Novo Nordisk A/S, Måløv, Denmark.
Center for Integrative Genomics (CIG), University of Lausanne, Lausanne, Switzerland.
Diabetologia. 2024 Feb;67(2):371-391. doi: 10.1007/s00125-023-06043-x. Epub 2023 Nov 28.
AIMS/HYPOTHESIS: Repeated exposures to insulin-induced hypoglycaemia in people with diabetes progressively impairs the counterregulatory response (CRR) that restores normoglycaemia. This defect is characterised by reduced secretion of glucagon and other counterregulatory hormones. Evidence indicates that glucose-responsive neurons located in the hypothalamus orchestrate the CRR. Here, we aimed to identify the changes in hypothalamic gene and protein expression that underlie impaired CRR in a mouse model of defective CRR.
High-fat-diet fed and low-dose streptozocin-treated C57BL/6N mice were exposed to one (acute hypoglycaemia [AH]) or multiple (recurrent hypoglycaemia [RH]) insulin-induced hypoglycaemic episodes and plasma glucagon levels were measured. Single-nuclei RNA-seq (snRNA-seq) data were obtained from the hypothalamus and cortex of mice exposed to AH and RH. Proteomic data were obtained from hypothalamic synaptosomal fractions.
The final insulin injection resulted in similar plasma glucose levels in the RH group and AH groups, but glucagon secretion was significantly lower in the RH group (AH: 94.5±9.2 ng/l [n=33]; RH: 59.0±4.8 ng/l [n=37]; p<0.001). Analysis of snRNA-seq data revealed similar proportions of hypothalamic cell subpopulations in the AH- and RH-exposed mice. Changes in transcriptional profiles were found in all cell types analysed. In neurons from RH-exposed mice, we observed a significant decrease in expression of Avp, Pmch and Pcsk1n, and the most overexpressed gene was Kcnq1ot1, as compared with AH-exposed mice. Gene ontology analysis of differentially expressed genes (DEGs) indicated a coordinated decrease in many oxidative phosphorylation genes and reduced expression of vacuolar H- and Na/K-ATPases; these observations were in large part confirmed in the proteomic analysis of synaptosomal fractions. Compared with AH-exposed mice, oligodendrocytes from RH-exposed mice had major changes in gene expression that suggested reduced myelin formation. In astrocytes from RH-exposed mice, DEGs indicated reduced capacity for neurotransmitters scavenging in tripartite synapses as compared with astrocytes from AH-exposed mice. In addition, in neurons and astrocytes, multiple changes in gene expression suggested increased amyloid beta (Aβ) production and stability. The snRNA-seq analysis of the cortex showed that the adaptation to RH involved different biological processes from those seen in the hypothalamus.
CONCLUSIONS/INTERPRETATION: The present study provides a model of defective counterregulation in a mouse model of type 2 diabetes. It shows that repeated hypoglycaemic episodes induce multiple defects affecting all hypothalamic cell types and their interactions, indicative of impaired neuronal network signalling and dysegulated hypoglycaemia sensing, and displaying features of neurodegenerative diseases. It also shows that repeated hypoglycaemia leads to specific molecular adaptation in the hypothalamus when compared with the cortex.
The transcriptomic dataset is available via the GEO ( http://www.ncbi.nlm.nih.gov/geo/ ), using the accession no. GSE226277. The proteomic dataset is available via the ProteomeXchange data repository ( http://www.proteomexchange.org ), using the accession no. PXD040183.
目的/假设:在糖尿病患者中,反复暴露于胰岛素诱导的低血糖会逐渐损害恢复正常血糖水平的代偿性反应(CRR)。这种缺陷的特征是胰高血糖素和其他代偿性激素分泌减少。有证据表明,位于下丘脑的葡萄糖反应神经元协调 CRR。在这里,我们旨在确定在 CRR 缺陷的小鼠模型中,导致 CRR 受损的下丘脑基因和蛋白质表达的变化。
高脂肪饮食喂养和低剂量链脲佐菌素处理的 C57BL/6N 小鼠接受一次(急性低血糖[AH])或多次(复发性低血糖[RH])胰岛素诱导的低血糖发作,并测量血浆胰高血糖素水平。从接受 AH 和 RH 的小鼠的下丘脑和皮层获得单细胞核 RNA 测序(snRNA-seq)数据。从下丘脑突触小体部分获得蛋白质组学数据。
最后一次胰岛素注射导致 RH 组和 AH 组的血浆血糖水平相似,但 RH 组的胰高血糖素分泌明显降低(AH:94.5±9.2 ng/l [n=33];RH:59.0±4.8 ng/l [n=37];p<0.001)。snRNA-seq 数据分析显示,在接受 AH 和 RH 暴露的小鼠中,下丘脑细胞亚群的比例相似。在所有分析的细胞类型中都发现了转录谱的变化。在 RH 暴露的小鼠的神经元中,与接受 AH 暴露的小鼠相比,观察到 Avp、Pmch 和 Pcsk1n 的表达显著降低,而最过度表达的基因是 Kcnq1ot1。差异表达基因(DEGs)的基因本体分析表明,许多氧化磷酸化基因的协调减少和液泡 H-和 Na/K-ATP 酶的表达减少;这些观察结果在突触小体部分的蛋白质组学分析中得到了很大程度的证实。与接受 AH 暴露的小鼠相比,来自 RH 暴露的小鼠的少突胶质细胞的基因表达发生了重大变化,表明髓鞘形成减少。来自 RH 暴露的小鼠的星形胶质细胞中的 DEGs 表明与来自 AH 暴露的小鼠的星形胶质细胞相比,三突触中神经递质清除的能力降低。此外,在神经元和星形胶质细胞中,多个基因表达的变化表明 Aβ(Aβ)产生和稳定性增加。RH 暴露的皮层的 snRNA-seq 分析表明,对 RH 的适应涉及到与在下丘脑看到的不同的生物学过程。
结论/解释:本研究提供了 2 型糖尿病小鼠模型中 CRR 缺陷的模型。它表明,反复的低血糖发作会导致多个缺陷,影响所有下丘脑细胞类型及其相互作用,提示神经元网络信号受损和低血糖感觉失调,并显示出神经退行性疾病的特征。它还表明,与皮层相比,反复低血糖会导致下丘脑特定的分子适应。
转录组数据集可通过 GEO(http://www.ncbi.nlm.nih.gov/geo/)获得,使用的 accession no. 是 GSE226277。蛋白质组数据集可通过 ProteomeXchange 数据存储库(http://www.proteomexchange.org)获得,使用的 accession no. 是 PXD040183。