The significance of glucose, insulin and potassium for immunology and oncology: a new model of immunity

Essential Minerals and Metabolic Adaptation of Immune Cells

Modern lifestyles deviated considerably from the ancestral routines towards major shifts in diets and increased sedentarism. The trace elements status of the human body is no longer adequately supported by micronutrient-inferior farmed meats and crop commodities produced by the existing agricultural food systems. This is particular evident in the increased obesogenic adipogenesis and low-grade inflammation that fails to resolve with time. The metabolically restrictive environment of the inflamed tissues drives activation and proliferation of transient and resident populations of immune cells in favor of pro-inflammatory phenotypes, as well as a part of the enhanced autoimmune response. As different stages of the immune activation and resolution depend on the availability of specific minerals to maintain the structural integrity of skin and mucus membranes, activation and migration of immune cells, activation of the complement system, and the release of pro-inflammatory cytokines and chemokines, this review discusses recent advances in our understanding of the contribution of select minerals in optimizing the responses of innate and adaptive immune outcomes. An abbreviated view on the absorption, transport, and delivery of minerals to the body tissues as related to metabolic adaptation is considered.

Glucose metabolism in lymphoid and inflammatory cells and tissues

PURPOSE OF REVIEW

To examine the role of glucose as a fuel for immune cells and the influence of glucose supply on immune-cell functional responses.

RECENT FINDINGS

Immune cells express the insulin receptor and a range of glucose-transporter isoforms. Glucose transporters are responsive to both immune stimulation and insulin. The pattern of glucose-transporter upregulation differs among different types of immune cell. In-vitro studies reveal that both hypo- and hyperglycaemia impair immune-cell functions and promote inflammatory responses. Clamp studies have revealed proinflammatory effects of hyperglycaemia and antiinflammatory and immune-promoting effects of insulin.

SUMMARY

Glucose is readily utilized by cells of the immune system and is used to generate energy and biosynthetic precursors. Activation of immune cells is associated with increased glucose utilization and this is facilitated, in part, by increased expression of glucose transporters. Immune cells express the insulin receptor and respond to insulin. Both hypo- and hyperglycaemia impair immune-cell functions and promote inflammatory responses. Insulin therapy in hyperglycaemic subjects may be of benefit through effects of both insulin itself and lowered glucose concentration. Excessive lowering of blood glucose concentration may also be harmful to the immune response.

Glucose transporter expression on the plasma membrane of resting and activated white blood cells

BACKGROUND

In white blood cells (WBC), the increase in glucose utilization is a prominent feature during immune response and this depends on the function of specific glucose transporter (GLUT) isoforms. The objective was to examine the effects of activation by Phorbol 12-myristate 13-acetate (PMA) or lipopolysaccharide (LPS) and insulin on the expression of GLUT isoforms in all subpopulations of WBC.

MATERIALS AND METHODS

Blood was withdrawn from 27 healthy subjects. The expression of GLUT1, GLUT3 and GLUT4 on the plasma membrane of resting and activated monocytes, T- and B-lymphocytes and polymorphonuclear cells (PMNs) was determined in the absence and presence of physiological concentrations of insulin, by flow cytometry.

RESULTS

GLUT1 did not respond to insulin in either resting or PMA/LPS activated state. In the resting state, monocytes and B-lymphocytes increased the abundance of GLUT3 and GLUT4 on their plasma membrane in response to insulin; in contrast, T-lymphocytes and PMNs were unresponsive to insulin. In the activated state, monocytes, B- and T- lymphocytes increased the expression of all three GLUT isoforms on their plasma membrane, whilst PMNs increased only GLUT1 and GLUT3; in all WBC, insulin augmented the expression of GLUT4 and GLUT3 isoforms in addition to the stimulation provided by the PMA or LPS treatment alone.

CONCLUSION

Activation of WBC leads to increased expression of GLUT1, GLUT3 and GLUT4 isoforms on their plasma membrane; this process was further augmented by insulin. During infection, these mechanisms may help to redistribute glucose as a potential source of energy away from peripheral tissues and direct it towards cells that mediate the immune response and are therefore crucial to survival.

Chronic malnutrition does not influence the development of ethylnitrosourea-induced brain tumors

There is controversy over the subject of malnutrition as a potential risk factor for cancer; we studied the effect of chronic malnutrition on the development of tumors in rats prenatally exposed to the carcinogenic ethylnitrosourea. Twelve pregnant Wistar rats were administered on the 19th day of gestation with a single i.v. dose of 30 mg/kg of ethylnitrosourea. Immediately after weaning, at 23 days of age, half of the offspring were nourished with a protein-deficient diet (less than 6%), which consisted mostly of a corn-based diet with high calorie and low fiber contents. In the adult age, 83 rats (74%) developed a tumor of the nervous system; in comparison with controls, we found no differences in time of development, site and histological characteristics of the tumors that developed in animals subjected to chronic malnutrition.