Department of Clinical Investigation, William Beaumont Army Medical Center, 5005 N. Piedras Street, El Paso, TX 79920-5001, USA.
Dig Dis Sci. 2012 Nov;57(11):2814-25. doi: 10.1007/s10620-012-2230-4. Epub 2012 Jun 10.
The molecular mechanisms of cellular changes responsible for diabetic gastroparesis, primarily seen in middle-aged women, still remain incompletely defined. We hypothesized that a decrease in the expression, dimerization, and post-translational modification of neuronal nitric oxide synthase alpha (nNOSα) is estrogen mediated and responsible for the gender-specific prevalence of this malady.
We induced diabetes by injecting male and female rats with streptozotocin. Male diabetic rats without gastroparesis were then injected with estrogen for 3 weeks and evaluated for gastroparesis development. Gastric tissues were analyzed for the elucidation of biochemical events associated with diabetes and gastroparetic dysfunction.
Although male diabetic, gastroparetic (either streptozotocin- or estrogen-induced) rats exhibited similarity in disease pathology to that of females, the molecular mechanisms of development were different. Our results indicate that slow gastric emptying in both male diabetic, gastroparetic rat groups was not associated with the level of expression of nNOSα in gastric tissues. However, nNOSα dimerization, which reflects nNOSα activation, did decline slightly in the antrum of diabetic males with estrogen-induced gastroparesis, suggesting a possible estrogen role. Females with diabetic gastroparesis, in contrast, demonstrated significantly impaired levels and dimerization of nNOSα in the antrum and pylorus. Although the precise mechanism remains unknown, nNOSα dimerization impairment in female antrum is apparently associated with reduced phosphorylation of Ser(1416) in the activation loop of nNOSα.
Taken together, these results demonstrate that gender and estrogens may be leading factors, through molecular changes involved in nitric oxide synthesis down-regulation, within the antrum and pylorus of female diabetic, gastroparetic rats.
导致糖尿病性胃轻瘫的细胞变化的分子机制主要发生在中年女性中,目前仍不完全明确。我们假设,神经元型一氧化氮合酶α(nNOSα)的表达、二聚化和翻译后修饰的减少是由雌激素介导的,并导致这种疾病在性别上的特定流行。
我们通过向雄性和雌性大鼠注射链脲佐菌素来诱导糖尿病。然后,雄性糖尿病而没有胃轻瘫的大鼠被注射雌激素 3 周,并评估胃轻瘫的发展情况。分析胃组织以阐明与糖尿病和胃轻瘫功能障碍相关的生化事件。
尽管雄性糖尿病、胃轻瘫(无论是链脲佐菌素还是雌激素诱导的)大鼠的疾病病理学与女性相似,但发病机制却不同。我们的结果表明,两种雄性糖尿病、胃轻瘫大鼠组的胃排空缓慢与胃组织中 nNOSα 的表达水平无关。然而,nNOSα 的二聚化反映了 nNOSα 的激活,在雌激素诱导的糖尿病雄性大鼠的胃窦中略有下降,这表明雌激素可能发挥作用。相比之下,患有糖尿病性胃轻瘫的女性在胃窦和幽门中表现出 nNOSα 的水平和二聚化明显受损。尽管确切的机制尚不清楚,但女性胃窦中的 nNOSα 二聚化损伤显然与 nNOSα 激活环中 Ser(1416)的磷酸化减少有关。
综上所述,这些结果表明,性别和雌激素可能是导致女性糖尿病性胃轻瘫大鼠胃窦和幽门中一氧化氮合成下调相关分子变化的主要因素。