Diabetes and Obesity Center of Excellence (T.H.M., M.E.M.,. V.D., A.C., G.J.M.), Department of Medicine, University of Washington, Seattle, Washington 98109; and Division of Endocrinology (S.C.C.), Department of Medicine, Albert Einstein College of Medicine, Bronx, New York 10461.
Endocrinology. 2014 Nov;155(11):4157-67. doi: 10.1210/en.2014-1169. Epub 2014 Aug 19.
Although the antidiabetic effects of leptin require intact neuronal melanocortin signaling in rodents with uncontrolled diabetes (uDM), increased melanocortin signaling is not sufficient to mimic leptin's glucose-lowering effects. The current studies were undertaken to clarify the role of melanocortin signaling in leptin's ability to correct metabolic and neuroendocrine disturbances associated with uDM. To accomplish this, bilateral cannulae were implanted in the lateral ventricle of rats with streptozotocin-induced diabetes, and leptin was coinfused with varying doses of the melanocortin 3/4 receptor (MC3/4R) antagonist, SHU9119. An additional cohort of streptozotocin-induced diabetes rats received intracerebroventricular administration of either the MC3/4R agonist, melanotan-II, or its vehicle. Consistent with previous findings, leptin's glucose-lowering effects were blocked by intracerebroventricular SHU9119. In contrast, leptin-mediated suppression of hyperglucagonemia involves both melanocortin dependent and independent mechanisms, and the degree of glucagon inhibition was associated with reduced plasma ketone body levels. Increased central nervous system melanocortin signaling alone fails to mimic leptin's ability to correct any of the metabolic or neuroendocrine disturbances associated with uDM. Moreover, the inability of increased melanocortin signaling to lower diabetic hyperglycemia does not appear to be secondary to release of the endogenous MC3/4R inverse agonist, Agouti-related peptide (AgRP), because AgRP knockout mice did not show increased susceptibility to the antidiabetic effects of increased MC3/4R signaling. Overall, these data suggest that 1) AgRP is not a major driver of diabetic hyperglycemia, 2) mechanisms independent of melanocortin signaling contribute to leptin's antidiabetic effects, and 3) melanocortin receptor blockade dissociates leptin's glucose-lowering effect from its action on other features of uDM, including reversal of hyperglucagonemia and ketosis, suggesting that brain control of ketosis, but not blood glucose levels, is glucagon dependent.
虽然瘦素在未控制糖尿病(uDM)的啮齿动物中的抗糖尿病作用需要完整的神经元黑皮质素信号,但增加黑皮质素信号不足以模拟瘦素的降血糖作用。本研究旨在阐明黑皮质素信号在瘦素纠正与 uDM 相关的代谢和神经内分泌紊乱中的作用。为了实现这一目标,在链脲佐菌素诱导的糖尿病大鼠的侧脑室中植入双侧套管,并将瘦素与不同剂量的黑皮质素 3/4 受体(MC3/4R)拮抗剂 SHU9119 共输注。另一组链脲佐菌素诱导的糖尿病大鼠接受了 MC3/4R 激动剂,黑素细胞刺激素-II,或其载体的脑室内给药。与先前的发现一致,瘦素的降血糖作用被脑室内的 SHU9119 阻断。相比之下,瘦素介导的高血糖素抑制涉及黑皮质素依赖和非依赖机制,并且胰高血糖素抑制的程度与血浆酮体水平降低有关。中枢神经系统黑皮质素信号的增加本身并不能模拟瘦素纠正与 uDM 相关的任何代谢或神经内分泌紊乱的能力。此外,增加的黑皮质素信号不能降低糖尿病高血糖症的原因似乎不是内源性 MC3/4R 反向激动剂,Agouti 相关肽(AgRP)的释放,因为 AgRP 敲除小鼠对增加的 MC3/4R 信号的抗糖尿病作用没有增加的易感性。总体而言,这些数据表明:1)AgRP 不是糖尿病高血糖的主要驱动因素,2)独立于黑皮质素信号的机制有助于瘦素的抗糖尿病作用,3)黑皮质素受体阻断可将瘦素的降血糖作用与其对 uDM 其他特征的作用分离,包括高血糖素血症和酮症的逆转,表明大脑对酮症的控制,但不是血糖水平,依赖于胰高血糖素。