Division of Endocrinology, Diabetes and Bone Diseases, The Samuel Bronfman Department of Medicine, Mount Sinai School of Medicine, New York, New York, USA.
Diabetes. 2010 Mar;59(3):686-93. doi: 10.2337/db09-1291. Epub 2009 Dec 3.
Type 2 diabetes increases breast cancer risk and mortality, and hyperinsulinemia has been identified as a major factor linking these two diseases. Thus, we hypothesized that pharmacological reduction of elevated insulin levels would attenuate type 2 diabetes-mediated mammary tumor progression.
We studied mammary tumor development in MKR(+/+) mice, a nonobese, hyperinsulinemic mouse model of type 2 diabetes. MKR(+/+) mice were either crossed with mice expressing the polyoma virus middle T oncogene specifically in the mammary gland or inoculated orthotopically with the mouse mammary tumor cell lines Met-1 and MCNeuA. MKR(+/+) or control mice harboring tumors were treated with CL-316243, a specific beta3-adrenergic receptor agonist, which sensitizes insulin action but has no direct effect on the mouse mammary epithelium or Met-1 and MCNeuA cells.
CL-316243 treatment significantly reduced the elevated insulin levels in MKR(+/+) mice and, as a consequence, attenuated mammary tumor progression in the three tumor models tested. This effect was accompanied by reductions in phosphorylation of insulin and IGF-I receptors in transformed mammary tissue.
Insulin-sensitizing treatment is sufficient to abrogate type 2 diabetes-mediated mammary tumor progression. Therefore, early administration of insulin-sensitizing therapy may reduce breast cancer risk and mortality in patients with type 2 diabetes.
2 型糖尿病会增加乳腺癌的发病风险和死亡率,而高胰岛素血症已被确定为连接这两种疾病的主要因素。因此,我们假设通过药物降低升高的胰岛素水平可以减轻 2 型糖尿病引起的乳腺肿瘤进展。
我们研究了 MKR(+/+)小鼠的乳腺肿瘤发展情况,MKR(+/+)是一种非肥胖、高胰岛素血症的 2 型糖尿病小鼠模型。MKR(+/+)小鼠与在乳腺中特异性表达多瘤病毒中间 T 癌基因的小鼠杂交,或与 Met-1 和 MCNeuA 小鼠乳腺肿瘤细胞系原位接种。MKR(+/+)或携带肿瘤的对照小鼠用 CL-316243 治疗,CL-316243 是一种特异性的β3-肾上腺素能受体激动剂,它增强胰岛素的作用,但对小鼠乳腺上皮或 Met-1 和 MCNeuA 细胞没有直接影响。
CL-316243 治疗显著降低了 MKR(+/+)小鼠的高胰岛素水平,并因此减轻了三种肿瘤模型中乳腺肿瘤的进展。这一效应伴随着转化的乳腺组织中胰岛素和 IGF-I 受体磷酸化的减少。
胰岛素增敏治疗足以消除 2 型糖尿病引起的乳腺肿瘤进展。因此,早期给予胰岛素增敏治疗可能会降低 2 型糖尿病患者的乳腺癌发病风险和死亡率。