gut-brain hormone, modulates intestinal glucose transport in goldfish (Carassius auratus). Three intestinal glucose transporters, the facilitative glucose transporter 2 (GLUT2), and the sodium/glucose co-transporters 1 (SGLT1) and 2 (SGLT2), were studied. Immunostaining of intestinal sections found colocalization of ghrelin and GLUT2 and SGLT2 in mucosal cells. Some cells containing GLUT2, SGLT1 and SGLT2 coexpressed the ghrelin/growth hormone secretagogue receptor 1a (GHS-R1a). Intraperitoneal glucose administration led to a significant increase in serum ghrelin levels, as well as an upregulation of intestinal preproghrelin, ghrelin O-acyltransferase and ghs-r1 expression. In vivo and in vitro ghrelin treatment caused a concentration- and time-dependent modulation (mainly stimulatory) of GLUT2, SGLT1 and SGLT2. These effects were abolished by the GHS-R1a antagonist [D-Lys3]-GHRP-6 and the phospholipase C inhibitor U73122, suggesting that ghrelin actions on glucose transporters are mediated by GHS-R1a via the PLC/PKC signaling pathway. Finally, ghrelin stimulated the translocation of GLUT2 into the plasma membrane of goldfish primary intestinal cells. Overall, data reported here indicate an important role for ghrelin in the modulation of glucoregulatory machinery and glucose homeostasis in fish.
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Affiliation(s)
- Ayelén Melisa Blanco
- Departamento de Fisiología (Fisiología Animal II), Facultad de Biología, Universidad Complutense de Madrid, Madrid, Spain.,Laboratory of Integrative Neuroendocrinology, Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Juan Ignacio Bertucci
- Laboratory of Integrative Neuroendocrinology, Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.,Instituto de Investigaciones Biotecnológicas-Instituto Tecnológico Chascomús, Buenos Aires, Argentina
| | - Naresh Ramesh
- Laboratory of Integrative Neuroendocrinology, Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - María Jesús Delgado
- Departamento de Fisiología (Fisiología Animal II), Facultad de Biología, Universidad Complutense de Madrid, Madrid, Spain
| | - Ana Isabel Valenciano
- Departamento de Fisiología (Fisiología Animal II), Facultad de Biología, Universidad Complutense de Madrid, Madrid, Spain
| | - Suraj Unniappan
- Laboratory of Integrative Neuroendocrinology, Department of Veterinary Biomedical Sciences, Western College of Veterinary Medicine, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
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Li S, Li H, Yang D, Yu X, Irwin DM, Niu G, Tan H. Excessive Autophagy Activation and Increased Apoptosis Are Associated with Palmitic Acid-Induced Cardiomyocyte Insulin Resistance. J Diabetes Res 2017; 2017:2376893. [PMID: 29318158 PMCID: PMC5727752 DOI: 10.1155/2017/2376893] [Citation(s) in RCA: 33] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/07/2017] [Revised: 08/26/2017] [Accepted: 09/12/2017] [Indexed: 12/13/2022] Open
Abstract
Diabetic cardiomyopathy (DCM) remains the major cause of death associated with diabetes. Researchers have demonstrated the importance of impaired cardiac insulin signaling in this process. Insulin resistance (IR) is an important predictor of DCM. Previous studies examining the dynamic changes in autophagy during IR have yielded inconsistent results. This study aimed to investigate the dynamic changes in autophagy and apoptosis in the rat H9c2 cardiomyocyte IR model. H9c2 cells were treated with 500 μM palmitic acid (PA) for 24 hours, resulting in the induction of IR. To examine autophagy, monodansylcadaverine staining, GFP-LC3 puncta confocal observation, and Western blot analysis of LC3I-to-LC3II conversion were used. Results of these studies showed that autophagic acid vesicles increased in numbers during the first 24 hours and then decreased by 36 hours after PA treatment. Western blot analysis showed that treatment of H9c2 cells with 500 μM PA for 24 hours decreased the expression of Atg12-Atg5, Atg16L1, Atg3, and PI3Kp85. Annexin V/PI flow cytometry revealed that PA exposure for 24 hours increased the rate of apoptosis. Together, this study demonstrates that PA induces IR in H9c2 cells and that this process is accompanied by excessive activation of autophagy and increases in apoptosis.
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Affiliation(s)
- Shanxin Li
- Department of Pharmacology, School of Basic Medical Sciences, Health Science Center, Peking University, Beijing 100191, China
| | - Hui Li
- Department of Pharmacology, School of Basic Medical Sciences, Health Science Center, Peking University, Beijing 100191, China
| | - Di Yang
- Department of Pharmacology, School of Basic Medical Sciences, Health Science Center, Peking University, Beijing 100191, China
| | - Xiuyan Yu
- Department of Pharmacology, School of Basic Medical Sciences, Health Science Center, Peking University, Beijing 100191, China
| | - David M. Irwin
- Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, ON, Canada M5S 1A8
| | - Gang Niu
- Beijing N&N Genetech Company, Beijing 100082, China
| | - Huanran Tan
- Department of Pharmacology, School of Basic Medical Sciences, Health Science Center, Peking University, Beijing 100191, China
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Abstract
CONTEXT Salvianolic acid B (Sal B) is regarded as a potent antidiabetic agent and has been reported to possess cardioprotective effect in vivo. OBJECTIVE This study investigated the cardioprotective effects of Sal B on H9c2 cells injury caused by high glucose in vitro, and clarified the possible mechanisms. MATERIALS AND METHODS Di ferent concentrations of Sal B were incubated with cells for 12 h prior being exposed to high glucose for 24 h. Cardioprotective effects of Sal B were evaluated using CCK-8 assay, ELISA, Hoechst 33258 nucleus staining, and western blot. RESULTS Following a 24 h exposure of H9c2 to high glucose, obvious reduction was found in cell viability (45%), GSH (54.8 ± 9.4 ng/mg protein), catalase (1.22 ± 0.12 U/mg protein), and GPX level (67.9 ± 9.4 U/mg protein), which were associated with the increases of GSSG (1.99 ± 0.28 ng/mg protein) and ROS (2.00 ± 0.19 RFU/mg protein) production. High glucose also elevated IL-6 (1.8-fold), IL-1β (1.9-fold), and TNF-α (1.6-fold) level, as well as induced cell apoptosis and NF-κB (6.1-fold) activation. However, Sal B (25 and 50 μM) elevated cell viability (28% and 44%), ameliorated oxidative stress (GSH, 1.3- and 1.6-fold; catalase, 1.9- and 2.0-fold; GPX, 1.1- and 1.4-fold; GSSG, 0.9- and 0.8-fold; ROS, 0.6- and 0.5-fold), and inflammatory response (IL-6, 0.9- and 0.7-fold; IL-1β, 0.8- and 0.6-fold; TNF-α, 0.9- and 0.8-fold), and inhibited cell apoptosis and NF-κB (0.5- and 0.2-fold) expression. CONCLUSION Sal B attenuated high glucose-induced injury and cytotoxicity through inhibiting inflammatory cytokine production in H9c2 cardiac cells.
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Affiliation(s)
- Bei Sun
- a Department of Vasculocardiology, Yantaishan Hospital , Yantai , Shandong , PR China
| | - Chen Li
- b Department of Endocrinology, Qilu Hospital of Shandong University(Qingdao) , Qingdao , Shandong , PR China
| | - Luning Zuo
- a Department of Vasculocardiology, Yantaishan Hospital , Yantai , Shandong , PR China
| | - Pingping Liu
- c Department of Vasculocardiology, Yantai Affiliated Hospital of Binzhou Medical University , Yantai , Shandong , PR China
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Singh M, Chaudhary M, Vashistha A, Kaur G. Evaluation of effects of a preoperative 2-hour fast with glutamine and carbohydrate rich drink on insulin resistance in maxillofacial surgery. J Oral Biol Craniofac Res 2015; 5:34-9. [PMID: 25853046 PMCID: PMC4382506 DOI: 10.1016/j.jobcr.2015.02.006] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/16/2015] [Accepted: 02/14/2015] [Indexed: 02/07/2023] Open
Abstract
INTRODUCTION The aim of this prospective, randomized, single-blinded study was to compare the effects of preoperative fast for clear fluids on insulin resistance and hemodynamic stability on patient undergoing maxillofacial surgery. METHOD In this study 20 patients undergoing maxillofacial surgery were randomized into four groups i.e. - group I patients with standard 08 h fasting before anesthesia, group-II patients were given 400 ml and 200 ml of water 08 h and 2 h respectively before anesthesia, group III patients were given 400 ml water with 50 gms of glucose and 40 gm of glutamine 08 h before anesthesia and 200 ml water with 25 gms of glucose and 10 gm of glutamine 2 h before anesthesia, group IV patients were given 400 ml water with 50 gms of glucose 08 h before anesthesia and 200 ml water with 25 gms of glucose 2 h before anesthesia. Blood samples were collected pre-operatively and post-operatively. RESULTS Overall results suggest that Post-operative insulin resistance was greater in control patients (2.0 [0.3]) compared with the other 3 groups (placebo = 1.8 [0.9]); glutamine = (1.8 [0.6]); carbohydrate = (1.9 [0.6]). DISCUSSION This study shows that shortening of pre-operative fasting time for clear fluids until 2- h prior to anesthesia may induce a favorable environment for the post-operative course. In conclusion, Glutamine with carbohydrate drink can be used safely in surgical patients.
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Affiliation(s)
- Manpreet Singh
- Reader, Department of Oral & Maxillofacial Surgery, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh, 244001, India
| | - Manoj Chaudhary
- Head, Department of Oral & Maxillofacial Surgery, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh, 244001, India
| | - Arpit Vashistha
- Resident, Department of Oral & Maxillofacial Surgery, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh, 244001, India
| | - Gagandeep Kaur
- Reader, Department of Conservative Dentistry & Endodontics, Kothiwal Dental College & Research Centre, Moradabad, Uttar Pradesh, 244001, India
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Han L, Li J, Chen Y, Wang W, Zhang D, Liu G. Effects of Ghrelin on Triglyceride Accumulation and Glucose Uptake in Primary Cultured Rat Myoblasts under Palmitic Acid-Induced High Fat Conditions. Int J Endocrinol 2015; 2015:635863. [PMID: 26713091 PMCID: PMC4680104 DOI: 10.1155/2015/635863] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/10/2015] [Revised: 09/11/2015] [Accepted: 09/20/2015] [Indexed: 02/08/2023] Open
Abstract
This study aimed to study the effects of acylated ghrelin on glucose and triglyceride metabolism in rat myoblasts under palmitic acid- (PA-) induced high fat conditions. Rat myoblasts were treated with 0, 10(-11), 10(-9), or 10(-7) M acylated ghrelin and 0.3 mM PA for 12 h. Triglyceride accumulation was determined by Oil-Red-O staining and the glycerol phosphate dehydrogenase-peroxidase enzymatic method, and glucose uptake was determined by isotope tracer. The glucose transporter 4 (GLUT4), AMP-activated protein kinase (AMPK), acetyl-CoA carboxylase (ACC), and uncoupling protein 3 (UCP3) were assessed by RT-PCR and western blot. Compared to 0.3 mM PA, ghrelin at 10(-9) and 10(-7) M reduced triglyceride content (5.855 ± 0.352 versus 5.030 ± 0.129 and 4.158 ± 0.254 mM, P < 0.05) and prevented PA-induced reduction of glucose uptake (1.717 ± 0.264 versus 2.233 ± 0.333 and 2.333 ± 0.273 10(-2) pmol/g/min, P < 0.05). The relative protein expression of p-AMPKα/AMPKα, UCP3, and p-ACC under 0.3 mM PA was significantly reduced compared to controls (all P < 0.05), but those in the 10(-9) and 10(-7) M ghrelin groups were significantly protected from 0.3 mM PA (all P < 0.05). In conclusion, acylated ghrelin reduced PA-induced triglyceride accumulation and prevented the PA-induced decrease in glucose uptake in rat myoblasts. These effects may involve fatty acid oxidation.
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Affiliation(s)
- Lingling Han
- Department of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Jia Li
- Department of Endocrinology, The Fourth Hospital of China Medical University, Shenyang, Liaoning 110032, China
| | - Ying Chen
- Shenyang 93303 Military Hospital, Shenyang, Liaoning 110011, China
| | - Wei Wang
- Department of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Dan Zhang
- Department of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
| | - Guoliang Liu
- Department of Endocrinology, The First Hospital of China Medical University, Shenyang, Liaoning 110001, China
- *Guoliang Liu:
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Wu Y, Liu F, Zhang X, Shu L. Insulin modulates cytokines expression in human periodontal ligament cells. Arch Oral Biol 2014; 59:1301-6. [DOI: 10.1016/j.archoralbio.2014.07.002] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/23/2014] [Revised: 06/07/2014] [Accepted: 07/13/2014] [Indexed: 10/25/2022]
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Fang P, Shi M, Yu M, Guo L, Bo P, Zhang Z. Endogenous peptides as risk markers to assess the development of insulin resistance. Peptides 2014; 51:9-14. [PMID: 24184593 DOI: 10.1016/j.peptides.2013.10.025] [Citation(s) in RCA: 20] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/02/2013] [Revised: 10/19/2013] [Accepted: 10/21/2013] [Indexed: 01/15/2023]
Abstract
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.
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Affiliation(s)
- Penghua Fang
- Research Institution of Combining Chinese Traditional and Western Medicine, Medical College, Yangzhou University, Yangzhou, Jiangsu 225001, China; Department of Physiology, Nanjing University of Chinese Medicine Hanlin College, Taizhou, Jiangsu 225300, China
| | - Mingyi Shi
- Research Institution of Combining Chinese Traditional and Western Medicine, Medical College, Yangzhou University, Yangzhou, Jiangsu 225001, China
| | - Mei Yu
- Taizhou Hospital of Traditional Chinese Medicine, Nanjing University of Chinese Medicine, Taizhou, Jiangsu 225300, China
| | - Lili Guo
- Research Institution of Combining Chinese Traditional and Western Medicine, Medical College, Yangzhou University, Yangzhou, Jiangsu 225001, China
| | - Ping Bo
- Research Institution of Combining Chinese Traditional and Western Medicine, Medical College, Yangzhou University, Yangzhou, Jiangsu 225001, China
| | - Zhenwen Zhang
- Research Institution of Combining Chinese Traditional and Western Medicine, Medical College, Yangzhou University, Yangzhou, Jiangsu 225001, China; Department of Endocrinology, Clinical Medical College, Yangzhou University, Yangzhou, Jiangsu 225001, China.
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Kawaguchi T, Nagao Y, Sata M. Independent factors associated with altered plasma active ghrelin levels in HCV-infected patients. Liver Int 2013; 33:1510-6. [PMID: 23809581 DOI: 10.1111/liv.12235] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/03/2012] [Accepted: 05/22/2013] [Indexed: 02/06/2023]
Abstract
BACKGROUND & AIMS Metabolic disorders are frequently seen in hepatitis C virus (HCV)-infected patients. Ghrelin, a gut hormone, regulates hepatic metabolisms, and must be activated to exert its biological effects. The aims of this study were to investigate changes in plasma active ghrelin levels and identify independent factors associated with plasma active ghrelin levels in HCV-infected patients. METHODS We enrolled patients with HCV infection (n = 96), hepatitis B virus (HBV) infection (n = 49), non-alcoholic fatty liver disease (NAFLD; n = 20) and healthy subjects (CON; n = 16). Plasma active ghrelin levels were measured using ELISA. Factors associated with plasma active ghrelin levels were assessed by multivariate and Spearman's correlation analyses. RESULTS Plasma active ghrelin levels were significantly lower in relation to the severity of liver disease in both the HBV and HCV groups. Furthermore, HCV infection was identified as an independent factor associated with decreased plasma active ghrelin levels in the multivariate analysis (OR -3.05; 95% CI -0.93 to -19.51; P = 0.0192). Plasma active ghrelin levels were significantly correlated with serum albumin levels in the HCV group (ρ = 0.497, P < 0.0001). CONCLUSIONS We demonstrated that liver cirrhosis and HCV infection were independent factors associated plasma active ghrelin levels. Moreover, plasma active ghrelin levels were positively correlated with serum albumin levels among HCV-infected patients. Therefore, active ghrelin levels may be regulated by both progression of liver disease and HCV infection and could be involved in the regulation of serum albumin levels in HCV-infected patients.
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Affiliation(s)
- Takumi Kawaguchi
- Department of Digestive Disease Information & Research, Kurume University School of Medicine, Kurume, Japan; Division of Gastroenterology, Department of Medicine, Kurume University School of Medicine, Kurume, Japan
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Ling S, Birnbaum Y, Nanhwan MK, Thomas B, Bajaj M, Li Y, Li Y, Ye Y. Dickkopf-1 (DKK1) phosphatase and tensin homolog on chromosome 10 (PTEN) crosstalk via microRNA interference in the diabetic heart. Basic Res Cardiol 2013; 108:352. [PMID: 23636253 DOI: 10.1007/s00395-013-0352-2] [Citation(s) in RCA: 29] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/25/2013] [Revised: 03/12/2013] [Accepted: 04/05/2013] [Indexed: 12/14/2022]
Abstract
Competitive endogenous RNAs (ceRNAs) regulate mRNA transcripts containing common microRNA (miRNA) recognition elements (MREs) through sequestration of shared miRNAs. Interactions of ceRNA have been demonstrated in cancerous cells. However, a paucity of information is available relative to the interactions of ceRNAs interaction in diabetes mellitus and the myocardium. The purpose of this study is to assess the potential role of DKK1 and PTEN in ceRNA regulation utilizing their common miRNAs in diabetic cardiomyocytes. The interactions' regulation between PTEN and DKK1 were determined in two diabetic models in vivo (streptozotocin-induced type-1 DM mice and db/db mice) and in vitro (human cardiomyocytes cells exposed to hyperglycemia). The levels of DKK1 and PTEN (mRNA and protein) were upregulated in parallel in all three diabetic models. DKK1 modulates PTEN protein levels in a miRNA and 3'UTR-dependent manner. RNAi-mediated DKK1 gene silencing resulted in a decreased PTEN expression and vice versa. The effect was blocked when Dicer was inhibited. Silencing either PTEN or DKK1 resulted in an increase of the availabilities of shared miRNAs. The silencing of either PTEN or DKKI resulted in a suppression end of the luciferase-PTEN 3'UTR activity. However, the over expression of DKK1 3'UTR or PTEN 3'UTR resulted in an increase in the activity. The attenuation of DKK1 increased AKT phosphorylation, improved glucose uptake and decreased apoptosis in HCMs exposed to hyperglycemia. The effects were blocked by PI3K inhibition. DKK1 and PTEN transcripts are co-upregulated in DM and hyperglycemia. DKK1 and PTEN serve as ceRNA, affecting the expression of each other via competition for miRNAs binding.
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Affiliation(s)
- Shukuan Ling
- School of Life Science and Technology, Harbin Institute of Technology, Harbin, Heilongjiang, China
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Nagendran J, Waller TJ, Dyck JRB. AMPK signalling and the control of substrate use in the heart. Mol Cell Endocrinol 2013; 366:180-93. [PMID: 22750050 DOI: 10.1016/j.mce.2012.06.015] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/12/2011] [Revised: 03/29/2012] [Accepted: 06/21/2012] [Indexed: 12/21/2022]
Abstract
All mammalian cells rely on adenosine triphosphate (ATP) to maintain function and for survival. The heart has the highest basal ATP demand of any organ due to the necessity for continuous contraction. As such, the ability of the cardiomyocyte to monitor cellular energy status and adapt the supply of substrates to match the energy demand is crucial. One important serine/threonine protein kinase that monitors cellular energy status in the heart is adenosine monophosphate activated protein kinase (AMPK). AMPK is also a key enzyme that controls multiple catabolic and anabolic biochemical pathways in the heart and indirectly plays a crucial role in regulating cardiac function in both physiological and pathophysiological conditions. Herein, we review the involvement of AMPK in myocardial fatty acid and glucose transport and utilization, as it relates to basal cardiac function. We also assess the literature amassed on cardiac AMPK and discuss the controversies surrounding the role of AMPK in physiological and pathophysiological processes in the heart. The work reviewed herein also emphasizes areas that require further investigation for the purpose of eventually translating this information into improved patient care.
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Affiliation(s)
- Jeevan Nagendran
- Cardiovascular Research Centre, Department of Pediatrics, University of Alberta, Edmonton, Alberta, Canada
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Dock-Nascimento DB, de Aguilar-Nascimento JE, Magalhaes Faria MS, Caporossi C, Slhessarenko N, Waitzberg DL. Evaluation of the Effects of a Preoperative 2-Hour Fast With Maltodextrine and Glutamine on Insulin Resistance, Acute-Phase Response, Nitrogen Balance, and Serum Glutathione After Laparoscopic Cholecystectomy. JPEN J Parenter Enteral Nutr 2012; 36:43-52. [DOI: 10.1177/0148607111422719] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/29/2022]
Affiliation(s)
| | | | | | | | | | - Dan Linetzky Waitzberg
- LIM 35, Department of Gastroenterology, Medical School of University of São Paulo, São Paulo, Brazil
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Measurement of AMP-Activated Protein Kinase Activity and Expression in Response to Ghrelin. Methods Enzymol 2012; 514:271-87. [DOI: 10.1016/b978-0-12-381272-8.00017-9] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
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20
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Muccioli G, Lorenzi T, Lorenzi M, Ghè C, Arnoletti E, Raso GM, Castellucci M, Gualillo O, Meli R. Beyond the metabolic role of ghrelin: a new player in the regulation of reproductive function. Peptides 2011; 32:2514-21. [PMID: 22074955 DOI: 10.1016/j.peptides.2011.10.020] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/31/2011] [Revised: 10/23/2011] [Accepted: 10/23/2011] [Indexed: 11/30/2022]
Abstract
Ghrelin is a gastric peptide, discovered by Kojima et al. (1999) [55] as a result of the search for an endogenous ligand interacting with the "orphan receptor" GHS-R1a (growth hormone secretagogue receptor type 1a). Ghrelin is composed of 28 aminoacids and is produced mostly by specific cells of the stomach, by the hypothalamus and hypophysis, even if its presence, as well as that of its receptors, has been demonstrated in many other tissues, not least in gonads. Ghrelin potently stimulates GH release and participates in the regulation of energy homeostasis, increasing food intake, decreasing energy output and exerting a lipogenetic effect. Furthermore, ghrelin influences the secretion and motility of the gastrointestinal tract, especially of the stomach, and, above all, profoundly affects pancreatic functions. Despite of these previously envisaged activities, it has recently been hypothesized that ghrelin regulates several aspects of reproductive physiology and pathology. In conclusion, ghrelin not only cooperates with other neuroendocrine factors, such as leptin, in the modulation of energy homeostasis, but also has a crucial role in the regulation of the hypothalamic-pituitary gonadal axis. In the current review we summarize the main targets of this gastric peptide, especially focusing on the reproductive system.
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Affiliation(s)
- Giampiero Muccioli
- Department of Drug Science and Technology, Division of Medical Pharmacology, University of Torino, Via P. Giuria 13, 10125 Torino, Italy
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