Jo SeongHo, Jing Gu, Chen Junqin, Xu Guanlan, Shalev Anath
Comprehensive Diabetes Center, Department of Medicine, Division of Endocrinology, Diabetes, and Metabolism, University of Alabama at Birmingham, Birmingham, Alabama, USA.
Diabetes Obes Metab. 2025 Apr;27(4):2223-2231. doi: 10.1111/dom.16223. Epub 2025 Feb 3.
Glucagon-like peptide 1 receptor agonists and dual agonists have changed the treatment landscape of obesity and type 2 diabetes (T2D), but significant limitations have emerged due to their gastrointestinal side effects, loss of lean mass, and necessity for ongoing subcutaneous injections. Our objective was, therefore, to test a novel small molecule as a different and potentially better tolerated oral medications to improve obesity-associated impairment in glucose homeostasis.
High-fat diet (HFD)-fed mice or severely obese, leptin-deficient ob/ob mice were randomly assigned to serve as controls or receive oral TIX100, a novel thioredoxin-interacting protein (TXNIP) inhibitor just approved by the FDA as an investigational new drug for type 1 diabetes (T1D). The TIX100 effects on glucose intolerance and weight control were then assessed.
TIX100 protected against HFD-induced glucose intolerance, hyperinsulinemia, and hyperglucagonemia. TIX100 also reduced diet-induced adiposity resulting in 15% lower weight in treated mice as compared with controls on HFD (p <0.05), while preserving lean mass. Even though the TIX100 weight effects were lost in ob/ob mice, TIX100 improved glucose control leading to a dramatic 2.3% reduction in HbA1C (p <0.05), independent of any weight loss. This is consistent with the beneficial effects of TIX100 in non-obese diabetes models and its protection against elevated TXNIP and islet cell stress common to all diabetes types.
Thus, TIX100 may provide a novel, oral therapy for T2D that targets underlying disease pathology including islet cell dysfunction and hyperglucagonemia and promotes metabolic health and weight control without aggressive weight loss.
胰高血糖素样肽-1受体激动剂和双重激动剂改变了肥胖症和2型糖尿病(T2D)的治疗格局,但由于其胃肠道副作用、瘦体重流失以及需要持续皮下注射,已出现显著局限性。因此,我们的目标是测试一种新型小分子作为一种不同的、可能耐受性更好的口服药物,以改善肥胖相关的葡萄糖稳态受损。
将高脂饮食(HFD)喂养的小鼠或严重肥胖、瘦素缺乏的ob/ob小鼠随机分组,作为对照或接受口服TIX100,这是一种新型的硫氧还蛋白相互作用蛋白(TXNIP)抑制剂,刚刚被美国食品药品监督管理局(FDA)批准作为1型糖尿病(T1D)的研究性新药。然后评估TIX100对葡萄糖不耐受和体重控制的影响。
TIX100可预防HFD诱导的葡萄糖不耐受、高胰岛素血症和高胰高血糖素血症。TIX100还可减少饮食诱导的肥胖,与HFD喂养的对照小鼠相比,治疗组小鼠体重降低15%(p<0.05),同时保留瘦体重。尽管TIX100对ob/ob小鼠的体重影响消失,但TIX100改善了血糖控制,导致糖化血红蛋白(HbA1C)显著降低2.3%(p<0.05),且与体重减轻无关。这与TIX100在非肥胖糖尿病模型中的有益作用及其对所有糖尿病类型常见的TXNIP升高和胰岛细胞应激的保护作用一致。
因此,TIX100可能为T2D提供一种新型口服疗法,该疗法针对包括胰岛细胞功能障碍和高胰高血糖素血症在内的潜在疾病病理,促进代谢健康和体重控制,而无需剧烈减重。