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Musetti D, Cutolo CA, Bonetto M, Giacomini M, Maggi D, Viviani GL, Gandin I, Traverso CE, Nicolò M. Autonomous artificial intelligence versus teleophthalmology for diabetic retinopathy. Eur J Ophthalmol 2024:11206721241248856. [PMID: 38656241 DOI: 10.1177/11206721241248856] [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] [Indexed: 04/26/2024]
Abstract
Purpose: To assess the role of artificial intelligence (AI) based automated software for detection of Diabetic Retinopathy (DR) compared with the evaluation of digital retinography by two double masked retina specialists. Methods: Two-hundred one patients (mean age 65 ± 13 years) with type 1 diabetes mellitus or type 2 diabetes mellitus were included. All patients were undergoing a retinography and spectral domain optical coherence tomography (SD-OCT, DRI 3D OCT-2000, Topcon) of the macula. The retinal photographs were graded using two validated AI DR screening software (Eye Art TM and IDx-DR) designed to identify more than mild DR. Results: Retinal images of 201 patients were graded. DR (more than mild DR) was detected by the ophthalmologists in 38 (18.9%) patients and by the AI-algorithms in 36 patients (with 30 eyes diagnosed by both algorithms). Ungradable patients by the AI software were 13 (6.5%) and 16 (8%) for the Eye Art and IDx-DR, respectively. Both AI software strategies showed a high sensitivity and specificity for detecting any more than mild DR without showing any statistically significant difference between them. Conclusions: The comparison between the diagnosis provided by artificial intelligence based automated software and the reference clinical diagnosis showed that they can work at a level of sensitivity that is similar to that achieved by experts.
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Affiliation(s)
- Donatella Musetti
- Clinica Oculistica DiNOGMI, Università di Genova, Ospedale Policlinico San Martino IRCCS, Genova, Italy
| | - Carlo Alberto Cutolo
- Clinica Oculistica DiNOGMI, Università di Genova, Ospedale Policlinico San Martino IRCCS, Genova, Italy
| | | | | | - Davide Maggi
- Clinica Diabetologica, Università di Genova, Ospedale Policlinico San Martino IRCCS, Genova, Italy
| | - Giorgio Luciano Viviani
- Clinica Diabetologica, Università di Genova, Ospedale Policlinico San Martino IRCCS, Genova, Italy
| | - Ilaria Gandin
- Sciences, Biostatistic Unit, University of Trieste, Italy
| | - Carlo Enrico Traverso
- Clinica Oculistica DiNOGMI, Università di Genova, Ospedale Policlinico San Martino IRCCS, Genova, Italy
| | - Massimo Nicolò
- Clinica Oculistica DiNOGMI, Università di Genova, Ospedale Policlinico San Martino IRCCS, Genova, Italy
- Fondazione per la Macula onlus, Genova, Italy
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Puddu A, Maggi D. Special Issue: "Anti-inflammatory Effects of Glucagon-like Peptide-1". Int J Mol Sci 2024; 25:1997. [PMID: 38396675 PMCID: PMC10888676 DOI: 10.3390/ijms25041997] [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] [Subscribe] [Scholar Register] [Received: 01/26/2024] [Accepted: 02/04/2024] [Indexed: 02/25/2024] Open
Abstract
From the failure of gut extracts in diabetic patients' therapy to the effective action in cardiovascular outcomes [...].
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Affiliation(s)
- Alessandra Puddu
- Department of Internal Medicine and Medical Specialties, University of Genoa, 16132 Genoa, Italy;
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Ravera S, Bertola N, Puddu A, Bruno S, Maggi D, Panfoli I. Crosstalk between the Rod Outer Segments and Retinal Pigmented Epithelium in the Generation of Oxidative Stress in an In Vitro Model. Cells 2023; 12:2173. [PMID: 37681906 PMCID: PMC10487269 DOI: 10.3390/cells12172173] [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] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2023] [Revised: 08/21/2023] [Accepted: 08/22/2023] [Indexed: 09/09/2023] Open
Abstract
Dysfunction of the retinal pigment epithelium (RPE) is associated with several diseases characterized by retinal degeneration, such as diabetic retinopathy (DR). However, it has recently been proposed that outer retinal neurons also participate in the damage triggering. Therefore, we have evaluated the possible crosstalk between RPE and photoreceptors in priming and maintaining oxidative damage of the RPE. For this purpose, we used ARPE-19 cells as a model of human RPE, grown in normal (NG, 5.6 mM) or high glucose (HG, 25 mM) and unoxidized (UOx) or oxidized (Ox) mammalian retinal rod outer segments (OSs). ARPE-19 cells were efficient at phagocytizing rod OSs in both NG and HG settings. However, in HG, ARPE-19 cells treated with Ox-rod OSs accumulated MDA and lipofuscins and displayed altered LC3, GRP78, and caspase 8 expression compared to untreated and UOx-rod-OS-treated cells. Data suggest that early oxidative damage may originate from the photoreceptors and subsequently extend to the RPE, providing a new perspective to the idea that retinal degeneration depends solely on a redox alteration of the RPE.
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Affiliation(s)
- Silvia Ravera
- Department of Experimental Medicine, Università di Genoa, Via De Toni 14, 16132 Genova, Italy
| | - Nadia Bertola
- Molecular Pathology Unit, IRCCS Ospedale Policlinico San Martino, Largo Rosanna Benzi 10, 16132 Genova, Italy
| | - Alessandra Puddu
- Department of Internal Medicine and Medical Specialties, University of Genova, Viale Benedetto XV 6, 16132 Genova, Italy
| | - Silvia Bruno
- Department of Experimental Medicine, Università di Genoa, Via De Toni 14, 16132 Genova, Italy
| | - Davide Maggi
- Department of Internal Medicine and Medical Specialties, University of Genova, Viale Benedetto XV 6, 16132 Genova, Italy
| | - Isabella Panfoli
- Department of Pharmacy-(DIFAR), Università di Genova, Viale Benedetto XV 3, 16132 Genova, Italy
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Puddu A, Montecucco F, Maggi D. Caveolin-1 and Atherosclerosis: Regulation of LDLs Fate in Endothelial Cells. Int J Mol Sci 2023; 24:ijms24108869. [PMID: 37240214 DOI: 10.3390/ijms24108869] [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: 03/16/2023] [Revised: 04/28/2023] [Accepted: 05/15/2023] [Indexed: 05/28/2023] Open
Abstract
Caveolae are 50-100 nm cell surface plasma membrane invaginations observed in terminally differentiated cells. They are characterized by the presence of the protein marker caveolin-1. Caveolae and caveolin-1 are involved in regulating several signal transduction pathways and processes. It is well recognized that they have a central role as regulators of atherosclerosis. Caveolin-1 and caveolae are present in most of the cells involved in the development of atherosclerosis, including endothelial cells, macrophages, and smooth muscle cells, with evidence of either pro- or anti-atherogenic functions depending on the cell type examined. Here, we focused on the role of caveolin-1 in the regulation of the LDLs' fate in endothelial cells.
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Affiliation(s)
- Alessandra Puddu
- Department of Internal Medicine, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy
| | - Fabrizio Montecucco
- Department of Internal Medicine, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino Genoa, Italian Cardiovascular Network, Largo Rosanna Benzi 10, 16132 Genoa, Italy
| | - Davide Maggi
- Department of Internal Medicine, University of Genoa, Viale Benedetto XV, 6, 16132 Genoa, Italy
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Concistrè A, Petramala L, Pugliano CL, Celi M, Vinci F, Assanto E, Barchetta I, Perrone EP, Rella S, Iannazzo F, Angheloni A, Coraggio L, Di Rienzo F, Maggi D, Circosta F, Galardo G, Muscaritoli M, Letizia C. Analysis of prognostic factors in COVID-19 hospitalized patients: an Italian single-center case-control study. Eur Rev Med Pharmacol Sci 2023; 27:1207-1221. [PMID: 36808370 DOI: 10.26355/eurrev_202302_31232] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Subscribe] [Scholar Register] [Indexed: 02/23/2023]
Abstract
OBJECTIVE COVID-19 clinical presentation ranges from asymptomatic infection to an inflammatory cytokine storm with multi-organ failure and fatal outcomes. The identification of high-risk patients for severe disease is crucial to plan an early treatment and intensive follow-up. We aimed to investigate negative prognostic factors in a group of patients hospitalized for COVID-19. PATIENTS AND METHODS 181 patients (90 men and 91 women, mean age 66.56 ± 13.53 years) were enrolled. Each patient received a work-up including medical history, clinical examination, arterial blood gas analysis, laboratory blood tests, feasible ventilatory support required during hospital stay, intensive care setting required, duration of illness and length of hospital stay (>or<25 days). For the assessment of the severity of COVID-19, three main indicators were considered: 1) the intensive care unit (ICU) admission 2) the hospitalization length >25 days; 3) the need of non-invasive ventilation (NIV). RESULTS The independent risk factor associated with the ICU admission were lactic dehydrogenase elevation (p=0.046), C reactive protein elevation (p=0.014) at hospital admission and direct oral anticoagulant home therapy (p=0.048); for hospital length >25 days: early corticosteroid therapy (p=0.035); for NIV treatment: ferritin elevation at hospital admission (p=0.006). CONCLUSIONS The presence of the above factors may be useful to identify patients at high risk of developing a severe COVID-19 that need an early treatment and intensive follow-up.
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Affiliation(s)
- A Concistrè
- Internal Medicine COVID-19 Unit, Policlinico "Umberto I" University Hospital, Rome, Italy.
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Bassi M, Patti L, Silvestrini I, Strati MF, Ponzano M, Minuto N, Maggi D. One-year follow-up comparison of two hybrid closed-loop systems in Italian children and adults with type 1 diabetes. Front Endocrinol (Lausanne) 2023; 14:1099024. [PMID: 36777356 PMCID: PMC9909036 DOI: 10.3389/fendo.2023.1099024] [Citation(s) in RCA: 10] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/15/2022] [Accepted: 01/16/2023] [Indexed: 01/27/2023] Open
Abstract
BACKGROUND AND AIMS Tandem Control-IQ and MiniMed 780G are the main Advanced Hybrid Closed Loop (AHCL) systems currently available in pediatric and adult patients with Type 1 Diabetes (T1D). The aim of our study was to evaluate glycemic control after 1-year of follow-up extending our previous study of 1-month comparison between the two systems. METHODS We retrospectively compared clinical and continuous glucose monitoring (CGM) data from the patients included in the previous study which have completed 1-year observation period. The study population consisted of 74 patients, 42 Minimed 780G users and 32 Tandem Control-IQ users. Linear mixed models with random intercept were performed to study the variations over time and the interaction between time and system; Mann-Whitney or T-test were used to compare systems at 1-year. RESULTS Both systems have been shown to be effective in maintaining the glycemic improvement achieved one month after starting AHCL. Significant changes over time were observed for TIR, TAR, TAR>250mg/dl, average glucose levels and SD (p<0.001). At 1-year follow-up Minimed 780G obtained better improvement in TIR (p<0.001), TAR (p=0.002), TAR>250mg/dl (p=0.001), average glucose levels (p<0.001). The comparison of the glycemic parameters at 1-year showed a significant superiority of Minimed 780G in terms of TIR (71% vs 68%; p=0.001), TAR (p=0.001), TAR>250 (p=0.009), average glucose levels(p=0.001) and SD (p=0.031). CONCLUSIONS The use of AHCL systems led to a significant improvement of glycemic control at 1-month, which is maintained at 1-year follow-up. MiniMed is more effective than Tandem in reaching the International recommended glycemic targets. Continuous training and education in the use of technology is essential to get the best out of the most advanced technological tools.
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Affiliation(s)
- Marta Bassi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, University of Genoa, Genoa, Italy
| | - Luca Patti
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, Italy
| | - Irene Silvestrini
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, Italy
| | - Marina Francesca Strati
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, University of Genoa, Genoa, Italy
| | - Marta Ponzano
- Department of Health Science (DiSSAL), University of Genoa, Genoa, Italy
| | - Nicola Minuto
- Department of Pediatrics, IRCCS Istituto Giannina Gaslini, University of Genoa, Genoa, Italy
- *Correspondence: Nicola Minuto,
| | - Davide Maggi
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, Italy
- Diabetes Clinic, IRCCS Ospedale Policlinico San Martino Genoa, Genoa, Italy
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Puddu A, Maggi D. Anti-Inflammatory Effects of GLP-1R Activation in the Retina. Int J Mol Sci 2022; 23:ijms232012428. [PMID: 36293281 PMCID: PMC9604172 DOI: 10.3390/ijms232012428] [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] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/06/2022] [Revised: 10/12/2022] [Accepted: 10/13/2022] [Indexed: 11/23/2022] Open
Abstract
Glucagon-like peptide-1 (GLP-1) is an incretin hormone, mainly produced by enteroendocrine L cells, which participates in the regulation of glucose homeostasis, and in reduction in body weight by promoting satiety. Actions of GLP-1 are mediated by activation of its receptor GLP-1R, which is widely expressed in several tissues including the retina. The effects of GLP-1R activation are useful in the management of type 2 diabetes mellitus (T2DM). In addition, the activation of GLP-1R has anti-inflammatory effects in several organs, suggesting that it may be also useful in the treatment of inflammatory diseases. Inflammation is a common element in the pathogenesis of several ocular diseases, and the protective effects of treatment with GLP-1 emerged also in retinal diseases. In this review we highlight the anti-inflammatory effects of GLP-1R activation in the retina. Firstly, we summarized the pathogenic role of inflammation in ocular diseases. Then, we described the pleiotropic effects of GLP-1R activation on the cellular components of the retina which are mainly involved in the pathogenesis of inflammatory retinal diseases: the retinal ganglion cells, retinal pigment epithelial cells and endothelial cells.
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Maggi D, Romano R, Carsten O. Transitions Between Highly Automated and Longitudinally Assisted Driving: The Role of the Initiator in the Fight for Authority. Hum Factors 2022; 64:601-612. [PMID: 32865032 PMCID: PMC9008545 DOI: 10.1177/0018720820946183] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/05/2020] [Accepted: 07/06/2020] [Indexed: 05/24/2023]
Abstract
OBJECTIVE A driving simulator study explored how drivers behaved depending on their initial role during transitions between highly automated driving (HAD) and longitudinally assisted driving (via adaptive cruise control). BACKGROUND During HAD, drivers might issue a take-over request (TOR), initiating a transition of control that was not planned. Understanding how drivers behave in this situation and, ultimately, the implications on road safety is of paramount importance. METHOD Sixteen participants were recruited for this study and performed transitions of control between HAD and longitudinally assisted driving in a driving simulator. While comparing how drivers behaved depending on whether or not they were the initiators, different handover strategies were presented to analyze how drivers adapted to variations in the authority level they were granted at various stages of the transitions. RESULTS Whenever they initiated the transition, drivers were more engaged with the driving task and less prone to follow the guidance of the proposed strategies. Moreover, initiating a transition and having the highest authority share during the handover made the drivers more engaged with the driving task and attentive toward the road. CONCLUSION Handover strategies that retained a larger authority share were more effective whenever the automation initiated the transition. Under driver-initiated transitions, reducing drivers' authority was detrimental for both performance and comfort. APPLICATION As the operational design domain of automated vehicles (Society of Automotive Engineers [SAE] Level 3/4) expands, the drivers might very well fight boredom by taking over spontaneously, introducing safety issues so far not considered but nevertheless very important.
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Maggi D, Romano R, Carsten O. The effect of inconsistent steering guidance during transitions from Highly Automated Driving. Accid Anal Prev 2022; 167:106572. [PMID: 35121504 DOI: 10.1016/j.aap.2022.106572] [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] [Track Full Text] [Subscribe] [Scholar Register] [Received: 09/21/2021] [Revised: 12/14/2021] [Accepted: 01/16/2022] [Indexed: 06/14/2023]
Abstract
This driving simulator study investigated the effect of inconsistent steering guidance during system and user-initiated transitions from Highly Automated Driving (HAD). In particular, the aim of the study was to understand if steering conflicts could be achieved by adopting inconsistent steering guidance and whether these conflicts could be exploited to accelerate drivers' steering engagement within a limited time. Inconsistent steering guidance was generated by switching the guidance on and off at 3 different frequencies (0.1, 0.2 and 0.3 Hz). Results revealed that steering engagement has more to do with the initiation rather than the quality of the steering guidance. In fact, drivers were more engaged with the steering task when they initiated the transition themselves. Compared to system-initiated transitions, in user-initiated ones, drivers exerted stronger steering inputs throughout the transition, which allowed them to maintain larger Time To Lane Crossing (TTLC) values with fewer steering corrections. During system-initiated transitions, drivers started to actively engage with the steering activity only after more than 5 s from the start of the transition but were able to achieve a steering behaviour close to the one shown during user-initiated transitions at 10 s.
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Puddu A, Ravera S, Panfoli I, Bertola N, Maggi D. High Glucose Impairs Expression and Activation of MerTK in ARPE-19 Cells. Int J Mol Sci 2022; 23:ijms23031144. [PMID: 35163068 PMCID: PMC8835591 DOI: 10.3390/ijms23031144] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2021] [Revised: 01/09/2022] [Accepted: 01/17/2022] [Indexed: 12/19/2022] Open
Abstract
MerTK (Mer Tyrosine Kinase) is a cell surface receptor that regulates phagocytosis of photoreceptor outer segments (POS) in retinal pigment epithelial (RPE) cells. POS phagocytosis is impaired in several pathologies, including diabetes. In this study, we investigate whether hyperglycemic conditions may affect MerTK expression and activation in ARPE-19 cells, a retinal pigment epithelial cellular model. ARPE-19 cells were cultured in standard (CTR) or high-glucose (HG) medium for 24 h. Then, we analyzed: mRNA levels and protein expression of MerTK and ADAM9, a protease that cleaves the extracellular region of MerTK; the amount of cleaved Mer (sMer); and the ability of GAS6, a MerTK ligand, to induce MerTK phosphorylation. Since HG reduces miR-126 levels, and ADAM9 is a target of miR-126, ARPE-19 cells were transfected with miR-126 inhibitor or mimic; then, we evaluated ADAM9 expression, sMer, and POS phagocytosis. We found that HG reduced expression and activation of MerTK. Contextually, HG increased expression of ADAM9 and the amount of sMer. Overexpression of miR-126 reduced levels of sMer and improved phagocytosis in ARPE-19 cells cultured with HG. In this study, we demonstrate that HG compromises MerTK expression and activation in ARPE-19 cells. Our results suggest that HG up-regulates ADAM9 expression, leading to increased shedding of MerTK. The consequent rise in sMer coupled to reduced expression of MerTK impairs binding and internalization of POS in ARPE-19 cells.
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Affiliation(s)
- Alessandra Puddu
- Department of Internal Medicine and Medical Specialties, University of Genova, 16132 Genova, Italy;
- Correspondence:
| | - Silvia Ravera
- Dipartimento di Medicina Sperimentale, Università di Genoa, Via De Toni 14, 16132 Genova, Italy; (S.R.); (N.B.)
| | - Isabella Panfoli
- Dipartimento di Farmacia (DIFAR), Università di Genova, V.le Benedetto XV 3, 16132 Genova, Italy;
| | - Nadia Bertola
- Dipartimento di Medicina Sperimentale, Università di Genoa, Via De Toni 14, 16132 Genova, Italy; (S.R.); (N.B.)
| | - Davide Maggi
- Department of Internal Medicine and Medical Specialties, University of Genova, 16132 Genova, Italy;
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Sanguineti R, Puddu A, Nicolò M, Traverso CE, Cordera R, Viviani GL, Maggi D. miR-126 Mimic Counteracts the Increased Secretion of VEGF-A Induced by High Glucose in ARPE-19 Cells. J Diabetes Res 2021; 2021:6649222. [PMID: 33709000 PMCID: PMC7932804 DOI: 10.1155/2021/6649222] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 11/13/2020] [Revised: 01/25/2021] [Accepted: 02/03/2021] [Indexed: 12/27/2022] Open
Abstract
Vascular endothelial growth factor-A (VEGF-A) has a pathologic role in microvascular diabetic complication, such as diabetic retinopathy (DR). miR-126 plays an important role in vascular development and angiogenesis by regulating the expression of VEGF-A. Since levels of miR-126 have been found downregulated in diabetes, this study is aimed at investigating whether hyperglycemia affects expression of miR-126 in a retinal pigment epithelium cell line. ARPE-19 cells were transfected with miR-126 inhibitor or with miR-126 mimic and the respective scramble negative control. After 24 hours, medium was replaced and cells were cultured for 24 hours in normal (CTR) or diabetic condition (HG). Then, we analyzed mRNA levels of miR-126, VEGF-A, PI3KR2, and SPRED1. We also evaluated protein amount of HIF-1α, PI3KR2, and SPRED1 and VEGF-A secretion. The results showed that exposure of ARPE-19 cells to HG significantly decreased miR-126 levels; mRNA levels of VEGF-A and PI3KR2 were inversely correlated with those of miR-126. Overexpression of miR-126 under HG restored HIF-1α expression and VEGF-A secretion to the level of CTR cells. These results indicate that reduced levels of miR-126 may contribute to DR progression by increasing expression of VEGF-A in RPE cells. In addition, we provide evidence that upregulation of miR-126 in RPE cells counteracts the rise of VEGF-A secretion induced by hyperglycemia. In conclusion, our data support a role of miR-126 mimic-approach in counteracting proangiogenic effects of hyperglycemia.
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Affiliation(s)
- Roberta Sanguineti
- Department of Internal Medicine and Medical Specialties, Viale Benedetto XV XV, Genova, Italy
| | - Alessandra Puddu
- Department of Internal Medicine and Medical Specialties, Viale Benedetto XV XV, Genova, Italy
| | - Massimo Nicolò
- Department of Neuroscience, Ophthalmology and Genetics, Viale Benedetto, Genova, Italy
- Fondazione per la Macula Onlus–Genova, Piazza della Vittoria, Genova, Italy
| | - Carlo Enrico Traverso
- Department of Neuroscience, Ophthalmology and Genetics, Viale Benedetto, Genova, Italy
| | - Renzo Cordera
- Department of Internal Medicine and Medical Specialties, Viale Benedetto XV XV, Genova, Italy
| | - Giorgio L. Viviani
- Department of Internal Medicine and Medical Specialties, Viale Benedetto XV XV, Genova, Italy
| | - Davide Maggi
- Department of Internal Medicine and Medical Specialties, Viale Benedetto XV XV, Genova, Italy
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Puddu A, Maggi D. Emerging Role of Caveolin-1 in GLP-1 Action. Front Endocrinol (Lausanne) 2021; 12:668012. [PMID: 33935978 PMCID: PMC8079975 DOI: 10.3389/fendo.2021.668012] [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] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/15/2021] [Accepted: 03/22/2021] [Indexed: 11/13/2022] Open
Abstract
Glucagon-like peptide-1 (GLP-1) is a gut hormone mainly produced in the intestinal epithelial endocrine L cells, involved in maintaining glucose homeostasis. The use of GLP-1 analogous and dipeptidyl peptidase-IV (DPP-IV) inhibitors is well-established in Type 2 Diabetes. The efficacy of these therapies is related to the activation of GLP-1 receptor (GLP-1R), which is widely expressed in several tissues. Therefore, GLP-1 is of great clinical interest not only for its actions at the level of the beta cells, but also for the extra-pancreatic effects. Activation of GLP-1R results in intracellular signaling that is regulated by availability of downstream molecules and receptor internalization. It has been shown that GLP-1R co-localizes with caveolin-1, the main component of caveolae, small invagination of the plasma membrane, which are involved in controlling receptor activity by assembling signaling complexes and regulating receptor trafficking. The aim of this review is to outline the important role of caveolin-1 in mediating biological effects of GLP-1 and its analogous.
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Bassi M, Teliti M, Lezzi M, Iosca A, Strati MF, Carmisciano L, d’Annunzio G, Minuto N, Maggi D. A Comparison of Two Hybrid Closed-Loop Systems in Italian Children and Adults With Type 1 Diabetes. Front Endocrinol (Lausanne) 2021; 12:802419. [PMID: 35116007 PMCID: PMC8805205 DOI: 10.3389/fendo.2021.802419] [Citation(s) in RCA: 15] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/26/2021] [Accepted: 12/23/2021] [Indexed: 12/11/2022] Open
Abstract
Tandem Control-IQ and Minimed 780G represent the most Advanced Hybrid Closed Loop (AHCL) systems currently available in pediatric and adult subjects with Type 1 Diabetes (T1D). We retrospectively compared clinical and continuous glucose monitoring data from 51 patients who upgraded to Minimed 780G system and have completed 1-month observation period with data from 39 patients who upgraded to Tandem Control-IQ. Inverse probability weighting was used to minimize the basal characteristics imbalances. Both AHCL systems showed a significant improvement in glycemic parameters. Minimed 780G group achieved higher TIR increase (p= 0.004) and greater reduction of blood glucose average (p= 0.001). Tandem Control-IQ system significantly reduced the occurrence of TBR (p= 0.010) and the Coefficient of Variation of glucose levels (p= 0.005). The use of ACHL systems led to a significant improvement of glycemic control substantially reaching the International recommended glycemic targets. Minimed 780G appears to be more effective in managing hyperglycemia, while Tandem Control-IQ seems to be more effective in reducing time in hypoglycemia.
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Affiliation(s)
- Marta Bassi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Marsida Teliti
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, Italy
| | - Marilea Lezzi
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Arianna Iosca
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, Italy
| | - Marina Francesca Strati
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Genoa, Italy
- Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Luca Carmisciano
- Department of Helath Science (DiSSAL), University of Genoa, Genoa, Italy
| | - Giuseppe d’Annunzio
- Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
| | - Nicola Minuto
- Department of Pediatrics, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Istituto Giannina Gaslini, Genoa, Italy
- *Correspondence: Nicola Minuto,
| | - Davide Maggi
- Department of Internal Medicine and Medical Specialties (DiMI), University of Genoa, Genoa, Italy
- Department of Helath Science (DiSSAL), University of Genoa, Genoa, Italy
- Diabetes Clinic, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS) Ospedale Policlinico San Martino Genoa, Genoa, Italy
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14
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Ravera S, Caicci F, Degan P, Maggi D, Manni L, Puddu A, Nicolò M, Traverso CE, Panfoli I. Inhibitory Action of Antidiabetic Drugs on the Free Radical Production by the Rod Outer Segment Ectopic Aerobic Metabolism. Antioxidants (Basel) 2020; 9:E1133. [PMID: 33203090 PMCID: PMC7696108 DOI: 10.3390/antiox9111133] [Citation(s) in RCA: 9] [Impact Index Per Article: 2.3] [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: 10/08/2020] [Revised: 11/04/2020] [Accepted: 11/12/2020] [Indexed: 12/17/2022] Open
Abstract
Rod outer segments (OS) express the FoF1-ATP synthase and the respiratory chain, conducting an ectopic aerobic metabolism that produces free radicals in vitro. Diabetic retinopathy, a leading cause of vision loss, is associated with oxidative stress in the outer retina. Since metformin and glibenclamide, two anti-type 2 diabetes drugs, target the respiratory complexes, we studied the effect of these two drugs, individually or in association, on the free radical production in purified bovine rod OS. ATP synthesis, oxygen consumption, and oxidative stress production were assayed by luminometry, oximetry and flow cytometry, respectively. The expression of FoF1-ATP synthase was studied by immunogold electron microscopy. Metformin had a hormetic effect on the OS complex I and ATP synthetic activities, being stimulatory at concentrations below 1 mM, and inhibitory above. Glibenclamide inhibited complexes I and III, as well as ATP production in a concentration-dependent manner. Maximal concentrations of both drugs inhibited the ROI production by the light-exposed OS. Data, consistent with the delaying effect of these drugs on the onset of diabetic retinopathy, suggest that a combination of the two drugs at the beginning of the treatment might reduce the oxidative stress production helping the endogenous antioxidant defences in avoiding retinal damage.
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Affiliation(s)
- Silvia Ravera
- Dipartimento di Medicina Sperimentale, Università di Genoa, Via De Toni 14, 16132 Genova, Italy;
| | - Federico Caicci
- Dipartimento di Biologia, Università di Padova, via U. Bassi 58/B, 35121 Padova, Italy; (F.C.); (L.M.)
| | - Paolo Degan
- U.O. Mutagenesis and Preventive Oncology, IRCCS Ospedale Policlinico San Martino, L.go R. Benzi, 10, 16132 Genova, Italy;
| | - Davide Maggi
- Department of Internal Medicine and Medical Specialties, University of Genova, 16132 Genova, Italy; (D.M.); (A.P.)
| | - Lucia Manni
- Dipartimento di Biologia, Università di Padova, via U. Bassi 58/B, 35121 Padova, Italy; (F.C.); (L.M.)
| | - Alessandra Puddu
- Department of Internal Medicine and Medical Specialties, University of Genova, 16132 Genova, Italy; (D.M.); (A.P.)
| | - Massimo Nicolò
- Clinica Oculistica (DINOGMI), Università di Genova, V.le Benedetto XV 6, 16132 Genova, Italy; (M.N.); (C.E.T.)
- Fondazione per la Macula onlus, Università di Genova, V.le Benedetto XV 6, 16132 Genova, Italy
| | - Carlo E. Traverso
- Clinica Oculistica (DINOGMI), Università di Genova, V.le Benedetto XV 6, 16132 Genova, Italy; (M.N.); (C.E.T.)
| | - Isabella Panfoli
- Dipartimento di Farmacia (DIFAR), Università di Genova, V.le Benedetto XV 3, 16132 Genova, Italy
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15
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Cordera R, Pinducciu C, Maggi D. Type 1 diabetes and technology at time of COVID-19: A case report. Eur J Clin Invest 2020; 50:e13290. [PMID: 32441765 PMCID: PMC7267139 DOI: 10.1111/eci.13290] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/15/2020] [Revised: 05/11/2020] [Accepted: 05/14/2020] [Indexed: 11/29/2022]
Affiliation(s)
- Renzo Cordera
- Department of Internal MedicineUniversity of Genova and Policlinico San MartinoGenovaItaly
| | - Cristina Pinducciu
- Department of Internal MedicineUniversity of Genova and Policlinico San MartinoGenovaItaly
| | - Davide Maggi
- Department of Internal MedicineUniversity of Genova and Policlinico San MartinoGenovaItaly
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16
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Bauckneht M, Cossu V, Castellani P, Piccioli P, Orengo AM, Emionite L, Di Giulio F, Donegani MI, Miceli A, Raffa S, Borra A, Capitanio S, Morbelli S, Caviglia G, Bruno S, Ravera S, Maggi D, Sambuceti G, Marini C. FDG uptake tracks the oxidative damage in diabetic skeletal muscle: An experimental study. Mol Metab 2019; 31:98-108. [PMID: 31918925 PMCID: PMC6920267 DOI: 10.1016/j.molmet.2019.11.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [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: 09/26/2019] [Revised: 10/29/2019] [Accepted: 11/03/2019] [Indexed: 01/01/2023] Open
Abstract
OBJECTIVES The present study aims to verify the relationship between glucose consumption and uptake of 18F-2-deoxy-glucose (FDG) in the skeletal muscle (SM) of experimental models of streptozotocin-induced diabetes mellitus (STZ-DM). METHODS The study included 36 Balb/c mice. Two weeks after intraperitoneal administration of saline (control group, n = 18) or 150 mg streptozotocin (STZ-DM group, n = 18), the two cohorts were submitted to an oral glucose tolerance test and were further subdivided into three groups (n = 6 each): untreated and treated with metformin (MTF) at low or high doses (10 or 750 mg/kg daily, respectively). Two weeks thereafter, all mice were submitted to dynamic micro-positron emission tomography (PET) imaging after prolonged fasting. After sacrifice, enzymatic pathways and response to oxidative stress were evaluated in harvested SM. RESULTS On PET imaging, the FDG uptake rate in hindlimb SM was significantly lower in nondiabetic mice as compared with STZ-DM-untreated mice. MTF had no significant effect on SM FDG uptake in untreated mice; however, its high dose induced a significant decrease in STZ-DM animals. Upon conventional analysis, the SM standard uptake value was higher in STZ-DM mice, while MTF was virtually ineffective in either control or STZ-DM models. This metabolic reprogramming was not explained by any change in cytosolic glucose metabolism. By contrast, it closely agreed with the catalytic function of hexose-6P-dehydrogenase (H6PD; i.e., the trigger of a specific pentose phosphate pathway selectively located within the endoplasmic reticulum). In agreement with this role, the H6PD enzymatic response to both STZ-DM and MTF matched the activation of the NADPH-dependent antioxidant responses to the increased generation of reactive oxygen species caused by chronic hyperglycemia. Ex vivo analysis of tracer kinetics confirmed that the enhanced SM avidity for FDG occurred despite a significant reduction in glucose consumption, while it was associated with increased radioactivity transfer to the endoplasmic reticulum. CONCLUSIONS These data challenge the current dogma linking FDG uptake to the glycolytic rate. They instead introduce a new model considering a strict link between the uptake of this glucose analog, H6PD reticular activity, and oxidative damage in diabetes, at least under fasting condition.
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Affiliation(s)
- Matteo Bauckneht
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Vanessa Cossu
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Patrizia Castellani
- Cell Biology Unit, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy
| | - Patrizia Piccioli
- Cell Biology Unit, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy
| | - Anna Maria Orengo
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy
| | - Laura Emionite
- Animal Facility, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy
| | - Francesco Di Giulio
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy
| | | | - Alberto Miceli
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Stefano Raffa
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Anna Borra
- Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Selene Capitanio
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy
| | - Silvia Morbelli
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Giacomo Caviglia
- Department Experimental Medicine, University of Genoa, Len Battista Alberti 2, 16132 Genoa, Italy
| | - Silvia Bruno
- Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, 16132 Genoa, Italy
| | - Silvia Ravera
- Department of Internal Medicine, University of Genoa, Viale Benedetto XV 6, 16132 Genoa, Italy
| | - Davide Maggi
- Diabetes Unit, IRCCS Ospedale Policlinico San Martino Genoa, Largo Benzi 10, 16132 Genoa, Italy; Department of Mathematics (DIMA), University of Genoa, Via Dodecaneso 35, 16146 Genoa, Italy
| | - Gianmario Sambuceti
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; Department of Health Sciences, University of Genoa, Via Pastore 1, 16132 Genoa, Italy
| | - Cecilia Marini
- Nuclear Medicine, IRCCS Ospedale Policlinico San Martino, Largo Benzi 10, 16132 Genoa, Italy; CNR Institute of Molecular Bioimaging and Physiology (IBFM), Via Fratelli Cervi 93, 20090 Segrate (MI), Italy.
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17
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Marinelli L, Maggi D, Trompetto C, Renzetti P. Neuroradiological Evolution of Glycaemic Hemichorea-Hemiballism and the Possible Role of Brain Hypoperfusion. Eur J Case Rep Intern Med 2019; 6:001257. [PMID: 31890704 PMCID: PMC6886634 DOI: 10.12890/2019_001257] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [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: 08/21/2019] [Accepted: 09/20/2019] [Indexed: 11/30/2022] Open
Abstract
Background Lateralized involuntary movements consistent with hemichorea-hemiballism (HCHB) may appear following the development of contralateral haemorrhagic or ischaemic lesions of the basal ganglia, particularly the striatum (caudate nucleus and putamen). This condition is called vascular HCHB, but the same symptoms can be caused by a completely different striatal lesion. Glycaemic HCHB may occur in patients with uncontrolled hyperglycaemia: basal ganglia hyperdensity is seen on brain CT, while increased T1 signal intensity and reduced susceptibility-weighted imaging (SWI) and gradient-echo sequences (T2*-GRE) are detected on MRI. Case description An 83-year-old man with multiple vascular risk factors and uncontrolled chronic hyperglycaemia was admitted for ischaemic stroke presenting with dysarthria and mild left hemiparesis. No involuntary movements were reported at admission. The emergent brain CT scan was negative for vascular acute lesions, while a mild bilateral hyperdensity of the striata was detectable. Involuntary movements on the left side of the body, consistent with HCHB, appeared 27 days later. The alterations on brain CT completely disappeared after 3 months. On brain MRI, the T1 signal alterations resolved after 10 months, while SWI and T2*-GRE sequences showed persisting alterations after 2 years. Discussion Detailed brain imaging demonstrated evolution of striatal alterations of glycaemic HCHB before the appearance of involuntary movements and during the following 2 years. The association between ischaemic stroke and glycaemic HCHB favours the hypothesis that chronic hyperglycaemia more likely determines striatal alterations and the clinical picture of HCHB when vascular hypoperfusion also occurs. LEARNING POINTS
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Affiliation(s)
- Lucio Marinelli
- Dep of Neuroscience, Ophthalmology, Genetics, Maternal and Child Health, Uni of Genoa, Italy
| | - Davide Maggi
- Diabetology Clinic, Department of Internal Medicine, University of Genoa, Italy
| | - Carlo Trompetto
- Department of Neuroscience, Rehabilitation, Ophthalmology, Genetics, Maternal and Child Health, University of Genoa, Italy
| | - Paolo Renzetti
- epartment of Neuroradiology, IRCCS Ospedale Policlinico San Martino, Genoa, Italy
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18
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Bonaventura A, Liberale L, Carbone F, Vecchié A, Bonomi A, Scopinaro N, Camerini GB, Papadia FS, Maggi D, Cordera R, Dallegri F, Adami G, Montecucco F. Baseline neutrophil-to-lymphocyte ratio is associated with long-term T2D remission after metabolic surgery. Acta Diabetol 2019; 56:741-748. [PMID: 30993529 DOI: 10.1007/s00592-019-01345-2] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/21/2019] [Accepted: 04/08/2019] [Indexed: 12/29/2022]
Abstract
AIMS Metabolic surgery is considered as a therapeutic option for obese patients with type 2 diabetes (T2D). In order to identify novel laboratory variables that could improve the selection of patients who might greatly benefit from a surgical approach, we focused on the neutrophil-to-lymphocyte ratio (NLR) as a predictor of long-term T2D remission following metabolic surgery. METHODS Thirty-one obese patients with T2D included in this pilot study underwent Roux-en-Y gastric bypass or biliopancreatic diversion (BPD) at the Surgical Department of Genoa University, IRCCS Ospedale Policlinico San Martino in Genoa (Italy). Before surgery, serum samples were collected to evaluate blood count, glycemic profile, and circulating neutrophil degranulation products. RESULTS The median age was 56 years, median body mass index (BMI) was 32.37 kg/m2, and median glycated hemoglobin was 8.4%. White blood cell count was in a range of normality, with a median NLR of 1.97. By a receiver operating characteristic curve analysis, NLR has been found to be significantly associated with T2D remission at 1, 3, and 5 years and the best cutoff of ≤ 1.97 has been identified by Youden index. When comparing study groups according to NLR cutoff, those with NLR ≤ 1.97 were older and underwent more often BPD. By a logistic regression analysis, NLR ≤ 1.97 has been found to predict T2D remission across 5 years, irrespective of baseline BMI. CONCLUSIONS A baseline low NLR is associated with long-term T2D remission in obese patients undergoing metabolic surgery, suggesting that circulating inflammatory cells (i.e., neutrophils) might negatively impact on T2D remission.
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Affiliation(s)
- Aldo Bonaventura
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy.
- Division of Cardiology, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA.
| | - Luca Liberale
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
- Center for Molecular Cardiology, University of Zürich, 12 Wagistrasse, 8952, Schlieren, Switzerland
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Alessandra Vecchié
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
- Division of Cardiology, Department of Internal Medicine, Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA
| | - Alice Bonomi
- Centro Cardiologico Monzino, IRCCS, Milan, Italy
| | - Nicola Scopinaro
- International Federation of Surgery for Obesity, Genoa, Italy
- Department of Surgery, University of Genoa, IRCCS Ospedale Policlinico San Martino, 10 Largo Benzi, 16132, Genoa, Italy
| | - Giovanni Bruno Camerini
- Department of Surgery, University of Genoa, IRCCS Ospedale Policlinico San Martino, 10 Largo Benzi, 16132, Genoa, Italy
| | - Francesco Saverio Papadia
- Department of Surgery, University of Genoa, IRCCS Ospedale Policlinico San Martino, 10 Largo Benzi, 16132, Genoa, Italy
| | - Davide Maggi
- Diabetology Unit, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Renzo Cordera
- Diabetology Unit, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Franco Dallegri
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
- IRCCS Ospedale Policlinico San Martino Genoa - Italian Cardiovascular Network, 10 Largo Benzi, 16132, Genoa, Italy
| | - Giovanni Adami
- International Federation of Surgery for Obesity, Genoa, Italy
- Department of Surgery, University of Genoa, IRCCS Ospedale Policlinico San Martino, 10 Largo Benzi, 16132, Genoa, Italy
| | - Fabrizio Montecucco
- IRCCS Ospedale Policlinico San Martino Genoa - Italian Cardiovascular Network, 10 Largo Benzi, 16132, Genoa, Italy
- First Clinic of Internal Medicine, Deparment of Internal Medicine and Centre of Excellence for Biomedical Research (CEBR), University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
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19
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Maggi D, Montecucco F, Adami G, Cordera R. Glycosylated haemoglobin (A1c) best values for type 2 diabetes in the battlefield much ado about nothing? (apparently). Diabetol Metab Syndr 2019; 11:48. [PMID: 31249634 PMCID: PMC6585025 DOI: 10.1186/s13098-019-0442-x] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/05/2019] [Accepted: 06/11/2019] [Indexed: 01/02/2023] Open
Abstract
Despite intensive research, therapy of diabetes mellitus type 2 (T2DM) is far from be effective. The most important unresolved issue is to establish a safe glycosylated hemoglobin C (A1c) value well balanced between benefit and side effects. As a result different guidelines suggest different A1c targets generating confusion for patients and clinicians. Here we report two observations which might support a relaxed A1c as suggested by American college of physician (ACP).
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Affiliation(s)
- Davide Maggi
- Diabetes Unit, IRCCS Ospedale Policlinico San Martino Genoa, 10 Largo Benzi, 16132 Genoa, Italy
- Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132 Genoa, Italy
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, and Centre of Excellence for Biomedical Research (CEBR), University of Genoa, 6 Viale Benedetto XV, 16132 Genoa, Italy
- IRCCS Ospedale Policlinico San Martino Genoa–Italian Cardiovascular Network, 10 Largo Benzi, 16132 Genoa, Italy
| | - Gianfranco Adami
- Diabetes Unit, IRCCS Ospedale Policlinico San Martino Genoa, 10 Largo Benzi, 16132 Genoa, Italy
- Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132 Genoa, Italy
| | - Renzo Cordera
- Diabetes Unit, IRCCS Ospedale Policlinico San Martino Genoa, 10 Largo Benzi, 16132 Genoa, Italy
- Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132 Genoa, Italy
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20
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Puddu A, Sanguineti R, Maggi D, Nicolò M, Traverso CE, Cordera R, Viviani GL. Advanced Glycation End-Products and Hyperglycemia Increase Angiopoietin-2 Production by Impairing Angiopoietin-1-Tie-2 System. J Diabetes Res 2019; 2019:6198495. [PMID: 31828164 PMCID: PMC6881581 DOI: 10.1155/2019/6198495] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/11/2019] [Revised: 10/11/2019] [Accepted: 10/18/2019] [Indexed: 12/19/2022] Open
Abstract
The angiopoietin-Tie-2 system plays a crucial role in the maintenance of endothelial integrity. Hyperglycemia and advanced glycation end-products (AGEs) are involved in endothelial cell dysfunction responsible of the pathogenesis of microvascular complications of diabetes. Here, we investigated whether glycated serum (GS) or hyperglycemia (HG) affect the angiopoietin-Tie-2 system in the microvascular endothelial cells HMEC-1. We found that culture for 5 days in the presence of AGEs and HG (alone or in combination) decreased cell proliferation, increased reactive oxygen species (ROS) production, and reduced ratio between the oxidized and the reduced form of glutathione. Since angiopoietin-1 (Ang-1) signaling regulates angiopoietin-2 (Ang-2) expression through inactivation of the forkhead transcription factor FoxO1, we investigated intracellular signaling of Ang-1 and expression of Ang-2. HG and AGEs reduced phosphorylation of Akt and abrogated phosphorylation of FoxO1 induced by Ang-1 without affecting neither Tie-2 expression nor its activation. Furthermore, AGEs and/or HG induced nuclear translocation of FoxO1 and increased Ang-2 production. In conclusion, we demonstrated that both hyperglycemia and AGEs affect the angiopoietin-Tie-2 system by impairing Ang-1/Tie-2 signaling and by increasing Ang-2 expression. These results suggest that therapeutic strategies useful in preventing or delaying the onset of diabetic vascular complications should be aimed to preserve Ang-1 signaling.
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Affiliation(s)
- Alessandra Puddu
- Department of Internal Medicine and Medical Specialties, University of Genova, Genova 16132, Italy
| | - Roberta Sanguineti
- Department of Internal Medicine and Medical Specialties, University of Genova, Genova 16132, Italy
| | - Davide Maggi
- Department of Internal Medicine and Medical Specialties, University of Genova, Genova 16132, Italy
| | - Massimo Nicolò
- Department of Neuroscience, Ophthalmology and Genetics, University of Genova, Genova 16132, Italy
- Fondazione per la Macula Onlus, Genova 16132, Italy
| | - Carlo E. Traverso
- Department of Neuroscience, Ophthalmology and Genetics, University of Genova, Genova 16132, Italy
| | - Renzo Cordera
- Department of Internal Medicine and Medical Specialties, University of Genova, Genova 16132, Italy
| | - Giorgio L. Viviani
- Department of Internal Medicine and Medical Specialties, University of Genova, Genova 16132, Italy
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21
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Fiorini S, Martini C, Malpassi D, Cordera R, Maggi D, Verri A, Barla A. Data-driven strategies for robust forecast of continuous glucose monitoring time-series. Annu Int Conf IEEE Eng Med Biol Soc 2018; 2017:1680-1683. [PMID: 29060208 DOI: 10.1109/embc.2017.8037164] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Abstract] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/10/2022]
Abstract
Over the past decade, continuous glucose monitoring (CGM) has proven to be a very resourceful tool for diabetes management. To date, CGM devices are employed for both retrospective and online applications. Their use allows to better describe the patients' pathology as well as to achieve a better control of patients' level of glycemia. The analysis of CGM sensor data makes possible to observe a wide range of metrics, such as the glycemic variability during the day or the amount of time spent below or above certain glycemic thresholds. However, due to the high variability of the glycemic signals among sensors and individuals, CGM data analysis is a non-trivial task. Standard signal filtering solutions fall short when an appropriate model personalization is not applied. State-of-the-art data-driven strategies for online CGM forecasting rely upon the use of recursive filters. Each time a new sample is collected, such models need to adjust their parameters in order to predict the next glycemic level. In this paper we aim at demonstrating that the problem of online CGM forecasting can be successfully tackled by personalized machine learning models, that do not need to recursively update their parameters.
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22
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Bonabello LA, Maggi D, Fiorini S, Tozzo V, Cordera R. Switching from Glargine to Degludec is not associated with an overt change in glucose control in a cohort of patients with type 1 diabetes: a CGM analysis. Acta Diabetol 2018. [PMID: 29525984 DOI: 10.1007/s00592-018-1121-3] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Affiliation(s)
- Laura Affinito Bonabello
- Department of Internal Medicine (DIMI), University of Genova and Ospedale Policlinico San Martino, viale Benedetto XV 6, 16132, Genoa, Italy
| | - Davide Maggi
- Department of Internal Medicine (DIMI), University of Genova and Ospedale Policlinico San Martino, viale Benedetto XV 6, 16132, Genoa, Italy
| | - Samuele Fiorini
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genova, Via Dodecaneso 35, Genoa, Italy
| | - Veronica Tozzo
- Department of Informatics, Bioengineering, Robotics and Systems Engineering, University of Genova, Via Dodecaneso 35, Genoa, Italy
| | - Renzo Cordera
- Department of Internal Medicine (DIMI), University of Genova and Ospedale Policlinico San Martino, viale Benedetto XV 6, 16132, Genoa, Italy.
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23
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Bonaventura A, Gallo F, Carbone F, Liberale L, Maggi D, Sacchi G, Dallegri F, Montecucco F, Cordera R. Levels of serum uric acid at admission for hypoglycaemia predict 1-year mortality. Acta Diabetol 2018; 55:323-330. [PMID: 29327150 DOI: 10.1007/s00592-017-1094-7] [Citation(s) in RCA: 6] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 10/25/2017] [Accepted: 12/21/2017] [Indexed: 11/27/2022]
Abstract
AIMS Hypoglycaemia represents a critical burden with clinical and social consequences in the management of diabetes. Serum uric acid (SUA) has been associated with cardiovascular diseases (CVD), but no conclusive findings are available nowadays in patients suffering from hypoglycaemia. We investigated whether SUA levels at the time of hypoglycaemia could predict all-cause mortality after 1-year follow-up. METHODS In total, 219 patients admitted to the Emergency Department (ED) of Ospedale Policlinico S. Martino of Genoa (Italy) have been enrolled between January 2011 and December 2014. The primary endpoint of the study consisted in determining whether SUA levels at the time of ED admission could predict the occurrence of death after 1 year. RESULTS The majority of patients were diabetic, especially type 2. CVD and chronic kidney disease were prevalent comorbidities. By a cut-off value obtained by the receiver operating characteristic curve analysis, a Kaplan-Meier analysis demonstrated that patients with SUA levels > 5.43 mg/dL were more prone to death after 1 year compared to those with lower SUA levels. The risk of death increased with high SUA levels both in the univariate and the multivariate models including estimated glomerular filtration rate, C-reactive protein, type of diabetes, and age-adjusted Charlson comorbidity index. CONCLUSIONS SUA could be useful as a predictor of 1-year mortality in hypoglycaemic patients, irrespective of severe comorbidities notably increasing the risk of death in these frail patients.
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Affiliation(s)
- Aldo Bonaventura
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy.
| | - Fiorenza Gallo
- Diabetology Unit, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Federico Carbone
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Luca Liberale
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
- Center for Molecular Cardiology, University of Zürich, 12 Wagistrasse, 8952, Schlieren, Switzerland
| | - Davide Maggi
- Diabetology Unit, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
| | - Giovanni Sacchi
- Emergency Department, Ospedale Policlinico San Martino, 10 Largo Benzi, 16132, Genoa, Italy
| | - Franco Dallegri
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
- Ospedale Policlinico San Martino, 10 Largo Benzi, 16132, Genoa, Italy
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
- Ospedale Policlinico San Martino, 10 Largo Benzi, 16132, Genoa, Italy
- Centre of Excellence for Biomedical Research (CEBR), University of Genoa, 9 Viale Benedetto XV, 16132, Genoa, Italy
| | - Renzo Cordera
- Diabetology Unit, Department of Internal Medicine, University of Genoa, 6 Viale Benedetto XV, 16132, Genoa, Italy
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24
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Maggi D, Bordone C, Briatore L, Cheli V, Fontana L, Mazzucchelli C, Montecucco F, Adami G, Cordera R. Glucose-targeted therapy for subjects with type 2 diabetes mellitus: primum non nocere. Eur J Clin Invest 2017; 47:691-693. [PMID: 28746976 DOI: 10.1111/eci.12791] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/14/2017] [Revised: 07/03/2017] [Accepted: 07/23/2017] [Indexed: 11/29/2022]
Affiliation(s)
- Davide Maggi
- Diabetes Unit, Department of Internal Medicine, University of Genova and Ospedale Policlinico S. Martino, Genova, Italy
| | - Caterina Bordone
- Diabetes Unit, Department of Internal Medicine, University of Genova and Ospedale Policlinico S. Martino, Genova, Italy
| | - Lucia Briatore
- Diabetes Unit, Department of Internal Medicine, University of Genova and Ospedale Policlinico S. Martino, Genova, Italy
| | - Valeria Cheli
- Diabetes Unit, Department of Internal Medicine, University of Genova and Ospedale Policlinico S. Martino, Genova, Italy
| | - Luigi Fontana
- Diabetes Unit, Department of Internal Medicine, University of Genova and Ospedale Policlinico S. Martino, Genova, Italy
| | - Chiara Mazzucchelli
- Diabetes Unit, Department of Internal Medicine, University of Genova and Ospedale Policlinico S. Martino, Genova, Italy
| | - Fabrizio Montecucco
- First Clinic of Internal Medicine, Department of Internal Medicine, University of Genova, Genova, Italy.,Ospedale Policlinico San Martino, Genova, Italy.,Centre of Excellence for Biomedical Research (CEBR), University of Genova, Genova, Italy
| | - Gianfranco Adami
- Diabetes Unit, Department of Internal Medicine, University of Genova and Ospedale Policlinico S. Martino, Genova, Italy
| | - Renzo Cordera
- Diabetes Unit, Department of Internal Medicine, University of Genova and Ospedale Policlinico S. Martino, Genova, Italy
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25
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Salani B, Ravera S, Fabbi P, Garibaldi S, Passalacqua M, Brunelli C, Maggi D, Cordera R, Ameri P. Glibenclamide Mimics Metabolic Effects of Metformin in H9c2 Cells. Cell Physiol Biochem 2017; 43:879-890. [PMID: 28954268 DOI: 10.1159/000481638] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/28/2017] [Accepted: 06/20/2017] [Indexed: 11/19/2022] Open
Abstract
BACKGROUND Sulfonylureas, such as glibenclamide, are antidiabetic drugs that stimulate beta-cell insulin secretion by binding to the sulfonylureas receptors (SURs) of adenosine triphosphate-sensitive potassium channels (KATP). Glibenclamide may be also cardiotoxic, this effect being ascribed to interference with the protective function of cardiac KATP channels for which glibenclamide has high affinity. Prompted by recent evidence that glibenclamide impairs energy metabolism of renal cells, we investigated whether this drug also affects the metabolism of cardiac cells. METHODS The cardiomyoblast cell line H9c2 was treated for 24 h with glibenclamide or metformin, a known inhibitor of the mitochondrial respiratory chain. Cell viability was evaluated by sulforodhamine B assay. ATP and AMP were measured according to the enzyme coupling method and oxygen consumption by using an amperometric electrode, while Fo-F1 ATP synthase activity assay was evaluated by chemiluminescent method. Protein expression was measured by western blot. RESULTS Glibenclamide deregulated energy balance of H9c2 cardiomyoblasts in a way similar to that of metformin. It inhibited mitochondrial complexes I, II and III with ensuing impairment of oxygen consumption and ATP synthase activity, ATP depletion and increased AMPK phosphorylation. Furthermore, glibenclamide disrupted mitochondrial subcellular organization. The perturbation of mitochondrial energy balance was associated with enhanced anaerobic glycolysis, with increased activity of phosphofructo kinase, pyruvate kinase and lactic dehydrogenase. Interestingly, some additive effects of glibenclamide and metformin were observed. CONCLUSIONS Glibenclamide deeply alters cell metabolism in cardiac cells by impairing mitochondrial organization and function. This may further explain the risk of cardiovascular events associated with the use of this drug, alone or in combination with metformin.
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Affiliation(s)
- Barbara Salani
- Laboratory of Metabolic Disease, Department of Internal Medicine (DiMI), University of Genova and IRCCS AOU San Martino - IST, Genova, Italy
| | - Silvia Ravera
- Biochemistry Laboratory, Department of Pharmacy (DIFAR), University of Genova, Genova, Italy
| | - Patrizia Fabbi
- Laboratory of Cardiovascular Biology, Department of Internal Medicine, University of Genova and IRCCS AOU San Martino - IST, Genova, Italy
| | - Silvano Garibaldi
- Laboratory of Cardiovascular Biology, Department of Internal Medicine, University of Genova and IRCCS AOU San Martino - IST, Genova, Italy
| | - Mario Passalacqua
- Department of Experimental Medicine, section of Biochemistry, University of´Genova, Genova, Italy
| | - Claudio Brunelli
- Laboratory of Cardiovascular Biology, Department of Internal Medicine, University of Genova and IRCCS AOU San Martino - IST, Genova, Italy
| | - Davide Maggi
- Laboratory of Metabolic Disease, Department of Internal Medicine (DiMI), University of Genova and IRCCS AOU San Martino - IST, Genova, Italy
| | - Renzo Cordera
- Laboratory of Metabolic Disease, Department of Internal Medicine (DiMI), University of Genova and IRCCS AOU San Martino - IST, Genova, Italy
| | - Pietro Ameri
- Laboratory of Cardiovascular Biology, Department of Internal Medicine, University of Genova and IRCCS AOU San Martino - IST, Genova, Italy
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26
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Gallo F, Maggi D, Cordera R. The economic burden of severe hypoglycemia: Two sides of the same coin. Comment on G. Veronese and Coll. Costs associated with emergency care and hospitalization for severe hypoglycemia. Nutr Metab Cardiovasc Dis 2016; 26:850-851. [PMID: 27212618 DOI: 10.1016/j.numecd.2016.04.003] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/11/2016] [Revised: 04/01/2016] [Accepted: 04/04/2016] [Indexed: 10/21/2022]
Affiliation(s)
- F Gallo
- DiMI University of Genova, IRCCS AOU San Martino - IST, Italy
| | - D Maggi
- DiMI University of Genova, IRCCS AOU San Martino - IST, Italy
| | - R Cordera
- DiMI University of Genova, IRCCS AOU San Martino - IST, Italy.
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27
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Marini C, Ravera S, Buschiazzo A, Bianchi G, Orengo AM, Bruno S, Bottoni G, Emionite L, Pastorino F, Monteverde E, Garaboldi L, Martella R, Salani B, Maggi D, Ponzoni M, Fais F, Raffaghello L, Sambuceti G. Discovery of a novel glucose metabolism in cancer: The role of endoplasmic reticulum beyond glycolysis and pentose phosphate shunt. Sci Rep 2016; 6:25092. [PMID: 27121192 PMCID: PMC4848551 DOI: 10.1038/srep25092] [Citation(s) in RCA: 59] [Impact Index Per Article: 7.4] [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: 01/26/2016] [Accepted: 04/07/2016] [Indexed: 12/25/2022] Open
Abstract
Cancer metabolism is characterized by an accelerated glycolytic rate facing reduced activity of oxidative phosphorylation. This “Warburg effect” represents a standard to diagnose and monitor tumor aggressiveness with 18F-fluorodeoxyglucose whose uptake is currently regarded as an accurate index of total glucose consumption. Studying cancer metabolic response to respiratory chain inhibition by metformin, we repeatedly observed a reduction of tracer uptake facing a marked increase in glucose consumption. This puzzling discordance brought us to discover that 18F-fluorodeoxyglucose preferentially accumulates within endoplasmic reticulum by exploiting the catalytic function of hexose-6-phosphate-dehydrogenase. Silencing enzyme expression and activity decreased both tracer uptake and glucose consumption, caused severe energy depletion and decreased NADPH content without altering mitochondrial function. These data document the existence of an unknown glucose metabolism triggered by hexose-6-phosphate-dehydrogenase within endoplasmic reticulum of cancer cells. Besides its basic relevance, this finding can improve clinical cancer diagnosis and might represent potential target for therapy.
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Affiliation(s)
- Cecilia Marini
- CNR Institute of Molecular Bioimaging and Physiology (IBFM), Milan, Section of Genoa, Genoa, Italy.,Nuclear Medicine Unit, Department of Health Sciences, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | | | - Ambra Buschiazzo
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | | | - Anna Maria Orengo
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Silvia Bruno
- Department of Experimental Medicine, University of Genoa, Genoa, Italy
| | - Gianluca Bottoni
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Laura Emionite
- Animal facility, IRCCS AOU San Martino-IST, Genoa, Italy
| | | | - Elena Monteverde
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Lucia Garaboldi
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | | | - Barbara Salani
- Department of Internal Medicine, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Davide Maggi
- Department of Internal Medicine, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
| | - Mirco Ponzoni
- Laboratorio di Oncologia, IRCCS G. Gaslini, Genoa, Italy
| | - Franco Fais
- Department of Experimental Medicine, University of Genoa, Genoa, Italy.,Molecular Pathology, IRCCS AOU San Martino-IST, Genoa, Italy
| | | | - Gianmario Sambuceti
- Nuclear Medicine Unit, Department of Health Sciences, University of Genoa and IRCCS AOU San Martino-IST, Genoa, Italy
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28
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Esposito AI, Amaro A, Angelini G, Emionite L, Gennari A, Indraccolo S, Maggi D, Marini C, Salani B, Sambuceti G, Sormani MP, Pfeffer U. Abstract 1182: Metformin affects breast cancer cell growth and disturbs an IGF1/insulin related gene network that correlates with breast cancer progression. Cancer Res 2015. [DOI: 10.1158/1538-7445.am2015-1182] [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: 11/16/2022]
Abstract
Abstract
Background
Obesity and the insulin resistance syndrome are risk factors for breast cancer and might also affect breast cancer progression. The anti-diabetic drug Metformin (METF) reduces the breast cancer risk in diabetic women. Insulin like growth factor 1 (IGF1) and insulin are involved in breast cancer tumorigenesis and progression.
We tested the effect of METF on the IGF1/insulin pathway and its involvement in breast cancer progression.
Methods
We developed a prognostic signature based on IGF1/insulin pathway genes using the Stockholm breast cancer microarray dataset of 149 cases for training and primary validation and the Uppsala dataset of 249 for external validation. The effect of METF on the prognostic gene set identified was tested in vitro on a panel of breast cancer cell lines. METF effects on proliferation and glucose metabolism were analyzed in vitro and in vivo. The insulin receptor substrate 2 (IRS2) was silenced by transfection with shRNA-lentiviral vectors. Xenograft growth, in the presence and absence of METF, was studied and 18FDG-uptake was measured in vitro and in vivo.
Results
A 15-gene signature (Insulin sensitivity score, ISS) was developed and predicted breast cancer metastasis with an accuracy similar to the Recurrence Score. ISS genes were expressed at variable levels in a breast cancer cell line panel and showed variable responsiveness to METF. The high expression correlation among the ISS genes observed in untreated breast cancer cell lines was lost upon treatment with METF. METF reduced breast cancer cell growth in vitro with IC50 values ranging from 1mM to 25mM. Growth of MDA-MB-231 cells and hyper-invasive subpopulations derived therefrom was reduced in vivo by oral administration of METF to xenografted nude mice. Response to METF in terms of IC50 values correlated with basal expression of the 15 ISS genes with the strongest inverse correlation observed for IRS2. Stable silencing of IRS2 reduced the MDA-231 cell responsiveness to METF in vitro.
Discussion
METF acts on the insulin/IGF1 axis by disturbing a network of breast cancer progression related genes and appears to depend in its action on the expression of IRS2 that inversely correlates with the sensitivity of cell lines to the drug. The disruption of the ISS gene network is expected to correlate with an effect on breast cancer growth and progression and in fact, mouse xenografts show reduced growth upon treatment with METF. IRS2 appears to be a major mediator of METF effects.
Citation Format: Alessia I. Esposito, Adriana Amaro, Giovanna Angelini, Laura Emionite, Alessandra Gennari, Stefano Indraccolo, Davide Maggi, Cecilia Marini, Barabara Salani, Gianmario Sambuceti, Maria Pia Sormani, Ulrich Pfeffer. Metformin affects breast cancer cell growth and disturbs an IGF1/insulin related gene network that correlates with breast cancer progression. [abstract]. In: Proceedings of the 106th Annual Meeting of the American Association for Cancer Research; 2015 Apr 18-22; Philadelphia, PA. Philadelphia (PA): AACR; Cancer Res 2015;75(15 Suppl):Abstract nr 1182. doi:10.1158/1538-7445.AM2015-1182
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Affiliation(s)
| | - Adriana Amaro
- 1San Martino Hospital/National Cancer Research Inst., Genova, Italy
| | | | - Laura Emionite
- 1San Martino Hospital/National Cancer Research Inst., Genova, Italy
| | | | | | - Davide Maggi
- 1San Martino Hospital/National Cancer Research Inst., Genova, Italy
| | - Cecilia Marini
- 4Institute of Bioimaging and Molecular Physiology, National Research Council, Genova, Italy
| | - Barabara Salani
- 1San Martino Hospital/National Cancer Research Inst., Genova, Italy
| | | | | | - Ulrich Pfeffer
- 1San Martino Hospital/National Cancer Research Inst., Genova, Italy
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29
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Mazzucchelli C, Bordone C, Maggi D, Cordera R. Comment on Inzucchi et al. Management of Hyperglycemia in Type 2 Diabetes, 2015: A Patient-Centered Approach. Update to a Position Statement of the American Diabetes Association and the European Association for the Study of Diabetes. Diabetes Care 2015;38:140-149. Diabetes Care 2015. [PMID: 26207066 DOI: 10.2337/dc15-0156] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 02/03/2023]
Affiliation(s)
- Chiara Mazzucchelli
- Department of Internal Medicine, University of Genova, Genova, Italy, and IRCCS San Martino, Genova, Italy
| | - Caterina Bordone
- Department of Internal Medicine, University of Genova, Genova, Italy, and IRCCS San Martino, Genova, Italy
| | - Davide Maggi
- Department of Internal Medicine, University of Genova, Genova, Italy, and IRCCS San Martino, Genova, Italy
| | - Renzo Cordera
- Department of Internal Medicine, University of Genova, Genova, Italy, and IRCCS San Martino, Genova, Italy
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30
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Ameri P, Bruzzone S, Mannino E, Sociali G, Andraghetti G, Salis A, Ponta ML, Briatore L, Adami GF, Ferraiolo A, Venturini PL, Maggi D, Cordera R, Murialdo G, Zocchi E. Impaired increase of plasma abscisic Acid in response to oral glucose load in type 2 diabetes and in gestational diabetes. PLoS One 2015; 10:e0115992. [PMID: 25723556 PMCID: PMC4344322 DOI: 10.1371/journal.pone.0115992] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/07/2014] [Accepted: 12/03/2014] [Indexed: 11/18/2022] Open
Abstract
The plant hormone abscisic acid (ABA) is present and active in humans, regulating glucose homeostasis. In normal glucose tolerant (NGT) human subjects, plasma ABA (ABAp) increases 5-fold after an oral glucose load. The aim of this study was to assess the effect of an oral glucose load on ABAp in type 2 diabetes (T2D) subjects. We chose two sub-groups of patients who underwent an oral glucose load for diagnostic purposes: i) 9 treatment-naive T2D subjects, and ii) 9 pregnant women with gestational diabetes (GDM), who underwent the glucose load before and 8–12 weeks after childbirth. Each group was compared with matched NGT controls. The increase of ABAp in response to glucose was found to be abrogated in T2D patients compared to NGT controls. A similar result was observed in the women with GDM compared to pregnant NGT controls; 8–12 weeks after childbirth, however, fasting ABAp and ABAp response to glucose were restored to normal in the GDM subjects, along with glucose tolerance. We also retrospectively compared fasting ABAp before and after bilio-pancreatic diversion (BPD) in obese, but not diabetic subjects, and in obese T2D patients, in which BPD resulted in the resolution of diabetes. Compared to pre-BPD values, basal ABAp significantly increased 1 month after BPD in T2D as well as in NGT subjects, in parallel with a reduction of fasting plasma glucose. These results indicate an impaired hyperglycemia-induced ABAp increase in T2D and in GDM and suggest a beneficial effect of elevated ABAp on glycemic control.
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Affiliation(s)
- Pietro Ameri
- Department of Internal Medicine, University of Genova, Viale Benedetto XV/6, 16132 Genova, Italy
| | - Santina Bruzzone
- Department of Experimental Medicine, Section of Biochemistry and CEBR, University of Genova, Viale Benedetto XV/1, 16132 Genova, Italy
| | - Elena Mannino
- Department of Experimental Medicine, Section of Biochemistry and CEBR, University of Genova, Viale Benedetto XV/1, 16132 Genova, Italy
| | - Giovanna Sociali
- Department of Experimental Medicine, Section of Biochemistry and CEBR, University of Genova, Viale Benedetto XV/1, 16132 Genova, Italy
| | - Gabriella Andraghetti
- Department of Internal Medicine, University of Genova, Viale Benedetto XV/6, 16132 Genova, Italy
| | - Annalisa Salis
- Department of Experimental Medicine, Section of Biochemistry and CEBR, University of Genova, Viale Benedetto XV/1, 16132 Genova, Italy
| | - Monica Laura Ponta
- Department of Internal Medicine, University of Genova, Viale Benedetto XV/6, 16132 Genova, Italy
| | - Lucia Briatore
- Department of Internal Medicine, University of Genova, Viale Benedetto XV/6, 16132 Genova, Italy
| | - Giovanni F. Adami
- Department of surgical sciences and integrated diagnostic, University of Genova, Largo R. Benzi 8, 16132 Genova, Italy
| | | | - Pier Luigi Venturini
- IRCSS San Martino IST, Largo R. Benzi 10, 16132 Genova, Italy
- Department of Neurosciences, Rehabilitation, Ophthalmology, Genetics and Mother and Child Sciences, University of Genova, Largo P. Daneo, 3, 16132 Genova, Italy
| | - Davide Maggi
- Department of Internal Medicine, University of Genova, Viale Benedetto XV/6, 16132 Genova, Italy
| | - Renzo Cordera
- Department of Internal Medicine, University of Genova, Viale Benedetto XV/6, 16132 Genova, Italy
| | - Giovanni Murialdo
- Department of Internal Medicine, University of Genova, Viale Benedetto XV/6, 16132 Genova, Italy
| | - Elena Zocchi
- Department of Experimental Medicine, Section of Biochemistry and CEBR, University of Genova, Viale Benedetto XV/1, 16132 Genova, Italy
- * E-mail:
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31
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Salani B, Ravera S, Amaro A, Salis A, Passalacqua M, Millo E, Damonte G, Marini C, Pfeffer U, Sambuceti G, Cordera R, Maggi D. IGF1 regulates PKM2 function through Akt phosphorylation. Cell Cycle 2015; 14:1559-67. [PMID: 25790097 PMCID: PMC4612106 DOI: 10.1080/15384101.2015.1026490] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/12/2014] [Revised: 02/20/2015] [Accepted: 02/28/2015] [Indexed: 10/23/2022] Open
Abstract
Pyruvate kinase M2 (PKM2) acts at the crossroad of growth and metabolism pathways in cells. PKM2 regulation by growth factors can redirect glycolytic intermediates into key biosynthetic pathway. Here we show that IGF1 can regulate glycolysis rate, stimulate PKM2 Ser/Thr phosphorylation and decrease cellular pyruvate kinase activity. Upon IGF1 treatment we found an increase of the dimeric form of PKM2 and the enrichment of PKM2 in the nucleus. This effect was associated to a reduction of pyruvate kinase enzymatic activity and was reversed using metformin, which decreases Akt phosphorylation. IGF1 induced an increased nuclear localization of PKM2 and STAT3, which correlated with an increased HIF1α, HK2, and GLUT1 expression and glucose entrapment. Metformin inhibited HK2, GLUT1, HIF-1α expression and glucose consumption. These findings suggest a role of IGFIR/Akt axis in regulating glycolysis by Ser/Thr PKM2 phosphorylation in cancer cells.
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Affiliation(s)
- Barbara Salani
- Department of Internal Medicine (DIMI); University of Genova; Genova, Italy
- IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro Genova, Italy
| | - Silvia Ravera
- Department of Pharmacy (DIFAR); University of Genova; Genova, Italy
| | - Adriana Amaro
- IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro Genova, Italy
| | - Annalisa Salis
- Department of Experimental Medicine, Section of Biochemistry, and Center of Excellence for Biomedical Research (CEBR); University of Genova; Genova, Italy
| | - Mario Passalacqua
- Department of Experimental Medicine (DIMES); University of Genova; Genova, Italy
- Department of Experimental Medicine (DIMES); Section of Biochemistry, and Italian Institute of Biostructures and Biosystems; University of Genova; Genova, Italy
| | - Enrico Millo
- Department of Experimental Medicine, Section of Biochemistry, and Center of Excellence for Biomedical Research (CEBR); University of Genova; Genova, Italy
| | - Gianluca Damonte
- Department of Experimental Medicine, Section of Biochemistry, and Center of Excellence for Biomedical Research (CEBR); University of Genova; Genova, Italy
| | - Cecilia Marini
- IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro Genova, Italy
- Department of Experimental Medicine (DIMES); University of Genova; Genova, Italy
- CNR Institute of Molecular Bioimaging and Physiology (IBFM); Genoa Section; Genova, Italy
| | - Ulrich Pfeffer
- IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro Genova, Italy
| | - Gianmario Sambuceti
- IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro Genova, Italy
- Department of Experimental Medicine (DIMES); University of Genova; Genova, Italy
| | - Renzo Cordera
- Department of Internal Medicine (DIMI); University of Genova; Genova, Italy
- IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro Genova, Italy
| | - Davide Maggi
- Department of Internal Medicine (DIMI); University of Genova; Genova, Italy
- IRCCS Azienda Ospedaliera Universitaria San Martino-IST Istituto Nazionale per la Ricerca sul Cancro Genova, Italy
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32
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Marini C, Salani B, Massollo M, Amaro A, Esposito AI, Orengo AM, Capitanio S, Emionite L, Riondato M, Bottoni G, Massara C, Boccardo S, Fabbi M, Campi C, Ravera S, Angelini G, Morbelli S, Cilli M, Cordera R, Truini M, Maggi D, Pfeffer U, Sambuceti G. Direct inhibition of hexokinase activity by metformin at least partially impairs glucose metabolism and tumor growth in experimental breast cancer. Cell Cycle 2014; 12:3490-9. [PMID: 24240433 PMCID: PMC3906335 DOI: 10.4161/cc.26461] [Citation(s) in RCA: 108] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/28/2022] Open
Abstract
Emerging evidence suggests that metformin, a widely used anti-diabetic drug, may be useful in the prevention and treatment of different cancers. In the present study, we demonstrate that metformin directly inhibits the enzymatic function of hexokinase (HK) I and II in a cell line of triple-negative breast cancer (MDA-MB-231). The inhibition is selective for these isoforms, as documented by experiments with purified HK I and II as well as with cell lysates. Measurements of 18F-fluoro-deoxyglycose uptake document that it is dose- and time-dependent and powerful enough to virtually abolish glucose consumption despite unchanged availability of membrane glucose transporters. The profound energetic imbalance activates phosphorylation and is subsequently followed by cell death. More importantly, the “in vivo” relevance of this effect is confirmed by studies of orthotopic xenografts of MDA-MB-231 cells in athymic (nu/nu) mice. Administration of high drug doses after tumor development caused an evident tumor necrosis in a time as short as 48 h. On the other hand, 1 mo metformin treatment markedly reduced cancer glucose consumption and growth. Taken together, our results strongly suggest that HK inhibition contributes to metformin therapeutic and preventive potential in breast cancer.
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Affiliation(s)
- Cecilia Marini
- CNR Institute of Bioimages and Molecular Physiology; Milan, Section of Genoa, Genoa, Italy
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Abstract
Metformin is the first-line treatment for type 2 diabetes. Results from several clinical studies have indicated that type 2 diabetic patients treated with metformin might have a lower cancer risk. One of the primary metabolic changes observed in malignant cell transformation is an increased catabolic glucose metabolism. In this context, once it has entered the cell through organic cation transporters, metformin decreases mitochondrial respiration chain activity and ATP production that, in turn, activates AMP-activated protein kinase, which regulates energy homeostasis. In addition, metformin reduces cellular energy availability and glucose entrapment by inhibiting hexokinase-II, which catalyses the glucose phosphorylation reaction. In this review, we discuss recent findings on molecular mechanisms that sustain the anticancer effect of metformin through regulation of glucose metabolism. In particular, we have focused on the emerging action of metformin on glycolysis in normal and cancer cells, with a drug discovery perspective.
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Affiliation(s)
- Barbara Salani
- Department of Internal Medicine (DIMI)University of Genova, Viale Benedetto XV/6, 16132 Genova, ItalyIRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro16132 Genova, ItalyDepartment of ExperimentalDiagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, ItalyCNR Institute of Organic Synthesis and Photoreactivity (ISOF)40129 Bologna, ItalyCNR Institute of Molecular Bioimaging and Physiology (IBFM)16132 Genova, ItalyDepartment of Health Science (DISSAL)University of Genova, 16132 Genova, Italy Department of Internal Medicine (DIMI)University of Genova, Viale Benedetto XV/6, 16132 Genova, ItalyIRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro16132 Genova, ItalyDepartment of ExperimentalDiagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, ItalyCNR Institute of Organic Synthesis and Photoreactivity (ISOF)40129 Bologna, ItalyCNR Institute of Molecular Bioimaging and Physiology (IBFM)16132 Genova, ItalyDepartment of Health Science (DISSAL)University of Genova, 16132 Genova, Italy
| | - Alberto Del Rio
- Department of Internal Medicine (DIMI)University of Genova, Viale Benedetto XV/6, 16132 Genova, ItalyIRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro16132 Genova, ItalyDepartment of ExperimentalDiagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, ItalyCNR Institute of Organic Synthesis and Photoreactivity (ISOF)40129 Bologna, ItalyCNR Institute of Molecular Bioimaging and Physiology (IBFM)16132 Genova, ItalyDepartment of Health Science (DISSAL)University of Genova, 16132 Genova, Italy Department of Internal Medicine (DIMI)University of Genova, Viale Benedetto XV/6, 16132 Genova, ItalyIRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro16132 Genova, ItalyDepartment of ExperimentalDiagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, ItalyCNR Institute of Organic Synthesis and Photoreactivity (ISOF)40129 Bologna, ItalyCNR Institute of Molecular Bioimaging and Physiology (IBFM)16132 Genova, ItalyDepartment of Health Science (DISSAL)University of Genova, 16132 Genova, Italy
| | - Cecilia Marini
- Department of Internal Medicine (DIMI)University of Genova, Viale Benedetto XV/6, 16132 Genova, ItalyIRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro16132 Genova, ItalyDepartment of ExperimentalDiagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, ItalyCNR Institute of Organic Synthesis and Photoreactivity (ISOF)40129 Bologna, ItalyCNR Institute of Molecular Bioimaging and Physiology (IBFM)16132 Genova, ItalyDepartment of Health Science (DISSAL)University of Genova, 16132 Genova, Italy
| | - Gianmario Sambuceti
- Department of Internal Medicine (DIMI)University of Genova, Viale Benedetto XV/6, 16132 Genova, ItalyIRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro16132 Genova, ItalyDepartment of ExperimentalDiagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, ItalyCNR Institute of Organic Synthesis and Photoreactivity (ISOF)40129 Bologna, ItalyCNR Institute of Molecular Bioimaging and Physiology (IBFM)16132 Genova, ItalyDepartment of Health Science (DISSAL)University of Genova, 16132 Genova, Italy Department of Internal Medicine (DIMI)University of Genova, Viale Benedetto XV/6, 16132 Genova, ItalyIRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro16132 Genova, ItalyDepartment of ExperimentalDiagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, ItalyCNR Institute of Organic Synthesis and Photoreactivity (ISOF)40129 Bologna, ItalyCNR Institute of Molecular Bioimaging and Physiology (IBFM)16132 Genova, ItalyDepartment of Health Science (DISSAL)University of Genova, 16132 Genova, Italy
| | - Renzo Cordera
- Department of Internal Medicine (DIMI)University of Genova, Viale Benedetto XV/6, 16132 Genova, ItalyIRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro16132 Genova, ItalyDepartment of ExperimentalDiagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, ItalyCNR Institute of Organic Synthesis and Photoreactivity (ISOF)40129 Bologna, ItalyCNR Institute of Molecular Bioimaging and Physiology (IBFM)16132 Genova, ItalyDepartment of Health Science (DISSAL)University of Genova, 16132 Genova, Italy Department of Internal Medicine (DIMI)University of Genova, Viale Benedetto XV/6, 16132 Genova, ItalyIRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro16132 Genova, ItalyDepartment of ExperimentalDiagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, ItalyCNR Institute of Organic Synthesis and Photoreactivity (ISOF)40129 Bologna, ItalyCNR Institute of Molecular Bioimaging and Physiology (IBFM)16132 Genova, ItalyDepartment of Health Science (DISSAL)University of Genova, 16132 Genova, Italy
| | - Davide Maggi
- Department of Internal Medicine (DIMI)University of Genova, Viale Benedetto XV/6, 16132 Genova, ItalyIRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro16132 Genova, ItalyDepartment of ExperimentalDiagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, ItalyCNR Institute of Organic Synthesis and Photoreactivity (ISOF)40129 Bologna, ItalyCNR Institute of Molecular Bioimaging and Physiology (IBFM)16132 Genova, ItalyDepartment of Health Science (DISSAL)University of Genova, 16132 Genova, Italy Department of Internal Medicine (DIMI)University of Genova, Viale Benedetto XV/6, 16132 Genova, ItalyIRCCS Azienda Ospedaliera Universitaria San Martino - IST Istituto Nazionale per la Ricerca sul Cancro16132 Genova, ItalyDepartment of ExperimentalDiagnostic and Specialty Medicine (DIMES), Alma Mater Studiorum, University of Bologna, Bologna, ItalyCNR Institute of Organic Synthesis and Photoreactivity (ISOF)40129 Bologna, ItalyCNR Institute of Molecular Bioimaging and Physiology (IBFM)16132 Genova, ItalyDepartment of Health Science (DISSAL)University of Genova, 16132 Genova, Italy
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Salani B, Marini C, Rio AD, Ravera S, Massollo M, Orengo AM, Amaro A, Passalacqua M, Maffioli S, Pfeffer U, Cordera R, Maggi D, Sambuceti G. Metformin impairs glucose consumption and survival in Calu-1 cells by direct inhibition of hexokinase-II. Sci Rep 2013; 3:2070. [PMID: 23797762 PMCID: PMC3691576 DOI: 10.1038/srep02070] [Citation(s) in RCA: 87] [Impact Index Per Article: 7.9] [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: 04/04/2013] [Accepted: 06/03/2013] [Indexed: 12/27/2022] Open
Abstract
The anti-hyperglycaemic drug metformin has important anticancer properties as shown by the direct inhibition of cancer cells proliferation. Tumor cells avidly use glucose as a source for energy production and cell building blocks. Critical to this phenotype is the production of glucose-6-phosphate (G6P), catalysed by hexokinases (HK) I and II, whose role in glucose retention and metabolism is highly advantageous for cell survival and proliferation. Here we show that metformin impairs the enzymatic function of HKI and II in Calu-1 cells. This inhibition virtually abolishes cell glucose uptake and phosphorylation as documented by the reduced entrapment of 18F-fluorodeoxyglucose. In-silico models indicate that this action is due to metformin capability to mimic G6P features by steadily binding its pocket in HKII. The impairment of this energy source results in mitochondrial depolarization and subsequent cell death. These results could represent a starting point to open effective strategies in cancer prevention and treatment.
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Affiliation(s)
- Barbara Salani
- Department of Internal Medicine-DIMI, University of Genova, 16132 Genova, Italy
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Mazzucchelli C, Bordone C, Maggi D, Cordera R. Comments on ORIGIN trial. Nutr Metab Cardiovasc Dis 2013; 23:e33-e34. [PMID: 23786822 DOI: 10.1016/j.numecd.2013.03.002] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/09/2013] [Accepted: 03/11/2013] [Indexed: 11/21/2022]
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Hamoudane M, Maffioli S, Cordera R, Maggi D, Salani B. Caveolin-1 and polymerase I and transcript release factor: new players in insulin-like growth factor-I receptor signaling. J Endocrinol Invest 2013; 36:204-8. [PMID: 23404184 DOI: 10.3275/8848] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 01/09/2023]
Abstract
Caveolae are plasma membrane regions enriched in Caveolin proteins which regulate vesicular transport, endocytosis, and cell signaling. IGF-I receptor (IGF-IR) localizes in caveolae and tyrosine phosphorylates Caveolin-1 (Cav-1), the most represented caveolar protein. Cav-1 participates to IGF-IR internalization and signaling directly interacting with IGF-IR and its substrates. Recently, polymerase I and transcript release factor (PTRF) or Cavin-1, has been identified in the caveolar backbone. PTRF does not play a Cav-1 ancillary role and emerging data support a direct role of PTRF in IGF-IR signaling. PTRF and Cav-1 can bind IGF-IR and regulate IGF-IR internalization and plasma membrane replacement, mechanisms frequently deregulated in cancer cells. Although the exact roles of Cav-1 and IGF-IR in human cancer continue to be a matter of some debate, there is a strong evidence for an association between Cav-1 and IGF-IR in cancer development. With the discovery of IGF-IR interaction with PTRF in caveolae, new insight emerged to understand the growing functions of these domains in IGF-I action.
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Affiliation(s)
- M Hamoudane
- Department of Internal Medicine (DiMI) University of Genoa, Genoa, Italy
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Massollo M, Marini C, Brignone M, Emionite L, Salani B, Riondato M, Capitanio S, Fiz F, Democrito A, Amaro A, Morbelli S, Piana M, Maggi D, Cilli M, Pfeffer U, Sambuceti G. Metformin temporal and localized effects on gut glucose metabolism assessed using 18F-FDG PET in mice. J Nucl Med 2013; 54:259-66. [PMID: 23287574 DOI: 10.2967/jnumed.112.106666] [Citation(s) in RCA: 44] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/25/2022] Open
Abstract
UNLABELLED In the course of metformin treatment, staging abdominal cancer lesions with (18)F-FDG PET images is often hindered by the presence of a high bowel radioactivity. The present study aimed to verify the mechanism underlying this phenomenon. METHODS Fifty-three mice were submitted to dynamic acquisitions of (18)F-FDG kinetics under fasting conditions. Three small-animal PET scans were obtained over a 4-mo study period. The animals were subdivided into 4 groups according to the following metformin administration protocol: group 1, untreated mice (n = 15); group 2, mice exposed to metformin treatment (750 mg/kg/d) for the 48 h before each PET study (pulsed, n = 10); group 3, mice treated for the whole study period (prolonged, n = 10); and group 4, mice in which prolonged treatment was interrupted 48 h before PET (interrupted, n = 8). The rate constant of (18)F-FDG uptake was estimated by Patlak analysis. At the end of the study, the ileum and colon were harvested, washed, and counted ex vivo. Two further groups, of 5 animals each, were included to evaluate the effect of prolonged metformin treatment on phosphorylated adenosine monophosphate (AMP)-activated protein kinase (pAMPK) form and gene expression for thioredoxin-interacting protein (TXNIP). RESULTS Pulsed treatment did not modify gut tracer retention with respect to the untreated group. Conversely, prolonged treatment induced a progressive increase in (18)F-FDG uptake that selectively involved the colonic wall, without any significant contamination of bowel content. This effect persisted after a complete drug washout in the interrupted group. These responses were paralleled by increased pAMPK availability and by reduced expression of TXNIP messenger RNA in colonic enterocytes exposed to prolonged metformin treatment. CONCLUSION Metformin causes a selective increase in colonic (18)F-FDG uptake. This effect appears after a relatively long period of treatment and persists soon after drug washout. Accordingly, the increased bowel glucose metabolism reflects a biologic response to chronic metformin treatment characterized by increased levels of pAMPK and reduced levels of TXNIP.
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Affiliation(s)
- Michela Massollo
- Nuclear Medicine, Department of Internal Medicine, University of Genoa and IRCCS San Martino-IST, 16132 Genoa, Italy
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Cerini C, Gondouin B, Dou L, Duval-Sabatier A, Brunet P, Dignat- George F, Burtey S, Okano K, Okano K, Iwasaki T, Jinnai H, Hibi A, Miwa N, Kimata N, Nitta K, Akiba T, Dolley-Hitze T, Verhoest G, Jouan F, Arlot-Bonnemains Y, Lavenu A, Belaud-Rotureau MA, Rioux-Leclercq N, Vigneau C, Cox SN, Sallustio F, Serino G, Loverre A, Pesce F, Gigante M, Zaza G, Stifanelli P, Ancona N, Schena FP, Marc P, Jacques T, Green JM, Mortensen RB, Verma R, Leu K, Schatz PJ, Wojchowski DM, Ihoriya C, Satoh M, Sasaki T, Kashihara N, Jung YJ, Kang KP, Lee AS, Lee JE, Lee S, Park SK, Kim W, Kang KP, Florian T, Tepel M, Ying L, Katharina K, Nora F, Antje W, Alexandra S, Chiu YT, Wu MJ, Liu ZH, Liang Y, Zheng CX, Chen ZH, Zeng CH, Ranzinger J, Rustom A, Kihm L, Heide D, Scheurich P, Zeier M, Schwenger V, Liu J, Liu J, Zhong F, Xu L, Zhou Q, Hao X, Wang W, Chen N, Zhong F, Zhong F, Liu X, Zhou Q, Hao X, Lu Y, Guo S, Wang W, Lin D, Chen N, Vilasi A, Deplano S, Deplano S, Cutillas P, Unwin R, Tam FWK, Medrano-Andres D, Lopez-Martinez V, Martinez-Miguel P, Cano JL, Arribas I, Rodiguez-Puyol M, Lopez-Ongil S, Kadoya H, Nagasu H, Satoh M, Sasaki T, Kashihara N, Lindeberg E, Grundstrom G, Alexandra S, Tepel M, Katharina K, Alexandra M, Ghosh CC, David S, Mukherjee A, John SG, Mcintyre CW, Haller H, Parikh SM, Troyano N, Del Nogal M, Olmos G, Mora I, DE Frutos S, Rodriguez-Puyol M, Ruiz MP, Rothe H, Rothe H, Shapiro W, Ketteler M, Ramakrishnan SK, Loupy A, Houillier P, Guilhermino Pereira L, Boim M, Aragao D, Casarini D, Jin Y, Jin Y, Chen N, Moon JY, Kim YG, Lee SH, Lee TW, Ihm CG, Kim EY, Lee HJ, Wi JG, Jeong KH, Ruan XZ, LI LC, Varghese Z, Chen JB, Lee CT, Moorhead J, Dou L, Gondouin B, Cerini C, Poitevin S, Brunet P, Dignat-George F, Stephane B, Bonanni A, Verzola D, Maggi D, Brunori G, Sofia A, Mannucci I, Maffioli S, Salani B, D'amato E, Saffioti S, Laudon A, Cordera R, Garibotto G, Maquigussa E, Boim M, Arnoni C, Guilhermino Pereira L. Cell signalling / Pathophysiology. Nephrol Dial Transplant 2012. [DOI: 10.1093/ndt/gfs213] [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] [Indexed: 11/12/2022] Open
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Bruzzone S, Ameri P, Briatore L, Mannino E, Basile G, Andraghetti G, Grozio A, Magnone M, Guida L, Scarfì S, Salis A, Damonte G, Sturla L, Nencioni A, Fenoglio D, Fiory F, Miele C, Beguinot F, Ruvolo V, Bormioli M, Colombo G, Maggi D, Murialdo G, Cordera R, De Flora A, Zocchi E. The plant hormone abscisic acid increases in human plasma after hyperglycemia and stimulates glucose consumption by adipocytes and myoblasts. FASEB J 2011; 26:1251-60. [PMID: 22075645 DOI: 10.1096/fj.11-190140] [Citation(s) in RCA: 70] [Impact Index Per Article: 5.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/04/2023]
Abstract
The plant hormone abscisic acid (ABA) is released from glucose-challenged human pancreatic β cells and stimulates insulin secretion. We investigated whether plasma ABA increased during oral and intravenous glucose tolerance tests (OGTTs and IVGTTs) in healthy human subjects. In all subjects undergoing OGTTs (n=8), plasma ABA increased over basal values (in a range from 2- to 9-fold). A positive correlation was found between the ABA area under the curve (AUC) and the glucose AUC. In 4 out of 6 IVGTTs, little or no increase of ABA levels was observed. In the remaining subjects, the ABA increase was similar to that recorded during OGTTs. GLP-1 stimulated ABA release from an insulinoma cell line and from human islets, by ∼10- and 2-fold in low and high glucose, respectively. Human adipose tissue also released ABA in response to high glucose. Nanomolar ABA stimulated glucose uptake, similarly to insulin, in rat L6 myoblasts and in murine 3T3-L1 cells differentiated to adipocytes, by increasing GLUT-4 translocation to the plasma membrane. Demonstration that a glucose load in humans is followed by a physiological rise of plasma ABA, which can enhance glucose uptake by adipose tissues and muscle cells, identifies ABA as a new mammalian hormone involved in glucose metabolism.
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Affiliation(s)
- Santina Bruzzone
- Department of Experimental Medicine, University of Genova, Viale Benedetto XV, 1 16132 Genova, Italy
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Salani B, Maffioli S, Hamoudane M, Parodi A, Ravera S, Passalacqua M, Alama A, Nhiri M, Cordera R, Maggi D. Caveolin‐1 is essential for metformin inhibitory effect on IGF1 action in non‐small‐cell lung cancer cells. FASEB J 2011; 26:788-98. [DOI: 10.1096/fj.11-192088] [Citation(s) in RCA: 51] [Impact Index Per Article: 3.9] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/23/2023]
Affiliation(s)
- Barbara Salani
- Department of Endocrinology and MedicineUniversity of Genoa Genoa Italy
| | - Sara Maffioli
- Department of Endocrinology and MedicineUniversity of Genoa Genoa Italy
| | - Meriem Hamoudane
- Department of Endocrinology and MedicineUniversity of Genoa Genoa Italy
- Faculty of Science and Techniques of TangierUniversity of Abdelmalek Essaãdi Tangier Morocco
| | - Alessia Parodi
- Department of Internal Medicine and Medical SpecialtiesUniversity of Genoa Genoa Italy
| | - Silvia Ravera
- Department of BiologyUniversity of Genoa Genoa Italy
| | - Mario Passalacqua
- Department of Experimental MedicineUniversity of Genoa Genoa Italy
- Italian Institute of Biostructures and BiosystemsUniversity of Genoa Genoa Italy
| | - Angela Alama
- Lung Cancer UnitNational Institute for Cancer Research Genoa Italy
| | - Mohamed Nhiri
- Faculty of Science and Techniques of TangierUniversity of Abdelmalek Essaãdi Tangier Morocco
| | - Renzo Cordera
- Department of Endocrinology and MedicineUniversity of Genoa Genoa Italy
| | - Davide Maggi
- Department of Endocrinology and MedicineUniversity of Genoa Genoa Italy
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Astorri E, Guglielmi C, Bombardieri M, Alessandri C, Buzzetti R, Maggi D, Valesini G, Pitzalis C, Pozzilli P. Circulating Reg1α proteins and autoantibodies to Reg1α proteins as biomarkers of β-cell regeneration and damage in type 1 diabetes. Horm Metab Res 2010; 42:955-60. [PMID: 20972946 DOI: 10.1055/s-0030-1267206] [Citation(s) in RCA: 18] [Impact Index Per Article: 1.3] [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] [Indexed: 10/18/2022]
Abstract
Type 1 diabetes is an autoimmune disease where β-cells are in a constant process of death and renewal. Reg genes play a role in β-cells regeneration. Reg proteins may be target of an autoimmune response in type 1 diabetes with consequent production of autoantibodies and failure of regeneration. The objective of this work was to characterize the role of Reg1α proteins and anti-Reg1α antibodies as biomarkers of β-cell regeneration and damage. Serum levels of Reg1α protein were investigated in 87 type 1 diabetic subjects (31 newly diagnosed and 56 long standing), 63 type 2 diabetic subjects, 39 subjects with systemic lupus erythematosus (SLE), a nonpancreatic autoimmune disorder, and 64 healthy subjects. The presence of anti-Reg1α antibodies and correlation with metabolic, immune, and genetic parameters were analyzed in diabetic subjects. Increased levels of Reg1α protein were observed in newly diagnosed (p=0.002), and long standing (p=0.001) type 1 diabetes patients and type 2 diabetic subjects (p<0.001). Anti-Reg1α antibodies were found in 47% of patients with type 1 diabetes. No correlation was found with metabolic, immune, and genetic parameters. Patients with SLE showed no increase in Reg1α protein. We report here for the first time raised serum Reg1α protein in type 1 and type 2 diabetes and anti-Reg1α antibodies in type 1 diabetes. Reg1α levels appear not to be influenced by genetic or metabolic control. These findings allow considering future studies on Reg1α protein and autoantibody as new tools in the evaluation and monitoring of β-cells regeneration and autoimmunity.
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Affiliation(s)
- E Astorri
- Centre for Experimental Medicine and Rheumatology, William Harvey Research Institute, Queen Mary's School of Medicine and Dentistry, Bart's and The London, London, UK.
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Salani B, Passalacqua M, Maffioli S, Briatore L, Hamoudane M, Contini P, Cordera R, Maggi D. IGF-IR internalizes with Caveolin-1 and PTRF/Cavin in HaCat cells. PLoS One 2010; 5:e14157. [PMID: 21152401 PMCID: PMC2994771 DOI: 10.1371/journal.pone.0014157] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/04/2010] [Accepted: 11/05/2010] [Indexed: 11/18/2022] Open
Abstract
BACKGROUND Insulin-like growth factor-I receptor (IGF-IR) is a tyrosine kinase receptor (RTK) associated with caveolae, invaginations of the plasma membrane that regulate vesicular transport, endocytosis and intracellular signaling. IGF-IR internalization represents a key mechanism of down-modulation of receptors number on plasma membrane. IGF-IR interacts directly with Caveolin-1 (Cav-1), the most relevant protein of caveolae. Recently it has been demonstrated that the Polymerase I and Transcript Release Factor I (PTRF/Cavin) is required for caveolae biogenesis and function. The role of Cav-1 and PTRF/Cavin in IGF-IR internalization is still to be clarified. METHODOLOGY/PRINCIPAL FINDINGS We have investigated the interaction of IGF-IR with Cav-1 and PTRF/Cavin in the presence of IGF1in human Hacat cells. We show that IGF-IR internalization triggers Cav-1 and PTRF/Cavin translocation from plasma membrane to cytosol and increases IGF-IR interaction with these proteins. In fact, Cav-1 and PTRF/Cavin co-immunoprecipitate with IGF-IR during receptor internalization. We found a different time course of co-immunoprecipitation between IGF-IR and Cav-1 compared to IGF-IR and PTRF/Cavin. Cav-1 and PTRF/Cavin silencing by siRNA differently affect surface IGF-IR levels following IGF1 treatment: Cav-1 and PTRF/Cavin silencing significantly affect IGF-IR rate of internalization, while PTRF/Cavin silencing also decreases IGF-IR plasma membrane recovery. Since Cav-1 phosphorylation could have a role in IGF-IR internalization, the mutant Cav-1Y14F lacking Tyr14 was transfected. Cav-1Y14F transfected cells showed a reduced internalization of IGF-IR compared with cells expressing wild type Cav-1. Receptor internalization was not impaired by Clathrin silencing. These findings support a critical role of caveolae in IGF-IR intracellular traveling. CONCLUSIONS/SIGNIFICANCE These data indicate that Caveolae play a role in IGF-IR internalization. Based on these findings, Cav-1 and PTRF/Cavin could represent two relevant and distinct targets to modulate IGF-IR function.
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Affiliation(s)
- Barbara Salani
- Department of Endocrinology and Medicine (DiSEM), University of Genova, Genova, Italy
| | - Mario Passalacqua
- Department of Experimental Medicine (DIMES), Centre of Excellence for Biomedical Research, University of Genova, Genova, Italy
- Italian Institute of Biostructures and Biosystems (INBB), University of Genova, Genova, Italy
| | - Sara Maffioli
- Department of Endocrinology and Medicine (DiSEM), University of Genova, Genova, Italy
| | - Lucia Briatore
- Department of Endocrinology and Medicine (DiSEM), University of Genova, Genova, Italy
| | - Meriem Hamoudane
- Department of Endocrinology and Medicine (DiSEM), University of Genova, Genova, Italy
| | - Paola Contini
- Department of Internal Medicine and Medical Specialties (DIMI), University of Genova, Genova, Italy
| | - Renzo Cordera
- Department of Endocrinology and Medicine (DiSEM), University of Genova, Genova, Italy
| | - Davide Maggi
- Department of Endocrinology and Medicine (DiSEM), University of Genova, Genova, Italy
- * E-mail:
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Briatore L, Salani B, Andraghetti G, Maggi D, Adami GF, Scopinaro N, Cordera R. Beta-cell function improvement after biliopancreatic diversion in subjects with type 2 diabetes and morbid obesity. Obesity (Silver Spring) 2010; 18:932-6. [PMID: 20186136 DOI: 10.1038/oby.2010.28] [Citation(s) in RCA: 28] [Impact Index Per Article: 2.0] [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] [Indexed: 12/14/2022]
Abstract
In subjects with obesity and type 2 diabetes mellitus (T2DM), biliopancreatic diversion (BPD) improves glucose stimulated insulin secretion, whereas the effects on other secretion mechanisms are still unknown. Our objective was to evaluate the early effects of BPD on nonglucose-stimulated insulin secretion. In 16 morbid obese subjects (9 with T2DM and 7 with normal fasting glucose (NFG)), we measured insulin secretion after glucose-dependent arginine stimulation test and after intravenous glucose tolerance test (IVGTT) before and 1 month after BPD. After surgery the mean weight lost was 13% in both groups. The acute insulin response during IVGTT was improved in T2DM after BDP (from 55 +/- 10 to 277 +/- 91 pmol/l, P = 0.03). A reduction of insulin response to arginine was observed in NFG, whereas opposite was found in T2DM. In particular, acute insulin response to arginine at basal glucose concentrations (AIR(basal)) was reduced but insulin response at 14 mmol/l of plasma glucose (AIR(14)) was increased. Therefore, after BPD any statistical difference in AIR(14) between NFG and T2DM disappeared (1,032 +/- 123 for NFG and 665 +/- 236 pmol/l for T2DM, P = ns). The same was observed for Slope(AIR), a measure of glucose potentiation, reduced in T2DM before BPD but increased after surgery, when no statistically significant difference resulted compared with NFG (Slope(AIR) after BPD: 78 +/- 11 in NFG and 56 +/- 18 pmol/l in T2DM, P = ns). In conclusion, in obese T2DM subjects 1 month after BPD we observed a great improvement of both glucose- and nonglucose-stimulated insulin secretions. The mechanisms by which BDP improve insulin secretion are still unknown.
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Affiliation(s)
- Lucia Briatore
- Department of Endocrinology and Medicine, University of Genova, Genoa, Italy
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Marini C, Bezante G, Gandolfo P, Modonesi E, Morbelli SD, Depascale A, Rollando D, Maggi D, Albertelli M, Armonino R, Balbi M, Brunelli C, Cordera R, Sambuceti G. Optimization of flow reserve measurement using SPECT technology to evaluate the determinants of coronary microvascular dysfunction in diabetes. Eur J Nucl Med Mol Imaging 2009; 37:357-67. [PMID: 19957177 DOI: 10.1007/s00259-009-1316-5] [Citation(s) in RCA: 15] [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] [Subscribe] [Scholar Register] [Received: 09/15/2009] [Accepted: 10/23/2009] [Indexed: 01/23/2023]
Abstract
PURPOSE The aim of this study was to validate a new method to measure regional myocardial perfusion reserve (MPR) with technetium-labelled tracers in patients with type 2 diabetes mellitus (DM2). METHODS A total of 40 consecutive DM2 patients without history of coronary artery disease (CAD) and 7 control subjects were recruited. Dipyridamole myocardial blood flow index (MBF) was assessed by measuring first transit counts in the pulmonary artery and myocardial count rate from gated SPECT images using (99m)Tc-labelled tracers. The corresponding MBF index was estimated 2 h later according to the same procedure. Regional myocardial perfusion reserve (MPR) was defined as the ratio between dipyridamole and baseline MBF using a 17-segment left ventricular (LV) model. Coronary flow reserve (CFR) was estimated by transthoracic contrast echo Doppler monitoring of flow velocity in the left anterior descending coronary artery (LAD) during the same session. RESULTS Estimated MPR was higher in control subjects than in patients (3.36 +/- 0.66 vs 1.91 +/- 0.61, respectively, p < 0.01). In patients, LAD CFR and LAD MPR were 2.01 +/- 0.78 vs 1.93 +/- 0.63, respectively (p = ns). The agreement between the two techniques was documented by their close correlation (r = 0.92, p < 0.001) and confirmed by the Bland-Altman analysis. Reversible perfusion defects occurred in 13 patients (32%) who showed similar MPR values as the remaining 27 (2.10 +/- 0.71 vs 1.83 +/- 0.71, respectively, p = ns). Finally, MPR was closely correlated with age (r = -0.50, p < 0.01) and time elapsed from the diagnosis of DM2 (r = -0.51, p < 0.01). CONCLUSION LV regional MPR can be accurately estimated with the broadly available single photon technology. Application of this method to DM2 patients documents the presence of a microvascular dysfunction homogeneously distributed throughout the LV walls and most frequently not associated with reversible perfusion defects.
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Affiliation(s)
- Cecilia Marini
- CNR Institute of Bioimages and Molecular Physiology, Milan, Italy.
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Maggi D, Andraghetti G, Cordera R. P-35: CYS 860 in the insulin receptor ß subunit is critical for signal transduction in transfected CHO cells. Exp Clin Endocrinol Diabetes 2009. [DOI: 10.1055/s-0029-1211578] [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] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/20/2022]
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Bezante GP, Briatore L, Rollando D, Maggi D, Setti M, Ghio M, Agosti S, Murdaca G, Balbi M, Barsotti A, Cordera R. Hypoadiponectinemia in lipodystrophic HIV individuals: a metabolic marker of subclinical cardiac damage. Nutr Metab Cardiovasc Dis 2009; 19:277-282. [PMID: 19422999 DOI: 10.1016/j.numecd.2008.07.009] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.7] [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: 02/08/2008] [Revised: 06/26/2008] [Accepted: 07/24/2008] [Indexed: 11/22/2022]
Abstract
BACKGROUND AND AIM To evaluate cardiovascular abnormalities in highly active antiretroviral therapy (HAART) treated HIV patients with no signs or symptoms of cardiovascular impairment, and to assess the relative role of multiple concomitant risk factors. METHODS AND RESULTS Forty-four consecutive HIV subjects (mean age 41+/-6 yrs) were enrolled. Inclusion criteria were HIV infection, CD4+cell count>150/ml, HAART treatment for at least 4 years. Metabolic serum levels, morphological and functional echocardiographic parameters were assessed in all subjects. Sixteen healthy age and sex matched subjects with no cardiovascular risk factors were recruited as controls. HIV patients showed increased left ventricular mass index with reduced mid-wall fractional shortening (mFS) when compared to controls (50.2+/-10.5 vs. 38.6+/-14.4, p=0.05 and 18.3+/-0.6 vs. 21.9+/-0.7, p<0.05, respectively). Twenty-nine patients were lipodystrophic (LD) and showed a longer HAART period (p=0.0004) and greater use of protease inhibitors (PI) (p=0.001). Coronary flow reserve (CFR) was significantly reduced in HIV patients as compared to controls (p<0.0001), as it was in LD subjects when compared to non-lipodystrophic ones (NLD) (p<0.001). Adiponectin concentrations were found to be significantly lower in LD subjects than in NLD ones (7.8+/-0.8 vs. 13.8+/-1.2 microg/ml, p=0.01), and showed a direct correlation with CFR. In multiple regression analysis, insulin, HDL and adiponectin accounted for 63% of CFR variations. CONCLUSIONS Left ventricular hypertrophy, depressed mFS and reduced CFR represent the main signs of subclinical cardiac damage in HIV subjects treated with HAART. Hypoadiponectinemia in these subjects seems to be a metabolic risk factor of cardiovascular impairment.
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Affiliation(s)
- G P Bezante
- Cardiology Unit, Department of Internal Medicine, University of Genova, Viale Benedetto XV/6, Genoa, Italy.
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Salani B, Briatore L, Garibaldi S, Cordera R, Maggi D. Caveolin-1 down-regulation inhibits insulin-like growth factor-I receptor signal transduction in H9C2 rat cardiomyoblasts. Endocrinology 2008; 149:461-5. [PMID: 18039791 DOI: 10.1210/en.2007-0312] [Citation(s) in RCA: 32] [Impact Index Per Article: 2.0] [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] [Indexed: 11/19/2022]
Abstract
Caveolin (Cav)-1, the major caveolar protein, directly interacts with IGF-I receptor (IGF-IR) and its intracellular substrates. To determine the role of Cav-1 in IGF-IR signaling, we transfected H9C2 cells with small interfering RNA specific for Cav-1-siRNA. The selective down-regulation of Cav-1 (90%) was associated with a smaller reduction of Cav-2, whereas Cav-3 expression was unaffected. A significant reduction of IGF-IR tyrosine phosphorylation in Cav-1-siRNA H9C2 cells was found compared with H9C2 control cells (Ctr-siRNA). The reduced IGF-IR autophosphorylation resulted in a decrease of insulin receptor substrate-1, Shc, and Akt activation. In addition, in Cav-1-siRNA H9C2 cells, IGF-I did not prevent apoptosis, suggesting that Cav-1 is required to mediate the antiapoptotic effect of IGF-I in cardiomyoblasts. The down-regulation of Cav-1 decreased IGF-IR activation and affected the ability of IGF-I to prevent apoptosis after serum withdrawal also in human umbilical vein endothelial cells. These results demonstrate that: 1) Cav-1 down-regulation negatively affects IGF-IR tyrosine phosphorylation; 2) this effect causes a reduced activation of insulin receptor substrate-1, Shc, and Akt; and 3) Cav-1 is involved in IGF-IR antiapoptotic signaling after serum deprivation.
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Affiliation(s)
- Barbara Salani
- Department of Endocrinology and Medicine, Viale Benedetto XV, 6, University of Genova, 5-16132, Genova, Italy
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Briatore L, Salani B, Andraghetti G, Danovaro C, Sferrazzo E, Scopinaro N, Adami GF, Maggi D, Cordera R. Restoration of acute insulin response in T2DM subjects 1 month after biliopancreatic diversion. Obesity (Silver Spring) 2008; 16:77-81. [PMID: 18223616 DOI: 10.1038/oby.2007.9] [Citation(s) in RCA: 48] [Impact Index Per Article: 3.0] [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] [Indexed: 12/25/2022]
Abstract
OBJECTIVE Biliopancreatic diversion (BPD) restores normal glucose tolerance in a few weeks in morbid obese subjects with type 2 diabetes, improving insulin sensitivity. However, there is less known about the effects of BPD on insulin secretion. We tested the early effects of BPD on insulin secretion in obese subjects with and without type 2 diabetes. METHODS AND PROCEDURES Twenty-one consecutive morbid obese subjects, 9 with type 2 diabetes (T2DM) and 12 with normal fasting glucose (NFG) were evaluated, just before and 1 month after BPD, by measuring body weight (BW), glucose, adipocitokines, homeostasis model assessment of insulin resistance (HOMA-IR), acute insulin response (AIR) to e.v. glucose and the insulinogenic index adjusted for insulin resistance ([DeltaI5/DeltaG5]/HOMA-IR). RESULTS Preoperatively, those with T2DM differed from those with NFG in showing higher levels of fasting glucose, reduced AIR (57.9 +/- 29.5 vs. 644.9 +/- 143.1 pmol/l, P < 0.01) and reduced adjusted insulinogenic index (1.0 +/- 0.5 vs. 17.6 +/- 3.9 1/mmol(2), P < 0.001). One month following BPD, in both groups BW was reduced (by approximately 11%), but all subjects were still severely obese; HOMA-IR and leptin decreased significanlty, while high-molecular weight (HMW) adiponectin and adjusted insulinogenic index increased. In the T2DM group, fasting glucose returned to non-diabetic values. AIR did not change in the NFG group, while in the T2DM group it showed a significant increase (from 58.0 +/- 29.5 to 273.8 +/- 47.2 pmol/l, P < 0.01). In the T2DM group, the AIR percentage variation from baseline was significantly related to changes in fasting glucose (r = 0.70, P = 0.02), suggesting an important relationship exists between impaired AIR and hyperglycaemia. DISCUSSION BPD is able to restore AIR in T2DM even just 1 month after surgery. AIR restoration is associated with normalization of fasting glucose concentrations.
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Affiliation(s)
- Lucia Briatore
- Department of Endocrinology and Medicine, University of Genova, Genova, Italy
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Salani B, Briatore L, Andraghetti G, Adami GF, Maggi D, Cordera R. High-molecular weight adiponectin isoforms increase after biliopancreatic diversion in obese subjects. Obesity (Silver Spring) 2006; 14:1511-4. [PMID: 17030961 DOI: 10.1038/oby.2006.174] [Citation(s) in RCA: 44] [Impact Index Per Article: 2.4] [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] [Indexed: 02/06/2023]
Abstract
OBJECTIVE Our objective was to test the effect of biliopancreatic diversion (BDP) in adiponectin multimerization. Adiponectin, the major protein secreted by adipose tissue, circulates in plasma in different isoforms. The most clinically relevant oligomers are high-molecular weight (HMW) multimers and low-molecular weight (LMW) trimers. Contrasting data on the effect of weight loss on adiponectin isoforms have been reported. RESEARCH METHODS AND PROCEDURES We measured total plasma adiponectin and HMW and LMW adiponectin oligomers (by Western blot analysis) before and 1 month after BPD, in 18 severely obese subjects. RESULTS One month after BPD, body weight decreased approximately 11%. Total adiponectin showed significant increase after BPD. In addition, we found a significant increase in HMW (percentage) adiponectin oligomers. We found a significant inverse correlation between HMW (percentage) and BMI before and after BPD. Homeostasis model of assessment-insulin resistance decreased significantly after the BPD, without any significant correlation with total serum adiponectin and adiponectin oligomers. DISCUSSION A moderate weight loss after BPD increases total and HMW adiponectin oligomers. The significant correlation between BMI and HMW (percentage) adiponectin oligomers but not between BMI and total adiponectin might indicate a role of body fat mass in regulation of adiponectin multimerization. These data suggest that HMW oligomers represent a very sensitive parameter to short-term BMI changes after BPD.
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Affiliation(s)
- Barbara Salani
- Department of Endocrinology, University of Genova, Genova, Italy
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