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      Rapamycin induces glucose intolerance in mice by reducing islet mass, insulin content, and insulin sensitivity

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          Abstract

          Rapamycin, a specific inhibitor for mTOR complex 1, is an FDA-approved immunosuppressant for organ transplant. Recent developments have raised the prospect of using rapamycin to treat cancer or diabetes and to delay aging. It is therefore important to assess how rapamycin treatment affects glucose homeostasis. Here, we show that the same rapamycin treatment reported to extend mouse life span significantly impaired glucose homeostasis of aged mice. Moreover, rapamycin treatment of lean C57B/L6 mice reduced glucose-stimulated insulin secretion in vivo and ex vivo as well as the insulin content and beta cell mass of pancreatic islets. Confounding the diminished capacity for insulin release, rapamycin decreased insulin sensitivity. The multitude of rapamycin effects thus all lead to glucose intolerance. As our findings reveal that chronic rapamycin treatment could be diabetogenic, monitoring glucose homeostasis is crucial when using rapamycin as a therapeutic as well as experimental reagent.

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          Most cited references21

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          Phosphorylation of IRS proteins, insulin action, and insulin resistance.

          Insulin signaling at target tissues is essential for growth and development and for normal homeostasis of glucose, fat, and protein metabolism. Control over this process is therefore tightly regulated. It can be achieved by a negative feedback control mechanism whereby downstream components inhibit upstream elements along the insulin-signaling pathway (autoregulation) or by signals from apparently unrelated pathways that inhibit insulin signaling thus leading to insulin resistance. Phosphorylation of insulin receptor substrate (IRS) proteins on serine residues has emerged as a key step in these control processes under both physiological and pathological conditions. The list of IRS kinases implicated in the development of insulin resistance is growing rapidly, concomitant with the list of potential Ser/Thr phosphorylation sites in IRS proteins. Here, we review a range of conditions that activate IRS kinases to phosphorylate IRS proteins on "hot spot" domains. The flexibility vs. specificity features of this reaction is discussed and its characteristic as an "array" phosphorylation is suggested. Finally, its implications on insulin signaling, insulin resistance and type 2 diabetes, an emerging epidemic of the 21st century are outlined.
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            Recovery from diabetes in mice by beta cell regeneration.

            The mechanisms that regulate pancreatic beta cell mass are poorly understood. While autoimmune and pharmacological destruction of insulin-producing beta cells is often irreversible, adult beta cell mass does fluctuate in response to physiological cues including pregnancy and insulin resistance. This plasticity points to the possibility of harnessing the regenerative capacity of the beta cell to treat diabetes. We developed a transgenic mouse model to study the dynamics of beta cell regeneration from a diabetic state. Following doxycycline administration, transgenic mice expressed diphtheria toxin in beta cells, resulting in apoptosis of 70%-80% of beta cells, destruction of islet architecture, and diabetes. Withdrawal of doxycycline resulted in a spontaneous normalization of blood glucose levels and islet architecture and a significant regeneration of beta cell mass with no apparent toxicity of transient hyperglycemia. Lineage tracing analysis indicated that enhanced proliferation of surviving beta cells played the major role in regeneration. Surprisingly, treatment with Sirolimus and Tacrolimus, immunosuppressants used in the Edmonton protocol for human islet transplantation, inhibited beta cell regeneration and prevented the normalization of glucose homeostasis. These results suggest that regenerative therapy for type 1 diabetes may be achieved if autoimmunity is halted using regeneration-compatible drugs.
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              Fasting and postchallenge glycemia and cardiovascular disease risk: the Framingham Offspring Study.

              To test the hypothesis that fasting hyperglycemia (FHG) and 2-h postchallenge glycemia (2hPG) independently increase the risk for cardiovascular disease (CVD). During 1991-1995, we examined 3,370 subjects from the Framingham Offspring Study who were free from clinical CVD (coronary heart disease, stroke, or intermittent claudication) or medication-treated diabetes, and we followed them for 4 years for incident CVD events. We used proportional-hazards regression to assess the risk associated with FHG (fasting plasma glucose > or =7.0 mmol/l) and 2hPG, independent of the risk predicted by standard CVD risk factors. Mean subject age was 54 years, 54% were women, and previously undiagnosed diabetes was present in 3.2% by FHG and 4.9% (164) by FHG or a 2hPG > or =11.1 mmol/l. Of these 164 subjects, 55 (33.5%) had 2hPG > or =11.1 without FHG, but these 55 subjects represented only 1.7% of the 3,261 subjects without FHG. During 12,242 person-years of follow-up, there were 118 CVD events. In separate sex- and CVD risk-adjusted models, relative risk (RR) for CVD with fasting plasma glucose > or =7.0 mmol/l was 2.8 (95% CI 1.6-5.0); RR for CVD per 2.1 mmol/l increase in 2hPG was 1.2 (1.1-1.3). When modeled together, the RR for FHG decreased to 1.5 (0.7-3.6), whereas the RR for 2hPG remained significant (1.1, 1.02-1.3). The c-statistic for a model including CVD risk factors alone was 0.744; with addition of FHG, it was 0.746, and with FHG and 2hPG, it was 0.752. Postchallenge hyperglycemia is an independent risk factor for CVD, but the marginal predictive value of 2hPG beyond knowledge of standard CVD risk factors is small.

                Author and article information

                Contributors
                +1-415-4768748 , +1-415-4765774 , Lily.Jan@ucsf.edu
                Journal
                J Mol Med (Berl)
                J. Mol. Med
                Journal of Molecular Medicine (Berlin, Germany)
                Springer-Verlag (Berlin/Heidelberg )
                0946-2716
                1432-1440
                22 November 2011
                22 November 2011
                May 2012
                : 90
                : 5
                : 575-585
                Affiliations
                [1 ]Howard Hughes Medical Institute, Departments of Physiology, Biochemistry and Biophysics, University of California, San Francisco, 1550, 4th Street, San Francisco, CA 94158 USA
                [2 ]Eli and Edythe Broad Center of Regeneration Medicine and Stem Cell Research, Howard Hughes Medical Institute, University of California, San Francisco, 35 Medical Center Way, San Francisco, CA 94143 USA
                Article
                834
                10.1007/s00109-011-0834-3
                3354320
                22105852
                089fadd2-58d3-490d-999a-4403e2ea1bd5
                © The Author(s) 2011
                History
                : 1 June 2011
                : 15 October 2011
                : 7 November 2011
                Categories
                Original Article
                Custom metadata
                © Springer-Verlag 2012

                Molecular medicine
                insulin,mtor,rapamycin,glucose intolerance,diabetes
                Molecular medicine
                insulin, mtor, rapamycin, glucose intolerance, diabetes

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