Exendin-4, a glucagon-like peptide-1 receptor agonist, suppresses pancreatic β-cell destruction induced by encephalomyocarditis virus.

Viral infection is one of the important factors for the pathogenesis of type 1 diabetes. Particularly, in fulminant type 1 diabetes, rapid β-cell destruction is suggested to be triggered by viral infection. Recently, glucagon-like peptide 1 (GLP-1) receptor agonists have been reported to have direct beneficial effects on β-cells, such as anti-apoptotic effect, increasing β-cell mass, and improvement of β-cell function. However, their effects on β-cell destruction induced by viral infections have not been elucidated. In this study, we used an encephalomyocarditis virus (EMCV)-induced diabetic model mouse to show that a GLP-1 receptor agonist, exendin-4, prevents β-cell destruction. Nine-week-old male DBA/2 mice were intraperitoneally injected with EMCV (200 plaque forming units (PFU)mouse(-1)). Low (20 nmolkg(-1)d(-1)) or high (40 nmolkg(-1)d(-1)) doses of exendin-4 were administered for 10d, starting from 2d before the infection, and the rate of diabetic onset was evaluated. In addition, the number of infiltrating macrophage per islet and the ratio of β-cell area to islet area were determined. The effects of exendin-4 on infected β-cells and macrophages were investigated by using MIN6 and RAW264 mouse macrophages. The incidence of diabetes was significantly lower in the high-dose exendin-4-treated group than in the control group. Furthermore, the β-cell area was significantly more preserved in the high-dose exendin-4-treated group than in the control. In addition, the number of macrophages infiltrating into the islets was significantly less in the high-dose exendin-4-treated group than in the control group. In vitro, exendin-4 reduced β-cell apoptosis, and tumor necrosis factor α (TNFα), interleukin β (IL-β), and inducible nitric oxide synthase (iNOS) production of infected or lipopolysaccharide (LPS)-stimulated macrophages. These results suggested that exendin-4 limits β-cell destruction by protecting β cells and reducing the inflammatory response of macrophages.