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Lazaridis II, Bosch AJT, Keller L, Low AJY, Tamarelle J, Moser SO, Winter DV, Gómez C, Peterson CJ, Schneider R, Kraljević M, Odermatt A, Vonaesch P, Peterli R, Delko T, Cavelti-Weder C. Metabolic outcomes in obese mice undergoing one-anastomosis gastric bypass (OAGB) with a long or a short biliopancreatic limb. Am J Physiol Endocrinol Metab 2024. [PMID: 38630050 DOI: 10.1152/ajpendo.00327.2023] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/02/2023] [Accepted: 04/10/2024] [Indexed: 04/23/2024]
Abstract
One-anastomosis gastric bypass (OAGB) has gained importance as a safe and effective operation to treat morbid obesity. It is not known whether a long biliopancreatic limb (BPL) in OAGB surgery compared to a short BPL results in beneficial metabolic outcomes. 5-week-old male C57BL/6J mice fed a high-fat diet for 8 weeks underwent OAGB surgery with defined short and long BPL lengths, or sham surgery combined with caloric restriction. Weight loss, glucose tolerance, obesity-related comorbidities, endocrine effects, gut microbiota and bile acids were assessed. Total weight loss was independent of the length of the BPL after OAGB surgery. However, a long BPL was associated with lower glucose-stimulated insulin on day 14, and an improved glucose tolerance on day 35 after surgery. A long BPL resulted in reduced total cholesterol. There were no differences in the resolution of metabolic dysfunction-associated steatotic liver disease and adipose tissue inflammation. Tendencies of an attenuated hypothalamic-pituitary-adrenal axis and aldosterone were present in the long BPL group. In OAGB-operated mice, we found an increase in primary conjugated bile acids (pronounced in long BPL) along with a loss in bacterial Desulfovibrionaceae and Erysipelotrichaceae and simultaneous increase in Akkermansiaceae, Sutterellaceae and Enterobacteriaceae. In sum, OAGB surgery with a long compared to a short BPL led to similar weight loss, but improved glucose metabolism, lipid and endocrine outcomes in obese mice, potentially mediated through changes in gut microbiota and related bile acids. Tailoring the BPL length in humans might help to optimize metabolic outcomes after bariatric surgery.
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Affiliation(s)
- Ioannis I Lazaridis
- University Hospital of Basel, Basel, Switzerland
- Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital, Clarunis, Switzerland
| | - Angela J T Bosch
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital of Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, University Hospital Basel, Basel, Switzerland
| | - Lena Keller
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital of Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, University Hospital Basel, Basel, Switzerland
| | - Andy J Y Low
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital of Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, University Hospital Basel, Basel, Switzerland
| | - Jeanne Tamarelle
- Department of Fundamental Microbiology, University of Lausanne, Lausanne,Switzerland
| | - Seraina O Moser
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Denise V Winter
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Cristina Gómez
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Caspar J Peterson
- University Hospital of Basel, Basel, Switzerland
- Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital, Clarunis, Switzerland
| | - Romano Schneider
- University Hospital of Basel, Basel, Switzerland
- Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital, Clarunis, Switzerland
| | - Marko Kraljević
- University Hospital of Basel, Basel, Switzerland
- Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital, Clarunis, Switzerland
| | - Alex Odermatt
- Division of Molecular and Systems Toxicology, Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Pascale Vonaesch
- Department of Fundamental Microbiology, University of Lausanne, Lausanne,Switzerland
| | - Ralph Peterli
- University Hospital of Basel, Basel, Switzerland
- Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital, Clarunis, Switzerland
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Tarik Delko
- Chirurgie Zentrum St. Anna, Hirslanden Klinik St. Anna, Switzerland
| | - Claudia Cavelti-Weder
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital of Basel, Basel, Switzerland
- Department of Biomedicine, University of Basel, University Hospital Basel, Basel, Switzerland
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital of Zurich, Zurich, Switzerland
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Baldrich A, Althaus D, Menter T, Hirsiger JR, Köppen J, Hupfer R, Juskevicius D, Konantz M, Bosch A, Drexler B, Gerull S, Ghosh A, Meyer BJ, Jauch A, Pini K, Poletti F, Berkemeier CM, Heijnen I, Panne I, Cavelti-Weder C, Niess JH, Dixon K, Daikeler T, Hartmann K, Hess C, Halter J, Passweg J, Navarini AA, Yamamoto H, Berger CT, Recher M, Hruz P. Post-transplant Inflammatory Bowel Disease Associated with Donor-Derived TIM-3 Deficiency. J Clin Immunol 2024; 44:63. [PMID: 38363399 PMCID: PMC10873237 DOI: 10.1007/s10875-024-01667-z] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/21/2023] [Accepted: 01/29/2024] [Indexed: 02/17/2024]
Abstract
Inflammatory bowel disease (IBD) occurring following allogeneic stem cell transplantation (aSCT) is a very rare condition. The underlying pathogenesis needs to be better defined. There is currently no systematic effort to exclude loss- or gain-of-function mutations in immune-related genes in stem cell donors. This is despite the fact that more than 100 inborn errors of immunity may cause or contribute to IBD. We have molecularly characterized a patient who developed fulminant inflammatory bowel disease following aSCT with stable 100% donor-derived hematopoiesis. A pathogenic c.A291G; p.I97M HAVCR2 mutation encoding the immune checkpoint protein TIM-3 was identified in the patient's blood-derived DNA, while being absent in DNA derived from the skin. TIM-3 expression was much decreased in the patient's serum, and in vitro-activated patient-derived T cells expressed reduced TIM-3 levels. In contrast, T cell-intrinsic CD25 expression and production of inflammatory cytokines were preserved. TIM-3 expression was barely detectable in the immune cells of the patient's intestinal mucosa, while being detected unambiguously in the inflamed and non-inflamed colon from unrelated individuals. In conclusion, we report the first case of acquired, "transplanted" insufficiency of the regulatory TIM-3 checkpoint linked to post-aSCT IBD.
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Affiliation(s)
- Adrian Baldrich
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Dominic Althaus
- Gastroenterology and Hepatology, University Center for Gastrointestinal and Liver Diseases, Clarunis, Basel, Switzerland
| | - Thomas Menter
- Pathology, Institute of Medical Genetics and Pathology, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Julia R Hirsiger
- Translational Immunology, Department of Biomedicine, University Hospital, Basel, Switzerland
| | - Julius Köppen
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Robin Hupfer
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Darius Juskevicius
- Molecular Diagnostics, Laboratory Medicine, University Hospital Basel, Basel, Switzerland
| | - Martina Konantz
- Allergy and Immunity Laboratory, Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Angela Bosch
- Translational Diabetes, Department of Biomedicine, University Hospital, Basel, Switzerland
| | - Beatrice Drexler
- Division of Hematology, University Hospital Basel, Basel, Switzerland
| | - Sabine Gerull
- Department of Oncology and Hematology, Kantonsspital Aarau, Aarau, Switzerland
| | - Adhideb Ghosh
- Competence Center for Personalized Medicine, University of Zürich/Eidgenössische Technische Hochschule (ETH), Zurich, Switzerland
| | - Benedikt J Meyer
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland
- Division of Hematology, University Hospital Basel, Basel, Switzerland
| | - Annaise Jauch
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Katia Pini
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Fabio Poletti
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Caroline M Berkemeier
- Division Medical Immunology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland
| | - Ingmar Heijnen
- Division Medical Immunology, Laboratory Medicine, University Hospital Basel, Basel, Switzerland
| | - Isabelle Panne
- Gastroenterology and Hepatology, University Center for Gastrointestinal and Liver Diseases, Clarunis, Basel, Switzerland
| | - Claudia Cavelti-Weder
- Translational Diabetes, Department of Biomedicine, University Hospital, Basel, Switzerland
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland
| | - Jan Hendrik Niess
- Gastroenterology and Hepatology, University Center for Gastrointestinal and Liver Diseases, Clarunis, Basel, Switzerland
| | - Karen Dixon
- Cancer Immunology, Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Thomas Daikeler
- Department of Rheumatology, University Hospital Basel, Basel, Switzerland
- University Center for Immunology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Karin Hartmann
- Allergy and Immunity Laboratory, Department of Biomedicine, University Hospital Basel and University of Basel, Basel, Switzerland
- Division of Allergy, Department of Dermatology, University Hospital Basel and University of Basel, Basel, Switzerland
| | - Christoph Hess
- Immunobiology Laboratory, Department of Biomedicine, University Basel Hospital, Basel, Switzerland
- Department of Medicine, Cambridge Institute of Therapeutic Immunology & Infectious Disease, University of Cambridge, Cambridge, UK
- University Center for Immunology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Jörg Halter
- Division of Hematology, University Hospital Basel, Basel, Switzerland
| | - Jakob Passweg
- Division of Hematology, University Hospital Basel, Basel, Switzerland
| | | | - Hiroyuki Yamamoto
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland
- Research Group 2, AIDS Research Center, National Institute of Infectious Diseases, Tokyo, Japan
| | - Christoph T Berger
- Translational Immunology, Department of Biomedicine, University Hospital, Basel, Switzerland
- University Center for Immunology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland
| | - Mike Recher
- Immunodeficiency Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland.
- University Center for Immunology, University Hospital Basel, Petersgraben 4, 4031, Basel, Switzerland.
| | - Petr Hruz
- Gastroenterology and Hepatology, University Center for Gastrointestinal and Liver Diseases, Clarunis, Basel, Switzerland.
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Bosch AJT, Keller L, Steiger L, Rohm TV, Wiedemann SJ, Low AJY, Stawiski M, Rachid L, Roux J, Konrad D, Wueest S, Tugues S, Greter M, Böni-Schnetzler M, Meier DT, Cavelti-Weder C. CSF1R inhibition with PLX5622 affects multiple immune cell compartments and induces tissue-specific metabolic effects in lean mice. Diabetologia 2023; 66:2292-2306. [PMID: 37792013 PMCID: PMC10627931 DOI: 10.1007/s00125-023-06007-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/25/2023] [Accepted: 07/07/2023] [Indexed: 10/05/2023]
Abstract
AIMS/HYPOTHESIS Colony stimulating factor 1 (CSF1) promotes the proliferation, differentiation and survival of macrophages, which have been implicated in both beneficial and detrimental effects on glucose metabolism. However, the physiological role of CSF1 signalling in glucose homeostasis and the potential therapeutic implications of modulating this pathway are not known. We aimed to study the composition of tissue macrophages (and other immune cells) following CSF1 receptor (CSF1R) inhibition and elucidate the metabolic consequences of CSF1R inhibition. METHODS We assessed immune cell populations in various organs by flow cytometry, and tissue-specific metabolic effects by hyperinsulinaemic-euglycaemic clamps and insulin secretion assays in mice fed a chow diet containing PLX5622 (a CSF1R inhibitor) or a control diet. RESULTS CSF1R inhibition depleted macrophages in multiple tissues while simultaneously increasing eosinophils and group 2 innate lymphoid cells. These immunological changes were consistent across different organs and were sex independent and reversible after cessation of the PLX5622. CSF1R inhibition improved hepatic insulin sensitivity but concomitantly impaired insulin secretion. In healthy islets, we found a high frequency of IL-1β+ islet macrophages. Their depletion by CSF1R inhibition led to downregulation of macrophage-related pathways and mediators of cytokine activity, including Nlrp3, suggesting IL-1β as a candidate insulin secretagogue. Partial restoration of physiological insulin secretion was achieved by injecting recombinant IL-1β prior to glucose stimulation in mice lacking macrophages. CONCLUSIONS/INTERPRETATION Macrophages and macrophage-derived factors, such as IL-1β, play an important role in physiological insulin secretion. A better understanding of the tissue-specific effects of CSF1R inhibition on immune cells and glucose homeostasis is crucial for the development of targeted immune-modulatory treatments in metabolic disease. DATA AVAILABILITY The RNA-Seq dataset is available in the Gene Expression Omnibus (GEO) under the accession number GSE189434 ( http://www.ncbi.nlm.nih.gov/geo/query/acc.cgi?acc=GSE189434 ).
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Affiliation(s)
- Angela J T Bosch
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Lena Keller
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Laura Steiger
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Theresa V Rohm
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | | | - Andy J Y Low
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Marc Stawiski
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Leila Rachid
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Julien Roux
- Department of Biomedicine, University of Basel, Basel, Switzerland
- Swiss Institute of Bioinformatics, Basel, Switzerland
| | - Daniel Konrad
- Division of Pediatric Endocrinology and Diabetology, University Children's Hospital, University of Zurich, Zurich, Switzerland
- Children's Research Centre, University Children's Hospital, University of Zurich, Zurich, Switzerland
| | - Stephan Wueest
- Division of Pediatric Endocrinology and Diabetology, University Children's Hospital, University of Zurich, Zurich, Switzerland
- Children's Research Centre, University Children's Hospital, University of Zurich, Zurich, Switzerland
| | - Sonia Tugues
- Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland
| | - Melanie Greter
- Institute of Experimental Immunology, University of Zurich, Zurich, Switzerland
| | | | - Daniel T Meier
- Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Claudia Cavelti-Weder
- Department of Biomedicine, University of Basel, Basel, Switzerland.
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ), University of Zurich (UZH), Zurich, Switzerland.
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Perakakis N, Harb H, Hale BG, Varga Z, Steenblock C, Kanczkowski W, Alexaki VI, Ludwig B, Mirtschink P, Solimena M, Toepfner N, Zeissig S, Gado M, Abela IA, Beuschlein F, Spinas GA, Cavelti-Weder C, Gerber PA, Huber M, Trkola A, Puhan MA, Wong WWL, Linkermann A, Mohan V, Lehnert H, Nawroth P, Chavakis T, Mingrone G, Wolfrum C, Zinkernagel AS, Bornstein SR. Mechanisms and clinical relevance of the bidirectional relationship of viral infections with metabolic diseases. Lancet Diabetes Endocrinol 2023; 11:675-693. [PMID: 37524103 DOI: 10.1016/s2213-8587(23)00154-7] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/26/2023] [Revised: 05/09/2023] [Accepted: 05/19/2023] [Indexed: 08/02/2023]
Abstract
Viruses have been present during all evolutionary steps on earth and have had a major effect on human history. Viral infections are still among the leading causes of death. Another public health concern is the increase of non-communicable metabolic diseases in the last four decades. In this Review, we revisit the scientific evidence supporting the presence of a strong bidirectional feedback loop between several viral infections and metabolic diseases. We discuss how viruses might lead to the development or progression of metabolic diseases and conversely, how metabolic diseases might increase the severity of a viral infection. Furthermore, we discuss the clinical relevance of the current evidence on the relationship between viral infections and metabolic disease and the present and future challenges that should be addressed by the scientific community and health authorities.
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Affiliation(s)
- Nikolaos Perakakis
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany; Paul Langerhans Institute Dresden, Helmholtz Munich, Technische Universität Dresden, Dresden 01307, Germany; German Center for Diabetes Research, Neuherberg, Germany.
| | - Hani Harb
- Medical Microbiology and Virology, Technische Universität Dresden, Dresden 01307, Germany
| | - Benjamin G Hale
- Institute of Medical Virology, University of Zürich, Zürich, Switzerland
| | - Zsuzsanna Varga
- Department of Pathology and Molecular Pathology, University of Zürich, Zürich, Switzerland
| | - Charlotte Steenblock
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany
| | - Waldemar Kanczkowski
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany
| | - Vasileia Ismini Alexaki
- Institute for Institute of Clinical Chemistry and Laboratory Medicine, Technische Universität Dresden, Dresden 01307, Germany
| | - Barbara Ludwig
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany; Paul Langerhans Institute Dresden, Helmholtz Munich, Technische Universität Dresden, Dresden 01307, Germany; Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden 01307, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Peter Mirtschink
- Institute for Institute of Clinical Chemistry and Laboratory Medicine, Technische Universität Dresden, Dresden 01307, Germany
| | - Michele Solimena
- Paul Langerhans Institute Dresden, Helmholtz Munich, Technische Universität Dresden, Dresden 01307, Germany; Department of Molecular Diabetology, Technische Universität Dresden, Dresden 01307, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Nicole Toepfner
- Department of Pediatrics, Technische Universität Dresden, Dresden 01307, Germany
| | - Sebastian Zeissig
- Center for Regenerative Therapies Dresden, Technische Universität Dresden, Dresden 01307, Germany; Department of Medicine I, Faculty of Medicine and University Hospital Carl Gustav Carus, Technische Universität Dresden, Dresden 01307, Germany
| | - Manuel Gado
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany; Paul Langerhans Institute Dresden, Helmholtz Munich, Technische Universität Dresden, Dresden 01307, Germany; German Center for Diabetes Research, Neuherberg, Germany
| | - Irene Alma Abela
- Institute of Medical Virology, University of Zürich, Zürich, Switzerland; Department of Infectious Diseases and Hospital Epidemiology, University of Zürich, Zürich, Switzerland
| | - Felix Beuschlein
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zürich, University of Zürich, Zürich, Switzerland; Medizinische Klinik und Poliklinik IV, Klinikum der Universität, Ludwig-Maximilians-Universität München, Munich, Germany
| | - Giatgen A Spinas
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Claudia Cavelti-Weder
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Philipp A Gerber
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zürich, University of Zürich, Zürich, Switzerland
| | - Michael Huber
- Institute of Medical Virology, University of Zürich, Zürich, Switzerland
| | - Alexandra Trkola
- Institute of Medical Virology, University of Zürich, Zürich, Switzerland
| | - Milo A Puhan
- Epidemiology, Biostatistics and Prevention Institute, University of Zürich, Zürich, Switzerland
| | - Wendy Wei-Lynn Wong
- and Department of Molecular Life Science, University of Zürich, Zürich, Switzerland
| | - Andreas Linkermann
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany; Division of Nephrology, Department of Medicine, Albert Einstein College of Medicine, Bronx, New York, USA
| | - Viswanathan Mohan
- Madras Diabetes Research Foundation and Dr. Mohan's Diabetes Specialties Centre, Chennai, Tamil Nadu, India
| | - Hendrik Lehnert
- Presidential Office, Paris Lodron Universität Salzburg, Salzburg, Austria
| | - Peter Nawroth
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany
| | - Triantafyllos Chavakis
- Paul Langerhans Institute Dresden, Helmholtz Munich, Technische Universität Dresden, Dresden 01307, Germany; Institute for Institute of Clinical Chemistry and Laboratory Medicine, Technische Universität Dresden, Dresden 01307, Germany; German Center for Diabetes Research, Neuherberg, Germany; Centre for Cardiovascular Science, Queen's Medical Research Institute, University of Edinburgh, Edinburgh, UK
| | - Geltrude Mingrone
- Department of Translational Medicine and Surgery, Università Cattolica del Sacro Cuore, Rome, Italy; Department of Medical and Surgical Sciences, Fondazione Policlinico Universitario A Gemelli IRCCS, Rome, Italy; Division of Diabetes and Nutritional Sciences, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
| | - Christian Wolfrum
- Laboratory of Translational Nutrition Biology, Institute of Food, Nutrition and Health, Department of Health Sciences and Technology, ETH Zürich, Schwerzenbach, Switzerland
| | - Annelies S Zinkernagel
- Department of Infectious Diseases and Hospital Epidemiology, University of Zürich, Zürich, Switzerland
| | - Stefan R Bornstein
- Department of Internal Medicine III, Technische Universität Dresden, Dresden 01307, Germany; Paul Langerhans Institute Dresden, Helmholtz Munich, Technische Universität Dresden, Dresden 01307, Germany; German Center for Diabetes Research, Neuherberg, Germany; Division of Diabetes and Nutritional Sciences, School of Cardiovascular and Metabolic Medicine and Sciences, Faculty of Life Sciences and Medicine, King's College London, London, UK
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Bosch AJT, Rohm TV, AlAsfoor S, Low AJY, Baumann Z, Parayil N, Noreen F, Roux J, Meier DT, Cavelti-Weder C. Diesel Exhaust Particle (DEP)-induced glucose intolerance is driven by an intestinal innate immune response and NLRP3 activation in mice. Part Fibre Toxicol 2023; 20:25. [PMID: 37400850 DOI: 10.1186/s12989-023-00536-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/23/2023] [Accepted: 06/20/2023] [Indexed: 07/05/2023] Open
Abstract
BACKGROUND We previously found that air pollution particles reaching the gastrointestinal tract elicit gut inflammation as shown by up-regulated gene expression of pro-inflammatory cytokines and monocyte/macrophage markers. This inflammatory response was associated with beta-cell dysfunction and glucose intolerance. So far, it remains unclear whether gut inflammatory changes upon oral air pollution exposure are causally linked to the development of diabetes. Hence, our aim was to assess the role of immune cells in mediating glucose intolerance instigated by orally administered air pollutants. METHODS To assess immune-mediated mechanisms underlying air pollution-induced glucose intolerance, we administered diesel exhaust particles (DEP; NIST 1650b, 12 µg five days/week) or phosphate-buffered saline (PBS) via gavage for up to 10 months to wild-type mice and mice with genetic or pharmacological depletion of innate or adaptive immune cells. We performed unbiased RNA-sequencing of intestinal macrophages to elucidate signaling pathways that could be pharmacologically targeted and applied an in vitro approach to confirm these pathways. RESULTS Oral exposure to air pollution particles induced an interferon and inflammatory signature in colon macrophages together with a decrease of CCR2- anti-inflammatory/resident macrophages. Depletion of macrophages, NLRP3 or IL-1β protected mice from air pollution-induced glucose intolerance. On the contrary, Rag2-/- mice lacking adaptive immune cells developed pronounced gut inflammation and glucose intolerance upon oral DEP exposure. CONCLUSION In mice, oral exposure to air pollution particles triggers an immune-mediated response in intestinal macrophages that contributes to the development of a diabetes-like phenotype. These findings point towards new pharmacologic targets in diabetes instigated by air pollution particles.
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Affiliation(s)
- Angela J T Bosch
- Department of Biomedicine, University of Basel, Basel, 4031, Switzerland
| | - Theresa V Rohm
- Department of Biomedicine, University of Basel, Basel, 4031, Switzerland
| | - Shefaa AlAsfoor
- Department of Biomedicine, University of Basel, Basel, 4031, Switzerland
| | - Andy J Y Low
- Department of Biomedicine, University of Basel, Basel, 4031, Switzerland
| | - Zora Baumann
- Department of Biomedicine, University of Basel, Basel, 4031, Switzerland
| | - Neena Parayil
- Department of Biomedicine, University of Basel, Basel, 4031, Switzerland
| | - Faiza Noreen
- Department of Biomedicine, University of Basel, Basel, 4031, Switzerland
- Swiss Institute of Bioinformatics, Basel, 4031, Switzerland
| | - Julien Roux
- Department of Biomedicine, University of Basel, Basel, 4031, Switzerland
- Swiss Institute of Bioinformatics, Basel, 4031, Switzerland
| | - Daniel T Meier
- Department of Biomedicine, University of Basel, Basel, 4031, Switzerland
| | - Claudia Cavelti-Weder
- Department of Biomedicine, University of Basel, Basel, 4031, Switzerland.
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, 4031, Switzerland.
- Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland.
- University Hospital Zurich, Rämistrasse 100, Zürich, 8009, Switzerland.
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6
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Bosch AJT, Rohm TV, AlAsfoor S, Low AJY, Keller L, Baumann Z, Parayil N, Stawiski M, Rachid L, Dervos T, Mitrovic S, Meier DT, Cavelti-Weder C. Lung versus gut exposure to air pollution particles differentially affect metabolic health in mice. Part Fibre Toxicol 2023; 20:7. [PMID: 36895000 PMCID: PMC9996885 DOI: 10.1186/s12989-023-00518-w] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/05/2023] [Accepted: 02/14/2023] [Indexed: 03/11/2023] Open
Abstract
BACKGROUND Air pollution has emerged as an unexpected risk factor for diabetes. However, the mechanism behind remains ill-defined. So far, the lung has been considered as the main target organ of air pollution. In contrast, the gut has received little scientific attention. Since air pollution particles can reach the gut after mucociliary clearance from the lungs and through contaminated food, our aim was to assess whether exposure deposition of air pollution particles in the lung or the gut drive metabolic dysfunction in mice. METHODS To study the effects of gut versus lung exposure, we exposed mice on standard diet to diesel exhaust particles (DEP; NIST 1650b), particulate matter (PM; NIST 1649b) or phosphate-buffered saline by either intratracheal instillation (30 µg 2 days/week) or gavage (12 µg 5 days/week) over at least 3 months (total dose of 60 µg/week for both administration routes, equivalent to a daily inhalation exposure in humans of 160 µg/m3 PM2.5) and monitored metabolic parameters and tissue changes. Additionally, we tested the impact of the exposure route in a "prestressed" condition (high-fat diet (HFD) and streptozotocin (STZ)). RESULTS Mice on standard diet exposed to particulate air pollutants by intratracheal instillation developed lung inflammation. While both lung and gut exposure resulted in increased liver lipids, glucose intolerance and impaired insulin secretion was only observed in mice exposed to particles by gavage. Gavage with DEP created an inflammatory milieu in the gut as shown by up-regulated gene expression of pro-inflammatory cytokines and monocyte/macrophage markers. In contrast, liver and adipose inflammation markers were not increased. Beta-cell secretory capacity was impaired on a functional level, most likely induced by the inflammatory milieu in the gut, and not due to beta-cell loss. The differential metabolic effects of lung and gut exposures were confirmed in a "prestressed" HFD/STZ model. CONCLUSIONS We conclude that separate lung and gut exposures to air pollution particles lead to distinct metabolic outcomes in mice. Both exposure routes elevate liver lipids, while gut exposure to particulate air pollutants specifically impairs beta-cell secretory capacity, potentially instigated by an inflammatory milieu in the gut.
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Affiliation(s)
- Angela J T Bosch
- Department of Biomedicine, University of Basel, 4031, Basel, Switzerland
| | - Theresa V Rohm
- Department of Biomedicine, University of Basel, 4031, Basel, Switzerland
| | - Shefaa AlAsfoor
- Department of Biomedicine, University of Basel, 4031, Basel, Switzerland
| | - Andy J Y Low
- Department of Biomedicine, University of Basel, 4031, Basel, Switzerland
| | - Lena Keller
- Department of Biomedicine, University of Basel, 4031, Basel, Switzerland
| | - Zora Baumann
- Department of Biomedicine, University of Basel, 4031, Basel, Switzerland
| | - Neena Parayil
- Department of Biomedicine, University of Basel, 4031, Basel, Switzerland
| | - Marc Stawiski
- Department of Biomedicine, University of Basel, 4031, Basel, Switzerland
| | - Leila Rachid
- Department of Biomedicine, University of Basel, 4031, Basel, Switzerland
| | - Thomas Dervos
- Department of Biomedicine, University of Basel, 4031, Basel, Switzerland
| | - Sandra Mitrovic
- Department of Laboratory Medicine, University Hospital Basel, 4031, Basel, Switzerland
| | - Daniel T Meier
- Department of Biomedicine, University of Basel, 4031, Basel, Switzerland
| | - Claudia Cavelti-Weder
- Department of Biomedicine, University of Basel, 4031, Basel, Switzerland. .,Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, 4031, Basel, Switzerland. .,Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Rämistrasse 100, 8009, Zurich, Switzerland.
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7
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Hepprich M, Mudry JM, Gregoriano C, Jornayvaz FR, Carballo S, Wojtusciszyn A, Bart PA, Chiche JD, Fischli S, Baumgartner T, Cavelti-Weder C, Braun DL, Günthard HF, Beuschlein F, Conen A, West E, Isenring E, Zechmann S, Bucklar G, Aubry Y, Dey L, Müller B, Hunziker P, Schütz P, Cattaneo M, Donath MY. Canakinumab in patients with COVID-19 and type 2 diabetes - A multicentre, randomised, double-blind, placebo-controlled trial. EClinicalMedicine 2022; 53:101649. [PMID: 36128334 PMCID: PMC9481336 DOI: 10.1016/j.eclinm.2022.101649] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/16/2022] [Revised: 08/12/2022] [Accepted: 08/12/2022] [Indexed: 01/08/2023] Open
Abstract
BACKGROUND Patients with type 2 diabetes and obesity have chronic activation of the innate immune system possibly contributing to the higher risk of hyperinflammatory response to SARS-CoV2 and severe COVID-19 observed in this population. We tested whether interleukin-1β (IL-1β) blockade using canakinumab improves clinical outcome. METHODS CanCovDia was a multicenter, randomised, double-blind, placebo-controlled trial to assess the efficacy of canakinumab plus standard-of-care compared with placebo plus standard-of-care in patients with type 2 diabetes and a BMI > 25 kg/m2 hospitalised with SARS-CoV2 infection in seven tertiary-hospitals in Switzerland. Patients were randomly assigned 1:1 to a single intravenous dose of canakinumab (body weight adapted dose of 450-750 mg) or placebo. Canakinumab and placebo were compared based on an unmatched win-ratio approach based on length of survival, ventilation, ICU stay and hospitalization at day 29. This study is registered with ClinicalTrials.gov, NCT04510493. FINDINGS Between October 17, 2020, and May 12, 2021, 116 patients were randomly assigned with 58 in each group. One participant dropped out in each group for the primary analysis. At the time of randomization, 85 patients (74·6 %) were treated with dexamethasone. The win-ratio of canakinumab vs placebo was 1·08 (95 % CI 0·69-1·69; p = 0·72). During four weeks, in the canakinumab vs placebo group 4 (7·0%) vs 7 (12·3%) participants died, 11 (20·0 %) vs 16 (28·1%) patients were on ICU, 12 (23·5 %) vs 11 (21·6%) were hospitalised for more than 3 weeks, respectively. Median ventilation time at four weeks in the canakinumab vs placebo group was 10 [IQR 6.0, 16.5] and 16 days [IQR 14.0, 23.0], respectively. There was no statistically significant difference in HbA1c after four weeks despite a lower number of anti-diabetes drug administered in patients treated with canakinumab. Finally, high-sensitive CRP and IL-6 was lowered by canakinumab. Serious adverse events were reported in 13 patients (11·4%) in each group. INTERPRETATION In patients with type 2 diabetes who were hospitalised with COVID-19, treatment with canakinumab in addition to standard-of-care did not result in a statistically significant improvement of the primary composite outcome. Patients treated with canakinumab required significantly less anti-diabetes drugs to achieve similar glycaemic control. Canakinumab was associated with a prolonged reduction of systemic inflammation. FUNDING Swiss National Science Foundation grant #198415 and University of Basel. Novartis supplied study medication.
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Affiliation(s)
- Matthias Hepprich
- University Hospital Basel, Division of Endocrinology, Diabetes and Metabolism, Basel, Switzerland
| | - Jonathan M. Mudry
- University Hospital Basel, Division of Endocrinology, Diabetes and Metabolism, Basel, Switzerland
| | - Claudia Gregoriano
- Medical University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Francois R. Jornayvaz
- Division of Endocrinology, Diabetes, Nutrition and Therapeutic Patient Education, Geneva University Hospital, Genève, Switzerland
| | - Sebastian Carballo
- Sevice of General Internal Medicine, Department of Medicine, Geneva University Hospitals, Geneva, Switzerland
| | - Anne Wojtusciszyn
- Service d'Endocrinologie Diabète et Métabolisme, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Pierre-Alexandre Bart
- Service of Internal Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Jean-Daniel Chiche
- Department of Intensive Care Medicine, Centre Hospitalier Universitaire Vaudois, Lausanne, Switzerland
| | - Stefan Fischli
- Department of Endocrinology, Luzerner Kantonsspital, Lucerne, Switzerland
| | - Thomas Baumgartner
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland
| | - Claudia Cavelti-Weder
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland
| | - Dominique L. Braun
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Huldrych F. Günthard
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Felix Beuschlein
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland
| | - Anna Conen
- Division of Infectious Diseases and Infection Prevention, Kantonsspital Aarau, Aarau, Switzerland
| | - Emily West
- Department of Infectious Diseases and Hospital Epidemiology, University Hospital Zurich, Zurich, Switzerland and Institute of Medical Virology, University of Zurich, Zurich, Switzerland
| | - Egon Isenring
- Medical University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Stefan Zechmann
- University Hospital Basel, Division of Endocrinology, Diabetes and Metabolism, Basel, Switzerland
| | - Gabriela Bucklar
- University Hospital Basel, Division of Endocrinology, Diabetes and Metabolism, Basel, Switzerland
| | - Yoann Aubry
- University Hospital Basel, Division of Endocrinology, Diabetes and Metabolism, Basel, Switzerland
| | - Ludovic Dey
- Hôpital du Jura, Site de Delémont, Delémont, Switzerland
| | - Beat Müller
- Medical University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Patrick Hunziker
- Intensive Care Unit, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Philipp Schütz
- Medical University Department of Medicine, Kantonsspital Aarau, Aarau, Switzerland
| | - Marco Cattaneo
- Department of Clinical Research, University of Basel, Basel, Switzerland
| | - Marc Y. Donath
- University Hospital Basel, Division of Endocrinology, Diabetes and Metabolism, Basel, Switzerland
- Corresponding author.
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8
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Abstract
Coronavirus disease 2019 (COVID-19) is characterized by a wide clinical spectrum that includes abnormalities in liver function indicative of liver damage. Conversely, people with liver diseases are at higher risk of severe COVID-19. In the current review, we summarize first the epidemiologic evidence describing the bidirectional relationship between COVID-19 and liver function/liver diseases. Additionally, we present the most frequent histologic findings as well as the most important direct and indirect mechanisms supporting a COVID-19 mediated liver injury. Furthermore, we focus on the most frequent liver disease in the general population, non-alcoholic or metabolic-associated fatty liver disease (NAFLD/MAFLD), and describe how COVID-19 may affect NAFLD/MAFLD development and progression and conversely how NAFLD/MAFLD may further aggravate a COVID-19 infection. Finally, we present the long-term consequences of the pandemic on the development and management of NAFLD.
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Affiliation(s)
- Carlotta Hoffmann
- University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany, Department of Internal Medicine III, Dresden, Germany
| | - Philipp A Gerber
- University Hospital Zurich (USZ) and University of Zurich (UZH), Switzerland, Department of Endocrinology, Diabetology and Clinical Nutrition, Zurich, Switzerland
| | - Claudia Cavelti-Weder
- University Hospital Zurich (USZ) and University of Zurich (UZH), Switzerland, Department of Endocrinology, Diabetology and Clinical Nutrition, Zurich, Switzerland
| | - Louisa Licht
- University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany, Department of Internal Medicine III, Dresden, Germany
| | - Reham Kotb
- Abu Dhabi University, Abu Dhabi, United Arab Emirates, College of Health Sciences, Abu Dhabi, United Arab Emirates
| | - Rania Al Dweik
- Abu Dhabi University, Abu Dhabi, United Arab Emirates, Department of Public Health, Abu Dhabi, United Arab Emirates
| | - Michele Cherfane
- Abu Dhabi University, Abu Dhabi, United Arab Emirates, College of Health Sciences, Abu Dhabi, United Arab Emirates
| | - Stefan R Bornstein
- University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany, Department of Internal Medicine III, Dresden, Germany
| | - Nikolaos Perakakis
- University Hospital Carl Gustav Carus, Technische Universität Dresden, Germany, Department of Internal Medicine III, Dresden, Germany
- University Hospital and Faculty of Medicine, TU Dresden, Dresden, Paul Langerhans Institute Dresden (PLID), Helmholtz Center Munich, Dresden, Germany
- Neuherberg, German Center for Diabetes Research (DZD e.V.), Neuherberg, Germany
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9
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Schneider R, Kraljević M, Peterli R, Rohm TV, Bosch AJ, Low AJ, Keller L, AlAsfoor S, Häfliger S, Yilmaz B, Peterson CJ, Lazaridis II, Vonaesch P, Delko T, Cavelti-Weder C. Roux-en-Y gastric bypass with a long compared to a short biliopancreatic limb improves weight loss and glycemic control in obese mice. Surg Obes Relat Dis 2022; 18:1286-1297. [DOI: 10.1016/j.soard.2022.06.286] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/20/2022] [Revised: 05/02/2022] [Accepted: 06/18/2022] [Indexed: 11/30/2022]
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10
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Rohm TV, Keller L, Bosch AJT, AlAsfoor S, Baumann Z, Thomas A, Wiedemann SJ, Steiger L, Dalmas E, Wehner J, Rachid L, Mooser C, Yilmaz B, Fernandez Trigo N, Jauch AJ, Wueest S, Konrad D, Henri S, Niess JH, Hruz P, Ganal-Vonarburg SC, Roux J, Meier DT, Cavelti-Weder C. Targeting colonic macrophages improves glycemic control in high-fat diet-induced obesity. Commun Biol 2022; 5:370. [PMID: 35440795 PMCID: PMC9018739 DOI: 10.1038/s42003-022-03305-z] [Citation(s) in RCA: 11] [Impact Index Per Article: 5.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2021] [Accepted: 03/22/2022] [Indexed: 12/13/2022] Open
Abstract
The obesity epidemic continues to worsen worldwide. However, the mechanisms initiating glucose dysregulation in obesity remain poorly understood. We assessed the role that colonic macrophage subpopulations play in glucose homeostasis in mice fed a high-fat diet (HFD). Concurrent with glucose intolerance, pro-inflammatory/monocyte-derived colonic macrophages increased in mice fed a HFD. A link between macrophage numbers and glycemia was established by pharmacological dose-dependent ablation of macrophages. In particular, colon-specific macrophage depletion by intrarectal clodronate liposomes improved glucose tolerance, insulin sensitivity, and insulin secretion capacity. Colonic macrophage activation upon HFD was characterized by an interferon response and a change in mitochondrial metabolism, which converged in mTOR as a common regulator. Colon-specific mTOR inhibition reduced pro-inflammatory macrophages and ameliorated insulin secretion capacity, similar to colon-specific macrophage depletion, but did not affect insulin sensitivity. Thus, pharmacological targeting of colonic macrophages could become a potential therapy in obesity to improve glycemic control. Expansion of pro-inflammatory macrophages in the colon occurs early after high-fat diet initiation, prior to macrophage accumulation in the adipose tissue, in a microbiome-dependent fashion. Macrophage depletion systemically and/or exclusively in the colon improves glucose metabolism.
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Affiliation(s)
- Theresa V Rohm
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Lena Keller
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Angela J T Bosch
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Shefaa AlAsfoor
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Zora Baumann
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | | | - Sophia J Wiedemann
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Laura Steiger
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Elise Dalmas
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Josua Wehner
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Leila Rachid
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Catherine Mooser
- Department of Visceral Surgery und Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Bahtiyar Yilmaz
- Department of Visceral Surgery und Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Nerea Fernandez Trigo
- Department of Visceral Surgery und Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Annaise J Jauch
- Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Stephan Wueest
- Division of Pediatric Endocrinology and Diabetology, and Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland
| | - Daniel Konrad
- Division of Pediatric Endocrinology and Diabetology, and Children's Research Center, University Children's Hospital, University of Zurich, Zurich, Switzerland
| | - Sandrine Henri
- Centre d'Immunologie de Marseille-Luminy, Aix Marseille Université, INSERM, CNRS, Marseille, France
| | - Jan H Niess
- Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland.,Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, Basel, Switzerland
| | - Petr Hruz
- Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland.,Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, Basel, Switzerland
| | - Stephanie C Ganal-Vonarburg
- Department of Visceral Surgery und Medicine, Bern University Hospital, University of Bern, Bern, Switzerland.,Department for BioMedical Research (DBMR), University of Bern, Bern, Switzerland
| | - Julien Roux
- Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland.,Swiss Institute of Bioinformatics (SIB), Basel, Switzerland
| | - Daniel T Meier
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Claudia Cavelti-Weder
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland. .,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland. .,Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland.
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11
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Schneider R, Kraljević M, Peterson CJ, Lazaridis I, Rohm TV, Bosch AJT, Low AJY, Vonaesch P, Peterli R, Delko T, Cavelti-Weder C. Roux-en-Y gastric bypass with a long compared to a short biliopancreatic limb leads to better weight loss and glycemic control in obese mice. Br J Surg 2021. [DOI: 10.1093/bjs/znab202.043] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
Abstract
Objective
Roux-en-Y gastric bypass (RYGB) shows durable long-term weight loss and control of comorbidities in randomized controlled trials. However, the impact of the proportions of the biliopancreatic limb (BPL) and the total alimentary limb (TALL) on weight loss or glucose metabolism is still unclear.
Methods
Six weeks old C57BL/6J mice were fed high fat diet (HFD) to induce obesity and glucose intolerance. Mice underwent RYGB surgery with a very-long BPL (35% of total bowel length [TBL]), long BPL (25% of TBL), short BPL (15 % of TBL), or sham surgery. The alimentary limb (AL) was adjusted in dependency on the BPL to achieve a fixed CC length. Glycemia was assessment by intraperitoneal glucose tolerance tests.
Results
Mice undergoing RYGB with a very-long BPL showed excessive weight loss and mortality and were therefore excluded for further analyses. Total weight loss (TWL%) was significantly higher in the long BPL- compared to short BPL-group. Mice with a long BPL showed significantly improved glucose tolerance 14 days postoperatively, while 35 days postoperatively, the improvement in glucose tolerance with a long BPL was much less distinctive.
Conclusion
RYGB with a longer BPL leads to improved results including weight loss and glucose tolerance. However, the metabolic improvements seem to decrease over time. These findings could potentially be translated to humans by adjusting the BPL according to body weight and comorbidities. To avoid possible negative effects of a longer BPL total bowel length measurement is mandatory.
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Affiliation(s)
- R Schneider
- Department of Visceral Surgery, Clarunis - University Abdominal Center, Basel, Switzerland
| | - M Kraljević
- Department of Visceral Surgery, Clarunis - University Abdominal Center, Basel, Switzerland
| | - C J Peterson
- Department of Visceral Surgery, Clarunis - University Abdominal Center, Basel, Switzerland
| | - I Lazaridis
- Department of Visceral Surgery, Clarunis - University Abdominal Center, Basel, Switzerland
| | - T V Rohm
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | - A J T Bosch
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | - A J Y Low
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | - P Vonaesch
- Swiss Tropical Health Institiute, Swiss Tropical Health and Public Health Institute, Basel, Switzerland
| | - R Peterli
- Department of Visceral Surgery, Clarunis - University Abdominal Center, Basel, Switzerland
| | - T Delko
- Department of Visceral Surgery, Clarunis - University Abdominal Center, Basel, Switzerland
| | - C Cavelti-Weder
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
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12
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Rohm TV, Fuchs R, Müller RL, Keller L, Baumann Z, Bosch AJT, Schneider R, Labes D, Langer I, Pilz JB, Niess JH, Delko T, Hruz P, Cavelti-Weder C. Obesity in Humans Is Characterized by Gut Inflammation as Shown by Pro-Inflammatory Intestinal Macrophage Accumulation. Front Immunol 2021; 12:668654. [PMID: 34054838 PMCID: PMC8158297 DOI: 10.3389/fimmu.2021.668654] [Citation(s) in RCA: 26] [Impact Index Per Article: 8.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2021] [Accepted: 04/26/2021] [Indexed: 12/17/2022] Open
Abstract
Chronic low-grade inflammation is a hallmark of obesity and associated with cardiovascular complications. However, it remains unclear where this inflammation starts. As the gut is constantly exposed to food, gut microbiota, and metabolites, we hypothesized that mucosal immunity triggers an innate inflammatory response in obesity. We characterized five distinct macrophage subpopulations (P1-P5) along the gastrointestinal tract and blood monocyte subpopulations (classical, non-classical, intermediate), which replenish intestinal macrophages, in non-obese (BMI<27kg/m2) and obese individuals (BMI>32kg/m2). To elucidate factors that potentially trigger gut inflammation, we correlated these subpopulations with cardiovascular risk factors and lifestyle behaviors. In obese individuals, we found higher pro-inflammatory macrophages in the stomach, duodenum, and colon. Intermediate blood monocytes were also increased in obesity, suggesting enhanced recruitment to the gut. We identified unhealthy lifestyle habits as potential triggers of gut and systemic inflammation (i.e., low vegetable intake, high processed meat consumption, sedentary lifestyle). Cardiovascular risk factors other than body weight did not affect the innate immune response. Thus, obesity in humans is characterized by gut inflammation as shown by accumulation of pro-inflammatory intestinal macrophages, potentially via recruited blood monocytes. Understanding gut innate immunity in human obesity might open up new targets for immune-modulatory treatments in metabolic disease.
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Affiliation(s)
- Theresa V Rohm
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Regula Fuchs
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | - Rahel L Müller
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | - Lena Keller
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Zora Baumann
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland.,Department of Surgery, University Hospital Basel, Basel, Switzerland
| | - Angela J T Bosch
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Romano Schneider
- Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland.,Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases Basel, St. Clara Hospital and University Hospital Basel, Basel, Switzerland
| | - Danny Labes
- Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland
| | - Igor Langer
- Department of Visceral Surgery, Lindenhof Hospital, Bern, Switzerland
| | - Julia B Pilz
- AMB-Arztpraxis MagenDarm Basel, Basel and MagenDarm Aarau, Aarau, Switzerland
| | - Jan H Niess
- Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland.,Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases Basel, St. Clara Hospital and University Hospital Basel, Basel, Switzerland
| | - Tarik Delko
- Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases Basel, St. Clara Hospital and University Hospital Basel, Basel, Switzerland
| | - Petr Hruz
- Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland.,Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases Basel, St. Clara Hospital and University Hospital Basel, Basel, Switzerland
| | - Claudia Cavelti-Weder
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland.,Department of Biomedicine (DBM), University of Basel, University Hospital Basel, Basel, Switzerland.,Department of Endocrinology, Diabetology and Clinical Nutrition, University Hospital Zurich (USZ) and University of Zurich (UZH), Zurich, Switzerland
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13
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Sarcevic J, Cavelti-Weder C, Berger CT, Trendelenburg M. Case Report-Secondary Antibody Deficiency Due to Endogenous Hypercortisolism. Front Immunol 2020; 11:1435. [PMID: 32733476 PMCID: PMC7358340 DOI: 10.3389/fimmu.2020.01435] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/09/2020] [Accepted: 06/03/2020] [Indexed: 11/13/2022] Open
Abstract
Therapeutic corticosteroids have an immunosuppressive function involving several pathways, including lymphocytopenia and hypogammaglobulinemia. While these effects have been well-described in patients that received corticosteroids for therapeutic reasons, the effects of endogenous corticosteroids on the immune system are less well-understood. Here, we describe a 21-year old patient with hypercortisolism due to an ACTH producing thymic tumor. In this patient, we observed a decrease in some of the immunoglobulin classes, and in specific B and T cell populations that resembled effects caused by corticosteroid treatment. IgG levels were restored following treatment and normalization of the hypercortisolism.
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Affiliation(s)
- Jelena Sarcevic
- Division of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland
| | - Claudia Cavelti-Weder
- Division of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | - Christoph T Berger
- Division of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.,Translational Immunology, Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Marten Trendelenburg
- Division of Internal Medicine, University Hospital Basel, University of Basel, Basel, Switzerland.,Clinical Immunology Laboratory, Department of Biomedicine, University of Basel, Basel, Switzerland
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14
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Schneider R, Kraljević M, Peterli R, Rohm TV, Klasen JM, Cavelti-Weder C, Delko T. GLP-1 Analogues as a Complementary Therapy in Patients after Metabolic Surgery: a Systematic Review and Qualitative Synthesis. Obes Surg 2020; 30:3561-3569. [PMID: 32500274 DOI: 10.1007/s11695-020-04750-7] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2020] [Revised: 05/25/2020] [Accepted: 05/28/2020] [Indexed: 12/25/2022]
Abstract
The evidence is strong that bariatric surgery is superior to medical treatment in terms of weight loss and comorbidities in patients with severe obesity. However, a considerable part of patients presents with unsatisfactory response in the long term. It remains unclear whether postoperative administration of glucagon-like peptide-1 analogues can promote additional benefits. Therefore, a systematic review of the current literature on the management of postoperative GLP-1 analogue usage after metabolic surgery was performed. From 4663 identified articles, 6 met the inclusion criteria, but only one was a randomized controlled trial. The papers reviewed revealed that GLP-1 analogues may have beneficial effects on additional weight loss and T2D remission postoperatively. Thus, the use of GLP-1 analogues in addition to surgery promises good results concerning weight loss and improvements of comorbidities and can be used in patients with unsatisfactory results after bariatric surgery.
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Affiliation(s)
- Romano Schneider
- Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, P.O. BOX, CH-4002, Basel, Switzerland.
| | - Marko Kraljević
- Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, P.O. BOX, CH-4002, Basel, Switzerland
| | - Ralph Peterli
- Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, P.O. BOX, CH-4002, Basel, Switzerland
| | - Theresa V Rohm
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, CH-4031, Basel, Switzerland.,Department of Biomedicine, University of Basel, University Hospital Basel, CH-4031, Basel, Switzerland
| | - Jennifer M Klasen
- Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, P.O. BOX, CH-4002, Basel, Switzerland
| | - Claudia Cavelti-Weder
- Clinic of Endocrinology, Diabetes and Metabolism, University Hospital Basel, CH-4031, Basel, Switzerland.,Department of Biomedicine, University of Basel, University Hospital Basel, CH-4031, Basel, Switzerland
| | - Tarik Delko
- Clarunis, Department of Visceral Surgery, University Center for Gastrointestinal and Liver Diseases, St. Clara Hospital and University Hospital Basel, P.O. BOX, CH-4002, Basel, Switzerland
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15
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Trinh B, Hepprich M, Betz MJ, Burkard T, Cavelti-Weder C, Seelig E, Meienberg F, Kratschmar DV, Beuschlein F, Reincke M, Odermatt A, Hall MN, Donath MY, Swierczynska MM. Treatment of Primary Aldosteronism With mTORC1 Inhibitors. J Clin Endocrinol Metab 2019; 104:4703-4714. [PMID: 31087053 DOI: 10.1210/jc.2019-00563] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/08/2019] [Accepted: 05/08/2019] [Indexed: 12/17/2022]
Abstract
CONTEXT Mammalian target of rapamycin complex 1 (mTORC1) activity is often increased in the adrenal cortex of patients with primary aldosteronism (PA), and mTORC1 inhibition decreases aldosterone production in adrenocortical cells, suggesting the mTORC1 pathway as a target for treatment of PA. OBJECTIVE To investigate the effect of mTORC1 inhibition on adrenal steroid hormones and hemodynamic parameters in mice and in patients with PA. DESIGN (i) Plasma aldosterone, corticosterone, and angiotensin II (Ang II) were measured in mice treated for 24 hours with vehicle or rapamycin. (ii) Plasma aldosterone levels after a saline infusion test, plasma renin, and 24-hour urine steroid hormone metabolome and hemodynamic parameters were measured during an open-label study in 12 patients with PA, before and after 2 weeks of treatment with everolimus and after a 2-week washout. MAIN OUTCOME MEASURES (i) Change in plasma aldosterone levels. (ii) Change in other steroid hormones, renin, Ang II, and hemodynamic parameters. RESULTS Treatment of mice with rapamycin significantly decreased plasma aldosterone levels (P = 0.007). Overall, treatment of PA patients with everolimus significantly decreased blood pressure (P < 0.05) and increased renin levels (P = 0.001) but did not decrease aldosterone levels significantly. However, prominent reduction of aldosterone levels upon everolimus treatment was observed in four patients. CONCLUSION In mice, mTORC1 inhibition was associated with reduced plasma aldosterone levels. In patients with PA, mTORC1 inhibition was associated with improved blood pressure and renin suppression. In addition, mTORC1 inhibition appeared to reduce plasma aldosterone in a subset of patients.
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Affiliation(s)
- Beckey Trinh
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, and Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Matthias Hepprich
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, and Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Matthias J Betz
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, and Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Thilo Burkard
- European Society of Hypertension Centre of Excellence, Medical Outpatient Department, and Department of Cardiology, University Hospital Basel, Basel, Switzerland
| | - Claudia Cavelti-Weder
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, and Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Eleonora Seelig
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, and Department of Biomedicine, University of Basel, Basel, Switzerland
| | - Fabian Meienberg
- Clinic of Endocrinology and Diabetology, Kantonsspital Baselland, Liestal, Switzerland
| | - Denise V Kratschmar
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | - Felix Beuschlein
- Klinik für Endokrinologie, Diabetologie und Klinische Ernährung, Universitätsspital Zürich, Zürich, Switzerland
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
| | - Martin Reincke
- Medizinische Klinik und Poliklinik IV, Klinikum der Universität München, Munich, Germany
| | - Alex Odermatt
- Department of Pharmaceutical Sciences, University of Basel, Basel, Switzerland
| | | | - Marc Y Donath
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, and Department of Biomedicine, University of Basel, Basel, Switzerland
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16
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Cavelti-Weder C, Zumsteg A, Li W, Zhou Q. Reprogramming of Pancreatic Acinar Cells to Functional Beta Cells by In Vivo Transduction of a Polycistronic Construct Containing Pdx1, Ngn3, MafA in Mice. ACTA ACUST UNITED AC 2017; 40:4A.10.1-4A.10.12. [PMID: 28152182 DOI: 10.1002/cpsc.21] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
To generate new beta cells after birth is a key focus of regenerative medicine, which could greatly aid the major health burden of diabetes. Beta-cell regeneration has been described using four different approaches: (1) the development of beta cells from putative precursor cells of the adult pancreas, which is termed neogenesis, (2) replication of existing beta cells, (3) differentiation from embryonic or induced pluripotent stem cells, and (4) reprogramming of non-beta cells to beta cells. Studies from the authors' laboratory have shown that beta-cell reprogramming can be achieved by transduction of adult pancreatic tissues with viral constructs containing the three developmentally important transcription factors Pdx1, Ngn3, and MafA. This protocol outlines the generation of a polycistronic construct containing the three transcription factors, the expansion and purification of the polycistronic virus, and in vivo transduction for acinar to beta-cell reprogramming in adult mice. The ultimate goal is to generate beta-like cells that resemble as closely as possible endogenous beta cells in phenotype and function for potential translational applications. © 2017 by John Wiley & Sons, Inc.
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Affiliation(s)
- C Cavelti-Weder
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Boston.,University Hospital of Basel, Department of Endocrinology, Diabetes, and Metabolism, Basel, Switzerland
| | - A Zumsteg
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge.,Covagen AG, Schlieren, Switzerland
| | - W Li
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge.,Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Tongji University School of Life Sciences and Technology, Shanghai
| | - Q Zhou
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge
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17
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Cavelti-Weder C, Li W, Zumsteg A, Stemann-Andersen M, Zhang Y, Yamada T, Wang M, Lu J, Jermendy A, Bee YM, Bonner-Weir S, Weir GC, Zhou Q. Hyperglycaemia attenuates in vivo reprogramming of pancreatic exocrine cells to beta cells in mice. Diabetologia 2016; 59:522-32. [PMID: 26693711 PMCID: PMC4744133 DOI: 10.1007/s00125-015-3838-7] [Citation(s) in RCA: 25] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/07/2015] [Accepted: 11/17/2015] [Indexed: 02/06/2023]
Abstract
AIMS/HYPOTHESIS Reprogramming of pancreatic exocrine to insulin-producing cells by viral delivery of the genes encoding transcription factors neurogenin-3 (Ngn3), pancreas/duodenum homeobox protein 1 (Pdx1) and MafA is an efficient method for reversing diabetes in murine models. The variables that modulate reprogramming success are currently ill-defined. METHODS Here, we assess the impact of glycaemia on in vivo reprogramming in a mouse model of streptozotocin-induced beta cell ablation, using subsequent islet transplantation or insulin pellet implantation for creation of groups with differing levels of glycaemia before viral delivery of transcription factors. RESULTS We observed that hyperglycaemia significantly impaired reprogramming of exocrine to insulin-producing cells in their quantity, differentiation status and function. With hyperglycaemia, the reprogramming of acinar towards beta cells was less complete. Moreover, inflammatory tissue changes within the exocrine pancreas including macrophage accumulation were found, which may represent the tissue's response to clear the pancreas from insufficiently reprogrammed cells. CONCLUSIONS/INTERPRETATION Our findings shed light on normoglycaemia as a prerequisite for optimal reprogramming success in a diabetes model, which might be important in other tissue engineering approaches and disease models, potentially facilitating their translational applications.
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Affiliation(s)
- Claudia Cavelti-Weder
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Harvard University, Boston, MA, USA
| | - Weida Li
- Translational Medical Center for Stem Cell Therapy and Institute for Regenerative Medicine, Shanghai East Hospital, Tongji University School of Life Sciences and Technology, Shanghai, The People's Republic of China
- Department of Stem Cell and Regenerative Biology, Harvard University, Sherman Fairchild 258C, 7 Divinity Ave, Cambridge, MA, 02138, USA
| | - Adrian Zumsteg
- Department of Stem Cell and Regenerative Biology, Harvard University, Sherman Fairchild 258C, 7 Divinity Ave, Cambridge, MA, 02138, USA
| | - Marianne Stemann-Andersen
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Harvard University, Boston, MA, USA
| | - Yuemei Zhang
- Department of Stem Cell and Regenerative Biology, Harvard University, Sherman Fairchild 258C, 7 Divinity Ave, Cambridge, MA, 02138, USA
| | - Takatsugu Yamada
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Harvard University, Boston, MA, USA
| | - Max Wang
- Department of Stem Cell and Regenerative Biology, Harvard University, Sherman Fairchild 258C, 7 Divinity Ave, Cambridge, MA, 02138, USA
| | - Jiaqi Lu
- Department of Stem Cell and Regenerative Biology, Harvard University, Sherman Fairchild 258C, 7 Divinity Ave, Cambridge, MA, 02138, USA
| | - Agnes Jermendy
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Harvard University, Boston, MA, USA
| | - Yong Mong Bee
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Harvard University, Boston, MA, USA
| | - Susan Bonner-Weir
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Harvard University, Boston, MA, USA
| | - Gordon C Weir
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Harvard University, Boston, MA, USA
| | - Qiao Zhou
- Department of Stem Cell and Regenerative Biology, Harvard University, Sherman Fairchild 258C, 7 Divinity Ave, Cambridge, MA, 02138, USA.
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18
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Yamada T, Cavelti-Weder C, Caballero F, Lysy PA, Guo L, Sharma A, Li W, Zhou Q, Bonner-Weir S, Weir GC. Reprogramming Mouse Cells With a Pancreatic Duct Phenotype to Insulin-Producing β-Like Cells. Endocrinology 2015; 156:2029-38. [PMID: 25836667 PMCID: PMC4430605 DOI: 10.1210/en.2014-1987] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/31/2022]
Abstract
Reprogramming technology has opened the possibility of converting one cell type into another by forced expression of transgenes. Transduction of adenoviral vectors encoding 3 pancreatic transcription factors, Pdx1, Ngn3, and MafA, into mouse pancreas results in direct reprogramming of exocrine cells to insulin-producing β-like cells. We hypothesized that cultured adult pancreatic duct cells could be reprogrammed to become insulin-producing β-cells by adenoviral-mediated expression of this same combination of factors. Exocrine were isolated from adult mouse insulin 1 promoter (MIP)-green fluorescent protein (GFP) transgenic mice to allow new insulin-expressing cells to be detected by GFP fluorescence. Cultured cells were transduced by an adenoviral vector carrying a polycistronic construct Ngn3/Pdx1/MafA/mCherry (Ad-M3C) or mCherry sequence alone as a control vector. In addition, the effects of glucagon-like peptide-1 (GLP-1) receptor agonist, exendin-4 (Ex-4) on the reprogramming process were examined. GFP(+) cells appeared 2 days after Ad-M3C transduction; the reprogramming efficiency was 8.6 ± 2.6% by day 4 after transduction. Ad-M3C also resulted in increased expression of β-cell markers insulin 1 and 2, with enhancement by Ex-4. Expression of other β-cell markers, neuroD and GLP-1 receptor, were also significantly up-regulated. The amount of insulin release into the media and insulin content of the cells were significantly higher in the Ad-M3C-transduced cells; this too was enhanced by Ex-4. The transduced cells did not secrete insulin in response to increased glucose, indicating incomplete differentiation to β-cells. Thus, cultured murine adult pancreatic cells with a duct phenotype can be directly reprogrammed to insulin-producing β-like cells by adenoviral delivery of 3 pancreatic transcription factors.
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Affiliation(s)
- Takatsugu Yamada
- Section on Islet Cell and Regenerative Biology (T.Y., C.C.-W., F.C., P.A.L., L.G., A.S., S.B.-W., G.C.W.), Research Division, Joslin Diabetes Center, Harvard Medical School, Boston, Massachusetts 02215; and Department of Stem Cell and Regenerative Biology (W.L., Q.Z.), Harvard Stem Cell Institute, Harvard University, Cambridge, Massachusetts 02138
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19
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Cavelti-Weder C, Li W, Zumsteg A, Stemann M, Yamada T, Bonner-Weir S, Weir G, Zhou Q. Direct Reprogramming for Pancreatic Beta-Cells Using Key Developmental Genes. Curr Pathobiol Rep 2015; 3:57-65. [PMID: 26998407 DOI: 10.1007/s40139-015-0068-0] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Abstract
Direct reprogramming is a promising approach for regenerative medicine whereby one cell type is directly converted into another without going through a multipotent or pluripotent stage. This reprogramming approach has been extensively explored for the generation of functional insulin-secreting cells from non-beta-cells with the aim of developing novel cell therapies for the treatment of people with diabetes lacking sufficient endogenous beta-cells. A common approach for such conversion studies is the introduction of key regulators that are important in controlling beta-cell development and maintenance. In this review, we will summarize the recent advances in the field of beta-cell reprogramming and discuss the challenges of creating functional and long-lasting beta-cells.
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Affiliation(s)
- Claudia Cavelti-Weder
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Boston, MA, USA
| | - Weida Li
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Adrian Zumsteg
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
| | - Marianne Stemann
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Boston, MA, USA
| | - Takatsugu Yamada
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Boston, MA, USA
| | - Susan Bonner-Weir
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Boston, MA, USA
| | - Gordon Weir
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Boston, MA, USA
| | - Qiao Zhou
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, MA, USA
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20
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Li W, Cavelti-Weder C, Zhang Y, Zhang Y, Clement K, Donovan S, Gonzalez G, Zhu J, Stemann M, Xu K, Hashimoto T, Yamada T, Nakanishi M, Zhang Y, Zeng S, Gifford D, Meissner A, Weir G, Zhou Q. Long-term persistence and development of induced pancreatic beta cells generated by lineage conversion of acinar cells. Nat Biotechnol 2014; 32:1223-30. [PMID: 25402613 DOI: 10.1038/nbt.3082] [Citation(s) in RCA: 73] [Impact Index Per Article: 7.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/14/2014] [Accepted: 10/23/2014] [Indexed: 01/17/2023]
Abstract
Direct lineage conversion is a promising approach to generate therapeutically important cell types for disease modeling and tissue repair. However, the survival and function of lineage-reprogrammed cells in vivo over the long term has not been examined. Here, using an improved method for in vivo conversion of adult mouse pancreatic acinar cells toward beta cells, we show that induced beta cells persist for up to 13 months (the length of the experiment), form pancreatic islet-like structures and support normoglycemia in diabetic mice. Detailed molecular analyses of induced beta cells over 7 months reveal that global DNA methylation changes occur within 10 d, whereas the transcriptional network evolves over 2 months to resemble that of endogenous beta cells and remains stable thereafter. Progressive gain of beta-cell function occurs over 7 months, as measured by glucose-regulated insulin release and suppression of hyperglycemia. These studies demonstrate that lineage-reprogrammed cells persist for >1 year and undergo epigenetic, transcriptional, anatomical and functional development toward a beta-cell phenotype.
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Affiliation(s)
- Weida Li
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Claudia Cavelti-Weder
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Boston, Massachusetts, USA
| | | | - Yinying Zhang
- 1] Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA. [2] Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Kendell Clement
- 1] Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA. [2] Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA. [3] Division of Health Sciences and Technology, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Scott Donovan
- 1] Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA. [2] Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | | | - Jiang Zhu
- 1] Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA. [2] Center for System Biology and Center for Cancer Research, Massachusetts General Hospital, Boston, Massachusetts, USA
| | - Marianne Stemann
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Boston, Massachusetts, USA
| | - Ke Xu
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Tatsu Hashimoto
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Takatsugu Yamada
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Boston, Massachusetts, USA
| | - Mio Nakanishi
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Yuemei Zhang
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
| | - Samuel Zeng
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
| | - David Gifford
- Department of Electrical Engineering and Computer Science, Massachusetts Institute of Technology, Cambridge, Massachusetts, USA
| | - Alexander Meissner
- 1] Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA. [2] Broad Institute of MIT and Harvard, Cambridge, Massachusetts, USA
| | - Gordon Weir
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center, Boston, Massachusetts, USA
| | - Qiao Zhou
- Department of Stem Cell and Regenerative Biology, Harvard University, Cambridge, Massachusetts, USA
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21
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Cavelti-Weder C, Li W, Weir GC, Zhou Q. Direct lineage conversion of pancreatic exocrine to endocrine Beta cells in vivo with defined factors. Methods Mol Biol 2014; 1150:247-62. [PMID: 24744004 DOI: 10.1007/978-1-4939-0512-6_17] [Citation(s) in RCA: 11] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Pancreatic exocrine cells can be directly converted to insulin(+) beta cells by adenoviral-mediated expression of three transcription factors Pdx1, Mafa, and Ngn3 in the adult mouse pancreas (Zhou et al., Nature 455(7213):627-632, 2008). This direct reprogramming approach offers a strategy to replenish beta-cell mass and may be further developed as a potential future treatment for diabetes. Here, we provide a detailed protocol for inducing exocrine to beta-cell reprogramming in mice. We also describe key analyses we routinely use to assess the phenotype and function of reprogrammed cells.
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Affiliation(s)
- Claudia Cavelti-Weder
- Section on Islet Cell and Regenerative Biology, Joslin Diabetes Center Boston, Boston, MA, USA
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22
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Cavelti-Weder C, Shtessel M, Reuss JE, Jermendy A, Yamada T, Caballero F, Bonner-Weir S, Weir GC. Pancreatic duct ligation after almost complete β-cell loss: exocrine regeneration but no evidence of β-cell regeneration. Endocrinology 2013; 154:4493-502. [PMID: 24029238 PMCID: PMC3836076 DOI: 10.1210/en.2013-1463] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/17/2022]
Abstract
There has been great interest in the extent of β-cell regeneration after pancreatic duct ligation (PDL) and whether α- to β-cell conversion might account for β-cell regeneration after near-complete β-cell loss. To assess these questions, we established a PDL-model in adult male rats after almost complete beta-cell depletion achieved by giving a single high dose of streptozocin (STZ) in the fasted state. Because of the resultant severe diabetes, rats were given islet cell transplants to allow long-term follow-up. Although animals were followed up to 10 months, there was no meaningful β-cell regeneration, be it through replication, neogenesis, or α- to β-cell conversion. In contrast, the acinar cell compartment underwent massive changes with first severe acinar degeneration upon PDL injury followed by the appearance of pancreatic adipocytes, and finally near-complete reappearance of acini. We conclude that β-cells and acinar cells, although originating from the same precursors during development, have very distinct regenerative potentials in our PDL model in adult rats.
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Affiliation(s)
- Claudia Cavelti-Weder
- Section on Islet Cell and Regenerative Biology, Research Division, Joslin Diabetes Center, Department of Medicine, Harvard Medical School, One Joslin Place, Boston, Massachusetts 02215.
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23
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Biason-Lauber A, Böni-Schnetzler M, Hubbard BP, Bouzakri K, Brunner A, Cavelti-Weder C, Keller C, Meyer-Böni M, Meier DT, Brorsson C, Timper K, Leibowitz G, Patrignani A, Bruggmann R, Boily G, Zulewski H, Geier A, Cermak JM, Elliott P, Ellis JL, Westphal C, Knobel U, Eloranta JJ, Kerr-Conte J, Pattou F, Konrad D, Matter CM, Fontana A, Rogler G, Schlapbach R, Regairaz C, Carballido JM, Glaser B, McBurney MW, Pociot F, Sinclair DA, Donath MY. Identification of a SIRT1 mutation in a family with type 1 diabetes. Cell Metab 2013; 17:448-455. [PMID: 23473037 PMCID: PMC3746172 DOI: 10.1016/j.cmet.2013.02.001] [Citation(s) in RCA: 89] [Impact Index Per Article: 8.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/18/2012] [Revised: 12/30/2012] [Accepted: 02/07/2013] [Indexed: 02/07/2023]
Abstract
Type 1 diabetes is caused by autoimmune-mediated β cell destruction leading to insulin deficiency. The histone deacetylase SIRT1 plays an essential role in modulating several age-related diseases. Here we describe a family carrying a mutation in the SIRT1 gene, in which all five affected members developed an autoimmune disorder: four developed type 1 diabetes, and one developed ulcerative colitis. Initially, a 26-year-old man was diagnosed with the typical features of type 1 diabetes, including lean body mass, autoantibodies, T cell reactivity to β cell antigens, and a rapid dependence on insulin. Direct and exome sequencing identified the presence of a T-to-C exchange in exon 1 of SIRT1, corresponding to a leucine-to-proline mutation at residue 107. Expression of SIRT1-L107P in insulin-producing cells resulted in overproduction of nitric oxide, cytokines, and chemokines. These observations identify a role for SIRT1 in human autoimmunity and unveil a monogenic form of type 1 diabetes.
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Affiliation(s)
- Anna Biason-Lauber
- Department of Medicine, University of Fribourg, CH-1700 Fribourg, Switzerland
| | - Marianne Böni-Schnetzler
- Endocrinology, Diabetes, and Metabolism, and Department of Biomedicine, University Hospital Basel, 4031 Basel, Switzerland
| | - Basil P. Hubbard
- Department of Genetics, Paul F. Glenn Laboratories for the Biological Mechanisms of Aging, Harvard Medical School, Boston, MA 02115, USA
| | - Karim Bouzakri
- Department of Genetic Medicine and Development, University of Geneva, University Medical Center, 1211 Geneva, Switzerland
| | - Andrea Brunner
- Endocrinology, Diabetes, and Metabolism, and Department of Biomedicine, University Hospital Basel, 4031 Basel, Switzerland
| | - Claudia Cavelti-Weder
- Endocrinology, Diabetes, and Metabolism, and Department of Biomedicine, University Hospital Basel, 4031 Basel, Switzerland
| | - Cornelia Keller
- Endocrinology, Diabetes, and Metabolism, and Department of Biomedicine, University Hospital Basel, 4031 Basel, Switzerland
| | - Monika Meyer-Böni
- Department of Medicine, University of Fribourg, CH-1700 Fribourg, Switzerland
| | - Daniel T. Meier
- Endocrinology, Diabetes, and Metabolism, and Department of Biomedicine, University Hospital Basel, 4031 Basel, Switzerland
| | - Caroline Brorsson
- Glostrup Research Institute, Glostrup University Hospital, 2600 Glostrup, Denmark
| | - Katharina Timper
- Endocrinology, Diabetes, and Metabolism, and Department of Biomedicine, University Hospital Basel, 4031 Basel, Switzerland
| | - Gil Leibowitz
- Endocrinology and Metabolism Service, Department of Medicine, Hadassah Hebrew University Medical Center, 91120 Jerusalem, Israel
| | - Andrea Patrignani
- Functional Genomic Center Zurich, Federal Institute of Technology University of Zurich, 8057 Zurich, Switzerland
| | - Remy Bruggmann
- Functional Genomic Center Zurich, Federal Institute of Technology University of Zurich, 8057 Zurich, Switzerland
| | - Gino Boily
- University of Ottawa, Ottawa, ON K1H 8L6, Canada
| | - Henryk Zulewski
- Endocrinology, Diabetes, and Metabolism, and Department of Biomedicine, University Hospital Basel, 4031 Basel, Switzerland
| | - Andreas Geier
- Gastroenterology and Hepatology Center of Integrative Human Physiology and University Hospital Zurich, 8091 Zurich, Switzerland
| | | | | | | | | | - Urs Knobel
- Endocrinology, Diabetes, and Metabolism, and Department of Biomedicine, University Hospital Basel, 4031 Basel, Switzerland
| | - Jyrki J. Eloranta
- Department of Clinical Pharmacology and Toxicology Center of Integrative Human Physiology and University Hospital Zurich, 8091 Zurich, Switzerland
| | | | | | - Daniel Konrad
- University Children's Hospital, 8032 Zurich, Switzerland
| | - Christian M. Matter
- Department of Cardiology Center of Integrative Human Physiology and University Hospital Zurich, 8091 Zurich, Switzerland
| | - Adriano Fontana
- Institute of Experimental Immunology University of Zurich, 8057 Zurich, Switzerland
| | - Gerhard Rogler
- Gastroenterology and Hepatology Center of Integrative Human Physiology and University Hospital Zurich, 8091 Zurich, Switzerland
| | - Ralph Schlapbach
- Functional Genomic Center Zurich, Federal Institute of Technology University of Zurich, 8057 Zurich, Switzerland
| | - Camille Regairaz
- Novartis Institutes for BioMedical Research, 4002 Basel, Switzerland
| | | | - Benjamin Glaser
- Endocrinology and Metabolism Service, Department of Medicine, Hadassah Hebrew University Medical Center, 91120 Jerusalem, Israel
| | | | - Flemming Pociot
- Glostrup Research Institute, Glostrup University Hospital, 2600 Glostrup, Denmark
| | - David A. Sinclair
- Department of Genetics, Paul F. Glenn Laboratories for the Biological Mechanisms of Aging, Harvard Medical School, Boston, MA 02115, USA
| | - Marc Y. Donath
- Endocrinology, Diabetes, and Metabolism, and Department of Biomedicine, University Hospital Basel, 4031 Basel, Switzerland
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Cavelti-Weder C, Babians-Brunner A, Keller C, Stahel MA, Kurz-Levin M, Zayed H, Solinger AM, Mandrup-Poulsen T, Dinarello CA, Donath MY. Effects of gevokizumab on glycemia and inflammatory markers in type 2 diabetes. Diabetes Care 2012; 35:1654-62. [PMID: 22699287 PMCID: PMC3402269 DOI: 10.2337/dc11-2219] [Citation(s) in RCA: 207] [Impact Index Per Article: 17.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Abstract
OBJECTIVE Metabolic activation of the innate immune system governed by interleukin (IL)-1β contributes to β-cell failure in type 2 diabetes. Gevokizumab is a novel, human-engineered monoclonal anti-IL-1β antibody. We evaluated the safety and biological activity of gevokizumab in patients with type 2 diabetes. RESEARCH DESIGN AND METHODS In a placebo-controlled, dose-escalation study, a total of 98 patients were randomly assigned to placebo (17 subjects) or gevokizumab (81 subjects) at increasing doses and dosing schedules. The primary objective of the study was to evaluate the safety profile of gevokizumab in type 2 diabetes. The secondary objectives were to assess pharmacokinetics for different dose levels, routes of administration, and regimens and to assess biological activity. RESULTS The study drug was well tolerated with no serious adverse events. There was one hypoglycemic event whereupon concomitant insulin treatment had to be reduced. Clearance of gevokizumab was consistent with that for a human IgG(2), with a half-life of 22 days. In the combined intermediate-dose group (single doses of 0.03 and 0.1 mg/kg), the mean placebo-corrected decrease in glycated hemoglobin was 0.11, 0.44, and 0.85% after 1, 2 (P = 0.017), and 3 (P = 0.049) months, respectively, along with enhanced C-peptide secretion, increased insulin sensitivity, and a reduction in C-reactive protein and spontaneous and inducible cytokines. CONCLUSIONS This novel IL-1β-neutralizing antibody improved glycemia, possibly via restored insulin production and action, and reduced inflammation in patients with type 2 diabetes. This therapeutic agent may be able to be used on a once-every-month or longer schedule.
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Affiliation(s)
- Claudia Cavelti-Weder
- Department of Endocrinology, Diabetes, and Metabolism,University Hospital Basel, Basel, Switzerland
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Cavelti-Weder C, Muggli B, Keller C, Babians-Brunner A, Biason-Lauber A, Donath MY, Schmid-Grendelmeier P. Successful use of omalizumab in an inadequately controlled type 2 diabetic patient with severe insulin allergy. Diabetes Care 2012; 35:e41. [PMID: 22619293 PMCID: PMC3357226 DOI: 10.2337/dc12-0115] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Claudia Cavelti-Weder
- From the Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland; the
| | - Bettina Muggli
- From the Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland; the
| | - Cornelia Keller
- Department of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland; the
| | - Andrea Babians-Brunner
- Department of Endocrinology, Diabetes and Clinical Nutrition, University Hospital Zurich, Zurich, Switzerland; the
| | - Anna Biason-Lauber
- Department of Endocrinology and Diabetology, University Children’s Hospital, Zurich, Switzerland; the
| | - Marc Y. Donath
- Department of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland; the
- Department of Biomedicine, University Hospital Basel, Basel, Switzerland; and the
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Cavelti-Weder C, Furrer R, Keller C, Babians-Brunner A, Solinger AM, Gast H, Fontana A, Donath MY, Penner IK. Inhibition of IL-1beta improves fatigue in type 2 diabetes. Diabetes Care 2011; 34:e158. [PMID: 21949230 PMCID: PMC3177746 DOI: 10.2337/dc11-1196] [Citation(s) in RCA: 45] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Claudia Cavelti-Weder
- From the Division of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | - Romana Furrer
- From the Division of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | - Cornelia Keller
- From the Division of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | - Andrea Babians-Brunner
- From the Division of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | | | - H. Gast
- Department of Neurology, Inselspital, University Berne, Berne, Switzerland; the
| | - A. Fontana
- Institute for Experimental Immunology, University of Zurich, Zurich, Switzerland; and the
| | - Marc Y. Donath
- From the Division of Endocrinology, Diabetes and Metabolism, University Hospital Basel, Basel, Switzerland
| | - Iris K. Penner
- Department of Cognitive Psychology and Methodology, University of Basel, Basel, Switzerland
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Abstract
Stem cells hold great promise for pancreatic beta cell replacement therapy for diabetes. In type 1 diabetes, beta cells are mostly destroyed, and in type 2 diabetes beta cell numbers are reduced by 40% to 60%. The proof-of-principle that cellular transplants of pancreatic islets, which contain insulin-secreting beta cells, can reverse the hyperglycemia of type 1 diabetes has been established, and there is now a need to find an adequate source of islet cells. Human embryonic stem cells can be directed to become fully developed beta cells and there is expectation that induced pluripotent stem (iPS) cells can be similarly directed. iPS cells can also be generated from patients with diabetes to allow studies of the genomics and pathogenesis of the disease. Some alternative approaches for replacing beta cells include finding ways to enhance the replication of existing beta cells, stimulating neogenesis (the formation of new islets in postnatal life), and reprogramming of pancreatic exocrine cells to insulin-producing cells. Stem-cell-based approaches could also be used for modulation of the immune system in type 1 diabetes, or to address the problems of obesity and insulin resistance in type 2 diabetes. Herein, we review recent advances in our understanding of diabetes and beta cell biology at the genomic level, and we discuss how stem-cell-based approaches might be used for replacing beta cells and for treating diabetes.
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Affiliation(s)
- Gordon C Weir
- Section on Islet Cell and Regenerative Biology, Research Division, Joslin Diabetes Center, One Joslin Place, Boston, MA 02215, USA, and the Department of Medicine, Harvard Medical School, 25 Shattuck Street, Boston, MA 02115, USA.
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