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      Targeting GLP-1 receptor trafficking to improve agonist efficacy

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          Abstract

          Glucagon-like peptide-1 receptor (GLP-1R) activation promotes insulin secretion from pancreatic beta cells, causes weight loss, and is an important pharmacological target in type 2 diabetes (T2D). Like other G protein-coupled receptors, the GLP-1R undergoes agonist-mediated endocytosis, but the functional and therapeutic consequences of modulating GLP-1R endocytic trafficking have not been clearly defined. Here, we investigate a series of biased GLP-1R agonists with variable propensities for GLP-1R internalization and recycling. Compared to a panel of FDA-approved GLP-1 mimetics, compounds that retain GLP-1R at the plasma membrane produce greater long-term insulin release, which is dependent on a reduction in β-arrestin recruitment and faster agonist dissociation rates. Such molecules elicit glycemic benefits in mice without concomitant increases in signs of nausea, a common side effect of GLP-1 therapies. Our study identifies a set of agents with specific GLP-1R trafficking profiles and the potential for greater efficacy and tolerability as T2D treatments.

          Abstract

          Glucagon-like peptide-1 receptor (GLP-1R) promotes insulin secretion from pancreatic beta cells and undergoes agonist-mediated endocytosis. Here, authors study GLP-1R endocytosis caused by different agonists and show that a longer plasma membrane retention time of GLP-1R results in greater long-term insulin release.

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          The arcuate nucleus mediates GLP-1 receptor agonist liraglutide-dependent weight loss.

          Liraglutide is a glucagon-like peptide-1 (GLP-1) analog marketed for the treatment of type 2 diabetes. Besides lowering blood glucose, liraglutide also reduces body weight. It is not fully understood how liraglutide induces weight loss or to what degree liraglutide acts directly in the brain. Here, we determined that liraglutide does not activate GLP-1-producing neurons in the hindbrain, and liraglutide-dependent body weight reduction in rats was independent of GLP-1 receptors (GLP-1Rs) in the vagus nerve, area postrema, and paraventricular nucleus. Peripheral injection of fluorescently labeled liraglutide in mice revealed the presence of the drug in the circumventricular organs. Moreover, labeled liraglutide bound neurons within the arcuate nucleus (ARC) and other discrete sites in the hypothalamus. GLP-1R was necessary for liraglutide uptake in the brain, as liraglutide binding was not seen in Glp1r(-/-) mice. In the ARC, liraglutide was internalized in neurons expressing proopiomelanocortin (POMC) and cocaine- and amphetamine-regulated transcript (CART). Electrophysiological measurements of murine brain slices revealed that GLP-1 directly stimulates POMC/CART neurons and indirectly inhibits neurotransmission in neurons expressing neuropeptide Y (NPY) and agouti-related peptide (AgRP) via GABA-dependent signaling. Collectively, our findings indicate that the GLP-1R on POMC/CART-expressing ARC neurons likely mediates liraglutide-induced weight loss.
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            Hypothalamic tanycytes are an ERK-gated conduit for leptin into the brain.

            Leptin secreted by adipocytes acts on the brain to reduce food intake by regulating neuronal activity in the mediobasal hypothalamus (MBH). Obesity is associated with resistance to high circulating leptin levels. Here, we demonstrate that peripherally administered leptin activates its receptor (LepR) in median eminence tanycytes followed by MBH neurons, a process requiring tanycytic ERK signaling and the passage of leptin through the cerebrospinal fluid. In mice lacking the signal-transducing LepRb isoform or with diet-induced obesity, leptin taken up by tanycytes accumulates in the median eminence and fails to reach the MBH. Triggering ERK signaling in tanycytes with EGF reestablishes leptin transport, elicits MBH neuron activation and energy expenditure in obese animals, and accelerates the restoration of leptin sensitivity upon the return to a normal-fat diet. ERK-dependent leptin transport by tanycytes could thus play a critical role in the pathophysiology of leptin resistance, and holds therapeutic potential for treating obesity. Copyright © 2014 Elsevier Inc. All rights reserved.
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              Glucagon-Like Peptide-1 and Its Class B G Protein–Coupled Receptors: A Long March to Therapeutic Successes

              The glucagon-like peptide (GLP)-1 receptor (GLP-1R) is a class B G protein–coupled receptor (GPCR) that mediates the action of GLP-1, a peptide hormone secreted from three major tissues in humans, enteroendocrine L cells in the distal intestine, α cells in the pancreas, and the central nervous system, which exerts important actions useful in the management of type 2 diabetes mellitus and obesity, including glucose homeostasis and regulation of gastric motility and food intake. Peptidic analogs of GLP-1 have been successfully developed with enhanced bioavailability and pharmacological activity. Physiologic and biochemical studies with truncated, chimeric, and mutated peptides and GLP-1R variants, together with ligand-bound crystal structures of the extracellular domain and the first three-dimensional structures of the 7-helical transmembrane domain of class B GPCRs, have provided the basis for a two-domain–binding mechanism of GLP-1 with its cognate receptor. Although efforts in discovering therapeutically viable nonpeptidic GLP-1R agonists have been hampered, small-molecule modulators offer complementary chemical tools to peptide analogs to investigate ligand-directed biased cellular signaling of GLP-1R. The integrated pharmacological and structural information of different GLP-1 analogs and homologous receptors give new insights into the molecular determinants of GLP-1R ligand selectivity and functional activity, thereby providing novel opportunities in the design and development of more efficacious agents to treat metabolic disorders.
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                Author and article information

                Contributors
                g.rutter@imperial.ac.uk
                a.tomas-catala@imperial.ac.uk
                Journal
                Nat Commun
                Nat Commun
                Nature Communications
                Nature Publishing Group UK (London )
                2041-1723
                23 April 2018
                23 April 2018
                2018
                : 9
                : 1602
                Affiliations
                [1 ]ISNI 0000 0001 2113 8111, GRID grid.7445.2, Section of Investigative Medicine, , Imperial College London, ; London, W12 0NN UK
                [2 ]ISNI 0000 0001 2113 8111, GRID grid.7445.2, Section of Cell Biology and Functional Genomics, , Imperial College London, ; London, W12 0NN UK
                [3 ]ISNI 0000 0001 2113 8111, GRID grid.7445.2, Centre for Pathology, , Imperial College London, ; London, W2 1NY UK
                [4 ]ISNI 0000 0004 1937 0490, GRID grid.10223.32, Department of Pathology, Faculty of Medicine, Ramathibodi Hospital, , Mahidol University, ; Bangkok, 10400 Thailand
                [5 ]ISNI 0000 0004 0376 1796, GRID grid.273406.4, New England Biolabs, Inc., ; Ipswich, 01938 MA USA
                [6 ]ISNI 0000 0001 2322 4988, GRID grid.8591.5, Department of Surgery, , University of Geneva, ; Geneva, CH-1211 Switzerland
                [7 ]ISNI 0000 0004 1936 8948, GRID grid.4991.5, Nuffield Department of Surgical Sciences, , University of Oxford, ; Oxford, OX3 9DU UK
                [8 ]ISNI 0000000417581884, GRID grid.18887.3e, Diabetes Research Institute (HSR-DRI), , San Raffaele Scientific Institute, ; Milan, 20132 Italy
                [9 ]GRID grid.15496.3f, Vita-Salute San Raffaele University, ; Milan, 20132 Italy
                [10 ]ISNI 0000 0004 1757 3729, GRID grid.5395.a, Department of Clinical and Experimental Medicine, Islet Cell Laboratory, , University of Pisa, ; Pisa, 56124 Italy
                [11 ]GRID grid.17089.37, Clinical Islet Laboratory and Clinical Islet Transplant Program, , University of Alberta, ; Edmonton, T6G 2C8 AB Canada
                [12 ]ISNI 0000 0001 2113 8111, GRID grid.7445.2, Section of Renal and Vascular Inflammation, , Imperial College London, ; London, W12 0NN UK
                [13 ]ISNI 0000 0004 4902 0432, GRID grid.1005.4, School of Medical Sciences, UNSW Sydney, ; Sydney, 2052 NSW Australia
                [14 ]ISNI 0000 0001 2113 8111, GRID grid.7445.2, Department of Surgery and Cancer, , Imperial College London, ; London, W12 0NN UK
                [15 ]ISNI 0000 0001 2248 6943, GRID grid.69566.3a, Tohoku University, ; Sendai, 980-8574 Japan
                Author information
                http://orcid.org/0000-0002-3169-6878
                http://orcid.org/0000-0002-2172-2198
                http://orcid.org/0000-0003-4206-737X
                http://orcid.org/0000-0001-6360-0343
                Article
                3941
                10.1038/s41467-018-03941-2
                5913239
                29686402
                df7ac59e-b5e6-428f-bda2-4200b5d068c3
                © The Author(s) 2018

                Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons license, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons license and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this license, visit http://creativecommons.org/licenses/by/4.0/.

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                : 30 May 2017
                : 21 March 2018
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