ABSTRACT
Mitochondria house many metabolic pathways required for homeostasis and growth. To explore how human cells respond to mitochondrial dysfunction, we performed metabolomics in fibroblasts from patients with various mitochondrial disorders and cancer cells with electron transport chain (ETC) blockade. These analyses revealed extensive perturbations in purine metabolism, and stable isotope tracing demonstrated that ETC defects suppress de novo purine synthesis while enhancing purine salvage. In human lung cancer, tumors with markers of low oxidative mitochondrial metabolism exhibit enhanced expression of the salvage enzyme hypoxanthine phosphoribosyl transferase 1 (HPRT1) and high levels of the HPRT1 product inosine monophosphate. Mechanistically, ETC blockade activates the pentose phosphate pathway, providing phosphoribosyl diphosphate to drive purine salvage supplied by uptake of extracellular bases. Blocking HPRT1 sensitizes cancer cells to ETC inhibition. These findings demonstrate how cells remodel purine metabolism upon ETC blockade and uncover a new metabolic vulnerability in tumors with low respiration.
Subject(s)
Mitochondria , Purines , Humans , Purines/metabolism , Purines/pharmacology , Mitochondria/metabolism , Electron Transport , Hypoxanthine Phosphoribosyltransferase/metabolism , Hypoxanthine Phosphoribosyltransferase/genetics , Pentose Phosphate Pathway , Fibroblasts/metabolism , Lung Neoplasms/metabolism , Lung Neoplasms/pathology , Lung Neoplasms/drug therapy , Cell Line, Tumor , Animals , Biological TransportABSTRACT
HMG-CoA reductase inhibitors (statins) are commonly used for dyslipidemia management to reduce the risk of cardiovascular disease (CVD). High-sensitivity C-reactive protein (hs-CRP) is an emerging systematic low-grade inflammatory marker associated with atherosclerotic CVD development. Despite racial/ethnic disparities in the use and response of statins and the anti-inflammatory effects of statins, the effectiveness of statins on inflammation and metabolic markers is unknown among Hispanics. We performed a retrospective cohort study using 150 adult patients scheduled for an annual physical exam at a family medicine clinic between January 1, 2021, and December 31, 2021. Effect size with a 95% confidence interval (CI) was estimated using adjusted regression analyses. Among 150 patients, 52 (34.67%) received statins. Patients who received statins had significantly reduced median hs-CRP (1.9 vs. 3.2, p=0.007), mean low-density lipoprotein (LDL-C) (101.18 vs. 124.6, p<0.001), and total cholesterol (172.6 vs. 194.5, p<0.001) concentrations compared to those who did not receive statins. In the propensity-scores matched analysis, lower concentrations of log-transformed hs-CRP (regression coefficient [RC], -0.48; 95%CI: -0.89, -0.07), LDL-C (RC, -19.57; 95%CI: -33.04, -6.1), and total cholesterol (RC, -23.47; 95%CI: -38.96, -7.98) were associated with statin use. In addition, hepatic steatosis (adjusted relative risk [aRR]=0.25; 95%CI: 0.08, 0.78, p= 0.017) was significantly lower among patients with the use of statins. Our study suggests that HMG-CoA reductase inhibitors may help reduce inflammation among Hispanic patients with dyslipidemia and hypertension. These findings have useful implications for preventing risk and disparities associated with cardiovascular and other inflammatory-induced diseases among the fastest-growing US Hispanic minorities.
ABSTRACT
We performed phylogenetic analysis on dengue virus serotype 2 Cosmopolitan genotype in Ho Chi Minh City, Vietnam. We document virus emergence, probable routes of introduction, and timeline of events. Our findings highlight the need for continuous, systematic genomic surveillance to manage outbreaks and forecast future epidemics.
Subject(s)
Dengue Virus , Dengue Virus/genetics , Phylogeny , Serogroup , Vietnam/epidemiology , GenotypeABSTRACT
Cancer cells reprogram their metabolism to support cell growth and proliferation in harsh environments. While many studies have documented the importance of mitochondrial oxidative phosphorylation (OXPHOS) in tumor growth, some cancer cells experience conditions of reduced OXPHOS in vivo and induce alternative metabolic pathways to compensate. To assess how human cells respond to mitochondrial dysfunction, we performed metabolomics in fibroblasts and plasma from patients with inborn errors of mitochondrial metabolism, and in cancer cells subjected to inhibition of the electron transport chain (ETC). All these analyses revealed extensive perturbations in purine-related metabolites; in non-small cell lung cancer (NSCLC) cells, ETC blockade led to purine metabolite accumulation arising from a reduced cytosolic NAD + /NADH ratio (NADH reductive stress). Stable isotope tracing demonstrated that ETC deficiency suppressed de novo purine nucleotide synthesis while enhancing purine salvage. Analysis of NSCLC patients infused with [U- 13 C]glucose revealed that tumors with markers of low oxidative mitochondrial metabolism exhibited high expression of the purine salvage enzyme HPRT1 and abundant levels of the HPRT1 product inosine monophosphate (IMP). ETC blockade also induced production of ribose-5' phosphate (R5P) by the pentose phosphate pathway (PPP) and import of purine nucleobases. Blocking either HPRT1 or nucleoside transporters sensitized cancer cells to ETC inhibition, and overexpressing nucleoside transporters was sufficient to drive growth of NSCLC xenografts. Collectively, this study mechanistically delineates how cells compensate for suppressed purine metabolism in response to ETC blockade, and uncovers a new metabolic vulnerability in tumors experiencing NADH excess.
ABSTRACT
P2-type ATPase sodium-potassium pumps (Na+/K+-ATPases) are ion-transporting enzymes that use ATP to transport Na+ and K+ on opposite sides of the lipid bilayer against their electrochemical gradients to maintain ion concentration gradients across the membranes in all animal cells. Despite the available molecular architecture of the Na+/K+-ATPases, a complete molecular mechanism by which the Na+ and K+ ions access into and are released from the pump remains unknown. Here we report five cryo-electron microscopy (cryo-EM) structures of the human alpha3 Na+/K+-ATPase in its cytoplasmic side-open (E1), ATP-bound cytoplasmic side-open (E1â¢ATP), ADP-AlF4- trapped Na+-occluded (E1â¢P-ADP), BeF3- trapped exoplasmic side-open (E2P) and MgF42- trapped K+-occluded (E2â¢Pi) states. Our work reveals the atomically resolved structural detail of the cytoplasmic gating mechanism of the Na+/K+-ATPase.
Subject(s)
Sodium-Potassium-Exchanging ATPase , Sodium , Adenosine Diphosphate , Adenosine Triphosphate , Animals , Cryoelectron Microscopy , Humans , Ions , Potassium/metabolism , Sodium/metabolism , Sodium-Potassium-Exchanging ATPase/metabolismABSTRACT
The activation of adenosine monophosphate-activated protein kinase (AMPK) in skeletal muscle coordinates systemic metabolic responses to exercise1. Autophagy-a lysosomal degradation pathway that maintains cellular homeostasis2-is upregulated during exercise, and a core autophagy protein, beclin 1, is required for AMPK activation in skeletal muscle3. Here we describe a role for the innate immune-sensing molecule Toll-like receptor 9 (TLR9)4, and its interaction with beclin 1, in exercise-induced activation of AMPK in skeletal muscle. Mice that lack TLR9 are deficient in both exercise-induced activation of AMPK and plasma membrane localization of the GLUT4 glucose transporter in skeletal muscle, but are not deficient in autophagy. TLR9 binds beclin 1, and this interaction is increased by energy stress (glucose starvation and endurance exercise) and decreased by a BCL2 mutation3,5 that blocks the disruption of BCL2-beclin 1 binding. TLR9 regulates the assembly of the endolysosomal phosphatidylinositol 3-kinase complex (PI3KC3-C2)-which contains beclin 1 and UVRAG-in skeletal muscle during exercise, and knockout of beclin 1 or UVRAG inhibits the cellular AMPK activation induced by glucose starvation. Moreover, TLR9 functions in a muscle-autonomous fashion in ex vivo contraction-induced AMPK activation, glucose uptake and beclin 1-UVRAG complex assembly. These findings reveal a heretofore undescribed role for a Toll-like receptor in skeletal-muscle AMPK activation and glucose metabolism during exercise, as well as unexpected crosstalk between this innate immune sensor and autophagy proteins.
Subject(s)
AMP-Activated Protein Kinases/metabolism , Beclin-1/metabolism , Muscle, Skeletal/metabolism , Physical Conditioning, Animal/physiology , Toll-Like Receptor 9/metabolism , Animals , Autophagy , Enzyme Activation , Exercise , Glucose/metabolism , Humans , Male , Mice , Models, Animal , Muscle, Skeletal/enzymology , Phosphatidylinositol 3-Kinase/metabolism , Toll-Like Receptor 9/deficiency , Toll-Like Receptor 9/genetics , Tumor Suppressor Proteins/metabolismABSTRACT
The bacterial periplasmic methionine-binding protein MetQ is involved in the import of methionine by the cognate MetNI methionine ATP binding cassette (ABC) transporter. The MetNIQ system is one of the few members of the ABC importer family that has been structurally characterized in multiple conformational states. Critical missing elements in the structural analysis of MetNIQ are the structure of the substrate-free form of MetQ, and detailing how MetQ binds multiple methionine derivatives, including both l- and d-methionine isomers. In this study, we report the structures of the Neisseria meningitides MetQ in substrate-free form and in complexes with l-methionine and with d-methionine, along with the associated binding constants determined by isothermal titration calorimetry. Structures of the substrate-free (N238A) and substrate-bound N. meningitides MetQ are related by a "Venus-fly trap" hinge-type movement of the two domains accompanying methionine binding and dissociation. l- and d-methionine bind to the same site on MetQ, and this study emphasizes the important role of asparagine 238 in ligand binding and affinity. A thermodynamic analysis demonstrates that ligand-free MetQ associates with the ATP-bound form of MetNI â¼40 times more tightly than does liganded MetQ, consistent with the necessity of dissociating methionine from MetQ for transport to occur.
Subject(s)
Bacterial Proteins/chemistry , Methionine/chemistry , Neisseria meningitidis/chemistry , Binding Sites , Models, Molecular , Molecular Structure , StereoisomerismABSTRACT
The Escherichia coli methionine ABC transporter MetNI exhibits both high-affinity transport toward l-methionine and broad specificity toward methionine derivatives, including d-methionine. In this work, we characterize the transport of d-methionine derivatives by the MetNI transporter. Unexpectedly, the N229A substrate-binding deficient variant of the cognate binding protein MetQ was found to support high MetNI transport activity toward d-selenomethionine. We determined the crystal structure at 2.95 Šresolution of the ATPγS-bound MetNIQ complex in the outward-facing conformation with the N229A apo MetQ variant. This structure revealed conformational changes in MetQ providing substrate access through the binding protein to the transmembrane translocation pathway. MetQ likely mediates uptake of methionine derivatives through two mechanisms: in the methionine-bound form delivering substrate from the periplasm to the transporter (the canonical mechanism) and in the apo form by facilitating ligand binding when complexed to the transporter (the noncanonical mechanism). This dual role for substrate-binding proteins is proposed to provide a kinetic strategy for ABC transporters to transport both high- and low-affinity substrates present in a physiological concentration range.
Subject(s)
ATP-Binding Cassette Transporters/metabolism , Methionine/metabolism , ATP-Binding Cassette Transporters/chemistry , ATP-Binding Cassette Transporters/genetics , Escherichia coli/genetics , Kinetics , Ligands , Protein Binding , Protein Conformation , Protein Transport , Recombinant Proteins/chemistry , Recombinant Proteins/genetics , Recombinant Proteins/metabolism , Selenomethionine/metabolism , Substrate SpecificityABSTRACT
Shigella bacteria constitute the causative agent of bacillary dysentery, an acute inflammatory disease causing the death of more than one million humans per year. A null mutation in the tgt gene encoding the tRNA-modifying enzyme tRNA-guanine transglycosylase (Tgt) was found to drastically decrease the pathogenicity of Shigella bacteria, suggesting the use of Tgt as putative target for selective antibiotics. The enzyme is only functionally active as a homodimer; thus, interference with the formation of its protein-protein interface is an attractive opportunity for therapeutic intervention. To better understand the driving forces responsible for the assembly, stability, and formation of the homodimer, we studied the properties of the residues that establish the dimer interface in detail. We performed site-directed mutagenesis and controlled shifts in the monomer/dimer equilibrium ratio in solution in a concentration-dependent manner by native mass spectrometry and used crystal structure analysis to elucidate the geometrical modulations resulting from mutational variations. The wild-type enzyme exhibits nearly exclusive dimer geometry. A patch of four aromatic amino acids, embedded into a ring of hydrophobic residues and further stabilized by a network of H-bonds, is essential for the stability of the dimer's contact. Accordingly, any perturbance in the constitution of this aromatic patch by nonaromatic residues reduces dimer stability significantly, with some of these exchanges resulting in a nearly exclusively monomeric state. Apart from the aromatic hot spot, the interface comprises an extended loop-helix motif that exhibits remarkable flexibility. In the destabilized mutated variants, the loop-helix motif adopts deviating conformations in the interface region, and a number of water molecules, penetrating into the interface, are observed.
Subject(s)
Pentosyltransferases/chemistry , Protein Multimerization , Zymomonas/enzymology , Dysentery, Bacillary/microbiology , Humans , Models, Molecular , Mutagenesis, Site-Directed , Pentosyltransferases/genetics , Point Mutation , Protein Stability , Shigella/chemistry , Shigella/enzymology , Shigella/genetics , Zymomonas/chemistry , Zymomonas/geneticsABSTRACT
Despite the ubiquitous role of ATP-binding cassette (ABC) importers in nutrient uptake, only the Escherichia coli maltose and vitamin B12 ABC transporters have been structurally characterized in multiple conformations relevant to the alternating access transport mechanism. To complement our previous structure determination of the E. coli MetNI methionine importer in the inward facing conformation (Kadaba et al. (2008) Science 321, 250-253), we have explored conditions stabilizing the outward facing conformation. Using two variants, the Walker B E166Q mutation with ATP+EDTA to stabilize MetNI in the ATP-bound conformation and the N229A variant of the binding protein MetQ, shown in this work to disrupt methionine binding, a high affinity MetNIQ complex was formed with a dissociation constant measured to be 27 nm. Using wild type MetQ containing a co-purified methionine (for which the crystal structure is reported at 1.6 Å resolution), the dissociation constant for complex formation with MetNI is measured to be â¼40-fold weaker, indicating that complex formation lowers the affinity of MetQ for methionine by this amount. Preparation of a stable MetNIQ complex is an essential step towards the crystallographic analysis of the outward facing conformation, a key intermediate in the uptake of methionine by this transport system.
Subject(s)
ATP-Binding Cassette Transporters/chemistry , Adenosine Triphosphatases/chemistry , Escherichia coli Proteins/chemistry , Membrane Transport Proteins/chemistry , Methionine/metabolism , Multiprotein Complexes/chemistry , Multiprotein Complexes/metabolism , ATP-Binding Cassette Transporters/metabolism , Adenosine Triphosphatases/metabolism , Crystallography, X-Ray , Escherichia coli Proteins/metabolism , Membrane Transport Proteins/metabolism , Methionine/chemistry , Models, Molecular , Protein Conformation , Protein StabilityABSTRACT
Two new crystal structures of the Escherichia coli high affinity methionine uptake ATP Binding Cassette (ABC) transporter MetNI, purified in the detergents cyclohexyl-pentyl-ß-D-maltoside (CY5) and n-decyl-ß-D-maltopyranoside (DM), have been solved in inward facing conformations to resolutions of 2.9 and 4.0 Å, respectively. Compared to the previously reported 3.7 Å resolution structure of MetNI purified in n-dodecyl-ß-D-maltopyranoside (DDM), the higher resolution of the CY5 data enabled significant improvements to the structural model in several regions, including corrections to the sequence registry, and identification of ADP in the nucleotide binding site. CY5 crystals soaked with selenomethionine established details of the methionine binding site in the C2 regulatory domain of the ABC subunit, including the displacement of the side chain of MetN residue methionine 301 by the exogenous ligand. When compared to the CY5 or DDM structures, the DM structure exhibits a significant repositioning of the dimeric C2 domains, including an unexpected register shift in the intermolecular ß-sheet hydrogen bonding between monomers, and a narrowing of the nucleotide binding space. The immediate proximity of the exogenous methionine binding site to the conformationally variable dimeric interface provides an indication of how methionine binding to the regulatory domains might mediate the phenomenon of transinhibition.
Subject(s)
ATP-Binding Cassette Transporters/chemistry , Escherichia coli Proteins/chemistry , ATP-Binding Cassette Transporters/antagonists & inhibitors , ATP-Binding Cassette Transporters/metabolism , Adenosine Diphosphate/chemistry , Adenosine Diphosphate/metabolism , Allosteric Regulation , Binding Sites , Escherichia coli Proteins/antagonists & inhibitors , Escherichia coli Proteins/metabolism , Methionine/chemistry , Methionine/metabolism , Models, Molecular , Mutagenesis, Site-Directed , Principal Component Analysis , Protein Conformation , Selenomethionine/chemistry , Selenomethionine/metabolismABSTRACT
Gas bubbles coalesce in deionized (DI) water because the water (foam) films between the bubbles are not stable. The so-called hydrophobic attraction has been suggested as the cause of the film instability and the bubble coalescence. In this work, microinterferometry experiments show that foam films of ultrapure DI water can last up to 10 s and the contact time between the two gas bubble surfaces at close proximity (approximately 1 microm separation distance) significantly influences the film drainage, rupture, and lifetime. Specifically, when the two bubbles were first brought into contact, the films instantly ruptured at 0.5 microm thickness. However, the film drainage rate and rupture thickness sharply decreased and the film lifetime steeply increased with increasing contact time up to 10 min, but then they leveled off. The constant thickness of film rupture was around 35 nm. Possible contamination was vigorously investigated and ruled out. It is argued that migration of gases inherently dissolved in water might cause the transient behavior of the water films at the short contact time. The film drainage rate and instability at the long contact time were analyzed employing Eriksson et al.'s phenomenological theory of long-range hydrophobic attraction (Eriksson, J. C.; Ljunggren, S.; Claesson, P. M., J. Chem. Soc., Faraday Trans. 2 1989, 85, 163-176) and the hypothesis of water molecular structure modified by dissolved gases, and the extended Stefan-Reynolds theory by incorporating the mobility of the air-DI-water interfaces.
ABSTRACT
Electrolytes have been found to stabilize thin films in nonaqueous solvents propylene carbonate and formamide, in the absence of surfactant. The thin film balance microinterferometry technique has been used to measure film lifetimes, drainage kinetics, and rupture thicknesses for thin films between air-nonaqueous solution interfaces. Electrolytes that were previously found to inhibit bubble coalescence in bulk bubble column measurements also increase the lifetimes of individual thin films across a similar concentration range (from 0 to 0.3 M). We report that increasing the concentration of inhibiting electrolyte stabilizes the thin liquid film in two ways: the rate of film drainage decreases, and the film reaches a lower thickness before rupturing. In contrast, noninhibiting electrolyte shows little to no effect on film stability. We have here demonstrated that both drainage and rupture processes are affected by the addition of electrolyte and the effect on the thin film is thus ion specific.
ABSTRACT
We report the effects of ions on rupture and lifetime of aqueous foam films formed from sodium chloride (NaCl), lithium chloride (LiCl), sodium acetate (NaAc), and sodium chlorate (NaClO 3) using microinterferometry. In the case of NaCl and LiCl, the foam films prepared from the salt solutions below 0.1 M were unstable they thinned until rupturing. The film lifetime measured from the first interferogram (appearing at a film thickness on the order of 500 nm) until the film rupture was only a second or so. However, relatively long lasting and nondraining films prepared from salt solutions above 0.1 M were observed. The film lifetime was significantly longer by 1 to 2 orders of magnitude, i.e., from 10 to 100 s. Importantly, both the film lifetime and the (average) thickness of the nondraining films increased with increasing salt concentration. This effect has not been observed with foam films stabilized by surfactants. The film lifetime and thickness also increased with increasing film radius. The films exhibited significant surface corrugations. The films with large radii often contained standing dimples. There was a critical film radius below which the films thinned until rupturing. In the cases of NaAc and NaClO 3, the films were unstable at all radii and salt concentrations they thinned until rupturing, ruling out the effect of solution viscosity on stabilizing the films.
Subject(s)
Ions , Surface-Active Agents/chemistry , Chemistry, Physical/methods , Chlorates/chemistry , Interferometry/instrumentation , Interferometry/methods , Lithium Chloride/chemistry , Models, Statistical , Salts/chemistry , Salts/pharmacology , Sodium Acetate/chemistry , Sodium Chloride/chemistry , Solutions/chemistry , Surface Properties , Time Factors , Water/chemistryABSTRACT
The c-Jun N-terminal kinases (JNKs) have been implicated in the development of insulin resistance, diabetes, and obesity. Genetic disruption of JNK1, but not JNK2, improves insulin sensitivity in diet-induced obese (DIO) mice. We applied RNA interference to investigate the specific role of hepatic JNK1 in contributing to insulin resistance in DIO mice. Adenovirus-mediated delivery of JNK1 short-hairpin RNA (Ad-shJNK1) resulted in almost complete knockdown of hepatic JNK1 protein without affecting JNK1 protein in other tissues. Liver-specific knockdown of JNK1 resulted in significant reductions in circulating insulin and glucose levels, by 57 and 16%, respectively. At the molecular level, JNK1 knockdown mice had sustained and significant increase of hepatic Akt phosphorylation. Furthermore, knockdown of JNK1 enhanced insulin signaling in vitro. Unexpectedly, plasma triglyceride levels were robustly elevated upon hepatic JNK1 knockdown. Concomitantly, expression of proliferator-activated receptor gamma coactivator 1 beta, glucokinase, and microsomal triacylglycerol transfer protein was increased. Further gene expression analysis demonstrated that knockdown of JNK1 up-regulates the hepatic expression of clusters of genes in glycolysis and several genes in triglyceride synthesis pathways. Our results demonstrate that liver-specific knockdown of JNK1 lowers circulating glucose and insulin levels but increases triglyceride levels in DIO mice.
Subject(s)
Gene Expression Regulation, Enzymologic , Glucose/metabolism , Insulin/metabolism , Liver/metabolism , Mitogen-Activated Protein Kinase 8/metabolism , Trans-Activators/biosynthesis , Triglycerides/blood , Adenoviridae/genetics , Adenoviridae/metabolism , Animal Feed , Animals , DNA Primers/chemistry , Mice , Mice, Obese , PPAR gamma/metabolism , Peroxisome Proliferator-Activated Receptor Gamma Coactivator 1-alpha , Phosphorylation , Transcription Factors , Triglycerides/metabolismABSTRACT
A series of metabolically stable butyrolactam 11beta-HSD1 inhibitors have been synthesized and biologically evaluated. These compounds exhibit excellent HSD1 potency and HSD2 selectivity, pharmacokinetic, and pharmacodynamic profiles.
Subject(s)
11-beta-Hydroxysteroid Dehydrogenase Type 1/antagonists & inhibitors , Lactams/pharmacology , Administration, Oral , Animals , Humans , Lactams/administration & dosage , Lactams/chemical synthesis , Lactams/pharmacokinetics , Metabolic Syndrome/drug therapy , MiceABSTRACT
RNA interference (RNAi) is an exciting new tool to effect acute in vivo knockdown of genes for pharmacological target validation. Testing the application of this technology to metabolic disease targets, three RNAi delivery methods were compared in two frequently utilized preclinical models of obesity and diabetes, the diet-induced obese (DIO) and B6.V-Lep
ABSTRACT
The Akt kinases are central nodes in signal transduction pathways that are important for cellular transformation and tumor progression. We report the development of a series of potent and selective indazole-pyridine based Akt inhibitors. These compounds, exemplified by A-443654 (K(i) = 160 pmol/L versus Akt1), inhibit Akt-dependent signal transduction in cells and in vivo in a dose-responsive manner. In vivo, the Akt inhibitors slow the progression of tumors when used as monotherapy or in combination with paclitaxel or rapamycin. Tumor growth inhibition was observed during the dosing interval, and the tumors regrew when compound administration was ceased. The therapeutic window for these compounds is narrow. Efficacy is achieved at doses approximately 2-fold lower than the maximally tolerated doses. Consistent with data from knockout animals, the Akt inhibitors induce an increase in insulin secretion. They also induce a reactive increase in Akt phosphorylation. Other toxicities observed, including malaise and weight loss, are consistent with abnormalities in glucose metabolism. These data show that direct Akt inhibition may be useful in cancer therapy, but significant metabolic toxicities are likely dose limiting.
Subject(s)
Indazoles/pharmacology , Indoles/pharmacology , Neoplasms/enzymology , Neoplasms/pathology , Protein Kinase Inhibitors/pharmacology , Protein Serine-Threonine Kinases/antagonists & inhibitors , Proto-Oncogene Proteins/antagonists & inhibitors , Animals , Antineoplastic Agents/chemistry , Antineoplastic Agents/pharmacology , Antineoplastic Agents/therapeutic use , Cell Line, Tumor , Disease Progression , Humans , Indazoles/chemistry , Indazoles/therapeutic use , Indoles/chemistry , Indoles/therapeutic use , Mice , Mice, SCID , Models, Molecular , Neoplasms/drug therapy , Phosphorylation/drug effects , Protein Kinase Inhibitors/chemistry , Protein Kinase Inhibitors/therapeutic use , Protein Serine-Threonine Kinases/chemistry , Protein Serine-Threonine Kinases/metabolism , Protein Structure, Tertiary , Proto-Oncogene Proteins/chemistry , Proto-Oncogene Proteins/metabolism , Proto-Oncogene Proteins c-akt , Pyridines/chemistry , Pyridines/pharmacology , Sensitivity and Specificity , Substrate SpecificityABSTRACT
Glucocorticoids amplify endogenous glucose production in type 2 diabetes by increasing hepatic glucose output. Systemic glucocorticoid blockade lowers glucose levels in type 2 diabetes, but with several adverse consequences. It has been proposed, but never demonstrated, that a liver-selective glucocorticoid receptor antagonist (LSGRA) would be sufficient to reduce hepatic glucose output (HGO) and restore glucose control to type 2 diabetic patients with minimal systemic side effects. A-348441 [(3b,5b,7a,12a)-7,12-dihydroxy-3-{2-[{4-[(11b,17b)-17-hydroxy-3-oxo-17-prop-1-ynylestra-4,9-dien-11-yl] phenyl}(methyl)amino]ethoxy}cholan-24-oic acid] represents the first LSGRA with significant antidiabetic activity. A-348441 antagonizes glucocorticoid-up-regulated hepatic genes, normalizes postprandial glucose in diabetic mice, and demonstrates synergistic effects on blood glucose in these animals when coadministered with an insulin sensitizer. In insulin-resistant Zucker fa/fa rats and fasted conscious normal dogs, A-348441 reduces HGO with no acute effect on peripheral glucose uptake. A-348441 has no effect on the hypothalamic pituitary adrenal axis or on other measured glucocorticoid-induced extrahepatic responses. Overall, A-348441 demonstrates that an LSGRA is sufficient to reduce elevated HGO and normalize blood glucose and may provide a new therapeutic approach for the treatment of type 2 diabetes.