自噬在2 型糖尿病和胰岛β 细胞中作用研究进展

胰岛素分泌缺陷和胰岛素抵抗是2型糖尿病发病的主要机制之一。高血糖和脂质代谢紊乱,是糖尿病发病机制中最重要的获得性因素。最近研究表明自噬在维持内环境稳定,胰岛β细胞数量分泌能力,及对抗胰岛素抵抗等方面有重要作用。本文就自噬的基本概念及在糖尿病发病和维持β细胞功能方面作一综述。     

胰岛β细胞炎症与2型糖尿病

2型糖尿病属于代谢性疾病,它的发生发展受环境因素和多种基因的共同调控.近年来研究认为2型糖尿病属于代谢性炎症,可能是由细胞因子介导的一种慢性炎症反应性疾病.胰岛作为胰岛素的分泌器官,它的异常是2型糖尿病发病进程中的一个重要病理基础.长期的高糖,高脂及巨噬细胞浸润等因素都会刺激细胞因子的大量生成,造成胰岛β细胞的炎症反应,对胰岛β细胞分泌胰岛素的功能和细胞活力产生不同程度的损伤,导致其功能障碍和凋亡,进而促使2型糖尿病的发生发展.本文根据国内外近几年的研究进展,进一步了探讨胰岛β细胞炎症与2型糖尿病的关系.这种代谢性炎症的研究,进一步阐明了炎症的发生,引起胰岛素抵抗、功能障碍的具体机制,革新了对2型糖尿病发病机理的认识,并为2型糖尿病的防治提供了新的方向.     

天然黄酮类化合物治疗2型糖尿病的机制研究进展

2型糖尿病(T2DM)是一种以胰岛素抵抗或胰岛β细胞分泌功能缺陷为特征的代谢性疾病。黄酮类化合物在预防和治疗2型糖尿病中发挥着重要作用,其作用靶点多、机制复杂,尚难完全阐明。因此,明确黄酮类单体化合物的作用机制十分重要。黄酮类化合物可作用于胰腺β细胞、肝细胞、脂肪细胞和骨骼肌细胞中的多个靶点和不同的信号通路。本文分类综述了近年来天然黄酮类化合物抗2型糖尿病作用及机制的研究进展。     

c-met 在大鼠胰岛β细胞INS-1 胰岛素分泌中的作用

目的:从c-met对胰岛β细胞增殖,细胞周期、糖耐受和对GLUT2的表达影响三个方面探讨c-met在胰岛β细胞功能的影响及相关机制。方法:在大鼠胰岛β细胞系INS-1中运用RNA干扰技术(RNAi)抑制HGF的特异性受体c-met蛋白的表达,检测其在正常的生理状况下对成熟的胰岛β细胞增殖以及功能维持的作用。结果:c-met蛋白对成熟的胰岛β细胞的增殖与周期并没有显著影响,但对于β细胞的功能维持具有重要意义。结论:通过调节GLUT2蛋白来维持β细胞的胰岛素分泌功能,有助于进一步阐明HGF/c-met通路在胰岛β细胞功能损伤的分子机制,从而为糖尿病的预防和治疗提供新的理论依据。     

2型糖尿病进程中胰岛β细胞功能变化的分子机制

近年来,2型糖尿病(type 2 diabetes,T2D)发病率迅速上升,已成为全球性的健康危机。最近的临床和基础研究表明,胰岛β细胞功能障碍是导致T2D及其相关并发症的重要原因。在2型糖尿病的自然病程中,胰岛β细胞经历从代偿到失代偿的动态变化;其中,代谢应激反应,如内质网应激(endoplasmic reticulum stress,ERstress)、氧化应激(oxidativestress)和炎症(inflammation)是β细胞功能变化的关键调控机制。本文总结了β细胞功能在2型糖尿病病程中动态变化的研究进展,以期深化对2型糖尿病分子机制的理解,为精准诊断和临床干预2型糖尿病提供参考。     

膜转运蛋白ABCA1与2型糖尿病

胰岛β细胞机能失调是2型糖尿病发病机理的关键所在,而细胞内胆固醇积聚是2型糖尿病β细胞机能失调的发生机制.胆固醇转运体———三磷酸腺苷结合盒转运子A1(ABCA1)缺乏,导致胰岛内胆固醇增加及胰岛素分泌受损,这表明胆固醇流出受损导致β细胞发生功能障碍.     

维生素D缺乏诱发糖尿病的机制

维生素D缺乏/不足近年来在全世界各年龄段人群中都非常普遍。维生素D在糖尿病发展过程中发挥着非常重要的作用。1型糖尿病患者常常具有骨健康风险,这与维生素D代谢异常关系密切。糖尿病患者并发维生素D缺乏的机制是多样的,涉及到内分泌紊乱引起的维生素D合成减少、炎症细胞因子影响、微血管病相关血流量减少等。2型糖尿病患者通常主要会出现胰岛B细胞功能、胰岛素敏感性、以及系统性的炎症反应三方面的缺陷。维生素D对胰岛素分泌有直接和间接的影响。胰岛素抵抗会引起肠激素抵抗,氧化应激,胰岛B细胞功能失调,以及基因和行为因素,都会促进肥胖个体中糖尿病发展。补充维生素D可能有利于改善胰岛素敏感性,有助于糖尿病的治疗。     

胰岛细胞环路

胰岛由分泌胰岛素的β细胞、分泌胰高血糖素的α细胞以及分泌生长抑素的δ细胞等多种细胞组成,其组织内的细胞环路对胰岛稳态和血糖维持有重要的调控作用,是目前胰岛功能和糖尿病研究的热点.最近的研究表明,α-β细胞对话对胰岛环路的建立以及正常β细胞的功能的发挥起着重要的调节作用,而且无论是β-δ环路功能障碍,还是δ-β环路的过度激活,都会导致胰岛稳态的破坏和血糖紊乱.这些研究为胰岛环路如何调节胰岛稳态和血糖水平提供了初步的线索,但更全面详细的研究尚未充分开展.因此,深入阐明胰岛环路的构成与功能,及其如何在生理和病理过程中发挥作用,不仅可以更好地理解胰岛如何作为一个组织在血糖代谢中维持自身稳态并发挥其功能,也可为通过调节和塑造胰岛环路,开发新型的糖尿病防治策略奠定基础.     

我国干细胞治疗糖尿病的基础与临床研究

胰岛β细胞功能衰竭和胰岛素抵抗是导致糖尿病发生发展的主要机制,目前的抗糖尿病药物没有针对糖尿病发病的关键环节,只能解除或缓解症状,延缓疾病进展,不能从根本上治愈该疾病.干细胞通过促进胰岛β细胞原位再生,提高胰岛β细胞自噬能力、调节胰岛巨噬细胞功能修复受损的胰岛β细胞以改善胰岛β细胞功能;通过多种途径活化骨骼肌、脂肪和肝脏IRS(1)-AKT-GLUT4信号通路改善外周组织胰岛素抵抗,为糖尿病的精准治疗提供了新的方向.我国研究者针对不同来源的干细胞使用不同输注方式治疗1型糖尿病和2型糖尿病开展了系列研究,取得了良好的临床疗效,且未发生严重不良反应,为干细胞治疗糖尿病的临床应用奠定了基础.     

胰高血糖素样多肽-1拮抗2型糖尿病胰岛细胞凋亡损伤（英文）

胰高血糖素样多肽-1(glucogen-like peptide-1,GLP-1)在胰岛素分泌过程中扮演重要角色,并在改善β细胞功能方面有着令人瞩目的效应,但有关其作用机制尚需更深入研究。本研究探讨GLP-1对2型糖尿病(type 2 diabetes mellitus,T2DM)大鼠模型胰岛细胞损伤的影响,观察GLP-1在T2DM大鼠胰岛细胞凋亡损伤机制中所发挥的作用。HE染色结果发现,糖尿病大鼠胰岛损伤。ELISA结果表明,糖尿病患者和糖尿病大鼠血清中GLP-1表达水平上调。放射免疫结果表明,GLP-1和谷氧还蛋白1(Grx1)促进HIT-T 15细胞分泌胰岛素,Cd抑制胰岛素的分泌。免疫组化结果表明,糖尿病大鼠GLP-1加药处理后,各组与糖尿病组相比,药物提高了Grx1和胰岛素表达水平,降低了胰高血糖素表达水平,同时降低了活性胱天蛋白酶3(caspase-3)的表达。本研究结果提示,GLP-1在肥胖T2DM大鼠胰岛细胞凋亡中起保护作用,同时可调节胰岛素和胰高血糖素水平,其机制可能与Grx1相关。     

Disruption of circadian rhythms accelerates development of diabetes through pancreatic beta-cell loss and dysfunction

Type 2 diabetes mellitus (T2DM) is complex metabolic disease that arises as a consequence of interactions between genetic predisposition and environmental triggers. One recently described environmental trigger associated with development of T2DM is disturbance of circadian rhythms due to shift work, sleep loss, or nocturnal lifestyle. However, the underlying mechanisms behind this association are largely unknown. To address this, the authors examined the metabolic and physiological consequences of experimentally controlled circadian rhythm disruption in wild-type (WT) Sprague Dawley and diabetes-prone human islet amyloid polypeptide transgenic (HIP) rats: a validated model of T2DM. WT and HIP rats at 3 months of age were exposed to 10 weeks of either a normal light regimen (LD: 12:12-h light/dark) or experimental disruption in the light-dark cycle produced by either (1) 6-h advance of the light cycle every 3 days or (2) constant light protocol. Subsequently, blood glucose control, beta-cell function, beta-cell mass, turnover, and insulin sensitivity were examined. In WT rats, 10 weeks of experimental disruption of circadian rhythms failed to significantly alter fasting blood glucose levels, glucose-stimulated insulin secretion, beta-cell mass/turnover, or insulin sensitivity. In contrast, experimental disruption of circadian rhythms in diabetes-prone HIP rats led to accelerated development of diabetes. The mechanism subserving early-onset diabetes was due to accelerated loss of beta-cell function and loss of beta-cell mass attributed to increases in beta-cell apoptosis. Disruption of circadian rhythms may increase the risk of T2DM by accelerating the loss of beta-cell function and mass characteristic in T2DM.     

Association between misalignment of circadian rhythm and obesity in Korean men: Sixth Korea National Health and Nutrition Examination Survey

ABSTRACT

Background: The disruption of circadian rhythm has been found to associate with obesity in vivo and in vitro. Sleep duration, eating habits, total feeding time, and nightshift work can also affect circadian rhythms. This study investigated the association between misalignment of circadian rhythm and obesity in Korean men, using a cross-sectional database.

Methods: This study used data from the Korean National Health and Nutrition Examination Survey (KNHANES), whose study population was 3,658 men aged 18 to 60 years. General and abdominal obesity was defined as a body mass index (BMI) ≥ 25 kg/m² and waist circumference ≥ 90 cm, respectively. Circadian rhythm factors were determined with a self-report questionnaire and included breakfast frequency, sleep duration, and work time. Frequency of breakfast was divided into regular breakfast (five to seven times a week) and irregular breakfast (less than five times a week). Sleep duration was divided into less than 7 hours, 7–9 hours, and over 9 hours. Working time was defined as day/evening, night shift, and other type. The adjusted odds ratios (aORs) and 95% confidence intervals (CIs) for general and abdominal obesity were calculated using multivariable logistic regression according to the number of factors that disturb the circadian rhythm.

Results: Participants with 1 (aOR 1.34, 95% Cl 1.10–1.61) and ≥2 (aOR 1.62, 95% Cl 1.29–2.05) factors disturbing circadian rhythms were associated with elevated risk for general obesity. Similarly, those with 1 (aOR 1.33, 95% Cl 1.09–1.63) and ≥2 (aOR 1.70, 95% Cl 1.32–2.20) factors had elevated risk for abdominal obesity.

Conclusions: Factors disturbing the circadian rhythm were associated with general and abdominal obesity. Additional studies are needed, and associations with metabolic diseases should be investigated.     

Disrupting Circadian Homeostasis of Sympathetic Signaling Promotes Tumor Development in Mice

Background

Cell proliferation in all rapidly renewing mammalian tissues follows a circadian rhythm that is often disrupted in advanced-stage tumors. Epidemiologic studies have revealed a clear link between disruption of circadian rhythms and cancer development in humans. Mice lacking the circadian genes Period1 and 2 (Per) or Cryptochrome1 and 2 (Cry) are deficient in cell cycle regulation and Per2 mutant mice are cancer-prone. However, it remains unclear how circadian rhythm in cell proliferation is generated in vivo and why disruption of circadian rhythm may lead to tumorigenesis.

Methodology/Principal Findings

Mice lacking Per1 and 2, Cry1 and 2, or one copy of Bmal1, all show increased spontaneous and radiation-induced tumor development. The neoplastic growth of Per-mutant somatic cells is not controlled cell-autonomously but is dependent upon extracellular mitogenic signals. Among the circadian output pathways, the rhythmic sympathetic signaling plays a key role in the central-peripheral timing mechanism that simultaneously activates the cell cycle clock via AP1-controlled Myc induction and p53 via peripheral clock-controlled ATM activation. Jet-lag promptly desynchronizes the central clock-SNS-peripheral clock axis, abolishes the peripheral clock-dependent ATM activation, and activates myc oncogenic potential, leading to tumor development in the same organ systems in wild-type and circadian gene-mutant mice.

Conclusions/Significance

Tumor suppression in vivo is a clock-controlled physiological function. The central circadian clock paces extracellular mitogenic signals that drive peripheral clock-controlled expression of key cell cycle and tumor suppressor genes to generate a circadian rhythm in cell proliferation. Frequent disruption of circadian rhythm is an important tumor promoting factor.     

Peripheral clock system circadian abnormalities in Cushing’s disease

ABSTRACT

In Cushing’s syndrome, the cortisol rhythm is impaired and can be associated with the disruption in the rhythmic expression of clock genes. In this study, we evaluated the expression of CLOCK, BMAL1, CRY1, CRY2, PER1, PER2, PER3 genes in peripheral blood leukocytes of healthy individuals (n = 13) and Cushing’s disease (CD) patients (n = 12). Participants underwent salivary cortisol measurement at 0900 h and 2300 h. Peripheral blood samples were obtained at 0900 h, 1300 h, 1700 h, and 2300 h for assessing clock gene expression by qPCR. Gene expression circadian variations were evaluated by the Cosinor method. In healthy controls, a circadian variation in the expression of CLOCK, BMAL1, CRY1, PER2, and PER3 was observed, whereas the expression of PER1 and CRY2 followed no specific pattern. The expression of PER2 and PER3 in healthy leukocytes presented a late afternoon acrophase, similarly to CLOCK, whereas CRY1 showed night acrophase, similarly to BMAL1. In CD patients, the circadian variation in the expression of clock genes was lost, along with the abolition of cortisol circadian rhythm. However, CRY2 exhibited a circadian variation with acrophase during the dark phase in patients. In conclusion, our data suggest that Cushing’s disease, which is characterized by hypercortisolism, is associated with abnormalities in the circadian pattern of clock genes. Higher expression of CRY2 at night outlines its putative role in the cortisol circadian rhythm disruption.     

Constant light alters serum hormone levels related to thyroid function in male CD-1 mice

ABSTRACT

Disruptions to the circadian rhythm can lead to altered metabolism. Modification of thyroid function may be a reason why circadian misalignment may contribute to future metabolic disorders. We investigated whether circadian disruption through constant light (LL) can lead to variations in hormone levels associated with thyroid function. Mice were exposed to LL or a 12:12 Light:Dark (LD) cycle for 6 weeks; then glucose tolerance and thyroid hormone levels were measured at ZT 6 and ZT 18. There was day/night variation in glucose tolerance, but LL had no effect. LL reduced TSH, increased fT4, and abolished day/night variation in fT3 and leptin. These findings illustrate that LL alters thyroid-related hormones, providing evidence of a link between circadian disruption and thyroid function.     

Development of Salivary Cortisol Circadian Rhythm and Reference Intervals in Full-Term Infants

BackgroundCortisol concentrations in plasma display a circadian rhythm in adults and children older than one year. Earlier studies report divergent results regarding when cortisol circadian rhythm is established. The present study aims to investigate at what age infants develop a circadian rhythm, as well as the possible influences of behavioral regularity and daily life trauma on when the rhythm is established. Furthermore, we determine age-related reference intervals for cortisol concentrations in saliva during the first year of life.Methods130 healthy full-term infants were included in a prospective, longitudinal study with saliva sampling on two consecutive days, in the morning (07:30-09:30), noon (10:00-12:00) and evening (19:30-21:30), each month from birth until the infant was twelve months old. Information about development of behavioral regularity and potential exposure to trauma was obtained from the parents through the Baby Behavior Questionnaire and the Life Incidence of Traumatic Events checklist.ResultsA significant group-level circadian rhythm of salivary cortisol secretion was established at one month, and remained throughout the first year of life, although there was considerable individual variability. No correlation was found between development of cortisol circadian rhythm and the results from either the Baby Behavior Questionnaire or the Life Incidence of Traumatic Events checklist. The study presents salivary cortisol reference intervals for infants during the first twelve months of life.ConclusionsCortisol circadian rhythm in infants is already established by one month of age, earlier than previous studies have shown. The current study also provides first year age-related reference intervals for salivary cortisol levels in healthy, full-term infants.     

Effect of Spaceflight on the Circadian Rhythm,Lifespan and Gene Expression of Drosophila melanogaster

Space travelers are reported to experience circadian rhythm disruption during spaceflight. However, how the space environment affects circadian rhythm is yet to be determined. The major focus of this study was to investigate the effect of spaceflight on the Drosophila circadian clock at both the behavioral and molecular level. We used China’s Shenzhou-9 spaceship to carry Drosophila. After 13 days of spaceflight, behavior tests showed that the flies maintained normal locomotor activity rhythm and sleep pattern. The expression level and rhythm of major clock genes were also unaffected. However, expression profiling showed differentially regulated output genes of the circadian clock system between space flown and control flies, suggesting that spaceflight affected the circadian output pathway. We also investigated other physiological effects of spaceflight such as lipid metabolism and lifespan, and searched genes significantly affected by spaceflight using microarray analysis. These results provide new information on the effects of spaceflight on circadian rhythm, lipid metabolism and lifespan. Furthermore, we showed that studying the effect of spaceflight on gene expression using samples collected at different Zeitgeber time could obtain different results, suggesting the importance of appropriate sampling procedures in studies on the effects of spaceflight.