Department of Endocrinology and Metabolism, State Key Laboratory of Female Fertility Promotion, Peking University Third Hospital, Beijing, China.
Clinical Stem Cell Research Center, Peking University Third Hospital, Beijing, China.
Diabetes. 2024 Jun 1;73(6):926-940. doi: 10.2337/db23-0553.
Sodium-glucose cotransporter 2 inhibitors, efficacious antidiabetic agents that have cardiovascular and renal benefits, can promote pancreatic β-cell regeneration in type 2 diabetic mice. However, the underlying mechanism remains unclear. In this study, we aimed to use multiomics to identify the mediators involved in β-cell regeneration induced by dapagliflozin. We showed that dapagliflozin lowered blood glucose level, upregulated plasma insulin level, and increased islet area in db/db mice. Dapagliflozin reshaped gut microbiota and modulated microbiotic and plasmatic metabolites related to tryptophan metabolism, especially l-tryptophan, in the diabetic mice. Notably, l-tryptophan upregulated the mRNA level of glucagon-like peptide 1 (GLP-1) production-related gene (Gcg and Pcsk1) expression and promoted GLP-1 secretion in cultured mouse intestinal L cells, and it increased the supernatant insulin level in primary human islets, which was eliminated by GPR142 antagonist. Transplant of fecal microbiota from dapagliflozin-treated mice, supplementation of l-tryptophan, or treatment with dapagliflozin upregulated l-tryptophan, GLP-1, and insulin or C-peptide levels and promoted β-cell regeneration in db/db mice. Addition of exendin 9-39, a GLP-1 receptor (GLP-1R) antagonist, or pancreatic Glp1r knockout diminished these beneficial effects. In summary, treatment with dapagliflozin in type 2 diabetic mice promotes β-cell regeneration by upregulating GLP-1 production, which is mediated via gut microbiota and tryptophan metabolism.
钠-葡萄糖共转运蛋白 2 抑制剂是一种有效的抗糖尿病药物,具有心血管和肾脏益处,可促进 2 型糖尿病小鼠的胰岛β细胞再生。然而,其潜在机制尚不清楚。在这项研究中,我们旨在使用多组学来鉴定达格列净诱导的β细胞再生所涉及的介质。我们发现达格列净降低了血糖水平,上调了血浆胰岛素水平,并增加了 db/db 小鼠的胰岛面积。达格列净重塑了肠道微生物群,并调节了与色氨酸代谢相关的微生物和血浆代谢物,特别是 l-色氨酸,在糖尿病小鼠中。值得注意的是,l-色氨酸上调了胰高血糖素样肽 1 (GLP-1) 产生相关基因(Gcg 和 Pcsk1)的 mRNA 水平表达,并促进了培养的小鼠肠 L 细胞中 GLP-1 的分泌,它增加了原代人胰岛的上清液胰岛素水平,这被 GPR142 拮抗剂消除。给予达格列净治疗小鼠的粪便微生物群移植、补充 l-色氨酸或给予达格列净可上调 l-色氨酸、GLP-1 和胰岛素或 C 肽水平,并促进 db/db 小鼠的β细胞再生。添加外啡肽 9-39,一种 GLP-1 受体 (GLP-1R) 拮抗剂,或胰腺 Glp1r 敲除可减弱这些有益作用。总之,在 2 型糖尿病小鼠中给予达格列净可通过上调 GLP-1 产生来促进β细胞再生,这是通过肠道微生物群和色氨酸代谢介导的。
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