The present invention relate to an agent of preventing or treating a diabetes mellitus and a method of preventing or treating a diabetes mellitus. In addition, the present invention is directed to an agent of controlling blood glucose level and a method of controlling blood glucose level, a method of identifying an agent that induces glucose-independent insulin secretion in a mammal, and a method of diagnosing a diabetes mellitus or low blood glucose level.
The main function of pancreatic β-cells is to synthesize and secrete insulin at appropriate rates to limit blood glucose fluctuations. Excessive secretion of insulin causes hypoglycemia, and insufficient secretion leads to diabetes. It is therefore not surprising that insulin secretion is subject to very tight control to ensure glucose homeostasis in the body. Insulin is stored in secretory granules in pancreatic β-cells and, upon stimulation with secretagogues, is released by exocytosis. The level of β-cell activity is determined by several different stimulators, including glucose, amino acids, fatty acids, neurotransmitters, and hormones. In spite of intensive studies, the processes that are involved in this stimulus-secretion coupling and that maintain exquisite control of insulin release are still incompletely understood.
Diabetes is one of the most common endocrine diseases across all age groups and populations. There are two major forms of diabetes mellitus: insulin-dependent (Type 1) diabetes mellitus (IDDM) which accounts for 5 to 10% of all cases, and non-insulin-dependent (Type 2) diabetes mellitus (NIDDM) which comprises roughly 90% of cases. Type 2 diabetes is associated with increasing age however there is a trend of increasing numbers of young people diagnosed with NIDDM, so-called maturity onset diabetes of the young (MODY). In both Type 1 and Type 2 cases, there is a loss of insulin secretion, either through destruction of the β-cells in the pancreas or defective secretion or production of insulin. In NIDDM, patients typically begin therapy by following a regimen of an optimal diet, weight reduction and exercise.
Type 2 diabetes mellitus is characterized by both insulin resistance and impaired insulin secretion. The control of insulin secretion is primarily regulated by glucose itself, but also involves an array of metabolic, neural, hormonal, and sometimes pharmacological factors. Initiators can increase insulin secretion in the absence of other stimulation, but potentiators require the presence of an initiator, usually glucose (Hedeskov C J et al., Physiol Rev 60:442-509, 1980). Many reports have suggested that hypoglycemia caused by diabetes treatment poses a serious problem.
Epidermal growth factor (EGF) is an important growth factor for the proliferation of different types of cells, especially fibroblasts and epithelial cells. EGF can also induce secretion events, including acrosomal exocytosis and the secretion of several hormones. Some members of the EGF family are proposed to have a role in the development of the pancreas. EGF and leukemia inhibitory factor (LIF) treatment in vitro generated an insulin-producing β-cell mass (Baeyens L et al., Diabetologia 48:49-57, 2005). The EGFR is expressed throughout the human fetal pancreas, and mice lacking EGFR show abnormal pancreatic islets (Miettinen P J, et al., Development 127:2617-2627, 2000). EGF also has shown to be related in the insulin content of rat pancreatic β-cells and regeneration of them (Li L, et al., Diabetes 53:608-615, 2004; Brand S J, et al., Pharmacol Toxicol 91:414-420, 2002; Suarez-Pinzon W L et al., Diabetes 54:2596-2601, 2005). EGF is also produced in the pancreas and its circulating levels and the EGFR are reduced in diabetic animals (Burgess A W, Br Med Bull 45:401-424, 1989; Kasayama S, et al., Proc Natl Acad Sci USA 86:7644-7648, 1989; Kashimata M, et al., Biochim Biophys Acta 923:496-500, 1987). However, the role of EGF in glucose regulation by modulating pancreatic function such as insulin secretion has not been studied yet.
Insulin secretion is mainly triggered by the elevation of intracellular Ca2+ but it can be modulated by several cellular signals such as protein kinases and phospholipases. Of them, mammalian phospholipase D (PLD) is a membrane bound enzyme that hydrolyzes phosphatidyl choline (PC) to generate a multifunctional lipid, phosphatidic acid (PA), in response to a variety of signals, including growth factors (Exton J H, Biochim Biophys Acta 1439:121-133, 1999). PA is an intracellular lipid second messenger involved in multiple physiological events. These findings suggest that agonist-induced PLD activation may play roles in multiple signaling events (Jones D, et al., Biochim Biophys Acta 1439:229-244, 1999; Honda A, et al., Cell 99:521-532, 1999). To date, two types of mammalian PLD, PLD1 and PLD2, have been cloned. They share a sequence homology of around 50% and contain similar regulatory domains, but show differences in localization and regulatory protein interactions (Frohman M A, et al., Biochim Biophys Acta 1439:175-186, 1999). PLD activity may be involved in various trafficking processes, particularly in the regulation of exocytosis (Jones D, et al., Biochim Biophys Acta 1439:229-244, 1999). PLD1 and PLD2 regulate different phases of exocytosis in mast cells by a two-step process (Choi W S, et al., J Immunol 168:5682-5689, 2002). In addition, PA is an important mediator of insulin exocytosis (Metz S A, Biochem J 270:427-435, 1990).
However, the role of EGF in glucose regulation by modulating pancreatic function such as insulin secretion has not been studied yet. The specific regulation of PLDs by secretagogues remains unclear.
The present inventors show that a brief exposure to EGF stimulates insulin secretion glucose-independently via a Ca2+ influx- and PLD2-dependent mechanism. Furthermore, the present invention shows that EGF is a novel secretagogue that lowers plasma glucose levels in normal and diabetic mice, suggesting the potential for EGF treatment in diabetes.
In one embodiment of the present invention, a pharmaceutical composition for preventing or treating diabetes mellitus comprising EGF as an effective agent is provided. The present invention provides an insulin-secreting agent comprising EGF, more preferably a glucose-independent insulin-secreting agent comprising EGF and wherein the EGF stimulates the insulin secretion of the pancreatic beta-cell in a glucose-independent manner. The present invention also provides a method of treating diabetes mellitus comprising administering to a subject an effective amount of EGF, wherein the amount of the EGF initiates the insulin secretion and low
In another embodiment, the present invention provides an agent of controlling a blood glucose level comprising EGF, and a method of controlling blood glucose level comprising administering an effective amount of a EGF to the mammal in need thereof.
In further embodiment, the present invention provides a diagnosing kit of the diabetes mellitus comprising the EGF and a method of diagnosing diabetes mellitus in a mammal using the EGF. More specifically, the method of diagnosing the diabetes mellitus can be performed by preparing blood sample of a subject, and determining the EGF concentration in the blood sample with antigen-antibody reaction.
In additional embodiment, the present invention provides a method of identifying an agent that induces glucose-independent insulin secretion in a mammal, the method comprising using the EGF.
A more complete appreciation of the invention, and many of the attendant advantages thereof, will be readily apparent as the same becomes better understood by reference to the following detailed description when considered in conjunction with the accompanying drawing, wherein:
A more complete appreciation of the invention, and many of the attendant advantages thereof, will be readily apparent as the same becomes better understood by reference to the following detailed description.
Epidermal growth factor (EGF) is synthesized in the pancreas and diabetic animals have low levels of EGF. However, the role of EGF in regulating the major function of pancreas such as glucose homeostasis has not been studied. Here, the present invention shows that EGF rapidly increased insulin secretion in mouse pancreatic islets, as well as in a pancreatic-cell line. These events were dependent on Ca2+ influx and PLD activity, particularly PLD2, as determined using pharmacological blockers and molecular manipulations such as overexpression and siRNA of PLD isozymes. In addition, EGF also increased plasma insulin levels and mediated glucose lowering in normal and diabetic mice. Here, for the first time, the present invention provides evidences that EGF is a novel secretagogue regulating plasma glucose levels and an agent for preventing or treating diabetes mellitus.
In an embodiment of the present invention, the present invention is directed to a pharmaceutical composition for preventing or treating diabetes mellitus comprising EGF and a pharmaceutically acceptable carrier. More specifically, the EGF can be human EGF. The EGF stimulates the insulin secretion from pancreatic beta-cell in a glucose-independent manner. The EGF simulates the insulin secretion through Ca2+ influx and PLP2 activation in pancreatic beta-cells or pancreatic islets.
The EGF is administered in an amount of 5 μg/kg to 100 μg/kg by weight of the subject, and more preferably, 10 μg/kg to 60 μg/kg by weight of the subject.
In another embodiment, the present invention provides a method for controlling blood glucose levels in a subject in need thereof comprising administering an effective amount of EGF to the subject.
In another embodiment, the present invention provides a method for controlling blood insulin levels in a subject in need thereof comprising administering an effective amount of EGF to the subject.
In the method of controlling blood glucose levels in a subject or controlling blood insulin levels in a subject, the controlling blood glucose level is performed by regulating the blood insulin levels in a glucose-independent manner. The EGF can be human EGF. The effective amount is 5 μg/kg to 100 μg/kg by weight of the subject, and more preferably, 10 μg/kg to 60 μg/kg by weight of the subject. The EGF is administered orally, subcutaneously, intravenously, or intramuscularly. The subject is a patient suffering from diabetes mellitus or a normal subject.
Dosage forms of a pharmaceutical composition of the present invention or its respective active ingredients include oral dosage forms such as tablets, capsules (including soft capsules and microcapsules), powders, granules, syrups, and etc.; and non-oral dosage forms such as injections (e.g., subcutaneous injections, intravenous injections, intramuscular injections, intraperitoneal injections, etc.), external application forms (e.g., nasal spray preparations, transdermal preparations, ointments, etc.), suppositories (e.g., rectal suppositories, vaginal suppositories, etc.), pellets, drip infusions, and etc.
The dosage of a pharmaceutical composition of the present invention may be appropriately determined with reference to the dosage recommended for the respective drug(s), and can be selected appropriately according to the subject, the age and body weight of the subject, current clinical status, administration time, dosage form, method of administration, combination of the drug(s), and etc. The dosage of an insulin sensitizer and an anorectic can be selected appropriately based on clinically used dosage. For administration of an insulin sensitizer to an adult diabetic patient (body weight: 50 kg), for instance, the dose per day is usually 0.01 to 1000 mg, preferably 0.1 to 500 mg. This dose can be administered once to several times a day.
EGF requires only brief exposure (1 min) to stimulate insulin secretion (
PLD is activated by EGF stimulation and this activation is a very rapid process than by other PLD-regulating molecules such as glucose etc. The mechanism underlying EGF-mediated activation of PLD remains controversial. Among them, EGF-dependent Ca2+ increases activate protein kinase C (PKC) and lead to PLD activation (Yeo E J, et al., J Biol Chem 270:3980-3988, 1995). Another report suggested that Ca2+ influx is associated with activation of PLD, and that PKC is involved in this process (Sun S H, et al., J Neurochem 73:334-343, 1999). However, there are limited studies about Ca2+-mediated PLD activation of specific isozymes. In the present study, the present inventors identified PLD2 as a Ca2+-dependent isozyme in the pancreatic β-cells by EGF treatment (
Metabolism of glucose results in closure of ATP-sensitive K+ channels, and the subsequent plasma membrane depolarization opens voltage-sensitive Ca2+ channels (Henquin J C, Diabetes 49:1751-1760, 2000). The resultant rise in the cytoplasmic free Ca2+ concentration is both necessary and sufficient for triggering an initial phase of insulin release that is mediated by fusion of predocked insulin granules with the plasma membrane (Mears D, J Membr Biol 200:57-66, 2004). Our results show that EGF-stimulated Ca2+ influx mediates insulin secretion (
EGF regulates pancreatic function, and is produced in the pancreas and pancreatic juice (Huotari M A, et al., Endocrinology 139:1494-1499, 1998). EGFR is expressed throughout the human fetal pancreas, and mice lacking EGFR showed abnormal formation of pancreatic islets. Some members of the EGF family have a role in the development of the pancreas. EGF regulates the insulin content of rat pancreatic β-cells, as well as their regeneration. Furthermore, EGF deficiency is associated with diabetes mellitus: in diabetic animals, EGF or EGFR levels are decreased in various organs or fluids, such as liver, the submandibular gland, plasma, and milk (Thulesen J, et al., Endocr Regul 27:139-144, 1993). Interestingly, levels of these proteins often recover after insulin curative treatment, and EGF and insulin act synergistically during diabetic healing (Hennessey P J, et al., Arch Surg 125:926-929, 1990). Although EGF shows crosstalk with GLP-1-dependent signaling, which upregulates insulin secretion (MacDonald P E, et al., J Biol Chem 278:52446-52453, 2003), there has been no report showing that EGF can acutely regulate the insulin secretion. Consistent with our in vitro findings from MIN6 (
The present invention is further explained in more detail with reference to the following examples. These examples, however, should not be interpreted as limiting the scope of the present invention in any manner.
Materials
The enhanced chemiluminescence (ECL) kit was purchased from Amersham Pharmacia Biotech (Buckinghamshire, United Kingdom); [3H]myristic acid from Dupont NEN (Boston, Mass.); Silica Gel 60 thin-layer chromatography plates from MERCK (Darmstadt, Germany); Dulbecco's modified Eagle's medium (DMEM), RPMI 1640 and LipofectAMINE from Invitrogen (Carlsbad, Calif.); Fetal calf serum from HyClone (Logan, Utah); EGF from the Daewoong Pharmaceutical Company (Seoul, Republic of Korea); Horseradish peroxidase-conjugated goat anti-rabbit IgG and anti-mouse IgA, IgG, and IgM from Kirkegaard and Perry Laboratories, Inc. (Gaithersburg, Md.); and Fluo-3 AM from Molecular Probes (Eugene, Oreg.). A polyclonal antibody (mSTP4) recognizing both PLD1 and PLD2 was produced as described previously (Lee et al., Biochim Biophys Acta 1347:199-204, 1997). A PLD2-specific antibody was generated as described previously (Kim et al., J Neurochem 85:1228-1236, 2003). All other chemicals were purchased from Sigma (St. Louis, Mo.).
EGF is produced in the pancreas, has pancreatic effects, and its circulating levels are altered in diabetes (Burgess A W, Br Med Bull 45:401-424, 1989; Kasayama S et al., Proc Natl Acad Sci USA 86:7644-7648, 1989). This example was performed to determine whether EGF could stimulate insulin secretion, and whether insulin secretion by EGF was additive by glucose treatment.
1.1 Method
Cell Culture The mouse insulin-producing cells MIN6m9 provided by Dr. Susumu Seino (Division of Cellular and Molecular Medicine, Kobe University Graduate School of Medicine, Kobe, Japan) were used between passages 19 and 25 and cultured in DMEM containing 25 mM glucose, 10 mM HEPES, 10% (v/v) fetal calf serum, 50 IU/ml penicillin, and 50 μg/ml streptomycin at 37° C. in a humidified CO2-controlled (5%) incubator. MIN6 cells were transfected using LipofectAMINE, as described previously (Kim et al., J Immunol 163:5462-5470, 1999) Transfection efficiency is about 30-40% by using LipofectAMINE.
Insulin Secretion Assay: Batches of 10-15 isolated islets or 1×106 cells/well grown in 12- or 24-well plates were washed twice with KRB supplemented with 0.2% bovine serum albumin (BSA), and then incubated for 60 min at 37° C. in the KRB solution. We used same number of islets in a same set of experiment. At the end of incubation, the solutions were replaced with fresh KRB containing test reagents and incubated for the designated time. The incubation medium was sampled and centrifuged to remove cells, and the supernatant was assayed for insulin with a radioimmunoassay (RIA) kit (Linco, St. Louis, Mo.).
Statistical Analysis: Results are presented as mean±SE or mean±SD (for PLD activity assay and insulin secretion assay). The statistical significance of differences between means was assessed by Student's t-test. P<0.05 was regarded as statistically significant.
1-2. Insulin Secretion Test of EGF on Mouse MIN6 Insulinoma Cells
To determine whether EGF could stimulate insulin secretion, the present inventors treated mouse MIN6 insulinoma cells with EGF. EGF significantly increased insulin secretion with a 1 min treatment. EGF showed time- and dose-dependent stimulation of insulin secretion from MIN6 cells, with kinetics more rapid than glucose (
The MIN6 cells were plated onto 24-well plates and grown for 24 h. The cells were washed twice with KRB supplemented with 0.2% BSA, and then incubated for 60 min at 37° C. in the KRB solution.
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1-3. Glucose Treatment on EGF-Induced EGF-Induced Insulin Secretion of Cells
To determine whether insulin secretion by EGF was additive by glucose treatment, the present inventors tested the effect of high (11 mM) glucose on EGF-induced insulin secretion. EGF increased insulin levels at basal concentration of glucose (2.7 mM), and additively increased glucose-induced insulin release at high (11 mM) glucose levels as well (
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Insulin secretion requires increases in intracellular Ca2+ concentrations ([Ca2+]i) (Barg S et al., Diabetes 51 (Suppl 1):S74-82, 2002). This example was carried out to determine the effect of Ca2+ influx on EGF-induced insulin secretion.
2.1 [Ca2+]i Measurement Method
Changes in intracellular Ca2+ levels were monitored using a Ca2+-sensitive dye under a confocal microscope. Cells were loaded with 2 μl Fluo-3 AM for 40 min at room temperature. After washing with Krebs-Ringer bicarbonate (KRB; 129 mM NaCl, 5 mM NaHCO3, 4.8 mM KCl, 1.2 mM KH2PO4, 1.0 mM CaCl2, 1.2 mM MgSO4, 2.7 mM glucose, and 10 mM HEPES, pH 7.4) buffer, the cells were further incubated for 15 min in the absence of Fluo-3 AM to de-esterify the dye. To exclude the possible effects of dye loading, the present inventors normalized levels with saponin at the end of the experiments. To normalize, the present inventors measured the residual fluorescence (Fo) at the end of the experiment, and subtracted that from the fluorescence under experimental conditions (F). Excitation of Fluo-3 AM was performed at 488-nm by an argon laser, and the emission range was 515-nm. Images were captured on an inverted confocal microscope (Zeiss LSM 510 Meta, Oberkochen, Germany) with a 20× objective lens.
2.2. Effect of Ca2+ Influx on EGF-Induced Insulin Secretion
The MIN6 cells were plated onto glass dishes or 24-well plates and grown for 24 h. The cells were washed twice with KRB supplemented with 0.2% BSA, and then incubated for 60 min at 37° C. in the KRB solution.
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EGF-induced insulin secretion from MIN6 cells was reduced by Ca2+ chelators (
Previous reports suggested that PLD is an important molecule that mediates various exocytosis (Jones D et al., Biochim Biophys Acta 1439:229-244, 1999; Choi W S et al., J Immunol 168:5682-5689, 2002; Metz S A et al., Biochem J 270:427-435, 1990). The present inventors firstly tested the PLD activity in MIN6 cells. PLD was activated rapidly (within 2 min) by EGF stimulation (
PLD Constructs: The full-length cDNAs of rat PLD1 or human PLD2 were ligated into pcDNA 3.1 vector for transfecting into cells.
SiRNA Sequences: The siRNA of 21-mers corresponding to mouse PLD1 (nucleotides 1099 to 1119, AACACGUUAGCUAAGUGGUAU) (SEQ ID NO:1) or PLD2 sequences (nucleotides 2539 to 2559, AACUCCAUCCAGGCUAUUCUG) (SEQ ID NO:2) were purchased from Dharmacon Research Inc. (Lafayette, Colo.). Results of a BLAST search of all siRNA sequences revealed no significant homology to any other sequences in the database program.
PLD Activity Assay in Cells: Cells grown in 6-well plates were washed twice with KRB, and then labeled with [3H]myristic acid for 4 h at 37° C. in the KRB solution. PLD activity was assayed by measuring the formation of phosphatidylbutanol (PBt) (Kim J H et al., J Immunol 163:5462-5470, 1999). The intensities of PBt spots in the presence of 0.4% 1-butanol were measured, and PLD activity was obtained by subtracting the corresponding intensities of spots obtained in the absence of 1-butanol.
To identify the PLD isozyme responsible for stimulating insulin secretion, the present inventors examined the effect of overexpression and silencing of PLD isozymes. We transfected MIN6 cells with an empty vector, PLD1, or PLD2, and stimulated them with EGF. PLD1 mediated glucose-dependent insulin secretion, as shown previously (data not shown) (Hughes W E et al., J Biol Chem 279:27534-27541, 2004). In contrast, PLD2 exclusively mediated EGF-dependent insulin secretion and overexpression of PLD1 showed a limited effect (upper panel of
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Because both Ca2+ influx and PLD activity are required for EGF-dependent insulin secretion, this example analyzed the relationship between them by testing the effect of Ca2+ influx on PLD activity and the effect of PLD activity on Ca2+ influx. Blocking Ca2+ influx by using EGTA or BAPTA/AM inhibited most of the PLD activity (
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Immunoblot Analysis: Proteins were denatured by boiling for 5 min at 95° C. in Laemmli sample buffer (Laemmli U K et al., Nature 227:680-685, 1970), separated by SDS-PAGE, and immunoblotted, as described previously (Kim J H et al., J Immunol 163:5462-5470, 1999).
To confirm the physiological significance of EGF, Ca2+, and PLD on insulin secretion, the present inventors prepared primary cultures of mouse islets. As expected, EGF rapidly increased insulin secretion (
To prepare mouse pancreatic islets, pancreatic islets were isolated from 7- to 8-week-old male BALB/c mice (Hyochang Science, Korea), as described previously (Jonas J C, et al., Diabetes 47:1266-1273, 1998). Isolated islets were transferred onto a 12 well plate, with 10-15 islets per well. We used same number of islets in a same set of experiment. The islets were maintained for up to 2 days in RPMI1640 medium containing 5 mM glucose and 10% fetal calf serum, and supplemented with 100 g/ml streptomycin and 100 U/ml penicillin.
The mouse pancreatic islets were plated onto 12-well plates and grown for 24 h. The islets were washed twice with KRB supplemented with 0.2% BSA, and then incubated for 60 min at 37° C. in the KRB solution.
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To confirm in vitro findings that EGF could stimulate insulin release, this example characterized the EGF-mediated responses of mouse plasma glucose and insulin levels in normal and obese db/db mice by injecting EGF intravenously.
Measurement of Plasma Glucose and Plasma Insulin Levels: 7- to 8-week-old male ICR mice were purchased from Hyochang Science (Seoul, Korea). C57BLKSJ-db/db mice were purchased from SLC (Japan). After fasting for 6 h, ICR or C57BLKSJ-db/db mice were intravenously injected with saline, EGF, insulin or glucose in the tail vein, and blood samples (0.1 ml) were collected. Concentrations of plasma glucose were measured by the glucose oxidase method with a portable glucose meter (Gluco-Dr, Korea). Plasma was separated by centrifugation and the plasma insulin assay was performed using a RIA kit. Animal care was conducted in accordance with our institution's guidelines.
Measurement of Plasma EGF Levels: 7- to 8-week-old male ICR mice were purchased from Hyochang Science (Seoul, Korea). After fasting for 6 h, ICR mice were orally injected with saline or glucose and blood samples (0.1 ml) were collected in EGTA coated tubes. Concentrations of plasma EGF levels were measured by EGF ELISA kit (KOMA biotech, Korea). Animal care was conducted in accordance with our institution's guidelines.
In preliminary experiments, EGF at 50 g/kg reached a saturated plasma glucose-lowering effect 10 min after the intravenous injection into 7- to 8-week-old male ICR mice (data not shown). This glucose-lowering effect of EGF (50 g/kg) had a similar potency to insulin and had a dose-dependency (
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While the present invention has been described in detail with reference to the preferred embodiments, those skilled in the art will appreciate that various modifications and substitutions can be made thereto without departing from the spirit and scope of the present invention as set forth in the appended claims.
This application claims priority to and the benefit of U.S. provisional application No. 60/807,374 filed in the United State of Patent and Trademark Office on Jul. 14, 2006, the entire content of which is incorporated hereinto by reference.
Filing Document | Filing Date | Country | Kind | 371c Date |
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PCT/KR2007/003451 | 7/16/2007 | WO | 00 | 1/13/2009 |
Number | Date | Country | |
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60807374 | Jul 2006 | US |