RESUMO
Matrix metalloproteinases (MMPs) and their inhibitors (TIMPs) play critical roles in regulating processes associated with malignant behavior. These endopeptidases selectively degrade components of the extracellular matrix (ECM), growth factors, and their receptors, contributing to cancer cell invasiveness and migratory characteristics by disrupting the basal membrane. However, the expression profile and role of various matrix metalloproteinases remain unclear, and only a few studies have focused on differences between diagnoses of brain tumors. Using quantitative real-time PCR analysis, we identified the expression pattern of ECM modulators (n = 10) in biopsies from glioblastoma (GBM; n = 20), astrocytoma (AST; n = 9), and meningioma (MNG; n = 19) patients. We found eight deregulated genes in the glioblastoma group compared to the benign meningioma group, with only MMP9 (FC = 2.55; p = 0.09) and TIMP4 (7.28; p < 0.0001) upregulated in an aggressive form. The most substantial positive change in fold regulation for all tumors was detected in matrix metalloproteinase 2 (MNG = 30.9, AST = 4.28, and GBM = 4.12). Notably, we observed an influence of TIMP1, demonstrating a positive correlation with MMP8, MMP9, and MMP10 in tumor samples. Subsequently, we examined the protein levels of the investigated MMPs (n = 7) and TIMPs (n = 3) via immunodetection. We confirmed elevated levels of MMPs and TIMPs in GBM patients compared to meningiomas and astrocytomas. Even when correlating glioblastomas versus astrocytomas, we showed a significantly increased level of MMP1, MMP3, MMP13, and TIMP1. The identified metalloproteases may play a key role in the process of gliomagenesis and may represent potential targets for personalized therapy. However, as we have not confirmed the relationship between mRNA expression and protein levels in individual samples, it is therefore natural that the regulation of metalloproteases will be subject to several factors.
Assuntos
Astrocitoma , Neoplasias Encefálicas , Glioblastoma , Humanos , Metaloproteinase 2 da Matriz/metabolismo , Metaloproteinase 9 da Matriz/metabolismo , Inibidor Tecidual de Metaloproteinase-1/metabolismo , Inibidores Teciduais de Metaloproteinases/metabolismoRESUMO
Deregulation of signalling pathways that regulate cell growth, survival, metabolism, and migration can frequently lead to the progression of cancer. Brain tumours are a large group of malignancies characterised by inter- and intratumoral heterogeneity, with glioblastoma (GBM) being the most aggressive and fatal. The present study aimed to characterise the expression of cancer pathway-related genes (n = 84) in glial tumour cell lines (A172, SW1088, and T98G). The transcriptomic data obtained by the qRT-PCR method were compared to different control groups, and the most appropriate control for subsequent interpretation of the obtained results was chosen. We analysed three widely used control groups (non-glioma cells) in glioblastoma research: Human Dermal Fibroblasts (HDFa), Normal Human Astrocytes (NHA), and commercially available mRNAs extracted from healthy human brain tissues (hRNA). The gene expression profiles of individual glioblastoma cell lines may vary due to the selection of a different control group to correlate with. Moreover, we present the original multicriterial decision making (MCDM) for the possible characterization of gene expression profiles. We observed deregulation of 75 genes out of 78 tested in the A172 cell line, while T98G and SW1088 cells exhibited changes in 72 genes. By comparing the delta cycle threshold value of the tumour groups to the mean value of the three controls, only changes in the expression of 26 genes belonging to the following pathways were identified: angiogenesis FGF2; apoptosis APAF1, CFLAR, XIAP; cellular senescence BM1, ETS2, IGFBP5, IGFBP7, SOD1, TBX2; DNA damage and repair ERCC5, PPP1R15A; epithelial to mesenchymal transition SNAI3, SOX10; hypoxia ADM, ARNT, LDHA; metabolism ATP5A1, COX5A, CPT2, PFKL, UQCRFS1; telomeres and telomerase PINX1, TINF2, TNKS, and TNKS2. We identified a human astrocyte cell line and normal human brain tissue as the appropriate control group for an in vitro model, despite the small sample size. A different method of assessing gene expression levels produced the same disparities, highlighting the need for caution when interpreting the accuracy of tumorigenesis markers.
Assuntos
Neoplasias Encefálicas , Glioblastoma , Tanquirases , Telomerase , Neoplasias Encefálicas/metabolismo , Proteínas de Ciclo Celular/metabolismo , Linhagem Celular Tumoral , Transição Epitelial-Mesenquimal , Fator 2 de Crescimento de Fibroblastos/metabolismo , Regulação Neoplásica da Expressão Gênica , Glioblastoma/metabolismo , Humanos , Superóxido Dismutase-1/genética , Tanquirases/metabolismo , Telomerase/metabolismo , Proteínas Supressoras de Tumor/genéticaRESUMO
BACKGROUND: Glioblastoma (GB) is the most common and biologically the most aggressive primary brain tumor of the central nervous system (CNS) in adults. Standard treatment for newly diagnosed GB consists of surgical resection, radiotherapy, and chemotherapy with temozolomide (TMZ). Despite numbers of studies, a resistance to chemotherapy is the major obstacle to successful GB treatment. OBJECTIVES: The aim of our study was to detect the sensitivity of glioblastoma T98G cells to TMZ treatment and subsequently to determine the expression changes of apoptosis-associated genes in glioblastoma cells. MATERIAL AND METHODS: The human glioblastoma cell line (T98G) was treated with specified concentrations of TMZ during different time periods. Their viability was measured by colorimetric MTT assay and the activation of the apoptotic pathway was determined by measuring the caspase 3/7 activity. Commercial pre-designed microfluidic array was used to quantify expression of human apoptosis-associated genes. RESULTS: The untreated control of T98G cell line against human brain total RNA standards reported significant changes in several apoptotic genes expression levels. We identified also a deregulation in geneexpression levels between the TMZ treated and untreated T98G cells associated with apoptotic pathways. After 48 hours of exposure of T98G cells to TMZ, we observed a significant deregulation ofseven genes: BBC3, BCL2L1, RIPK1, CASP3, BIRC2, CARD6 and DAPK1. These results can contribute to the importance of apoptosis in glioblastoma cells metabolism and effect of TMZ treatment. CONCLUSIONS: Identification of apoptotic gene panel in T98G cell line could help to improve understanding of brain tumor cells metabolism. Recognizing of the pro-apoptotic and anti-apoptotic genes expression changes could contribute to clarify the sensitivity to TMZ therapy and molecular base in healthy and tumor cells (Tab. 1, Fig. 2, Ref. 48).
Assuntos
Glioblastoma , Apoptose , Linhagem Celular Tumoral , Sobrevivência Celular , Expressão Gênica , Glioblastoma/tratamento farmacológico , Glioblastoma/genética , Glioblastoma/metabolismo , Humanos , Temozolomida/farmacologia , Temozolomida/uso terapêuticoRESUMO
Pyruvate carboxylase (PC) is an enzyme catalyzing the conversion of pyruvate to oxaloacetate, which possesses anaplerotic role in cellular metabolism. The expression of PC was confirmed in cells of several cancer types, in which it ensures several cellular functions, such as growth and division. To investigate the expression of PC in human astrocytoma, glioblastoma and neuroblastoma cells we applied the immunodetection methods. The results of the Western blot analysis and immunocytochemical detection revealed the presence of PC in human astrocytoma, glioblastoma and neuroblastoma cells. Furthermore, application of PC inhibitor, 3-chloro-1,2-dihydroxypropane (CDP), negatively impacts the viability of astrocytoma cells. The cytotoxic effect of CDP could be partially reversed by application of citrate, 2-oxoglutarate and malate in incubation media. Our results revealed that astrocytoma, glioblastoma and neuroblastoma cells are equipped with PC, which might significantly contribute by its anaplerotic activity to sustain the metabolism of cancer cells.
Assuntos
Astrocitoma , Glioblastoma , Neuroblastoma , Humanos , Piruvato Carboxilase , Ácido PirúvicoRESUMO
Clozapine (CLZ) stimulates several brain areas some of them being sensitive to stress. Aim of the present study was to reveal whether 7-day CLZ administration may: (1) activate the selected forebrain areas; (2) modulate response of these structures to a single forced swimming episode (FSW); (3) modulate response of these structures to FSW after 13-day preconditioning with mild unpredictable stress complex (CMS). Used groups of male Wistar rats: (a) vehicle or CLZ treated for 7 days; (b) vehicle or CLZ treated for 7 days and on the 7th day exposed to FSW; (c) CMS exposed for 13 days, from the 8th day injected with vehicle or CLZ and on the 14th day exposed to FSW. Vehicle or CLZ (10 mg kg-1 day-1 in 0.1% acetic acid) were administered intraperitoneally. c-Fos quantification was performed 90 min after FSW in the medial prefrontal cortex (mPFC), dorsolateral (dLS) and ventrolateral (vLS) septum, dorsolateral (DLStr) and dorsomedial (DMStr) striatum, nucleus accumbens shell (NAc shell) and core (NAc core), and hypothalamic paraventricular nucleus (PVN). In unstressed animals CLZ increased c-Fos expression in the mPFC, vLS, and PVN. After a single FSW, CLZ decreased the number of c-Fos immunoreactive cells in the vLS, DMStr, NAc shell, and NAc core. In CMS rats, CLZ suppressed c-Fos immunoreactivity in response to FSW in the PVN. Our data indicate that CLZ elicits different impact on neuronal activities in the brain areas studied and modifies the response of these structures to stress. CLZ effect seems to be affected by stress duration.
Assuntos
Antipsicóticos/farmacologia , Clozapina/farmacologia , Proteínas Proto-Oncogênicas c-fos/biossíntese , Estresse Psicológico/tratamento farmacológico , Estresse Psicológico/metabolismo , Animais , Condicionamento Psicológico , Corpo Estriado/efeitos dos fármacos , Corpo Estriado/metabolismo , Masculino , Núcleo Accumbens/efeitos dos fármacos , Núcleo Accumbens/metabolismo , Núcleo Hipotalâmico Paraventricular/efeitos dos fármacos , Núcleo Hipotalâmico Paraventricular/metabolismo , Córtex Pré-Frontal/efeitos dos fármacos , Córtex Pré-Frontal/metabolismo , Proteínas Proto-Oncogênicas c-fos/metabolismo , Ratos , Ratos Wistar , Restrição Física , NataçãoRESUMO
As the commonest type of cancer in Europe and the third most common type of cancer worldwide, colorectal carcinoma (CRC) poses a challenge for numerous scientific studies. At present, the cause of this disease is remains to be elucidated, but early diagnosis is only one solution to prevent serious health complications. As a structural scaffold, the extracellular matrix (ECM) is in direct contact with tumour cells and significantly interferes with tumour progression. During the process of tumorigenesis, the ECM undergoes structural changes in which collagens serve an important role. Their life cycle is regulated by proteolytic enzymes called matrix metalloproteinases (MMPs), which are controlled by tissue inhibitors of metalloproteinases (TIMPs). The present study analysed the gene expression of MMPs (MMP1-2-8-10-13), TIMPs (TIMP1-2-4) and collagens (COL1A1 and COL3A1) and the correlation with biochemical parameters in the adjacent rectal tissue (ART) of patients with CRC. The patients who underwent standard neoadjuvant pre-therapy showed increased concentrations of collagen in the normal ART. The mRNA levels of COL3A1, TIMP1 and TIMP2 were significantly higher in the ART of CRC patients (with or without pre-therapy) when compared with the control group. This finding suggested that TIMPs served an important role in the regulation of MMPs and in the modification of collagen content in the ECM. Despite the small data set, the present study provided insights into the transcriptomic relationships between the individual genes that are an integral part of the ECM.
RESUMO
A total of 750 ticks feeding on humans were collected during the years 2008-2018. The majority of ticks (94.8 %) came from Slovakia, with 3.5 % from the Czech Republic, 0.9 % from Austria, and 0.3 % from Hungary. Travellers from Ukraine, Croatia, France, and Cuba also brought one tick from each of these countries. The majority of the analysed ticks were identified as Ixodes ricinus (94.3 %). Dermacentor reticulatus (0.93 %), Haemaphysalis concinna (0.1 %), Haemaphysalis sp. (0.1 %), Ixodes arboricola (0.1 %), and Rhipicephalus sp. (0.1 %) were also encountered. The most frequently found stage of I. ricinus was the nymph (69.9 %) followed by adult females (20.4 %) and larvae (8.3 %). Ticks were predominantly found on children younger than 10 years (46.3 %) and adults between 30-39 years (21.4 %). In children younger than 10 years, the ticks were usually found on the head, while in other age categories, the ticks were predominantly attached to legs. Ticks were further individually analysed for the presence of Rickettsia spp., Coxiella burnetii, Borrelia burgdorferi sensu lato, Anaplasma phagocytophilum, Neoehrlichia mikurensis, Bartonella spp. and Babesia spp. The overall prevalences of tick-borne bacteria assessed in I. ricinus ticks acquired in Slovakia were: rickettsiae 25.0 % (95 % CI: 21.7-28.2), B. burgdorferi s.l. 20.5 % (95 % CI: 17.4-23.5), A. phagocytophilum 13.5 % (95 % CI: 10.9-16.0), Babesia spp. 5.2 % (95 % CI: 3.5-6.9), C. burnetii 3.0 % (95 % CI: 1.5-4.6), and N. mikurensis 4.4 % (95 % CI: 2.0-6.8). Pathogenic species Rickettsia raoultii, Rickettsia helvetica, Rickettsia monacensis, A. phagocytophilum, Borrelia garinii, Borrelia afzelii, Borrelia valaisiana, Babesia microti, and Babesia divergens were identified in D. reticulatus and I. ricinus ticks.
Assuntos
Bactérias Gram-Negativas/isolamento & purificação , Ixodidae/microbiologia , Adolescente , Adulto , Idoso , Animais , Criança , Pré-Escolar , Feminino , Bactérias Gram-Negativas/classificação , Humanos , Lactente , Ixodidae/crescimento & desenvolvimento , Larva/crescimento & desenvolvimento , Larva/microbiologia , Masculino , Pessoa de Meia-Idade , Ninfa/crescimento & desenvolvimento , Ninfa/microbiologia , Adulto JovemRESUMO
The situation following anti-obesity drug termination is rarely investigated, eventhough a decrease in body weight needs to be sustained. Therefore, this study examined the impact of twice-daily peripheral administration of 5 mg/kg [N-palm-γGlu-Lys11] prolactin-releasing peptide 31 (palm11-PrRP31) in mice with diet-induced obesity (DIO from consuming a high-fat diet) after 28 days of treatment (palm11-PrRP31 group) and after 14 days of peptide treatment followed by 14 days of discontinuation (palm11-PrRP31 + saline group). At the end of the treatment, cumulative food intake, body weight and subcutaneous fat weight/body weight ratio and leptin plasma level were reduced significantly in both the palm11-PrRP31 group and the palm11-PrRP31 + saline group compared to the saline control group. This reduction correlated with significantly increased FOSB, a marker of long-term neuronal potentiation, in the nucleus arcuatus and nucleus tractus solitarii, areas known to be affected by the anorexigenic effect of palm11-PrRP31. Moreover, activation of leptin-related hypothalamic signaling was registered through an increase in phosphoinositide-3-kinase, increased phosphorylation of protein kinase B (PKB, AKT) and enhanced extracellular signal-regulated kinase 1/2 phosphorylation. Besides, lowered apoptotic markers c-JUN N-terminal kinase and c-JUN phosphorylation were registered in the hypothalami of both palm11-PrRP31-treated groups. This study demonstrates that palm11-PrRP31 positively affects feeding and leptin-related hypothalamic signaling, not only after 28 days of treatment but even 14 days after the termination of a 14-day long treatment without the yo-yo effect.
Assuntos
Hipotálamo/metabolismo , Leptina/metabolismo , Hormônio Liberador de Prolactina/metabolismo , Transdução de Sinais , Animais , Apoptose , Ingestão de Alimentos , Jejum/sangue , Humanos , Masculino , Camundongos Endogâmicos C57BL , Camundongos Obesos , Neurônios/metabolismo , Tamanho do Órgão , Fosforilação , RNA Mensageiro/genética , RNA Mensageiro/metabolismo , Receptores para Leptina/metabolismoRESUMO
Effect of repeated asenapine (ASE) treatment on FosB/ΔFosB expression was studied in the hypothalamic paraventricular nucleus (PVN) of male rats exposed to chronic mild stress (CMS) for 21days. Our intention was to find out whether repeated ASE treatment for 14days may: 1) induce FosB/ΔFosB expression in the PVN; 2) activate selected PVN neuronal phenotypes, synthesizing oxytocin (OXY), vasopressin (AVP), corticoliberin (CRH) or tyrosine hydroxylase (TH); and 3) interfere with the impact of CMS. Control, ASE, CMS, and CMS+ASE treated groups were used. CMS included restraint, social isolation, crowding, swimming, and cold. From the 7th day of CMS, rats received ASE (0.3mg/kg) or saline (300µl/rat) subcutaneously, twice a day for 14days. They were sacrificed on the day 22nd (16-18h after last treatments). FosB/ΔFosB was visualized with avidin biotin peroxidase complex and OXY, AVP, CRH or TH antibodies by fluorescent dyes. Saline and ASE did not promote FosB/ΔFosB expression in the PVN. CMS and CMS+ASE elicited FosB/ΔFosB-expression in the PVN, whereas, ASE did not augment or attenuate FosB/ΔFosB induction elicited by CMS. FosB/ΔFosB-CRH occurred after CMS and CMS+ASE treatments in the PVN middle sector, while FosB/ΔFosB-AVP and FosB/ΔFosB-OXY after CMS and CMS+ASE treatments in the PVN posterior sector. FosB/ΔFosB-TH colocalization was rare. Larger FosB/ΔFosB profiles, running above the PVN, did not show any colocalizations. The study provides an anatomical/functional knowledge about an unaccented nature of prolonged ASE treatment at the level of PVN and excludes its positive or negative interplay with CMS effect. Data indicate that long-lasting ASE treatment might not act as a stressor acting at the PVN level.
Assuntos
Compostos Heterocíclicos de 4 ou mais Anéis/farmacologia , Neurônios/efeitos dos fármacos , Núcleo Hipotalâmico Paraventricular/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-fos/metabolismo , Estresse Fisiológico/fisiologia , Estresse Psicológico/metabolismo , Animais , Antipsicóticos/farmacologia , Temperatura Baixa , Hormônio Liberador da Corticotropina/metabolismo , Dibenzocicloeptenos , Masculino , Neurônios/metabolismo , Ocitocina/metabolismo , Núcleo Hipotalâmico Paraventricular/metabolismo , Ratos , Ratos Wistar , Restrição Física , Natação , Tirosina 3-Mono-Oxigenase/metabolismo , Vasopressinas/metabolismoRESUMO
Long-term effect of asenapine (ASE), an atypical antipsychotic drug, on FosB/ΔFosB quantitative variations in the striatum, septum, nucleus accumbens, and prefrontal cortex, was light microscopically evaluated in normal rats and rats preconditioned with chronic unpredictable mild stress (CMS). CMS included restraint, social isolation, crowding, swimming, and cold. The rats were exposed to CMS for 21 days. From the 7th day of CMS, the rats were injected subcutaneously with saline (300µl/rat) or ASE (0.3mg/kg b.w.), twice a day for 14 days. On the 22nd day, i.e. 16-18h after the last treatment, the animals were perfused with fixative and the brains cut into 30µm thick coronal sections. FosB/ΔFosB protein was immunohistochemically visualized by avidin-biotin peroxidase complex (ABC). Four groups of animals were investigated: control+vehicle, control+ASE, CMS+vehicle, and CMS+ASE. Repeated ASE treatment significantly increased the amount of FosB/ΔFosB immunostained cell nuclei in the dorsolateral and dorsomedial striatum and the shell of the nucleus accumbens, followed by strVM and coACC, as assessed by numerical analysis in both total (different size for each structure) and unified (equal size for each structure) brain sectors. The effect of ASE was significantly lowered by CMS preconditioning only in the dorsolateral striatum, dorsomedial striatum, and the shell of the nucleus accumbens, indicated by both total and unified calculations. Although, highest FosB/ΔFosB expression was seen in the prefrontal cortex and lowest in the dorsolateral and ventrolateral septum, no differences between the groups occurred. CMS itself did not affect FosB/ΔFosB expression level. These findings demonstrate for the first time that repeated administration of ASE may result in eliciting of long-lasting FosB/ΔFosB-like transcription factors that could mediate some of the persistent and region-specific changes in brain function, interconnected with chronic drug exposure. However, it cannot be excluded that the impact of repeated ASE exposure might be influenced by an ambient stressogen leverage.
Assuntos
Antipsicóticos/farmacologia , Compostos Heterocíclicos de 4 ou mais Anéis/farmacologia , Prosencéfalo/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-fos/metabolismo , Estresse Psicológico/tratamento farmacológico , Animais , Temperatura Baixa , Aglomeração , Dibenzocicloeptenos , Modelos Animais de Doenças , Imuno-Histoquímica , Masculino , Prosencéfalo/metabolismo , Ratos Wistar , Restrição Física , Isolamento Social , Estresse Psicológico/metabolismo , Natação , IncertezaRESUMO
Asenapine (ASE) is a novel atypical antipsychotic drug approved for the treatment of schizophrenia and bipolar disorder. Stress is an inseparable part of the human life, which may interfere with the therapeutic effect of different drugs. The aim of the present study was: (1) to delineate the quantitative and qualitative profiles of the ASE effect on Fos expression in the striatum, septum, nucleus accumbens, and the prefrontal cortex and (2) to find out whether a chronic unpredictable variable mild stress (CMS) preconditioning may modify the effect of acute ASE treatment. Stress paradigms included restrain, social isolation, crowding, swimming, and cold. The animals were exposed to CMS for 21 days and on the 22nd day received an injection of vehicle (saline 300 µl/rat s.c.) or ASE (0.3mg/kg s.c.). They were sacrificed 90 min after the treatments. Fos protein was visualized by avidin biotin peroxidase (ABC). Four groups of animals were investigated: controls+vehicle, controls+ASE, CMS+vehicle, and CMS+ASE. The number of Fos labeled neurons was calculated per total investigated area, which was selective for each structure, and also recalculated per unified sector. ASE treatment induced significant and very similar increase of the Fos expression in both ASE control and ASE CMS animals in comparison with saline control and CMS ones. Moreover, ASE induced regional differences in the number of Fos-positive neurons. In both ASE groups most pronounced response in the number of Fos profiles occurred in the dorsolateral striatum, ventrolateral septum, shell of the nucleus accumbens, and the medial prefrontal cortex. Mild Fos response was seen in the dorsomedial and ventromedial striatum and core of the nucleus accumbens. No response was seen in the dorsolateral septum. The present paper demonstrates for the first time the character of the Fos distribution in the forebrain structures induced by acute ASE treatment as well as ASE response to 21 days CMS preconditioning. The study provides an important comparative background that may help in the further understanding of the effect of ASE on the brain activation as well as its responsiveness to CMS challenges.
Assuntos
Antipsicóticos/farmacologia , Compostos Heterocíclicos de 4 ou mais Anéis/farmacologia , Neurônios/efeitos dos fármacos , Prosencéfalo/efeitos dos fármacos , Proteínas Proto-Oncogênicas c-fos/metabolismo , Estresse Psicológico/metabolismo , Animais , Dibenzocicloeptenos , Masculino , Neurônios/metabolismo , Prosencéfalo/metabolismo , Ratos , Ratos WistarRESUMO
OBJECTIVE: To examine the regulatory aspects of zinc-α2-glycoprotein (ZAG) association with obesity-related insulin resistance. METHODS: ZAG mRNA and protein were analyzed in subcutaneous adipose tissue (AT) and circulation of lean, obese, prediabetic, and type 2 diabetic men; both subcutaneous and visceral AT were explored in lean and extremely obese. Clinical and ex vivo findings were corroborated by results of in vitro ZAG silencing experiment. RESULTS: Subcutaneous AT ZAG was reduced in obesity, with a trend to further decrease with prediabetes and type 2 diabetes. ZAG was 3.3-fold higher in subcutaneous than in visceral AT of lean individuals. All differences were lost in extreme obesity. Obesity-associated changes in AT were not paralleled by alterations of circulating ZAG. Subcutaneous AT ZAG correlated with adiposity, adipocyte hypertrophy, whole-body and AT insulin sensitivity, mitochondrial content, expression of GLUT4, PGC1α, and adiponectin. Subcutaneous AT ZAG and adipocyte size were the only predictors of insulin sensitivity, independent on age and BMI. Silencing ZAG resulted in reduced adiponectin, IRS1, GLUT4, and PGC1α gene expression in primary human adipocytes. CONCLUSIONS: ZAG in subcutaneous, but not in visceral AT, was markedly reduced in obesity. Clinical, cellular, and molecular evidence indicate that ZAG plays an important role in modulating whole-body and AT insulin sensitivity.