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New Insight on Insulinoma Treatment in a Pet Rat-A Case Report. Animals (Basel) 2022; 12:ani12202783. [PMID: 36290169 PMCID: PMC9597777 DOI: 10.3390/ani12202783] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/16/2022] [Revised: 10/05/2022] [Accepted: 10/13/2022] [Indexed: 11/07/2022] Open
Abstract
Simple Summary Insulinomas are tumors of the pancreas that cause hypoglycemia. They have high prevalence in ferrets, whereas in rats are a much rare finding. The available literature on spontaneous insulinomas in rats is currently scarce. The patient from our case report was presented with no obvious hypoglycemic signs, only progressive weakness of the hind limbs was noted. However, a blood exam revealed low blood glucose and a mass in the pancreas was found on the abdominal ultrasound. The patient responded well to treatment with oral dexamethasone and survived nearly 4 months in good general condition. In geriatric rats peripheral neuropathy and pituitary tumors are very common, leading to mobility disfunction. That is why insulinoma should always be considered in cases of neurological deficits in these patients. Abstract Insulinomas are insulin-producing tumors of pancreatic beta cells that cause hypoglycemia. They are extremely common in ferrets but have also been reported in guinea pigs and rats. This is a case report of an older rat with spontaneous insulinoma, which was confirmed by histopathology. The patient was presented at a regular check-up due to a chronic respiratory disease. The owner noticed progressive weakness of the hind limbs, which is quite commonly seen in older rats. A blood exam revealed hypoglycemia, which could have been associated with paraparesis. The patient responded to treatment with oral dexamethasone and was regularly monitored. It survived nearly 4 months in good general condition. The rat finally died most probably due to severe hypoglycemia caused by progression of the pancreatic tumor. This is the first report of a pet rat with insulinoma that was successfully treated with glucocorticoids.
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Prolonged insulin-induced hypoglycaemia reduces ß-cell activity rather than number in pancreatic islets in non-diabetic rats. Sci Rep 2022; 12:14113. [PMID: 35982111 PMCID: PMC9388517 DOI: 10.1038/s41598-022-18398-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/03/2022] [Accepted: 08/10/2022] [Indexed: 12/05/2022] Open
Abstract
Pancreatic β-cells have an extraordinary ability to adapt to acute fluctuations in glucose levels by rapid changing insulin production to meet metabolic needs. Although acute changes have been characterised, effects of prolonged metabolic stress on β-cell dynamics are still unclear. Here, the aim was to investigate pancreatic β-cell dynamics and function during and after prolonged hypoglycaemia. Hypoglycaemia was induced in male and female rats by infusion of human insulin for 8 weeks, followed by a 4-week infusion-free recovery period. Animals were euthanized after 4 or 8 weeks of infusion, and either 2 days and 4 weeks after infusion-stop. Total volumes of pancreatic islets and β-cell nuclei, islet insulin and glucagon content, and plasma c-peptide levels were quantified. Prolonged hypoglycaemia reduced c-peptide levels, islet volume and almost depleted islet insulin. Relative β-cell nuclei: total pancreas volume decreased, while being unchanged relative to islet volume. Glucagon: total pancreas volume decreased during hypoglycaemia, whereas glucagon: islet volume increased. Within two days after infusion-stop, plasma glucose and c-peptide levels normalised and all remaining parameters were fully reversed after 4 weeks. In conclusion, our findings indicate that prolonged hypoglycaemia inactivates β-cells, which can rapidly be reactivated when needed, demonstrating the high plasticity of β-cells even following prolonged suppression.
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Sangiorgi ZV, Boss MK, Leary D, Prebble AR, Harrison LG, Carlson TA, LaRue SM, Johnston MS. Hypofractionated radiation therapy for treatment of an adrenal mass in a ferret. J Exot Pet Med 2021. [DOI: 10.1053/j.jepm.2021.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Jensen VFH, Mølck AM, Lykkesfeldt J, Fels JJ, Andersen L, Renaut R, McGuigan F, Åkesson KE, Bøgh IB. Importance of gestational hypoglycaemia for foetal malformations and skeletal development in rats. Reprod Toxicol 2019; 91:14-26. [PMID: 31644949 DOI: 10.1016/j.reprotox.2019.10.003] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2018] [Revised: 09/06/2019] [Accepted: 10/16/2019] [Indexed: 11/28/2022]
Abstract
The aim was to investigate embryo-foetal effects of continuous maternal insulin-induced hypoglycaemia extending throughout gestation or until gestation day (GD)17 (typical last day of dosing during pre-clinical evaluation) providing comparator data for safety assessment of longer-acting insulin analogues in non-diabetic rats. Pregnant rats received human insulin (HI)-infusion during gestation until either GD20 or GD17 (HI-GD20; HI-GD17). On GD20, foetal abnormalities and skeletal ossification/mineralisation were evaluated. HI-infusion induced continuous hypoglycaemia. Foetal skeletal and eye malformations (e.g. bent ribs, microphthalmia) were common in both groups. Foetal size and skeletal ossification/mineralisation decreased, particularly with infusion throughout gestation. Concluding, insulin-induced hypoglycaemia during gestation in non-diabetic rats is damaging to embryo-foetal growth and skeletal development, particularly after GD17. Three days without HI-infusion after GD17 allows for some developmental catch-up. Eye development is sensitive to HI-infusion before GD17. These results should serve as a benchmark during pre-clinical safety assessment of longer-acting insulin analogues tested in rats.
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Affiliation(s)
- Vivi Flou Hjorth Jensen
- Department of Toxicology Development Projects, Novo Nordisk A/S Maaloev, Denmark; Department of Veterinary and Animal Sciences, Section for Experimental Animal Models, University of Copenhagen, Copenhagen, Denmark; Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden; Department of Orthopedics, Skåne University, Malmö, Sweden.
| | - Anne-Marie Mølck
- Department of Toxicology Development Projects, Novo Nordisk A/S Maaloev, Denmark
| | - Jens Lykkesfeldt
- Department of Veterinary and Animal Sciences, Section for Experimental Animal Models, University of Copenhagen, Copenhagen, Denmark
| | | | - Lene Andersen
- Department of Clinical Bioanalysis, Novo Nordisk A/S, Maaloev, Denmark
| | - Ruth Renaut
- Division of Toxicology, Envigo, Eye, Suffolk, UK
| | - Fiona McGuigan
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden; Department of Orthopedics, Skåne University, Malmö, Sweden
| | - Kristina E Åkesson
- Department of Clinical Sciences Malmö, Clinical and Molecular Osteoporosis Research Unit, Lund University, Malmö, Sweden; Department of Orthopedics, Skåne University, Malmö, Sweden
| | - Ingrid Brück Bøgh
- Department of Toxicology Development Projects, Novo Nordisk A/S Maaloev, Denmark
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Robertson J, Brandão J, Blas-Machado U, Cohen E, Mayer J. SPONTANEOUS PANCREATIC ISLET CELL ADENOMA WITH PERIPHERAL NEUROPATHY IN A PET RAT (RATTUS NORVEGICUS). J Exot Pet Med 2019. [DOI: 10.1053/j.jepm.2018.10.003] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
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Pardo ID, Rao DB, Butt MT, Jortner BS, Valentine WM, Arezzo J, Sharma AK, Bolon B. Toxicologic Pathology of the Peripheral Nervous System (PNS): Overview, Challenges, and Current Practices. Toxicol Pathol 2018; 46:1028-1036. [DOI: 10.1177/0192623318800707] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
Peripheral nervous system (PNS) toxicity is a frequent adverse effect encountered in patients treated with certain therapeutics (e.g., antiretroviral drugs, cancer chemotherapeutics), in occupational workers exposed to industrial chemicals (e.g., solvents), or during accidental exposures to household chemicals and/or environmental agents (e.g., pesticides). However, the literature and expertise needed for the effective design, conduct, analysis, and reporting of safety studies to identify and define PNS toxicity are hard to find. This half-day course familiarized participants with basic PNS biology; causes and mechanisms of PNS pathology; classic methods and current best practice recommendations for PNS sampling, preparation, and evaluation; and examples of commonly observed lesions and artifacts. Three concluding case presentations synthesized information from the prior technical lectures by presenting real-world examples of lesions caused by drugs and chemicals to demonstrate how PNS toxicity may be addressed in evaluating product safety during nonclinical studies. Topics emphasized comparative and correlative data among animal species used in toxicity studies and clinical evaluation in humans in order to facilitate the translation of animal data into human risk assessment with respect to PNS toxicologic pathology.
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Affiliation(s)
| | - Deepa B. Rao
- Current employer: Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, Maryland, USA
| | - Mark T. Butt
- Tox Path Specialists, LLC, Frederick, Maryland, USA
| | - Bernard S. Jortner
- Virginia–Maryland Regional College of Veterinary Medicine, Virginia Polytechnic Institute and State University, Blacksburg, Virginia, USA
| | | | - Joseph Arezzo
- Albert Einstein College of Medicine, Bronx, New York, USA
| | | | - Brad Bolon
- GEMpath Inc., Longmont, Colorado, USA *Ingrid D. Pardo and Deepa B. Rao contributed equally to production of this article
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Jensen VF, Mølck AM, Lykkesfeldt J, Bøgh IB. Effect of maternal hypoglycaemia during gestation on materno-foetal nutrient transfer and embryo-foetal development: Evidence from experimental studies focused primarily on the rat. Reprod Toxicol 2018; 77:1-24. [DOI: 10.1016/j.reprotox.2018.01.007] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/19/2017] [Revised: 12/07/2017] [Accepted: 01/30/2018] [Indexed: 01/14/2023]
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Jensen VFH, Molck AM, Soeborg H, Nowak J, Chapman M, Lykkesfeldt J, Bogh IB. Proximal Neuropathy and Associated Skeletal Muscle Changes Resembling Denervation Atrophy in Hindlimbs of Chronic Hypoglycaemic Rats. Basic Clin Pharmacol Toxicol 2017; 122:165-175. [PMID: 28815909 DOI: 10.1111/bcpt.12870] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/09/2017] [Accepted: 07/19/2017] [Indexed: 11/29/2022]
Abstract
Peripheral neuropathy is one of the most common complications of diabetic hyperglycaemia. Insulin-induced hypoglycaemia (IIH) might potentially exacerbate or contribute to neuropathy as hypoglycaemia also causes peripheral neuropathy. In rats, IIH induces neuropathy associated with skeletal muscle changes. Aims of this study were to investigate the progression and sequence of histopathologic changes caused by chronic IIH in rat peripheral nerves and skeletal muscle, and whether such changes were reversible. Chronic IIH was induced by infusion of human insulin, followed by an infusion-free recovery period in some of the animals. Sciatic, plantar nerves and thigh muscle were examined histopathologically after four or eight weeks of infusion and after the recovery period. IIH resulted in high incidence of axonal degeneration in sciatic nerves and low incidence in plantar nerves indicating proximo-distal progression of the neuropathy. The neuropathy progressed in severity (sciatic nerve) and incidence (sciatic and plantar nerve) with the duration of IIH. The myopathy consisted of groups of angular atrophic myofibres which resembled histopathologic changes classically seen after denervation of skeletal muscle, and severity of the myofibre atrophy correlated with severity of axonal degeneration in sciatic nerve. Both neuropathy and myopathy were still present after four weeks of recovery, although the neuropathy was less severe. In conclusion, the results suggest that peripheral neuropathy induced by IIH progresses proximo-distally, that severity and incidence increase with duration of the hypoglycaemia and that these changes are partially reversible within four weeks. Furthermore, IIH-induced myopathy is most likely secondary to the neuropathy.
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Affiliation(s)
- Vivi F H Jensen
- Section for Experimental Animal Models, Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark.,Department of Toxicology, Safety Pharm and Pathology, Novo Nordisk A/S, Maaloev, Denmark
| | - Anne-Marie Molck
- Department of Toxicology, Safety Pharm and Pathology, Novo Nordisk A/S, Maaloev, Denmark
| | - Henrik Soeborg
- Department of Toxicology, Safety Pharm and Pathology, Novo Nordisk A/S, Maaloev, Denmark
| | - Jette Nowak
- Department of Toxicology, Safety Pharm and Pathology, Novo Nordisk A/S, Maaloev, Denmark
| | | | - Jens Lykkesfeldt
- Section for Experimental Animal Models, Department of Veterinary and Animal Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ingrid B Bogh
- Department of Toxicology, Safety Pharm and Pathology, Novo Nordisk A/S, Maaloev, Denmark
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Jensen VFH, Mølck AM, Berthelsen LO, Alifrangis L, Andersen L, Chapman M, Lykkesfeldt J, Bøgh IB. Toxicological Effects during and following Persistent Insulin-Induced Hypoglycaemia in Healthy Euglycaemic Rats. Basic Clin Pharmacol Toxicol 2017; 121:53-66. [DOI: 10.1111/bcpt.12769] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/12/2016] [Accepted: 02/13/2017] [Indexed: 12/27/2022]
Affiliation(s)
- Vivi F. H. Jensen
- Department of Veterinary and Animal Sciences; Section for Experimental Animal Models; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
- Department of Toxicology; Safety Pharm and Pathology; Novo Nordisk A/S; Maaloev Denmark
| | - Anne-Marie Mølck
- Department of Toxicology; Safety Pharm and Pathology; Novo Nordisk A/S; Maaloev Denmark
| | - Line O. Berthelsen
- Department of Toxicology; Safety Pharm and Pathology; Novo Nordisk A/S; Maaloev Denmark
| | - Lene Alifrangis
- Department of Development DMPK; Novo Nordisk A/S; Maaloev Denmark
| | - Lene Andersen
- Department of Diabetes Bioanalysis; Novo Nordisk A/S; Maaloev Denmark
| | | | - Jens Lykkesfeldt
- Department of Veterinary and Animal Sciences; Section for Experimental Animal Models; Faculty of Health and Medical Sciences; University of Copenhagen; Copenhagen Denmark
| | - Ingrid B. Bøgh
- Department of Toxicology; Safety Pharm and Pathology; Novo Nordisk A/S; Maaloev Denmark
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Jensen VFH, Mølck AM, Chapman M, Alifrangis L, Andersen L, Lykkesfeldt J, Bøgh IB. Chronic Hyperinsulinaemic Hypoglycaemia in Rats Is Accompanied by Increased Body Weight, Hyperleptinaemia, and Decreased Neuronal Glucose Transporter Levels in the Brain. Int J Endocrinol 2017; 2017:7861236. [PMID: 28421113 PMCID: PMC5379133 DOI: 10.1155/2017/7861236] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/30/2016] [Revised: 12/19/2016] [Accepted: 12/26/2016] [Indexed: 12/18/2022] Open
Abstract
The brain is vulnerable to hypoglycaemia due to a continuous need of energy substrates to meet its high metabolic demands. Studies have shown that severe acute insulin-induced hypoglycaemia results in oxidative stress in the rat brain, when neuroglycopenia cannot be evaded despite increased levels of cerebral glucose transporters. Compensatory measures in the brain during chronic insulin-induced hypoglycaemia are less well understood. The present study investigated how the brain of nondiabetic rats copes with chronic insulin-induced hypoglycaemia for up to eight weeks. Brain level of different substrate transporters and redox homeostasis was evaluated. Hyperinsulinaemia for 8 weeks consistently lowered blood glucose levels by 30-50% (4-6 mM versus 7-9 mM in controls). The animals had increased food consumption, body weights, and hyperleptinaemia. During infusion, protein levels of the brain neuronal glucose transporter were decreased, whereas levels of lipid peroxidation products were unchanged. Discontinued infusion was followed by transient systemic hyperglycaemia and decreased food consumption and body weight. After 4 weeks, plasma levels of lipid peroxidation products were increased, possibly as a consequence of hyperglycaemia-induced oxidative stress. The present data suggests that chronic moderate hyperinsulinaemic hypoglycaemia causes increased body weight and hyperleptinaemia. This is accompanied by decreased neuronal glucose transporter levels, which may be leptin-induced.
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Affiliation(s)
- Vivi F. H. Jensen
- Department of Veterinary Disease Biology, Section for Experimental Animal Models, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
- Department of Toxicology, Safety Pharm and Pathology, Novo Nordisk A/S, Maaloev, Denmark
- *Vivi F. H. Jensen:
| | - Anne-Marie Mølck
- Department of Toxicology, Safety Pharm and Pathology, Novo Nordisk A/S, Maaloev, Denmark
| | | | - Lene Alifrangis
- Department of Development DMPK, Novo Nordisk A/S, Maaloev, Denmark
| | - Lene Andersen
- Department of Development Bioanalysis, Novo Nordisk A/S, Maaloev, Denmark
| | - Jens Lykkesfeldt
- Department of Veterinary Disease Biology, Section for Experimental Animal Models, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ingrid B. Bøgh
- Department of Toxicology, Safety Pharm and Pathology, Novo Nordisk A/S, Maaloev, Denmark
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Jensen VFH, Mølck AM, Mårtensson M, Strid MA, Chapman M, Lykkesfeldt J, Bøgh IB. Assessment of implantable infusion pumps for continuous infusion of human insulin in rats: potential for group housing. Lab Anim 2016; 51:273-283. [PMID: 27465034 DOI: 10.1177/0023677216660740] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022]
Abstract
Group housing is considered to be important for rats, which are highly sociable animals. Single housing may impact behaviour and levels of circulating stress hormones. Rats are typically used in the toxicological evaluation of insulin analogues. Human insulin (HI) is frequently used as a reference compound in these studies, and a comparator model of persistent exposure by HI infusion from external pumps has recently been developed to support toxicological evaluation of long-acting insulin analogues. However, this model requires single housing of the animals. Developing an insulin-infusion model which allows group housing would therefore greatly improve animal welfare. The aim of the present study was to investigate the suitability of implantable infusion pumps for HI infusion in group-housed rats. Group housing of rats implanted with a battery-driven pump proved to be possible. Intravenous infusion of HI lowered blood glucose levels persistently for two weeks, providing a comparator model for use in two-week repeated-dose toxicity studies with new long-acting insulin analogues, which allows group housing, and thereby increasing animal welfare compared with an external infusion model.
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Affiliation(s)
- Vivi Flou Hjorth Jensen
- 1 Department of Veterinary Disease Biology, Experimental Pharmacology and Toxicology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark.,2 Department of Toxicology & Safety Pharmacology, Novo Nordisk A/S, Måøv, Denmark
| | - Anne-Marie Mølck
- 2 Department of Toxicology & Safety Pharmacology, Novo Nordisk A/S, Måøv, Denmark
| | - Martin Mårtensson
- 3 Department of Diabetes Analytical Development, Novo Nordisk A/S, Måøv, Denmark
| | | | | | - Jens Lykkesfeldt
- 1 Department of Veterinary Disease Biology, Experimental Pharmacology and Toxicology, Faculty of Health and Medical Sciences, University of Copenhagen, Copenhagen, Denmark
| | - Ingrid Brück Bøgh
- 2 Department of Toxicology & Safety Pharmacology, Novo Nordisk A/S, Måøv, Denmark
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