School of Medicine, University of Washington, Seattle, WA, 98195, USA.
Geriatric Research Education and Clinical Center, Veterans Affairs Puget Sound Health Care System, Seattle, WA, 98108, USA.
Fluids Barriers CNS. 2023 Apr 19;20(1):28. doi: 10.1186/s12987-023-00431-6.
Insulin transport across the blood-brain barrier (BBB) is a highly regulated, saturable process, known to be affected by many peripheral substrates including insulin itself and triglycerides. This is in contrast to insulin leakage into peripheral tissues. Whether the central nervous system (CNS) can control the rate of insulin uptake by brain remains to be determined. Insulin BBB interactions are impaired in Alzheimer's disease (AD) and CNS insulin resistance is widely prevalent in AD. Therefore, if CNS insulin controls the rate of insulin transport across the BBB, then the defective transport of insulin seen in AD could be one manifestation of the resistance to CNS insulin observed in AD.
We investigated whether enhancing CNS insulin levels or induction of CNS insulin resistance using an inhibitor of the insulin receptor altered the blood-to-brain transport of radioactively labeled insulin in young, healthy mice.
We found that insulin injected directly into the brain decreased insulin transport across the BBB for whole brain and the olfactory bulb in male mice, whereas insulin receptor blockade decreased transport in female mice for whole brain and hypothalamus. Intranasal insulin, currently being investigated as a treatment in AD patients, decreased transport across the BBB of the hypothalamus.
These results suggest CNS insulin can control the rate of insulin brain uptake, connecting CNS insulin resistance to the rate of insulin transport across the BBB.
胰岛素穿过血脑屏障(BBB)的转运是一个高度调控、饱和的过程,已知会受到许多外周底物的影响,包括胰岛素本身和甘油三酯。这与胰岛素漏入外周组织形成对比。中枢神经系统(CNS)是否可以控制大脑对胰岛素的摄取速率还有待确定。阿尔茨海默病(AD)中胰岛素 BBB 相互作用受损,CNS 胰岛素抵抗在 AD 中广泛存在。因此,如果 CNS 胰岛素控制胰岛素穿过 BBB 的转运速率,那么在 AD 中观察到的胰岛素转运缺陷可能是 AD 中观察到的对 CNS 胰岛素抵抗的一种表现。
我们研究了通过胰岛素受体抑制剂增强 CNS 胰岛素水平或诱导 CNS 胰岛素抵抗是否会改变年轻健康小鼠放射性标记胰岛素的血脑转运。
我们发现,直接注射到大脑中的胰岛素会降低雄性小鼠整个大脑和嗅球的胰岛素穿过 BBB 的转运,而胰岛素受体阻断会降低雌性小鼠整个大脑和下丘脑的转运。鼻内胰岛素目前正在 AD 患者中进行研究作为一种治疗方法,可降低下丘脑的 BBB 转运。
这些结果表明 CNS 胰岛素可以控制胰岛素进入大脑的速率,将 CNS 胰岛素抵抗与胰岛素穿过 BBB 的转运速率联系起来。