Okamoto H, Yamamoto H
Princess Takamatsu Symp. 1983;13:297-308.
Alloxan and streptozotocin, which produce diabetes mellitus in experimental animals, have been known to inhibit various functions of pancreatic islets including proinsulin synthesis. However, little is known about the mechanisms underlying the action of these agents in pancreatic islets. Our recent in vivo and in vitro study using rats and isolated islets showed that one of the primary targets of the diabetogenic agents is the DNA of pancreatic islets. The first step is the generation of hydroxyl radical by alloxan which attacks DNA to produce strand breaks. In the case of streptozotocin, the alkylating activity of this compound may be causally related to its ability to induce DNA strand breaks. Subsequently, the fragmented DNA activates poly(ADP-ribose) synthetase which depletes cellular NAD. Since NAD is the most abundant of cellular coenzymes and participates in many biological reactions in mammalian cells, the reduction in intracellular NAD to such a nonphysiological level may severely affect islet cell functions including proinsulin synthesis. These results, in turn, raise the possibility that insulin-dependent diabetes may be preventable by inhibiting the occurrence of DNA strand breaks or the poly(ADP-ribose) synthetase. In fact, by poly(ADP-ribose) synthetase inhibitors such as nicotinamide and picolinamide, alloxan- and streptozotocin-induced NAD depletion was completely prevented, and B-cell functions including proinsulin synthesis proceeded normally. However, poly(ADP-ribose) synthetase inhibitors did not prevent the DNA strand breaks at all. Therefore, B-cells may survive with the residual DNA damage within their genome. About one year after the combined administration to rats of alloxan or streptozotocin with poly(ADP-ribose) synthetase inhibitors, diabetes did not develop but islet B-cell tumors were found frequently. This suggests that insulin-dependent diabetes and B-cell tumors are closely related with respect to their developmental processes. In other words, DNA breaks initiate two kinds of pathological state in B-cells, one is degeneratively and the other is oncogenically expressed.
四氧嘧啶和链脲佐菌素可在实验动物中诱发糖尿病,已知它们会抑制胰岛的多种功能,包括胰岛素原的合成。然而,关于这些药物在胰岛中作用的潜在机制却知之甚少。我们最近利用大鼠和分离的胰岛进行的体内和体外研究表明,致糖尿病药物的主要靶点之一是胰岛的DNA。第一步是四氧嘧啶产生羟基自由基,它攻击DNA导致链断裂。就链脲佐菌素而言,该化合物的烷基化活性可能与其诱导DNA链断裂的能力存在因果关系。随后,断裂的DNA激活聚(ADP-核糖)合成酶,从而消耗细胞内的NAD。由于NAD是细胞中最丰富的辅酶,并参与哺乳动物细胞中的许多生物反应,细胞内NAD减少到如此非生理水平可能会严重影响胰岛细胞功能,包括胰岛素原的合成。这些结果反过来又增加了一种可能性,即通过抑制DNA链断裂或聚(ADP-核糖)合成酶的发生,胰岛素依赖型糖尿病可能是可预防的。事实上,通过使用烟酰胺和吡啶酰胺等聚(ADP-核糖)合成酶抑制剂,完全防止了四氧嘧啶和链脲佐菌素诱导的NAD消耗,包括胰岛素原合成在内的B细胞功能正常进行。然而,聚(ADP-核糖)合成酶抑制剂根本无法防止DNA链断裂。因此,B细胞可能在其基因组内残留DNA损伤的情况下存活。在给大鼠联合使用四氧嘧啶或链脲佐菌素与聚(ADP-核糖)合成酶抑制剂约一年后,糖尿病并未发生,但经常发现胰岛B细胞瘤。这表明胰岛素依赖型糖尿病和B细胞瘤在其发育过程中密切相关。换句话说,DNA断裂在B细胞中引发两种病理状态,一种是退行性表达,另一种是致癌性表达。