Placental Inositol Reduced in Gestational Diabetes as Glucose Alters Inositol Transporters and IMPA1 Enzyme Expression.

CONTEXT: Perturbed inositol physiology in insulin-resistant conditions has led to proposals of inositol supplementation for gestational diabetes (GDM) prevention, but placental inositol biology is poorly understood. OBJECTIVE: Investigate associations of maternal glycemia with placental inositol content, determine glucose effects on placental expression of inositol enzymes and transporters, and examine relations with birthweight. DESIGN AND PARTICIPANTS: Case-control study of placentae from term singleton pregnancies (GDM n = 24, non-GDM n = 26), and culture of another 9 placentae in different concentrations of glucose and myo-inositol for 48 hours. MAIN OUTCOME MEASURES: Placental inositol was quantified by the Megazyme assay. Relative expression of enzymes involved in myo-inositol metabolism and plasma membrane inositol transport was determined by quantitative RT-PCR and immunoblotting. Linear regression analyses were adjusted for maternal age, body mass index, ethnicity, gestational age, and sex. RESULTS: Placental inositol content was 17% lower in GDM compared with non-GDM. Higher maternal mid-gestation glycemia were associated with lower placental inositol. Increasing fasting glycemia was associated with lower protein levels of the myo-inositol synthesis enzyme, IMPA1, and the inositol transporters, SLC5A11 and SLC2A13, the expression of which also correlated with placental inositol content. In vitro, higher glucose concentrations reduced IMPA1 and SLC5A11 mRNA expression. Increasing fasting glycemia positively associated with customized birthweight percentile as expected in cases with low placental inositol, but this association was attenuated with high placental inositol. CONCLUSION: Glycemia-induced dysregulation of placental inositol synthesis and transport may be implicated in reduced placental inositol content in GDM, and this may in turn be permissive to accelerated fetal growth.

Effects of maternal protein supplementation and inclusion of rumen-protected fat in the finishing diet on nutrient digestibility and expression of intestinal genes in Nellore steers.

The study aimed to evaluate nutrient digestibility and intestine gene expression in the progeny from cows supplemented during gestation and fed diets with or without rumen-protected fat (RPF) in the feedlot. Forty-eight Nellore steers, averaging 340 kg, were housed in individual pens and allotted in a completely randomized design using a 2 × 2 factorial arrangement (dams nutrition × RPF). Cows' supplementation started after 124 ± 21 days of gestation. The feedlot lasted 135 days and diets had the inclusion of zero or 6% of RPF. Digestibility was evaluated by total feces collection. Steers were slaughtered using the concussion technique and samples of pancreas and small intestine were collected immediately after the slaughter to analyze α-amylase activity, and the expression of SLC5A1, CD36, and CCK and villi morphometry. Feeding RPF increased nutrients digestibility (p < 0.01). There was no effect of maternal nutrition on digestibility and α-amylase activity in steers (p > 0.05). Duodenal expression of SLC5A1, CD36, and CCK increased in the progeny from restricted cows. In conclusion, protein restriction during mid to late gestation of dams has long-term effects on small-intestine length and on expression of membrane transporters genes in the duodenum of the progeny. However, maternal nutrition does not affect digestibility in the feedlot.

Natural Products as Lead Compounds for Sodium Glucose Cotransporter (SGLT) Inhibitors.

Glucose homeostasis is maintained by antagonistic hormones such as insulin and glucagon as well as by regulation of glucose absorption, gluconeogenesis, biosynthesis and mobilization of glycogen, glucose consumption in all tissues and glomerular filtration, and reabsorption of glucose in the kidneys. Glucose enters or leaves cells mainly with the help of two membrane integrated transporters belonging either to the family of facilitative glucose transporters (GLUTs) or to the family of sodium glucose cotransporters (SGLTs). The intestinal glucose absorption by endothelial cells is managed by SGLT1, the transfer from them to the blood by GLUT2. In the kidney SGLT2 and SGLT1 are responsible for reabsorption of filtered glucose from the primary urine, and GLUT2 and GLUT1 enable the transport of glucose from epithelial cells back into the blood stream.The flavonoid phlorizin was isolated from the bark of apple trees and shown to cause glucosuria. Phlorizin is an inhibitor of SGLT1 and SGLT2. With phlorizin as lead compound, specific inhibitors of SGLT2 were developed in the last decade and some of them have been approved for treatment mainly of type 2 diabetes. Inhibition of SGLT2 eliminates excess glucose via the urine. In recent times, the dual SGLT1/SGLT2 inhibitory activity of phlorizin has served as a model for the development and testing of new drugs exhibiting both activities.Besides phlorizin, also some other flavonoids and especially flavonoid enriched plant extracts have been investigated for their potency to reduce postprandial blood glucose levels which can be helpful in the prevention and supplementary treatment especially of type 2 diabetes.

Phloridzin-sensitive transport of echinacoside and acteoside and altered intestinal absorption route after application of Cistanche tubulosa extract.

OBJECTIVES: The objective of this study was to address the beneficial effects of Cistanche tubulosa extract on improving the low intestinal permeability of echinacoside (ECH) and acteoside (ACT). METHODS: Absorption of ECH and ACT in C. tubulosa extract was characterized using human intestinal Caco-2 cell monolayers with intact compounds. Glucose transporter-dependent absorption of ECH and ACT was confirmed by an in-situ intestinal perfusion technique. KEY FINDINGS: The apparent permeability (Papp ) was not significantly different between intact ECH and intact ACT. In the presence of phloridzin, the Pap p of the ECH and ACT at a high dose was reduced to 20% of the respective non-treatment, but was not altered by phloretin and verapamil. C. tubulosa extract at low and high doses enhanced the Papp of ECH and ACT (both by threefold), resulting in their large participation in sodium-dependent glucose transporter-independent absorption. At a low concentration, concomitant ECH and ACT levels in portal blood were significantly suppressed by phloridzin. CONCLUSION: The dietary and medicinal C. tubulosa extract enhancing the intestinal absorption of ECH and ACT may serve to better manage human health, although the involvement of phloridzin-sensitive transport should be reduced.

Dapagliflozin: a review of its use in patients with type 2 diabetes.

Dapagliflozin (Forxiga(®), Farxiga(®)) is an orally administered sodium-glucose co-transporter-2 (SGLT2) inhibitor used in the management of patients with type 2 diabetes. Dapagliflozin reduces renal glucose reabsorption by inhibiting the transporter protein SGLT2 in the renal proximal tubule, thereby increasing urinary glucose excretion and reducing blood glucose levels. Its mechanism of action is independent of insulin secretion or action; therefore, dapagliflozin provides complementary therapy when used in combination with other antihyperglycaemic drugs. This article updates an earlier review of dapagliflozin and focuses on longer-term efficacy and tolerability data (e.g. from extensions of earlier clinical trials), as well as data from studies in special patient populations (e.g. history of cardiovascular disease). Numerous well-designed clinical trials with dapagliflozin, primarily as add-on therapy for 24 weeks (but also as monotherapy or initial combination therapy), have consistently demonstrated reductions in glycosylated haemoglobin, fasting plasma glucose levels and bodyweight. Extensions of these trials show the effects are maintained over longer-term follow-up periods of ≈1-4 years and dapagliflozin is generally well tolerated. Dapagliflozin has a low risk of hypoglycaemia, although the incidence varies depending on background therapy, and genital mycotic infections (particularly in women) are the most common adverse events. Dapagliflozin is not recommended in patients with moderate or severe renal impairment. In view of its unique mechanism of action and now well-established efficacy and tolerability profile, dapagliflozin is a useful treatment option in the management of type 2 diabetes, although its effects on diabetic complications remain to be evaluated.

Delphinol® standardized maqui berry extract reduces postprandial blood glucose increase in individuals with impaired glucose regulation by novel mechanism of sodium glucose cotransporter inhibition.

AIM: The impetus of our study was to investigate the effects of a nutritional supplement Delphinol®, an extract of maqui berries (Aristotelia chilensis) standardised to ≥25% delphinidins and ≥35% total anthocyanins, on postprandial blood glucose and insulin levels and identify the physiologic mechanism involved. METHODS: Postprandial blood glucose and insulin were investigated in double-blind, placebo-controlled, cross-over fashion in ten volunteers with moderate glucose intolerance. Longer term effects on blood sugar levels were investigated in streptozotocin-diabetic rats over a four months period. Effects of maqui berry delphinidins on sodium-glucose symport were examined in rodent jejenum of the small intestine. RESULTS: Delphinol® intake prior to rice consumption statistical significantly lowered post prandial blood glucose and insulin as compared to placebo. We identified an inhibition of Na+-dependant glucose transport by delphinidin, the principal polyphenol to which Delphinol® is standardised. In a diabetic rat model the daily oral application of Delphinol® over a period of four months significantly lowered fasting blood glucose levels and reached values indistinguishable from healthy non-diabetic rats. CONCLUSION: Our results suggest a potential use of Delphinol® for naturally controlling post-prandial blood glucose owed to inhibition of sodium glucose co-transporter in small intestine.

Sodium-glucose transporter type 3-mediated neuroprotective effect of acetylcholine suppresses the development of cerebral ischemic neuronal damage.

Cerebral ischemia can be exacerbated by post-ischemic hyperglycemia, which may involve the cerebral sodium-glucose transporter (SGLT). However, the contribution of each SGLT isoform in cerebral ischemia is still unclear. SGLT-1, -3, -4, and -6 have been reported to be expressed in various brain regions. Among these isoforms, only SGLT-3 does not transport glucose, but depolarizes the plasma membrane when glucose is bound, suggesting that SGLT-3 is a glucose sensor. Therefore, in this study, we investigated the involvement of cerebral SGLT-3 in the development of ischemia. The mouse model of focal ischemia was generated by middle cerebral artery occlusion (MCAO). Neuronal damage was assessed by histological and behavioral analyses. Fasting blood glucose levels on day 1 after MCAO were not affected in SGLT-3 siRNA-mediated knockdown of SGLT-3. The development of infarct volume and behavioral abnormalities on day 1 after MCAO were exacerbated in SGLT-3 knockdown mice (control group: n=7, 94.2 ± 21.8 mm(3), 2 (1.6-2.4), SGLT-3 knockdown group: n=6, 1414.8 ± 492.4 mm(3), 6 (5.8-6.3), P<0.05). Moreover, SGLT-3 expression levels were significantly decreased in the striatum (65.0 ± 8.1%, P<0.05) on day 1, and in the hippocampus (67.6 ± 7.2%, P<0.05) and hypothalamus (47.5 ± 5.1%, P<0.01) on day 3 after MCAO (n=12-13). These effects were significantly inhibited by donepezil (DPZ) treatment (SGLT-3 knockdown group: n=6, 1419.0 ± 181.5 mm(3), 3.6 (3.4-3.7), SGLT-3 knockdown and 3mg/kg DPZ-treated group: n=5, 611.3 ± 205.3 mm(3), 1.5 (1.4-1.8), P<0.05). Immunofluorescence revealed that SGLT-3 and choline acetyltransferase were co-localized in the cortex. Our results indicated that cerebral SGLT-3 suppressed neuronal damage by the activation of cholinergic neurons, which are neuroprotective. In contrast, other cerebral SGLT isoforms may be involved in the development of ischemia.

Feeding of banana flower and pseudostem to diabetic rats results in modulation of renal GLUTs, TGFß, PKC and extracellular matrix components.

BACKGROUND AND AIMS: Sustained hyperglycemia as a result of diabetes mellitus results in over-expression of glucose transporters (GLUTs/SGLTs), protein kinase C-α (PKC-α) and transforming growth factor-ß (TGF-ß) in kidney which increases synthesis and accumulation of extracellular matrix (ECM) components leading to diabetic nephropathy. Previous results from our laboratory showed that banana flower (BF) and pseudostem (BS) ameliorated diabetic complications and reduced formation of advanced glycation end-products (AGEs). In this study, attempts were made to delineate the changes observed in GLUTs and ECM components in kidney by feeding BF and BS at the molecular level. METHODS AND RESULTS: Diabetes was induced in male Wistar rats by injecting streptozotocin. Rats were fed with standard AIN-76 diet or diet supplemented with 5% BF or BS. Rats fed with diet supplemented with aminoguanidine (0.05%) were used as a positive control. Effect of BF and BS on expression of GLUTs/SGLTs, PKC and TGF ß in kidney was evaluated by RT-PCR and accumulation of ECM components in kidney was quantitated by ELISA and immunohistochemistry. BF and BS modulated the over-expression of GLUT 1, 2, 5, SGLT 1, 2 and factors such as PKC-α and TGF-ß to various extents. This impinged on the synthesis of ECM components like laminin, fibronectin and type-IV collagen. CONCLUSION: The results suggest that BF and BS reduce the diabetic nephropathy complications which are accompanied by changes at the molecular level.

Preclinical species and human disposition of PF-04971729, a selective inhibitor of the sodium-dependent glucose cotransporter 2 and clinical candidate for the treatment of type 2 diabetes mellitus.

(1S,2S,3S,4R,5S)-5-[4-Chloro-3-(4-ethoxybenzyl)phenyl]-1-hydroxymethyl-6,8-dioxabicyclo[3.2.1]octane-2,3,4-triol (PF-04971729), a potent and selective inhibitor of the sodium-dependent glucose cotransporter 2, is currently in phase 2 trials for the treatment of diabetes mellitus. This article describes the preclinical species and in vitro human disposition characteristics of PF-04971729 that were used in experiments performed to support the first-in-human study. Plasma clearance was low in rats (4.04 ml · min(-1) · kg(-1)) and dogs (1.64 ml · min(-1) · kg(-1)), resulting in half-lives of 4.10 and 7.63 h, respectively. Moderate to good bioavailability in rats (69%) and dogs (94%) was observed after oral dosing. The in vitro biotransformation profile of PF-04971729 in liver microsomes and cryopreserved hepatocytes from rat, dog, and human was qualitatively similar; prominent metabolic pathways included monohydroxylation, O-deethylation, and glucuronidation. No human-specific metabolites of PF-04971729 were detected in in vitro studies. Reaction phenotyping studies using recombinant enzymes indicated a role of CYP3A4/3A5, CYP2D6, and UGT1A9/2B7 in the metabolism of PF-04971729. No competitive or time-dependent inhibition of the major human cytochrome P450 enzymes was discerned with PF-04971729. Inhibitory effects against the organic cation transporter 2-mediated uptake of [(14)C]metformin by PF-04971729 also were very weak (IC(50) = ∼900 µM). Single-species allometric scaling of rat pharmacokinetics of PF-04971729 was used to predict human clearance, distribution volume, and oral bioavailability. Human pharmacokinetic predictions were consistent with the potential for a low daily dose. First-in-human studies after oral administration indicated that the human pharmacokinetics/dose predictions for PF-04971729 were in the range that is likely to yield a favorable pharmacodynamic response.

Transporters involved in glucose and water absorption in the Dysdercus peruvianus (Hemiptera: Pyrrhocoridae) anterior midgut.

Little is known about insect intestinal sugar absorption, in spite of the recent findings, and even less has been published regarding water absorption. The aim of this study was to shed light on putative transporters of water and glucose in the insect midgut. Glucose and water absorptions by the anterior ventriculus of Dysdercus peruvianus midgut were determined by feeding the insects with a glucose and a non-absorbable dye solution, followed by periodical dissection of insects and analysis of ventricular contents. Glucose absorption decreases glucose/dye ratios and water absorption increases dye concentrations. Water and glucose transports are activated (water 50%, glucose 33%) by 50 mM K(2)SO(4) and are inhibited (water 46%, glucose 82%) by 0.2 mM phloretin, the inhibitor of the facilitative hexose transporter (GLUT) or are inhibited (water 45%, glucose 35%) by 0.1 mM phlorizin, the inhibitor of the Na(+)-glucose cotransporter (SGLT). The results also showed that the putative SGLT transports about two times more water relative to glucose than the putative GLUT. These results mean that D. peruvianus uses a GLUT-like transporter and an SGLT-like transporter (with K(+) instead of Na(+)) to absorb dietary glucose and water. A cDNA library from D. peruvianus midgut was screened and we found one sequence homologous to GLUT1, named DpGLUT, and another to a sodium/solute symporter, named DpSGLT. Semi-quantitative RT-PCR studies revealed that DpGLUT and DpSGLTs mRNA were expressed in the anterior midgut, where glucose and water are absorbed, but not in fat body, salivary gland and Malpighian tubules. This is the first report showing the involvement of putative GLUT and SGLT in both water and glucose midgut absorption in insects.

Identification of a novel sodium-dependent fructose transport activity in the hepatopancreas of the Atlantic lobster Homarus americanus.

[(3)H]Fructose and [(3)H]glucose transport were determined in brush-border membrane vesicles (BBMV), basolateral membrane vesicles (BLMV) and isolated cells (E, R, F, B) of H. americanus (Atlantic lobster) hepatopancreas. Glucose transport in BBMV was equilibrative in the absence of sodium and concentrative in the presence of sodium. Sodium-dependent glucose transport by BBMV was not inhibited by a tenfold molar excess of fructose. Glucose transport by BLMV was equilibrative and sodium independent. Fructose uptake by BBMV and BLMV was equilibrative in the absence of sodium and concentrative in the presence of sodium. This enhancement was not affected by a tenfold molar excess of glucose in the presence of sodium. E-, F- and B-cells showed sodium-dependent uptake of fructose, while R-cells did not. Sodium-dependent fructose uptake by E-cells was not inhibited by a tenfold molar excess of glucose or mannose. Western blot analysis of BBMV, BLMV and E-, R-, F- and B-cells using rabbit polyclonal antibodies directed against epitopes of mammalian GLUT2, GLUT5, SGLT1 and SGLT4 indicated the presence of cross-reacting lobster proteins. Sequence alignment of the mammalian proteins with translated, lobster expressed sequence tags also indicated significant identity between species. Comparison of fructose and glucose uptake in the absence and presence of sodium by BBMV, BLMV and isolated cells indicated the presence of a distinct sodium-dependent transport activity for each sugar in the Atlantic lobster.

Dissociation between sensing and metabolism of glucose in sugar sensing neurones.

Some of the neurones controlling sleep, appetite and hormone release act as specialized detectors of ambient glucose. Their sugar sensing is conventionally thought to involve glucokinase-dependent metabolism of glucose to ATP, which then alters membrane excitability by modulating ATP-dependent channels or transporters, such as ATP-inhibited K(+) channels (K(ATP)). However, recent studies also provide examples of both glucose-excited (GE) and glucose-inhibited (GI) neurones that sense glucose independently of such metabolic pathways. Two-thirds of hypothalamic GE neurones in primary cultures are also excited by the non-metabolizable glucose analogue alpha-methylglucopyranoside (alpha-MDG), which acts as a substrate for electrogenic (depolarizing) sodium-glucose cotransporter (SGLT). The excitatory responses to both glucose and alpha-MDG are abolished by arresting SGLT activity by sodium removal or the SGLT inhibitor phloridzin. Direct depolarization and excitation by glucose-triggered SGLT activity may ensure that GE neurones continue to sense glucose in 'high-energy' states, when K(ATP) channels are closed. A major class of hypothalamic GI neurones, the orexin/hypocretin cells, also appear to use a non-metabolic sensing strategy. In these cells, glucose-induced hyperpolarization and inhibition are unaffected by glucokinase inhibitors such as alloxan, D-glucosamine, and N-acetyl-D-glucosamine, and mimicked by the non-metabolizable glucose analogue 2-deoxyglucose, but not by stimulating intracellular ATP production with lactate. The dissociation between sensing and metabolism of sugar may allow the brain to predict and prevent adverse changes in extracellular glucose levels with minimal impact on the flow of intracellular fuel.

Absorption and metabolism of cyanidin-3-glucoside and cyanidin-3-rutinoside extracted from wild mulberry (Morus nigra L.) in rats.

The mechanism of uptake of anthocyanins (as well as the type) from food in the intestine is not clear. Anthocyanin-rich extract from wild mulberry, composed of cyanidin-3-glucoside (79%) and cyanidin-3-rutinoside (cy-3-rut) (19%), was orally administered to Wistar rats, and their concentrations were determined in plasma, kidney, and the gastrointestinal (GI) tract. The 2 glycosylated forms showed maximum concentration at 15 minutes after oral administration, both in plasma and kidney. The cyanidin-3-glucoside and cy-3-rut were found in plasma as glucuronides, as sulfates of cyanidin, and as unchanged forms. The area under the curve of concentration vs time (AUC(0-8h)) was 2.76 +/- 0.88 microg hour/mL and 9.74 +/- 0.75 microg hour/g for plasma and kidney, respectively. In spite of the low absorption, the increase in plasma anthocyanin level resulted in a significant increase in antioxidant capacity (P < .05). In the GI tract (stomach and small and large intestines), cyanidin glycosides were found unchanged, but a low amount of the aglycone form was present. Anthocyanin glycosides were no longer detected in the GI tract after 8 hours of administration. In vitro fermentation showed that the 2 cyanidin glycosides were totally metabolized by the rat colonic microflora, explaining their disappearance. In addition, the 2 products of their degradation, cyanidin and protocatechuic acid, were not detected in plasma and probably do not influence plasma antioxidant capacity. As found by the everted sac model, anthocyanins were transported across the enterocyte by the sodium-dependent glucose transporter.

A 96-well automated method to study inhibitors of human sodium-dependent D-glucose transport.

The sodium-dependent D-glucose transporter (SGLT) family is involved in glucose uptake via intestinal absorption (SGLT1) or renal reabsorption (SGLT1 and SGLT2). Current methods for the screening of inhibitors of SGLT transporters are complex, expensive and very labor intensive, and have not been applied to human SGLT transporters. The purpose of the present study was to develop an alternative 96-well automated method to study the activity of human SGLT1 and SGLT2. Chinese hamster ovary (CHO) Flp-In cells were stably transfected with pcDNA5-SGLT1 or pcDNA5-SGLT2 plasmid and maintained in hygromycin-selection Ham's F12 culture medium until hygromycin-resistant clones were developed. SGLT1 and SGLT2 gene expression was evaluated by relative real-time reverse transcription-polymerase chain reaction (RT-PCR) quantification, Western blotting, and immunocytochemical analysis. The clones with higher expression of SGLT1 and SGLT2 were used for transport studies using [14C]-methyl-alpha-D-glucopyranoside ([14C]AMG). The advantage of using the 96-well format is the low amount of radioactive compounds and inhibitory substances required, and its ability to establish reproducibility because repetition into the assay. This method represents an initial approach in the development of transport-based high-throughput screening in the search for inhibitors of glucose transport. The proposed method can easily be performed to yield quantitative data regarding key aspects of glucose membrane transport and kinetic studies of potential inhibitors of human SGLT1 and SGLT2.