Effects of zinc ion on the conformation of antigenic determinants on insulin

Zn2+ chelation by serum albumin improves hexameric Zn2+-insulin dissociation into monomers after exocytosis

β-cells release hexameric Zn2+-insulin into the extracellular space, but monomeric Zn2+-free insulin appears to be the only biologically active form. The mechanisms implicated in dissociation of the hexamer remain unclear, but they seem to be Zn2+ concentration-dependent. In this study, we investigate the influence of albumin binding to Zn2+ on Zn2+-insulin dissociation into Zn2+-free insulin and its physiological, methodological and therapeutic relevance. Glucose and K+-induced insulin release were analyzed in isolated mouse islets by static incubation and perifusion experiments in the presence and absence of albumin and Zn2+ chelators. Insulin tolerance tests were performed in rats using different insulin solutions with and without Zn2+ and/or albumin. Albumin-free buffer does not alter quantification by RIA of Zn2+-free insulin but strongly affects RIA measurements of Zn2+-insulin. In contrast, accurate determination of Zn2+-insulin was obtained only when bovine serum albumin or Zn2+ chelators were present in the assay buffer solution. Albumin and Zn2+ chelators do not modify insulin release but do affect insulin determination. Preincubation with albumin or Zn2+ chelators promotes the conversion of "slow" Zn2+-insulin into "fast" insulin. Consequently, insulin diffusion from large islets is ameliorated in the presence of Zn2+ chelators. These observations support the notion that the Zn2+-binding properties of albumin improve the dissociation of Zn2+-insulin into subunits after exocytosis, which may be useful in insulin determination, insulin pharmacokinetic assays and islet transplantation.

Zinc-dependent effects of small molecules on the insulin-sensitive transcription factor FOXO1a and gluconeogenic genes

Metal-binding compounds have recently been reported to have anti-hyperglycaemic properties in vivo. In the current study, we have investigated the ability of these compounds and related structures to induce insulin-like signal transduction to downstream effectors such as the transcription factor FOXO1a and the key gluconeogenic regulatory enzymes phosphoenolpyruvate carboxykinase (PEPCK) and glucose 6-phosphatase (G6Pase). Our results indicate that β-thujaplicin, diethyldithiocarbamate (DEDTC) and its clinically-used dimer disulfiram, induce insulin-like dose-dependent effects on signalling to FOXO1a in a manner that is strictly dependent on the presence of zinc ions, as other ions including aluminium, cobalt, copper, lithium and manganese cannot substitute. The most potent compound tested on gluconeogenesis is disulfiram, which in the presence of 10 μM zinc, inhibited both PEPCK and G6Pase with an IC50 of 4 μM. Our results demonstrate that metal-binding compounds with diverse structures can induce zinc-dependent insulin-like effects on signal transduction and gene expression.

Hair tissue mineral analysis and metabolic syndrome

Deficiency of minerals causes functional abnormality of enzymes, frequently resulting in metabolic disturbance. We investigated possible relationship between minerals and metabolic syndrome by analysis of hair tissue minerals. We selected 848 subjects older than 20 years of age at Ajou University Hospital from May 2004 to February 2007. We excluded the subjects who had cancers, steroid and thyroid medication, and incomplete record from the study. Finally, 343 subjects were eligible. We performed cross-sectional analysis for the relationship between minerals and metabolic syndrome. The contents of calcium, magnesium, and copper in the metabolic syndrome group were significantly lower than those of the normal group, whereas the amounts of sodium, potassium, and mercury in the metabolic syndrome group were significantly higher than those of the normal group. By dividing the subjects into quartile with the level of calcium, magnesium, and mercury concentrations, we carried out logistic regression analysis to study the subjects and found that the subjects in the third quartile of calcium and magnesium concentrations had significantly lower odds ratio (OR) of the metabolic syndrome compared with that of the lowest quartile group [OR = 0.30, confidence interval (CI) = 0.10-0.89; OR = 0.189, CI = 0.063-0.566] and that the subjects in the highest mercury quartile had significantly higher OR of the metabolic syndrome compared with that of the lowest mercury quartile group (OR = 7.35, CI = 1.73-31.1). As part of the metabolic syndrome, the optimal calcium and magnesium concentrations in hair tissue may reflect decreased risk of metabolic syndrome, whereas high mercury concentration in hair tissue may indicate increased risk of metabolic syndrome.

Effects of sulfonylurea on the secretion and disposition of insulin and C-peptide

In an attempt to examine the influence of sulfonylurea on the secretion, disposition and effect of insulin, 9 diabetic patients were studied during three one-month medications with (a) chlorpropamide (t1/2 greater than 24 h) once daily, (b) glipizide (t1/2 2-4 h) once daily, and (c) glipizide in divided dosage. The food intake of each patient was identical during each examination period. Blood concentrations of C-peptide, insulin, glucose, and drugs were determined before and after breakfast and lunch on the 4th day of each examination period. As expected, once-daily administration of glipizide led to higher after-breakfast concentrations of the drug than when the dose was divided. However, the C-peptide changes following breakfast were similar both during these two treatments and also during chlorpropamide, indicating that the amounts of insulin released from the pancreas were equivalent. In spite of this, glipizide once daily yielded 60-70% more insulin in systemic blood following breakfast than did the two other treatments. Reasonably, this signifies that the hepatic extraction of insulin was reduced during once-daily glipizide, allowing more insulin to reach systemic circulation. In addition, this was found to promote a more effective utilization of glucose following breakfast. Following lunch, the C-peptide release, the plasma insulin increase and the blood glucose reduction were greater when glipizide was given in divided dosage than when once-daily glipizide or chlorpropamide was employed. This occurred even though the after-lunch concentration of glipizide in systemic blood was lower rather than higher during divided than during once-daily administration. This supports the notion that the effect of orally administered sulfonylurea is determined not only by its concentration in systemic blood but also by its gastroenterohepatic appearance. Glipizide may offer greater therapeutic flexibility than chlorpropamide, but further studies are required to define the optimum choice and use of sulfonylureas.

[Role of zinc in insulin resistance]

This review reports the etiological aspects of insulin resistance as well as the participation of zinc in this process. Zinc participates in the metabolic pathways involving protein synthesis, and the metabolism of carbohydrate, lipid and nucleic acid. This element has been associated with the interaction between hormones and their receptors and to the improvement in the post-receptor stimulus. In vitro studies show that insulin may form a complex with zinc improving the solubility of this hormone in the pancreatic beta cells and also increasing the binding ability of insulin to its receptor. Regarding obesity and insulin resistance, alterations in zinc concentration and distribution in tissues, as well as improvement in sensitivity to insulin after supplementation with this element, have been detected. Thus, the metabolic role of zinc in the insulin resistance syndrome should be further investigated having in mind that this element may contribute to the control of the usual metabolic alterations present in obese patients.

Selenium, zinc and copper in plasma of patients with type 1 diabetes mellitus in different metabolic control states

The Studies of selenium (Se), zinc (Zn) and copper (Cu) levels in diabetic patients have led to contradictory findings as the possible relationship between the degree of diabetic control and the changes in mineral contents. In the present study the plasma Cu, Se, and Zn contents of diabetic patients and healthy people were measured and the relationship between these contents and diabetic metabolic control, as determined by glycosylated hemoglobin (HbA1c), was studied. The mean plasma Se content in diabetic patients was significantly lower than in controls (p < 0.01) and a negative correlation between the plasma contents of Se and HbA1c was found. No statistically significant differences in plasma Zn contents, either between patients with type 1 diabetes mellitus and control, were found. A statistically significant sex difference in plasma Cu contents was observed in the control population. In females, statistically significant differences were found in plasma Cu contents between the control subjects and the diabetic patients with medium or poor metabolic control, as well as between diabetic patients with good and poor metabolic control. In males, the only statistically significant differences were between the control subjects and diabetic patients with poor metabolic control. The correlation between plasma contents of Cu and HbA1c is not significant.

Zinc, insulin and diabetes

The relationship between diabetes, insulin and zinc (Zn) is complex with no clear cause and effect relationships. In Type 1 diabetes there is a lack of insulin production, in Type 2 diabetes resistance to the effects of insulin are predominant. Both Type 1 and Type 2 have the same long-term complications. Diabetes effects zinc homeostasis in many ways, although it is most probably the hyperglycemia, rather than any primary lesion related to diabetes, which is responsible for the increased urinary loss and decreases in total body zinc. The role of Zn deficiency, which could, at least potentially, exacerbate the cytokine-induced damage in the autoimmune attack which destroys the islet cell in Type 1 diabetes, is unclear. Since Zn plays a clear role in the synthesis, storage and secretion of insulin as well as conformational integrity of insulin in the hexameric form, the decreased Zn, which affects the ability of the islet cell to produce and secrete insulin, might then compound the problem, particularly in Type 2 diabetes. Several of the complications of diabetes may be related to increased intracellular oxidants and free radicals associated with decreases in intracellular Zn and in Zn dependent antioxidant enzymes. There appears to be a complex interrelationship between Zn and both Type 1 and Type 2 diabetes. The role of Zn in the clinical management of diabetes, its complications, or in its prevention is, at best, unclear.

Zinc prevents the structural and functional properties of free radical treated-insulin

We have previously reported that zinc deficiency could increase in vivo lipid peroxidation and decrease rat insulin sensitivity. In the present paper, we address the hypothesis of the role of zinc on insulin molecule in relation to free radical damage. From native recombinant human insulin, we prepared a zinc-depleted insulin. Both preparations were subjected to controlled free radical attack by incubation in the presence of 2,2'-azobis(2-amidinopropane) hydrochloride (AAPH). To obtain minimally oxidized insulin, the oxidation process was monitored by measuring the intrinsic fluorescence of the insulin preparations. For 2.5 mM of AAPH, the autofluorescence of zinc-depleted insulin markedly decreased as compared to that of native insulin. These data are in favor of conformational changes of the insulin molecule which were further studied by quenching of fluorescence by means of potassium iodide. Using the euglycaemic hyperinsulinic glucose clamp technique in rats, the in vivo activities of the different insulin preparations, showed that oxidized zinc-depleted insulin had a marked reduced activity as compared to oxidized native insulin. From our results, we suggest that structural modification of the insulin molecule took place after zinc depletion and free radical treatment. Moreover, zinc depletion appeared to increase the susceptibility of insulin to free radicals.

Immunoelectrophoretic characterization of insulin monomers and polymers

Insulin monomers and polymers were analysed by quantitative immunoelectrophoretic procedures. The Zn-insulin hexamer dissociated reversibly by dialysis against the Zn-free electrophoresis buffer. The Zn-insulin polymers showed precipitin reactions of partial identity. Monomeric salt-free insulin migrated as soluble immune complexes in the antiserum gel. The insulin monomer did not absorb the precipitating antibodies against the Zn-insulin polymers. Thus the polymer structure creates antigenic epitopes absent from the insulin monomer. As insulin is probably released from the beta cells in the relatively stable form of Zn-insulin hexamers, selective monomer assays might underestimate the total content of immunoreactive insulin in the biological fluids. Electroimmunoassay of Zn-insulin immunoreactive antigens in human urine defines a normal reference range of 10-25 ng/ml.

Identification of human T cells that require zinc for growth

Zinc is an essential trace element required for normal function of the immune system. Deficiency of zinc results in marked thymic atrophy in experimental animals, and in man immunodeficiency is a recognized complication of zinc deprivation. Although numerous proteins require zinc as a cofactor, its precise functions in the immune system remain unknown. The mechanism by which metals stimulate lymphocytes, whether all T cells are responsive, and the relationship to zinc requirements have not been determined. We unexpectedly isolated a number of human T-cell lines that have a highly specific requirement for zinc. The ability to respond to zinc resides in only a subset of T cells since antigen-specific clones are not stimulated by zinc. Although proliferation requires the presence of antigen-presenting cells and is restricted by class II MHC antigens, antigen-presenting cells could not be pulsed with zinc to induce T-cell activation. Our results suggest that zinc-dependent T cells are a subset of CD4+ cells present in all normal individuals and that zinc stimulates their growth by novel mechanisms.

65 zinc absorption in patients with insulin-dependent diabetes mellitus assessed by whole-body counting technique

The gastrointestinal absorption of zinc was measured in patients with insulin-dependent diabetes mellitus. The concentration of zinc in serum was similar to healthy individuals. However the urinary excretion rate of zinc relative to the creatinine excretion, was approximately doubled (p less than 0.001) in the diabetics. The absorption of 65Zn tended to be lower in diabetics, but did not reach the level of statistical significance (retention percent 30.6 versus 42.6 (p greater than 0.10). A hypothesis of intracellular zinc depletion with time in insulin-dependent diabetics is proposed.

Zinc in human health and disease

The importance of zinc in human health and disease has been reviewed by reporting data from the recent literature. The role of zinc in human nutrition, general health, skin diseases, acrodermatitis enteropathica, reproductive physiology and pathophysiology, pregnancy, non-insulin-dependent diabetes mellitus as well as atherosclerosis is discussed. The consequences of zinc deficiency and toxicity are also illustrated.

Role of zinc supplementation in type II diabetes mellitus

Zinc is required for normal immune function and taste acuity and enhances the in vitro effectiveness of insulin. Impaired immune function and taste have been reported in diabetic subjects, and decreased serum zinc levels and hyperzincuria occur in some diabetic subjects and animals. Subjects with type II diabetes were examined to determine whether the similar effects of zinc depletion and diabetes are causally related. Low serum zinc levels were found in 16 of 180 subjects (9 percent). There was no correlation between serum zinc and glycosylated hemoglobin levels. Natural killer cell activity did not differ between diabetic subjects (n = 28) and control subjects (n = 38) and did not correlate with serum zinc levels. T lymphocyte response to phytohemagglutinin was lower in diabetic subjects than in control subjects (70 +/- 10 versus 103 +/- 7 X 10(3) counts per minute) but was not lowest in those with the lowest zinc levels. Taste thresholds for hydrochloric acid, sucrose, sodium chloride, and urea were elevated in diabetic subjects (n = 28) versus control subjects (n = 10), but thresholds did not correlate with glycosylated hemoglobin or serum zinc levels. Zinc supplementation in nine diabetic subjects had no effect on the glycosylated hemoglobin level, natural killer cell activity, or taste thresholds, but it did increase mitogen activity in those with the lowest initial phytohemagglutinin responses. It is concluded that zinc deficiency occurs in a subset of subjects with type II diabetes but is not related to diabetes control and does not explain decreased taste acuity. Zinc deficiency may play a role in abnormal immune function in type II diabetes mellitus.

Recognition of human insulin in vitro by T cells from subjects treated with animal insulins

Structurally defined proteins and peptides have provided considerable information about the specificity and regulation of immune responses in inbred animals. Many diabetics require therapy with insulin; therefore, we used this defined protein as a model antigen to investigate immune responses in the outbred human population. In this report, we examine human T cell recognition of antigenic determinants on various insulins. A group of 25 subjects was selected from over 200 diabetics because of the magnitude of their in vitro responses. 13 of the 25 had significant T cell responses to human insulin despite treatment with only beef/pork insulin mixtures. This autoimmunity may be attributed to crossreactivity of lymphocytes highly reactive to "foreign" epitopes on therapeutic insulins. Alternatively, identical determinants shared by human and animal insulins may be recognized. By employing additional insulins not used therapeutically and isolated A and B chains, several potential mechanisms for lymphocyte autoreactivity to human insulin were demonstrated. Some epitopes are conformational and require recognition of an intact molecule, whereas other epitopes may arise from antigen processing at the cellular level. Studies using zinc-free insulins suggest that zinc-induced alterations of the molecular surface may result in some shared reactivities between animal and human insulin. Furthermore, T cell reactivity against "foreign" epitopes is more complex than anticipated from differences in amino acid sequence. The response patterns of many subjects indicate that the A-chain loop associates with the N-terminal B chain to form a complex determinant. This determinant is recognized more often than individual amino acids. We conclude that insulin therapy generates polyclonal T cell responses directed at multiple epitopes on the molecule. Many of these epitopes are not identified by amino acid exchanges and their presence on human insulin leads to apparent autoimmunity.

A zinc-dependent epitope on the molecule of thymulin, a thymic hormone

Thymulin is a nonapeptide hormone produced by thymic epithelial cells. Its biological activity is strictly dependent on the presence of the metal zinc in the molecule. Antithymulin monoclonal antibodies have been produced against either the synthetic (AS1) or the natural intraepithelial (AE1) molecule. These monoclonal antibodies were screened for their abilities to inhibit the zinc-dependent biological activity of the hormone and were shown to bind to thymic epithelial cells. By using biological and immunofluorescence assays, the two antibodies were shown to recognize exclusively the zinc-coupled thymulin molecule. Other antithymulin antibodies screened by RIA or ELISA (using a zinc-deprived substrate) recognized a zinc-independent epitope on the thymulin molecule. These data indicate the existence of a zinc-specific conformation on the thymulin molecule. They are in agreement with NMR studies showing that the zinc-containing hormone has a unique structure.

Abnormal zinc metabolism in type II diabetes mellitus

Zinc metabolism in 20 patients with stable type II diabetes mellitus was investigated. Twenty-five percent of these patients had depressed serum zinc concentrations, and all demonstrated hyperzincuria. Urinary zinc loss was greater when proteinuria was present and correlated with the mean serum glucose concentration. Studies of gastrointestinal zinc absorption suggested zinc malabsorption in patients with type II diabetes mellitus. Glucose infusion in normal dogs produced hyperzincuria without a diminution in serum zinc. It is concluded that hyperzincuria, resulting from a glucose-mediated process that is not osmotic, interacts with impaired zinc absorption to produce zinc deficiency in patients with type II diabetes mellitus.

Effects of new insulins on insulin and C-peptide antibodies, insulin dose, and diabetic control

24 diabetic patients stabilised on conventional bovine insulins and possessing insulin antibodies underwent a study of the immunological and clinical consequences of changes in both purity and species of their insulin preparations. After a 2-month run-in period patients were treated for 3 consecutive 4-month periods with (a) purified bovine insulin (20-40 ppm proinsulin), (b) highly purified porcine insulin, and (c) semisynthetic human insulin, without elective dose changes. Mean insulin antibody levels changed little on purified bovine insulin (22.2 leads to 23.4 micrograms/l) but fell on highly purified porcine (23.4 leads to 12.9 micrograms/l) and remained much the same on Semi-Synthetic human insulin. In contrast, C-peptide antibodies fell significantly and continuously throughout the study. The slower rate of fall in C-peptide antibody levels is likely to be due to the prolonged half-life of circulating exogenous proinsulin in the presence of insulin antibody. Although insulin dose remained constant the incidence of hypoglycaemic episodes did not increase and glycosylated haemoglobin levels rose significantly when patients were on porcine insulin. The deterioration in diabetic control may have been due to greater temporal mismatch between insulin needs and insulin availability with pork or human insulin than with beef insulins, and to reduced insulin antibody levels. The use of purer insulins which more closely resemble the human form can cause a significant reduction in levels of insulin and C-peptide antibodies. Although these changes may have other benefits they do not necessarily produce better diabetic control. Subcutaneous insulin regimens need to be tailored to the individual patient and, indirectly, to his antibody status.

Insulin antibodies induced by bovine insulin therapy

Insulin antibodies are detectable in the sera of most patients within 3-4 months of starting treatment with conventional bovine insulins. Various factors determine the immunogenicity of insulin preparations including the genetic background of the recipient. This causes wide variation in response. Solid phase absorption studies as well as competitive binding in fluid phase indicate that the antibodies formed are almost always specific for determinants shared by the endogenous human molecule. This has important implications for the metabolic effect of insulin antibodies in vivo as well as for mechanisms of autoantibody production in man.

Influence of sulfonylureas on the secretion, disposal and effect of insulin

The influence of sulfonylurea on the secretion, disposal and effect of insulin was studied in 9 Type 2 diabetics during 3 one-month courses of treatment with a) chlorpropamide (t1/2 greater than 24 h) once daily, b) glipizide (t1/2 = 2-4 h) once daily, and c) glipizide in divided doses. Food intake by each patient was identical during each period. Blood concentrations of immunoreactive insulin (IRI) and C-peptide (radioimmunoassays), and of glucose (enzymatic assay), chlorpropamide (gas chromatography) and glipizide (high-pressure liquid chromatography) were determined before and after breakfast and lunch on the 4th day of each examination period. All comparisons were intraindividual. Despite the lunch-time dose of glipizide given during the divided dose treatment, once-daily administration of this drug led to higher drug concentrations not only after breakfast but also for the first few hours after lunch. Divided dosage, on the other hand, led to higher concentrations later. In contrast to once-daily dosage, continuous exposure to glipizide was found in most patients. Chlorpropamide gave the most continuous sulfonylurea exposure. The blood glucose levels were inversely related to the concurrent sulfonylurea concentrations; glucose levels after breakfast and lunch were lowest during once-daily glipizide, whereas the fasting level was lowest during chlorpropamide treatment. The IRI response to breakfast was 60%-70% higher during once-daily glipizide than during the other two treatments but the C-peptide responses to breakfast were almost identical. Thus, the greater after-breakfast availability of peripheral insulin appeared to be due to an effect of glipizide on the extrapancreatic disposal of the hormone.

Zinc and insulin metabolism

A review of experimental studies of the effect of zinc nutrition on insulin metabolism is presented. In addition to a short introduction to the synthesis, secretion, and action of insulin, the effects of zinc deficiency-specifically on glucose tolerance, insulin secretion, insulin synthesis and storage, and on total insulin-like activity-are dealt with. The concentrations of zinc and chromium in serum, pancreas, and liver are compared to those of zinc-deficient animals and pair-fed controls.In contrast to pair-fed controls, zinc-deficient rats had unaltered proinsulin contents after glucose stimulation, but they showed a diminished glucose tolerance, lowered serum insulin content, and an elevated total insulin-like activity. The serum zinc concentration of the deficient animals was greatly reduced and did not change during glucose stimulation, whereas it rose in the case of the pair-fed controls. The serum chromium concentration increased in both groups in response to glucose stimulation. In the pancreas of the deficient animals, the zinc concentration was reduced 60% and it increased during the glucose tolerance test. In the liver there were no significant differences. The chromium concentrations were elevated in both the pancreas and liver of the zinc-deficient rats by 60 and 100%, respectively, and were not influenced by glucose injection.These studies show clearly that nutritional zinc deficiency influences insulin metabolism and action.