Acute effects of insulin on surface insulin receptors in isolated hepatocytes. Evidence for a recycling pathway

Association between the preoperative fasting and postprandial C-peptide AUC with resolution of type 2 diabetes 6 months following bariatric surgery

BACKGROUND AND AIMS

Bariatric surgery results in the remission of type 2 diabetes mellitus (T2DM) in morbidly obese subjects. The aim of the study was to investigate the predictive value of both static and dynamic measures of C-peptide in relation to T2DM resolution 6 months after bariatric surgery regardless of the operation type.

METHODS AND RESULTS

A non-randomized prospective study of 24 participants with T2DM undergoing bariatric surgery. Measurements of fasting and 2-hour plasma glucose, insulin, C-peptide and measures of insulin sensitivity were recorded temporally during an oral glucose tolerance test pre-operatively and 6 months post-operatively. A responder was defined with a fasting glucose <5.6 mmol/L and HbA1c <6.0% postoperatively. Within the sample there were 11 responders and 13 non-responders at 6 months. There was a significant difference in the duration of diabetes between the groups. Fasting C-peptide (P≤0.05) and 2-hour C-peptide (P≤0.05) were higher in responders compared to non-responders. Significantly higher C-peptide levels were observed preoperatively at all time points for responders, with significantly higher area under the curve (AUC0-60 and AUC0-120). Using the lower quartiles for C-peptide levels, both fasting C-peptide (>2.5 ng/mL [0.83 nmol/L]) and 2-hour C-peptide (>5.2 ng/mL [1.73 nmol/L]) had a sensitivity and negative predictive value of 100% to predict T2DM remission. Logistic regression showed that C-peptide, duration of diabetes and BMI were associated with response. The area under the ROC curve was 0.94 and a regression model predicted diabetes remission with a sensitivity of 85.7% and a specificity of 88.9%.

CONCLUSIONS

This study demonstrated that static (fasting) and dynamic (AUC, 2-hour) C-peptide measurements predict T2DM resolution 6 months following bariatric surgery. This work provides insight into C-peptide dynamics as a predictor of response to bariatric surgery.

Identification of a cis-acting element and a novel trans-acting factor of the human insulin receptor gene in HepG2 and rat liver cells

The liver is a major target organ of insulin and is important for glucose homeostasis. We analyzed the tissue specific regulation of the insulin receptor gene in the liver by studying the cis-acting element and trans-acting factor of the human insulin receptor gene in human hepatoma cell line, HepG2 cells. In the chloramphenicol acetyl transferase (CAT) assay with chimeric plasmids containing various deletions and insertions of the human insulin receptor promoter/CAT gene, a HepG2 cell specific cis-acting element was identified between nt -592 to -577 of the promoter. In electrophoretic mobility shift assay and UV cross-link analysis, a 35-kDa nuclear protein that bound to 5'-TCCCTCCC-3' (nt -588 to -581) sequence was identified in HepG2 cells as well as in rat hepatocytes. This nuclear protein, designated as hepatocyte-specific transcription factor of the insulin receptor gene (HTFIR), might play an important role in tissue-specific expression of the insulin receptor gene in the liver.

Absence of insulin-receptor downregulation in hepatocytes from hyperinsulinemic rats

Insulin-induced downregulation of the insulin receptor occurs in conditions associated with high extracellular concentrations of insulin. This paper describes the effect of experimental hyperinsulinemia on insulin binding to isolated hepatocytes. In vivo experimental hyperinsulinemia was produced in rats by subcutaneous injection of long-acting insulin at low (10 mU.g-1.day-1), medium (up to 25 mU.g-1.day-1), and high (up to 50 mU.g-1.day-1) doses over 1 or 2 wk. Insulin-stimulated lipogenesis was measured to determine the efficacy of the experimentally produced hyperinsulinemia. The results showed that 1) insulin-induced downregulation, determined by insulin binding, was not present in hepatocytes from any of the hyperinsulinemic rats; 2) insulin binding was increased in hepatocytes from 1- and 2-wk high-dose hyperinsulinemic rats compared with 1-wk sucrose-control (P less than 0.05), 2-wk sucrose-control (P less than 0.01), and normal rats (P less than 0.01); 3) increased binding may have been due to an increase in the number of low-affinity receptors; 4) insulin's effect on lipogenesis (i.e., insulin-stimulated lipogenesis minus the basal value) was increased in either 1-wk (P less than 0.001) or 2-wk (P less than 0.001) high-dose insulin-treated rats compared with either normal or 2-wk sucrose-control rats; 5) insulin's effect on hepatocyte lipogenesis in sucrose-control (P less than 0.025) and in all other insulin-treated (P less than 0.008 or P less than 0.05 for 2-wk medium dose) rats was greater than insulin's effect in normal hepatocytes. The reasons for the absence of downregulation are not clear, but rapid receptor recycling, rapid degradation, and upregulation are listed as possibilities.

Uncoupling between the insulin-receptor cycle and the cellular degradation of the hormone in cultured foetal hepatocytes. Effect of drugs and temperature that inhibit insulin degradation

Sequential changes in the numbers of cell-surface receptors induced by a transitory exposure to insulin in cultured 18-day foetal-rat hepatocytes were investigated in the presence of drugs and at a temperature of 22 degrees C, which inhibit cellular insulin degradation. Chloroquine (70 microM) and monensin (3 microM) did not greatly change the initial rate of internalization of cell-surface receptor sites after exposure to 10 nM-insulin, but led to a steady state after 20 min, which represented 40% of the initial binding, compared with 5 min and 60% in the absence of the drug. Moreover, these drugs strongly decreased the proportion of receptor sites recovered at the cell surface after subsequent removal of the hormone. They were ineffective when insulin was not present. The removal of monensin together with the hormone allowed partial restoration of cell-surface receptor sites and degradation of cell-associated insulin to start again at the initial speed, indicating a reversible effect of the drug. During this phase, the drug concentration-dependence for the two effects showed that receptor recycling was restored with concentrations of monensin not as low as for insulin degradation. The effect of vinblastine (50-100 microM) was similar to that of chloroquine and monensin, whereas no modification in the internalization and recovery processes was observed in the presence of bacitracin concentrations (1-3 mM) that inhibit insulin degradation by 70%. A temperature of 22 degrees C did not prevent the receptor internalization, but had a slowing effect on the recycling process, which appeared to vary in experiments where insulin degradation remained inhibited. The present study shows that the process of insulin degradation mediated by receptor endocytosis is not a prerequisite for insulin-receptor recycling in cultured foetal hepatocytes.

Glucocorticoids and the isolated rat hepatocyte

Following incubation at 37 degrees C with tritiated glucocorticoids isolated hepatocytes prepared from non-adrenalectomized rats show rapid uptake of label. Uptake is non-saturable, and non-linear over the first 60 sec of exposure to steroids. HPLC separation of aqueous extracts of cells and incubation medium shows that polar metabolites of the natural steroid, corticosterone, appear within 10 sec, whereas the synthetic glucocorticoid, dexamethasone, is not altered. Our results suggest that diffusion is the most important process by which glucocorticoids enter liver cells, and that the predominant fate of corticosterone is rapid metabolism.

Degradation of insulin receptors by hepatoma cells: insulin-induced down-regulation results from an increase in the rate of basal receptor degradation

The degradation of insulin receptors was studied in cultured Zajdela hepatoma cells (ZHC). Receptor distribution within the cell was evaluated by estimating: i) surface receptor level on entire cells, ii) total cell receptors solubilized by Triton from cell membranes and iii) intracellular receptors solubilized from cells whose surface receptors had been inactivated with trypsin. In the absence of insulin, 80-90% of the insulin binding sites were located on the cell surface. When insulin was added, a rapid decrease of surface receptors was observed. After 2 h, their level was reduced nearly by half; this reduction was accounted for by an actual receptor loss from the cell without an increase in the intracellular pool. These results indicate that insulin enhanced the rate of receptor degradation within the cell. Basal receptor inactivation was studied by using tunicamycin which inhibits new receptor synthesis. The surface receptor number was decreased with a half-life of 7 h, while the level of internal sites remained unchanged. Both basal and insulin-activated receptor degradation were markedly slowed down by chloroquine or dansylcadaverine, indicating the importance of endocytic pathways in this process. Similarly, when de novo protein glycosylation was inhibited for 24 h by tunicamycin, both basal and insulin-activated receptor inactivation were precluded.(ABSTRACT TRUNCATED AT 250 WORDS)

Insulin binding and degradation in isolated hepatocytes from streptozotocin injected rats

Isolated hepatocytes from streptozotocin injected rats bound the same amount of [125I]monoiodoinsulin as hepatocytes from control rats. Scatchard analysis confirmed that insulin receptor number and affinity were the same for both groups. Relatively more cell-associated radioactivity was located intracellularly in hepatocytes from streptozotocin injected rats. Pretreatment with chloroquine resulted in a smaller increase in intracellular [125I]monoiodoinsulin in cells isolated from streptozotocin injected rats than for control cells. These results suggest that intracellular insulin processing occurs more slowly in hepatocytes isolated from streptozotocin injected rats than from control rats.