Insulin Research, Novo Nordisk A/S, Novo Nordisk Park, DK-2760, Maaloev, Denmark.
Diabetologia. 2018 Nov;61(11):2447-2457. doi: 10.1007/s00125-018-4684-1. Epub 2018 Jul 12.
AIMS/HYPOTHESIS: Recent studies with normal rats and mouse allograft models have reported that insulin and insulin analogues do not activate the IGF-1 receptor in vivo, and that this characteristic therefore cannot be responsible for the increased incidence of mammary tumours observed for the insulin analogue X10 in chronic toxicity studies with Sprague Dawley rats. This is in clear contrast to reports of insulin and insulin analogues in vitro. Clarification of this is important for understanding the mechanisms behind possible growth-promoting effects of insulin analogues, and will have implications for the development of novel insulin analogues.
We established a xenograft model in BALB/c nude mice with the human colon cancer cell line COLO-205, which expresses human insulin and IGF-1 receptors, and explored the acute and chronic effects of treatment with supra-pharmacological doses of human insulin, insulin analogue X10 and human IGF-1. With a novel antibody, acute IGF-1 receptor activation was also examined in various tissues from normal rats treated with human insulin, insulin analogue X10 or human IGF-1. Finally, the effects of pharmacologically relevant doses of human insulin and insulin analogue X10 on receptor activation and growth of COLO-205 xenograft were explored in BALB/c nude mice with alloxan-induced hyperglycaemia.
In normal rats and in BALB/c nude mice bearing a COLO-205 cell xenograft, treatment with supra-pharmacological doses of human insulin, insulin analogue X10 or human IGF-1 resulted in activation of insulin receptors as well as IGF-1 receptors. Treatment of diabetic nude mice with pharmacologically relevant doses of human insulin or insulin analogue X10, which decreased blood glucose from hyperglycaemic levels to the normoglycaemic range, did not increase IGF-1 receptor activation. Furthermore, repeated treatment with supra-pharmacological as well as pharmacological doses of human insulin or insulin analogue X10 did not influence the growth of COLO-205 xenografts.
CONCLUSIONS/INTERPRETATION: This study demonstrates that activation of IGF-1 receptors in cancer cells by insulin and insulin analogues cannot be considered as a purely in vitro phenomenon. It does occur in vivo in animal models, although only after treatment with supra-pharmacological doses. Furthermore, treatment with insulin or insulin analogue X10 did not influence the growth of COLO-205 xenografts under normo- or hypoglycaemic conditions. Further studies are needed before a conclusion can be reached on whether IGF-1 receptor activation by insulin analogues correlates with increased growth in vivo.
目的/假设:最近对正常大鼠和小鼠同种异体移植模型的研究报告称,胰岛素和胰岛素类似物在体内不会激活 IGF-1 受体,因此这一特征不能解释在 Sprague Dawley 大鼠慢性毒性研究中观察到胰岛素类似物 X10 引起的乳腺肿瘤发生率增加。这与胰岛素和胰岛素类似物的体外报告形成鲜明对比。澄清这一点对于理解胰岛素类似物可能具有的促生长作用的机制非常重要,并且对新型胰岛素类似物的开发具有重要意义。
我们建立了一个 BALB/c 裸鼠异种移植模型,使用表达人胰岛素和 IGF-1 受体的人结肠癌细胞系 COLO-205,探索了超生理剂量的人胰岛素、胰岛素类似物 X10 和人 IGF-1 治疗的急性和慢性作用。使用一种新型抗体,还研究了正常大鼠用人胰岛素、胰岛素类似物 X10 或人 IGF-1 治疗后各种组织中的 IGF-1 受体的急性激活情况。最后,在伴有高血糖的 BALB/c 裸鼠中,研究了药理相关剂量的人胰岛素和胰岛素类似物 X10 对 COLO-205 异种移植物的受体激活和生长的影响。
在正常大鼠和携带 COLO-205 细胞异种移植物的 BALB/c 裸鼠中,超生理剂量的人胰岛素、胰岛素类似物 X10 或人 IGF-1 治疗可激活胰岛素受体和 IGF-1 受体。用药理相关剂量的人胰岛素或胰岛素类似物 X10 治疗糖尿病裸鼠,可使血糖从高血糖水平降至正常血糖范围,但不会增加 IGF-1 受体的激活。此外,反复用超生理剂量和药理剂量的人胰岛素或胰岛素类似物 X10 治疗不会影响 COLO-205 异种移植物的生长。
结论/解释:这项研究表明,胰岛素和胰岛素类似物在癌细胞中激活 IGF-1 受体不能被认为是纯粹的体外现象。它确实在动物模型中发生,但仅在超生理剂量治疗后才会发生。此外,在正常血糖或低血糖条件下,用胰岛素或胰岛素类似物 X10 治疗不会影响 COLO-205 异种移植物的生长。在得出胰岛素类似物通过 IGF-1 受体激活与体内生长增加是否相关的结论之前,还需要进一步研究。