Li Biao, Li Wan, Liu Tiancai, Zha Longying
Department of Nutrition and Food Hygiene, Guangdong Provincial Key Laboratory of Tropical Disease Research, National Medical Products Administration Key Laboratory of Cosmetic Safety Evaluation, School of Public Health, Southern Medical University, Guangzhou, Guangdong, China.
School of Physical Education, Hubei Minzu University, Enshi, China.
Front Mol Biosci. 2023 Jan 9;9:1024786. doi: 10.3389/fmolb.2022.1024786. eCollection 2022.
Noncommunicable diseases (NCDs), such as diabetes and related neurological disorders, are considered to not be directly transmissible from one person to another. However, NCDs may be transmissible through extracellular vesicles (EVs). A long-term high-fat diet (HFD) can induce a series of health issues like hyperlipidemia, type 2 diabetes mellitus (T2DM), and diabetic peripheral neuropathy (DPN) due to insulin resistance. Multiple molecular signaling changes can stimulate insulin resistance, especially blocking insulin signaling by increased insulin resistance inducer (phosphorylation of negative regulatory sites of insulin receptor substrate (IRS) proteins) and decreased tyrosine phosphorylation of insulin receptor substrate (phosphorylation of positive regulatory sites of IRS), thus leading to reduced phosphorylation of AKT enzymes. Current efforts to treat T2DM and prevent its complications mainly focus on improving insulin sensitivity, enhancing insulin secretion, or supplementing exogenous insulin based on a common assumption that insulin resistance is noncommunicable. However, insulin resistance is transmissible within multiple tissues or organs throughout the body. Exploring the regulatory roles of EVs in developing insulin resistance may provide novel and effective preventive and therapeutic strategies.
非传染性疾病（NCDs），如糖尿病及相关神经紊乱疾病，被认为不会在人与人之间直接传播。然而，非传染性疾病可能通过细胞外囊泡（EVs）进行传播。长期高脂饮食（HFD）会因胰岛素抵抗引发一系列健康问题，如高脂血症、2型糖尿病（T2DM）和糖尿病性周围神经病变（DPN）。多种分子信号变化可刺激胰岛素抵抗，特别是通过增加胰岛素抵抗诱导因子（胰岛素受体底物（IRS）蛋白负调控位点的磷酸化）和降低胰岛素受体底物的酪氨酸磷酸化（IRS正调控位点的磷酸化）来阻断胰岛素信号，从而导致AKT酶的磷酸化减少。目前治疗2型糖尿病及其并发症的努力主要集中在提高胰岛素敏感性、增强胰岛素分泌或补充外源性胰岛素，基于一个普遍的假设，即胰岛素抵抗是不可传播的。然而，胰岛素抵抗可在全身多个组织或器官内传播。探索细胞外囊泡在胰岛素抵抗发生发展中的调节作用可能会提供新的有效预防和治疗策略。
