Yamauchi Toshimasa, Hara Kazuo, Kubota Naoto, Terauchi Yasuo, Tobe Kazuyuki, Froguel Philippe, Nagai Ryozo, Kadowaki Takashi
Department of Internal Medicine, Graduate School of Medicine, University of Tokyo, Tokyo 113-8655, Japan.
Curr Drug Targets Immune Endocr Metabol Disord. 2003 Dec;3(4):243-54. doi: 10.2174/1568008033340090.
Genome-wide scanning is a powerful tool to identify susceptible chromosome loci, however, individual chromosomal regions still have many candidate genes. Although cDNA microarray analysis provides valuable information for identifying genes involved in pathogenesis, expression levels of many genes are changed. A novel approach for identification of therapeutic targets is the combination of genome-wide scanning and the use of DNA chips, as shown in Fig. (1). Using DNA chips, we screened for secreted molecules, the expressions of which were changed in adipose tissues from mice rendered insulin resistance. Decreased expression of one of these molecules, adiponectin/Acrp30, correlates strongly with insulin resistance. Interestingly, recent genome-wide scans have mapped a susceptibility locus for type 2 diabetes and metabolic syndrome to chromosome 3q27, where adiponectin gene is located. Decreasing serum adiponectin levels are associated with increased risk for type 2 diabetes. Interestingly, adiponectin was decreased in insulin resistant rodent models both of obesity and lipoatrophy, and replenishment of adiponectin ameliorated their insulin resistance. Moreover, adiponectin transgenic mice ameliorated insulin resistance and diabetes Adiponectin knockout mice showed insulin resistance and glucose intolerance. In muscle and liver, adiponectin activated AMP kinase and PPARalpha pathways thereby increasing beta-oxidation of lipids, leading to decreased TG content, which ameliorated insulin resistance under a high-fat diet. Despite similar plasma glucose and lipid levels on an apoE deficient background, adiponectin transgenic apoE deficient mice showed amelioration of atherosclerosis, which was associated with decreased expressions of class A scavenger receptor and tumor necrosis factor alpha. Finally, cDNA encoding adiponectin receptors (AdipoR1 and R2) have been identified by expression cloning, which facilitates the understanding of molecular mechanisms of adiponectin actions and obesity-linked diseases such as diabetes and atherosclerosis and the designing of novel antidiabetic and anti-atherogenic drugs with AdipoR1 and R2 as molecular targets.
全基因组扫描是识别易感染色体位点的有力工具,然而,单个染色体区域仍有许多候选基因。虽然cDNA微阵列分析为识别参与发病机制的基因提供了有价值的信息,但许多基因的表达水平发生了变化。如图1所示,一种识别治疗靶点的新方法是将全基因组扫描与DNA芯片的使用相结合。利用DNA芯片,我们筛选了分泌分子,这些分子在胰岛素抵抗小鼠的脂肪组织中表达发生了变化。其中一种分子脂联素/Acrp30的表达降低与胰岛素抵抗密切相关。有趣的是,最近的全基因组扫描已将2型糖尿病和代谢综合征的一个易感位点定位到3q27染色体,脂联素基因就位于该区域。血清脂联素水平降低与2型糖尿病风险增加相关。有趣的是,在肥胖和脂肪萎缩的胰岛素抵抗啮齿动物模型中脂联素均降低,补充脂联素可改善其胰岛素抵抗。此外,脂联素转基因小鼠改善了胰岛素抵抗和糖尿病。脂联素基因敲除小鼠表现出胰岛素抵抗和葡萄糖不耐受。在肌肉和肝脏中,脂联素激活了AMP激酶和PPARα途径,从而增加了脂质的β氧化,导致甘油三酯含量降低,在高脂饮食下改善了胰岛素抵抗。尽管在载脂蛋白E缺陷背景下血浆葡萄糖和脂质水平相似,但脂联素转基因载脂蛋白E缺陷小鼠的动脉粥样硬化得到了改善,这与A类清道夫受体和肿瘤坏死因子α的表达降低有关。最后,通过表达克隆鉴定了编码脂联素受体(AdipoR1和R2)的cDNA,这有助于理解脂联素作用的分子机制以及糖尿病和动脉粥样硬化等肥胖相关疾病,并有助于设计以AdipoR1和R2为分子靶点的新型抗糖尿病和抗动脉粥样硬化药物。