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Kannt A, Madsen AN, Kammermeier C, Elvert R, Klöckener T, Bossart M, Haack T, Evers A, Lorenz K, Hennerici W, Rocher C, Böcskei Z, Guillemot JC, Mikol V, Pattou F, Staels B, Wagner M. Incretin combination therapy for the treatment of non-alcoholic steatohepatitis. Diabetes Obes Metab 2020; 22:1328-1338. [PMID: 32196896 DOI: 10.1111/dom.14035] [Citation(s) in RCA: 16] [Impact Index Per Article: 4.0] [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: 12/28/2019] [Revised: 03/04/2020] [Accepted: 03/16/2020] [Indexed: 12/17/2022]
Abstract
AIMS To test specific mono-agonists to the glucagon-like peptide-1 receptor (GLP-1R), glucagon receptor (GCGR) and glucose-dependent insulinotropic peptide receptor (GIPR), individually and in combination, in a mouse model of diet-induced non-alcoholic steatohepatitis (NASH) and fibrosis in order to decipher the contribution of their activities and potential additive effects to improving systemic and hepatic metabolism. MATERIALS AND METHODS We induced NASH by pre-feeding C57BL/6J mice a diet rich in fat, fructose and cholesterol for 36 weeks. This was followed by 8 weeks of treatment with the receptor-specific agonists 1-GCG (20 μg/kg twice daily), 2-GLP1 (3 μg/kg twice daily) or 3-GIP (30 μg/kg twice daily), or the dual (1 + 2) or triple (1 + 2 + 3) combinations thereof. A dual GLP-1R/GCGR agonistic peptide, 4-dual-GLP1/GCGR (30 μg/kg twice daily), and liraglutide (100 μg/kg twice daily) were included as references. RESULTS Whereas low-dose 1-GCG or 3-GIP alone did not influence body weight, liver lipids and histology, their combination with 2-GLP1 provided additional weight loss, reduction in liver triglycerides and improvement in histological disease activity score. Notably, 4-dual-GLP-1R/GCGR and the triple combination of selective mono-agonists led to a significantly stronger reduction in the histological non-alcoholic fatty liver disease activity score compared to high-dose liraglutide, at the same extent of body weight loss. CONCLUSIONS GCGR and GIPR agonism provide additional, body weight-independent improvements on top of GLP-1R agonism in a murine model of manifest NASH with fibrosis.
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Affiliation(s)
- Aimo Kannt
- Sanofi Research and Development, Frankfurt, Germany
- Experimental Pharmacology, Medical Faculty Mannheim, University of Heidelberg, Mannheim, Germany
- Fraunhofer Institute for Molecular Biology and Applied Ecology IME, Branch for Translational Medicine and Pharmacology TMP, Frankfurt, Germany
| | | | | | - Ralf Elvert
- Sanofi Research and Development, Frankfurt, Germany
| | | | | | | | | | | | | | - Corinne Rocher
- Sanofi Research and Development, Chilly-Mazarin Cedex, France
| | - Zsolt Böcskei
- Sanofi Research and Development, Chilly-Mazarin Cedex, France
| | | | - Vincent Mikol
- Sanofi Research and Development, Chilly-Mazarin Cedex, France
| | - Francois Pattou
- Univ Lille, Inserm, CHU Lille, Institut Pasteur de Lille, UMR1011-EGID, Lille, France
| | - Bart Staels
- Univ Lille, Inserm, CHU Lille, Institut Pasteur de Lille, UMR1011-EGID, Lille, France
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Schmoll D, Ziegler N, Viollet B, Foretz M, Even PC, Azzout-Marniche D, Nygaard Madsen A, Illemann M, Mandrup K, Feigh M, Czech J, Glombik H, Olsen JA, Hennerici W, Steinmeyer K, Elvert R, Castañeda TR, Kannt A. Activation of Adenosine Monophosphate-Activated Protein Kinase Reduces the Onset of Diet-Induced Hepatocellular Carcinoma in Mice. Hepatol Commun 2020; 4:1056-1072. [PMID: 32626837 PMCID: PMC7327225 DOI: 10.1002/hep4.1508] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [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] [Received: 11/29/2019] [Revised: 03/03/2020] [Accepted: 03/03/2020] [Indexed: 12/19/2022] Open
Abstract
The worldwide obesity and type 2 diabetes epidemics have led to an increase in nonalcoholic fatty liver disease (NAFLD). NAFLD covers a spectrum of hepatic pathologies ranging from simple steatosis to nonalcoholic steatohepatitis, characterized by fibrosis and hepatic inflammation. Nonalcoholic steatohepatitis predisposes to the onset of hepatocellular carcinoma (HCC). Here, we characterized the effect of a pharmacological activator of the intracellular energy sensor adenosine monophosphate–activated protein kinase (AMPK) on NAFLD progression in a mouse model. The compound stimulated fat oxidation by activating AMPK in both liver and skeletal muscle, as revealed by indirect calorimetry. This translated into an ameliorated hepatic steatosis and reduced fibrosis progression in mice fed a diet high in fat, cholesterol, and fructose for 20 weeks. Feeding mice this diet for 80 weeks caused the onset of HCC. The administration of the AMPK activator for 12 weeks significantly reduced tumor incidence and size. Conclusion: Pharmacological activation of AMPK reduces NAFLD progression to HCC in preclinical models.
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Affiliation(s)
| | | | - Benoit Viollet
- Université de Paris Institut Cochin CNRS UMR 8104 INSERM U1016 Paris France
| | - Marc Foretz
- Université de Paris Institut Cochin CNRS UMR 8104 INSERM U1016 Paris France
| | - Patrick C Even
- UMR Nutrition Physiology and Ingestive Behavior AgroParisTech INRA Université Paris-Saclay Paris France
| | - Dalila Azzout-Marniche
- UMR Nutrition Physiology and Ingestive Behavior AgroParisTech INRA Université Paris-Saclay Paris France
| | | | | | | | | | | | | | | | | | | | | | | | - Aimo Kannt
- Sanofi R&D Frankfurt Germany.,Institute of Experimental Pharmacology Medical Faculty Mannheim University of Heidelberg Mannheim Germany.,Fraunhofer IME Translational Medicine and Pharmacology Frankfurt Germany
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Elvert R, Bossart M, Herling AW, Weiss T, Zhang B, Kannt A, Wagner M, Haack T, Evers A, Dudda A, Keil S, Lorenz M, Lorenz K, Riz M, Hennerici W, Larsen PJ. Team Players or Opponents: Coadministration of Selective Glucagon and GLP-1 Receptor Agonists in Obese Diabetic Monkeys. Endocrinology 2018; 159:3105-3119. [PMID: 29992313 DOI: 10.1210/en.2018-00399] [Citation(s) in RCA: 16] [Impact Index Per Article: 2.7] [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: 04/26/2018] [Accepted: 07/03/2018] [Indexed: 01/06/2023]
Abstract
We assessed the therapeutic contribution of the individual components of glucagon-like peptide-1 receptor (GLP-1R) and glucagon receptor (GCGR) agonists alone and in combination upon energy homeostasis and glycemic control in diet-induced obese, diabetic nonhuman primates. The pharmacological active dose ranges of selective agonists were established through a dose-finding study, followed by a 6-week chronic study. Repeated subcutaneous administration of a selective GCGR agonist (30 µg/kg once daily) did not affect food intake or body weight, whereas the selective GLP-1R agonist (3 µg/kg once daily) alone decreased energy intake by 18% and body weight by 3.8% ± 0.9%. Combination of both agonists reduced significantly cumulative food intake by 27% and body weight by 6.6% ± 0.9%. Fasting plasma glucose (FPG) was improved by GLP-1R agonist (baseline vs end of study, 176.7 ± 34.0 vs 115.9 ± 16.1 mg/dL). In contrast, groups exposed to GCGR agonist experienced nonsignificant elevations of FPG. More accurate assessment of therapeutic interventions on glucose homeostasis was tested by an IV glucose tolerance test. Glucose excursion was significantly elevated by chronic GCGR agonist administration, whereas it was significantly decreased in GLP-1R agonist-treated monkeys. In the combination group, a nonsignificant increase of glucose excursion was seen, concomitantly with significantly increased insulin secretion. We conclude that chronic glucagon agonism does not affect energy homeostasis in nonhuman primates. In combination with GLP-1R agonism, glucagon agonism synergistically enhances negative energy balance with resulting larger body weight loss. However, adding GCGR to GLP-1R agonism diminishes glycemic control in diabetic monkeys. Therefore, long-term therapeutic implications of using GLP-1R/GCGR coagonists for weight management in diabetes warrants further scrutiny.
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Affiliation(s)
- Ralf Elvert
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | - Martin Bossart
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | - Andreas W Herling
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | - Tilo Weiss
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | | | - Aimo Kannt
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
- Institute of Experimental and Clinical Pharmacology and Toxicology, Medical Faculty Mannheim, Heidelberg University, Mannheim, Germany
| | - Michael Wagner
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | - Torsten Haack
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | - Andreas Evers
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | - Angela Dudda
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | - Stefanie Keil
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | - Martin Lorenz
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | - Katrin Lorenz
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | - Michela Riz
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | - Wolfgang Hennerici
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
| | - Philip J Larsen
- Sanofi-Aventis Deutschland GmbH, Industriepark Höchst, Frankfurt, German
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Konnerth D, Dünnweber W, Hering W, Trautmann W, Trombik W, Zipper W, Habs D, Hennerici W, Hennrich HJ, Kroth R, Lazzarini A, Repnow R, Metag V, Simon RS. Correlated spin orientations in 12C. Phys Rev Lett 1985; 55:588-591. [PMID: 10032394 DOI: 10.1103/physrevlett.55.588] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 05/23/2023]
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