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Zhang X, Zhu X, Bi X, Huang J, Zhou L. The Insulin Receptor: An Important Target for the Development of Novel Medicines and Pesticides. Int J Mol Sci 2022; 23:ijms23147793. [PMID: 35887136 PMCID: PMC9325136 DOI: 10.3390/ijms23147793] [Citation(s) in RCA: 12] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/06/2022] [Revised: 07/10/2022] [Accepted: 07/12/2022] [Indexed: 02/04/2023] Open
Abstract
The insulin receptor (IR) is a transmembrane protein that is activated by ligands in insulin signaling pathways. The IR has been considered as a novel therapeutic target for clinical intervention, considering the overexpression of its protein and A-isoform in multiple cancers, Alzheimer’s disease, and Type 2 diabetes mellitus in humans. Meanwhile, it may also serve as a potential target in pest management due to its multiple physiological influences in insects. In this review, we provide an overview of the structural and molecular biology of the IR, functions of IRs in humans and insects, physiological and nonpeptide small molecule modulators of the IR, and the regulating mechanisms of the IR. Xenobiotic compounds and the corresponding insecticidal chemicals functioning on the IR are also discussed. This review is expected to provide useful information for a better understanding of human IR-related diseases, as well as to facilitate the development of novel small-molecule activators and inhibitors of the IR for use as medicines or pesticides.
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Distinct signaling by insulin and IGF-1 receptors and their extra- and intracellular domains. Proc Natl Acad Sci U S A 2021; 118:2019474118. [PMID: 33879610 DOI: 10.1073/pnas.2019474118] [Citation(s) in RCA: 37] [Impact Index Per Article: 12.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
Insulin and insulin-like growth factor 1 (IGF-1) receptors share many downstream signaling pathways but have unique biological effects. To define the molecular signals contributing to these distinct activities, we performed global phosphoproteomics on cells expressing either insulin receptor (IR), IGF-1 receptor (IGF1R), or chimeric IR-IGF1R receptors. We show that IR preferentially stimulates phosphorylations associated with mammalian target of rapamycin complex 1 (mTORC1) and Akt pathways, whereas IGF1R preferentially stimulates phosphorylations on proteins associated with the Ras homolog family of guanosine triphosphate hydrolases (Rho GTPases), and cell cycle progression. There were also major differences in the phosphoproteome between cells expressing IR versus IGF1R in the unstimulated state, including phosphorylation of proteins involved in membrane trafficking, chromatin remodeling, and cell cycle. In cells expressing chimeric IR-IGF1R receptors, these differences in signaling could be mapped to contributions of both the extra- and intracellular domains of these receptors. Thus, despite their high homology, IR and IGF1R preferentially regulate distinct networks of phosphorylation in both the basal and stimulated states, allowing for the unique effects of these hormones on organismal function.
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Ashraf A, Palakkott A, Ayoub MA. Anti-Insulin Receptor Antibodies in the Pathology and Therapy of Diabetes Mellitus. Curr Diabetes Rev 2021; 17:198-206. [PMID: 32496987 DOI: 10.2174/1573399816666200604122345] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/03/2020] [Revised: 05/12/2020] [Accepted: 05/24/2020] [Indexed: 11/22/2022]
Abstract
Diabetes mellitus (DM) is recognized as the most common and the world's fastest-growing chronic disease with severe complications leading to increased mortality. Many strategies exist for the management of DM and its control, including treatment with insulin and insulin analogs, oral hypoglycemic therapy such as insulin secretion stimulators and insulin sensitizers, and diet and physical training. Over the years, many types of drugs and molecules with an interesting pharmacological diversity have been developed and proposed for their anti-diabetic potential. Such molecules target diverse key receptors, enzymes, and regulatory/signaling proteins known to be directly or indirectly involved in the pathophysiology of DM. Among them, insulin receptor (IR) is undoubtedly the target of choice for its central role in insulin-mediated glucose homeostasis and its utilization by the major insulin-sensitive tissues such as skeletal muscles, adipose tissue, and the liver. In this review, we focus on the implication of antibodies targeting IR in the pathology of DM as well as the recent advances in the development of IR antibodies as promising anti-diabetic drugs. The challenge still entails development of more powerful, highly selective, and safer anti-diabetic drugs.
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Affiliation(s)
- Arshida Ashraf
- Department of Biology, College of Science, The United Arab Emirates University (UAEU), PO Box 15551, Al Ain, United Arab Emirates
| | - Abdulrasheed Palakkott
- Department of Biology, College of Science, The United Arab Emirates University (UAEU), PO Box 15551, Al Ain, United Arab Emirates
| | - Mohammed Akli Ayoub
- Department of Biology, College of Science, The United Arab Emirates University (UAEU), PO Box 15551, Al Ain, United Arab Emirates
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Chen X, Daniels NA, Cottrill D, Cao Y, Wang X, Li Y, Shriwas P, Qian Y, Archer MW, Whitticar NB, Jahan I, Nunemaker CS, Guo A. Natural Compound α-PGG and Its Synthetic Derivative 6Cl-TGQ Alter Insulin Secretion: Evidence for Diminishing Glucose Uptake as a Mechanism. Diabetes Metab Syndr Obes 2021; 14:759-772. [PMID: 33658814 PMCID: PMC7917315 DOI: 10.2147/dmso.s284295] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2020] [Accepted: 12/24/2020] [Indexed: 12/17/2022] Open
Abstract
PURPOSE Previously we showed that natural compound α-penta-galloyl-glucose (α-PGG) and its synthetic derivative 6-chloro-6-deoxy-1,2,3,4-tetra-O-galloyl-α-D-glucopyranose (6Cl-TGQ) act to improve insulin signaling in adipocytes by increasing glucose transport. In this study, we investigated the mechanism of actions of α-PGG and 6Cl-TGQ on insulin secretion. METHODS Mouse islets and/or INS-1832/13 beta-cells were used to test the effects of our compounds on glucose-stimulated insulin secretion (GSIS), intracellular calcium [Ca2+]i using fura-2AM, glucose transport activity via a radioactive glucose uptake assay, intracellular ATP/ADP, and extracellular acidification (ECAR) and mitochondrial oxygen consumption rates (OCAR) using Seahorse metabolic analysis. RESULTS Both compounds reduced GSIS in beta-cells without negatively affecting cell viability. The compounds primarily diminished glucose uptake into islets and beta-cells. Despite insulin-like effects in the peripheral tissues, these compounds do not act through the insulin receptor in islets. Further interrogation of the stimulus-secretion pathway showed that all the key metabolic factors involved in GSIS including ECAR, OCAR, ATP/ADP ratios, and [Ca2+]i of INS-1832/13 cells were diminished after the compound treatment. CONCLUSION The compounds suppress glucose uptake of the beta-cells, which consequently slows down the rates of glycolysis and ATP synthesis, leading to decrease in [Ca2+]i and GSIS. The difference between adipocytes and beta-cells in effects on glucose uptake is of great interest. Further structural and functional modifications could produce new compounds with optimized therapeutic potentials for different target cells. The higher potency of synthetic 6Cl-TGQ in enhancing insulin signaling in adipocytes but lower potency in reducing glucose uptake in beta-cells compared to α-PGG suggests the feasibility of such an approach.
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Affiliation(s)
- Xiaozhuo Chen
- The Diabetes Institute at Ohio University, Athens, OH, 45701, USA
- The Edison Biotechnology Institute, Athens, OH, 45701, USA
- Department of Biological Sciences, Athens, OH, 45701, USA
- Department of Biomedical Sciences, Athens, OH, 45701, USA
- Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA
- Interdisciplinary Graduate Program in Molecular and Cellular Biology, Athens, OH, 45701, USA
- Department of Chemistry and Biochemistry, Athens, OH, 45701, USA
| | - Nigel A Daniels
- The Diabetes Institute at Ohio University, Athens, OH, 45701, USA
- Department of Biomedical Sciences, Athens, OH, 45701, USA
- Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA
- Department of Specialty Medicine, Athens, OH, 45701, USA
| | - David Cottrill
- The Edison Biotechnology Institute, Athens, OH, 45701, USA
- Department of Biological Sciences, Athens, OH, 45701, USA
| | - Yanyang Cao
- The Edison Biotechnology Institute, Athens, OH, 45701, USA
- Department of Biological Sciences, Athens, OH, 45701, USA
| | - Xuan Wang
- The Edison Biotechnology Institute, Athens, OH, 45701, USA
- Department of Biological Sciences, Athens, OH, 45701, USA
| | - Yunsheng Li
- The Edison Biotechnology Institute, Athens, OH, 45701, USA
| | - Pratik Shriwas
- The Edison Biotechnology Institute, Athens, OH, 45701, USA
- Department of Biological Sciences, Athens, OH, 45701, USA
| | - Yanrong Qian
- The Edison Biotechnology Institute, Athens, OH, 45701, USA
| | - Michael W Archer
- The Diabetes Institute at Ohio University, Athens, OH, 45701, USA
- Department of Biomedical Sciences, Athens, OH, 45701, USA
| | - Nicholas B Whitticar
- Department of Biomedical Sciences, Athens, OH, 45701, USA
- Translational Biomedical Sciences Program, Ohio University, Athens, OH, 45701, USA
| | - Ishrat Jahan
- The Diabetes Institute at Ohio University, Athens, OH, 45701, USA
- Department of Biomedical Sciences, Athens, OH, 45701, USA
| | - Craig S Nunemaker
- The Diabetes Institute at Ohio University, Athens, OH, 45701, USA
- Department of Biological Sciences, Athens, OH, 45701, USA
- Department of Biomedical Sciences, Athens, OH, 45701, USA
- Heritage College of Osteopathic Medicine, Athens, OH, 45701, USA
- Craig S Nunemaker Department of Biomedical Sciences, 1 Ohio University, Athens, OH, 45701, USATel +1 740-593-2387Fax +1 740-593-4795 Email
| | - Aili Guo
- Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, University of California at Davis (UC Davis) School of Medicine, UC Davis Health Science, Sacramento, CA, 95817, USA
- Correspondence: Aili Guo Department of Internal Medicine, Division of Endocrinology, Diabetes and Metabolism, University of California at Davis (UC Davis) School of Medicine, UC Davis Health Science, PSSB, G400, 4150 V St., Sacramento, CA, 95817, USATel +1 916-734-3730Fax +1 916-734-2292 Email
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Xu SFS, Andersen DB, Izarzugaza JMG, Kuhre RE, Holst JJ. In the rat pancreas, somatostatin tonically inhibits glucagon secretion and is required for glucose-induced inhibition of glucagon secretion. Acta Physiol (Oxf) 2020; 229:e13464. [PMID: 32145704 DOI: 10.1111/apha.13464] [Citation(s) in RCA: 29] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/26/2019] [Revised: 02/28/2020] [Accepted: 03/04/2020] [Indexed: 12/20/2022]
Abstract
AIM It is debated whether the inhibition of glucagon secretion by glucose results from direct effects of glucose on the α-cell (intrinsic regulation) or by paracrine effects exerted by beta- or delta-cell products. METHODS To study this in a more physiological model than isolated islets, we perfused isolated rat pancreases and measured glucagon, insulin and somatostatin secretion in response to graded increases in perfusate glucose concentration (from 3.5 to 4, 5, 6, 7, 8, 10, 12 mmol/L) as well as glucagon responses to blockage/activation of insulin/GABA/somatostatin signalling with or without addition of glucose. RESULTS Glucagon secretion was reduced by about 50% (compared to baseline secretion at 3.5 mmol/L) within minutes after increasing glucose from 4 to 5 mmol/L (P < .01, n = 13). Insulin secretion was increased minimally, but significantly, compared to baseline (3.5 mmol/L) at 4 mmol/L, whereas somatostatin secretion was not significantly increased from baseline until 7 mmol/L. Hereafter secretion of both increased gradually up to 12 mmol/L glucose. Neither recombinant insulin (1 µmol/L), GABA (300 µmol/L) or the insulin-receptor antagonist S961 (at 1 µmol/L) affected basal (3.5 mmol/L) or glucose-induced (5.0 mmol/L) attenuation of glucagon secretion (n = 7-8). Somatostatin-14 attenuated glucagon secretion by ~ 95%, and blockage of somatostatin-receptor (SSTR)-2 or combined blockage of SSTR-2, -3 and -5 by specific antagonists increased glucagon output (at 3.5 mmol/L glucose) and prevented glucose-induced (from 3.5 to 5.0 mmol/L) suppression of secretion. CONCLUSION Somatostatin is a powerful and tonic inhibitor of glucagon secretion from the rat pancreas and is required for glucose to inhibit glucagon secretion.
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Affiliation(s)
- Stella F. S. Xu
- Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Daniel B. Andersen
- Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | | | - Rune E. Kuhre
- Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
| | - Jens J. Holst
- Department of Biomedical Sciences Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
- Novo Nordisk Foundation Center for Basic Metabolic Research Faculty of Health and Medical Sciences University of Copenhagen Copenhagen Denmark
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Wang G. Body Mass Dynamics Is Determined by the Metabolic Ohm's Law and Adipocyte-Autonomous Fat Mass Homeostasis. iScience 2020; 23:101176. [PMID: 32480131 PMCID: PMC7262567 DOI: 10.1016/j.isci.2020.101176] [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: 01/19/2020] [Revised: 04/05/2020] [Accepted: 05/14/2020] [Indexed: 11/06/2022] Open
Abstract
An ODE model integrating metabolic mechanisms with clinical data reveals an Ohm's law governing lifetime body mass dynamics, where fat and lean tissues are analogous to a parallel nonlinear capacitor and resistor, respectively. The law unexpectedly decouples weight stability (a cell-autonomous property of adipocytes) and weight change (a parabolic trajectory governed by Ohm's law). In middle age, insulin resistance causes fat accumulation to avoid excessive body shrinkage in old age. Moderate middle-age spread is thus natural, not an anomaly caused by hypothalamic defects, as proposed by lipostatic theory. These discoveries provide valuable insights into health care practices such as weight control and health assessment, explain certain observed phenomena, make testable predictions, and may help to resolve major conundrums in the field. The ODE model, which is more comprehensive than Ohm's law, is useful to study metabolism at the detailed microscopic levels.
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Affiliation(s)
- Guanyu Wang
- Department of Biology, Southern University of Science and Technology, Shenzhen, Guangdong 518055, China; Guangdong Provincial Key Laboratory of Computational Science and Material Design, Shenzhen, Guangdong 518055, China; Guangdong Provincial Key Laboratory of Cell Microenviroment and Disease Research, Shenzhen, Guangdong 518055, China; Shenzhen Key Laboratory of Cell Microenviroment, Shenzhen, Guangdong 518055, China.
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Late Cognitive Consequences of Gestational Diabetes to the Offspring, in a New Mouse Model. Mol Neurobiol 2019; 56:7754-7764. [PMID: 31115777 DOI: 10.1007/s12035-019-1624-0] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/18/2019] [Accepted: 04/24/2019] [Indexed: 12/17/2022]
Abstract
Gestational diabetes mellitus (GD) is a form of insulin resistance triggered during gestation, which affects approximately 10% of pregnant women. Although previously considered a transient condition with few long-term consequences, growing evidence suggest that GD may be linked to permanent metabolic and neurologic changes in the offspring. Currently available GD models fail to recapitulate the full spectrum of this disease, thus providing limited information about the true burden of this condition. Here, we describe a new mouse model of GD, based on the administration of an insulin receptor antagonist (S961, 30 nmol/kg s.c. daily) during pregnancy. Pregnant mice developed increased fasting glycemia and glucose intolerance in the absence of maternal obesity, with a return to normoglycemia shortly after parturition. Moreover, we showed that the adult offspring of GD dams presented pronounced metabolic and cognitive dysfunction when exposed to short-term high-fat diet (HFD). Our data demonstrate that S961 administration to pregnant mice comprises a valuable approach to study the complex pathophysiology of GD, as well as strategies focused on prevention and treatment of both the mother and the offspring. Our findings suggest that the offspring of GD mothers are more susceptible to metabolic and cognitive impairments when exposed to high-fat diet later in life, thus indicating that approaches to prevent and treat these late effects should be pursued.
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Hinke SA, Cieniewicz AM, Kirchner T, D'Aquino K, Nanjunda R, Aligo J, Perkinson R, Cooper P, Boayke K, Chiu ML, Jarantow S, Lacy ER, Liang Y, Johnson DL, Whaley JM, Lingham RB, Kihm AJ. Unique pharmacology of a novel allosteric agonist/sensitizer insulin receptor monoclonal antibody. Mol Metab 2018; 10:87-99. [PMID: 29453154 PMCID: PMC5985231 DOI: 10.1016/j.molmet.2018.01.014] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/06/2017] [Revised: 01/02/2018] [Accepted: 01/17/2018] [Indexed: 12/12/2022] Open
Abstract
Objective Insulin resistance is a key feature of Type 2 Diabetes (T2D), and improving insulin sensitivity is important for disease management. Allosteric modulation of the insulin receptor (IR) with monoclonal antibodies (mAbs) can enhance insulin sensitivity and restore glycemic control in animal models of T2D. Methods A novel human mAb, IRAB-A, was identified by phage screening using competition binding and surface plasmon resonance assays with the IR extracellular domain. Cell based assays demonstrated agonist and sensitizer effects of IRAB-A on IR and Akt phosphorylation, as well as glucose uptake. Lean and diet-induced obese mice were used to characterize single-dose in vivo pharmacological effects of IRAB-A; multiple-dose IRAB-A effects were tested in obese mice. Results In vitro studies indicate that IRAB-A exhibits sensitizer and agonist properties distinct from insulin on the IR and is translated to downstream signaling and function; IRAB-A bound specifically and allosterically to the IR and stabilized insulin binding. A single dose of IRAB-A given to lean mice rapidly reduced fed blood glucose for approximately 2 weeks, with concomitant reduced insulin levels suggesting improved insulin sensitivity. Phosphorylated IR (pIR) from skeletal muscle and liver were increased by IRAB-A; however, phosphorylated Akt (pAkt) levels were only elevated in skeletal muscle and not liver vs. control; immunochemistry analysis (IHC) confirmed the long-lived persistence of IRAB-A in skeletal muscle and liver. Studies in diet-induced obese (DIO) mice with IRAB-A reduced fed blood glucose and insulinemia yet impaired glucose tolerance and led to protracted insulinemia during a meal challenge. Conclusion Collectively, the data suggest IRAB-A acts allosterically on the insulin receptor acting non-competitively with insulin to both activate the receptor and enhance insulin signaling. While IRAB-A produced a decrease in blood glucose in lean mice, the data in DIO mice indicated an exacerbation of insulin resistance; these data were unexpected and suggested the interplay of complex unknown pharmacology. Taken together, this work suggests that IRAB-A may be an important tool to explore insulin receptor signaling and pharmacology. A novel anti-insulin receptor monoclonal antibody (IRAB-A) was identified that has both agonist and sensitizing activities. IRAB-A increases the receptor's affinity for insulin by binding to an allosteric site and does not compete with insulin. Mice injected once with IRAB-A show improved glycemia and reduced insulinemia, indicative of enhanced insulin sensitivity. In diet induced obese mice, the insulin sensitizing effect of IRAB-A appears to depend on the degree of insulin resistance. Chronic treatment of obese mice showed mixed effects on glucose homeostasis under normal fed or meal challenged conditions.
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Affiliation(s)
- Simon A Hinke
- Cardiovascular and Metabolism Therapeutic Area, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House, PA, 19477, USA.
| | - Anne M Cieniewicz
- Janssen BioTherapeutics, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House PA 19477, USA
| | - Thomas Kirchner
- Cardiovascular and Metabolism Therapeutic Area, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House, PA, 19477, USA
| | - Katharine D'Aquino
- Cardiovascular and Metabolism Therapeutic Area, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House, PA, 19477, USA
| | - Rupesh Nanjunda
- Janssen BioTherapeutics, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House PA 19477, USA
| | - Jason Aligo
- Janssen BioTherapeutics, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House PA 19477, USA
| | - Robert Perkinson
- Janssen BioTherapeutics, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House PA 19477, USA
| | - Philip Cooper
- Janssen BioTherapeutics, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House PA 19477, USA
| | - Ken Boayke
- Janssen BioTherapeutics, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House PA 19477, USA
| | - Mark L Chiu
- Janssen BioTherapeutics, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House PA 19477, USA
| | - Steve Jarantow
- Janssen BioTherapeutics, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House PA 19477, USA
| | - Eilyn R Lacy
- Janssen BioTherapeutics, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House PA 19477, USA
| | - Yin Liang
- Cardiovascular and Metabolism Therapeutic Area, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House, PA, 19477, USA
| | - Dana L Johnson
- Cardiovascular and Metabolism Therapeutic Area, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House, PA, 19477, USA
| | - Jean M Whaley
- Cardiovascular and Metabolism Therapeutic Area, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House, PA, 19477, USA
| | - Russell B Lingham
- Janssen BioTherapeutics, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House PA 19477, USA
| | - Anthony J Kihm
- Janssen BioTherapeutics, Janssen Pharmaceutical Research & Development LLC, 1400 McKean Road, Spring House PA 19477, USA.
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