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Thesis (M.D.)—-Boston University

Made available in DSpace on 2014-06-11T19:23:01Z (GMT). No. of bitstreams: 0 Previous issue date: 2011-10-31Bitstream added on 2014-06-13T20:49:47Z : No. of bitstreams: 1 destro_m_me_botib.pdf: 1170172 bytes, checksum: dde49d0cf6d568f068e97098c9cdebe7 (MD5) / Conselho Nacional de Desenvolvimento Científico e Tecnológico (CNPq) / O aumento da secreção de insulina estimulada por glicose é um mecanismo adaptativo observado nas ilhotas pancreáticas de animais resistentes à insulina. Estudos relatam que os ácidos graxos livres estimulam a secreção de insulina através da ativação do GPR40. Diante destes fatos, investigamos a secreção de insulina, a expressão de proteínas da via do GPR40 nas células ß e a participação dos lipídios na resistência à insulina induzida por dexametasona, através do tratamento com o redutor de lipídios bezafibrato. Os grupos receberam gavagem uma vez ao dia durante 28 dias: Controle (CTL) e DEXA com goma arábica 5% (1 ml/kg, peso corpóreo); BEZA e BEZA-DEXA com bezafibrato (300 mg/kg, p.c.). Nos últimos 5 dias de tratamento os grupos receberam injeções intraperitoniais: CTL e BEZA de solução salina (1 ml/kg, p.c.); DEXA e BEZA-DEXA de dexametasona (Decadron® 1,0 mg/kg, p.c). A secreção de insulina estimulada por glicose aumentou nos grupos BEZA e DEXA. BEZA-DEXA exibiu diminuição dos níveis de ácidos graxos livres, triglicérides e de insulina, mas não houve elevação dos níveis de glicose no sangue. Além disso, houve melhora na resistência à insulina e restauração do padrão de secreção de insulina, em comparação ao grupo DEXA. Nas ilhotas dos animais BEZA-DEXA a expressão das proteínas GPR40, PLCß1 e PKCδ foi significativamente maior em relação aos valores obtidos em DEXA. Esta via permaneceu inalterada nas ilhotas de DEXA e BEZA. Em conclusão, o tratamento com bezafibrato melhorou a função das células ß e impediu a indução de resistência à insulina pelo tratamento com dexametasona, mas os mecanismos não são conhecidos. O aumento na secreção de insulina em DEXA aparentemente não está relacionado com a ativação do GPR40. Contrariando a literatura, apesar da redução na secreção de insulina, as ilhotas dos animais BEZA-DEXA apresentaram ativação da via do GPR40 / Increased glucose-stimulated insulin secretion is an adaptive mechanism exhibited by pancreatic islets from insulin resistant animal. Studies report that the free fatty acids stimulate the insulin secretion via GPR40. As such, we investigate the expression of GPR40 in ß-cells and the involvement of lipids in dexamethasone-induced IR, by lipid-lowering therapy with bezafibrate. Groups received once daily gavage for 28 days: Control (CTL) and DEXA with gum Arabic 5% (1.0 mg/kg, body weight); BEZA and BEZA-DEXA with bezafibrate (300 mg/kg, b.w.). In the last 5 days of the treatment groups received intraperitoneal injections: CTL and BEZA of saline (1.0 mg/kg, b.w.); DEXA and BEZA-DEXA of dexamethasone (Decadron® 1.0 mg/kg, b.w.). The glucose-stimulated insulin secretion increased in the DEXA and BEZA groups. BEZA-DEXA shows decrease in fatty acids, triglycerides and insulin levels, but not raised blood glucose levels. In addition, there was improved in insulin resistance and restoration the insulin secretory pattern, when compared to DEXA group. In BEZA-DEXA islets, GPR40, PLCß1 and PKCδ protein content was significantly higher than DEXA. This pathway remained unchanged in DEXA and BEZA islets. In conclusion, bezafibrate treatment improved ß-cell function and prevented dexamethasone-induced IR, but the mechanisms are not known. Augmented insulin secretion in DEXA appears to be unrelated to the activation of the GPR40. Contrary to the literature, despite the reduction in insulin secretion, BEZA-DEXA islets showed activation of the GPR40 pathway

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第22884号 / 医博第4678号 / 新制||医||1048(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 長船 健二, 教授 羽賀 博典, 教授 椛島 健治 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

Indiana University-Purdue University Indianapolis (IUPUI) / Diabetes mellitus is a complex metabolic disease that currently affects an estimated 422 million people worldwide, with incidence rates rising annually. Type 1 diabetes (T1D) accounts for 5-10% of these cases. Its complications remain a major cause of global deaths. T1D is characterized by autoimmune destruction of β-cell mass. Efforts to preserve and protect β-cell mass in the preclinical stages of T1D are limited by few blood-borne biomarkers of β-cell destruction. In healthy β-cells, insulin secretion requires soluble n-ethylmaleimide-sensitive factor-attachment protein receptor (SNARE) complexes and associated accessory regulatory proteins to promote the docking and fusion of insulin vesicles at the plasma membrane. Two target membrane (t)-SNARE proteins, Syntaxin 1/4 and SNAP25/23, and one vesicle-associated (v)-SNARE protein, VAMP2, constitute the SNARE core complex. SNARE complex assembly is also facilitated by the regulatory protein, Double C2-domain protein β (DOC2B). I hypothesized that DOC2B deficiency may underlie β-cell susceptibility to T1D damage; conversely , overexpression of DOC2B may protect β-cell mass. Indeed, with regard to DOC2B abundance, my studies show reduced levels of DOC2B in platelets and islets of prediabetic rodents and new-onset T1D humans. Remarkably, clinical islet transplantation in T1D humans restores platelet DOC2B levels, indicating a correlation With regard to protection/functional effects, DOC2B deficiency enhances susceptibility to T1D in mice, while overexpression of DOC2B selectively in β-cells protects mice from chemically induced T1D; this correlates with preservation of functional β-cell mass. Mechanistically, overexpression of DOC2B and the DOC2B peptide, C2AB, protects clonal β-cell against cytokine or thapsigargin-induced apoptosis and reduces ER stress; this is dependent on C2AB’s calcium binding capacity. C2AB is sufficient to enhance glucose stimulated insulin secretion (GSIS) and SNARE activation in clonal β-cells to the same extent as full-length DOC2B. In summary, these studies identify DOC2B as a potential biomarker and novel therapeutic target for prevention/management of T1D.

京都大学 / 0048 / 新制・課程博士 / 博士(医学) / 甲第21342号 / 医博第4400号 / 新制||医||1031(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 長船 健二, 教授 羽賀 博典, 教授 妹尾 浩 / 学位規則第4条第1項該当 / Doctor of Medical Science / Kyoto University / DFAM

京都大学 / 新制・論文博士 / 博士(医学) / 乙第13610号 / 論医博第2320号 / 新制||医||1073(附属図書館) / 京都大学大学院医学研究科医学専攻 / (主査)教授 川口 義弥, 教授 伊達 洋至, 教授 長船 健二 / 学位規則第4条第2項該当 / Doctor of Medical Science / Kyoto University / DFAM

Thesis (MScMedSc)--Stellenbosch University, 2015. / ENGLISH ABSTRACT: Diabetes Mellitus is a metabolic disease characterized by the loss of beta cells from the islets, thereby disrupting islet composition and architecture which are important components that influence islet function. The experimental technique of pancreatic duct ligation (PDL), which is thought to induce the regeneration of beta cells within the adult pancreas, was investigated as a novel treatment strategy for diabetes. This study aimed at investigating the possibility that the PDL model may have the capacity to restore normal islet composition and architecture in diabetic animals, which could make it an effective approach to reverse diabetes. Male Wistar rats (n=55) were divided into three study groups: the normal control (NC) group, the diabetic control (DC) group consisting of five subgroups (day 0, 3, 5, 10 and 30) and the experimental (EX) group consisting of four subgroups (day 3, 5, 10 and 30). The experimental group was exposed to PDL. All pancreata were divided into a P1 portion (proximal to the point of ligature) and P2 portion (distal to the point of ligature) for histological assessment. Animals’ non-fasting blood glucose levels (BGLs) and body weights were monitored. The general morphology of the tissue was studied, while an immunohistochemical (IHC) study was performed to determine insulin, pancreatic polypeptide, glucagon and somatostatin protein expression in the P1 and P2 portions of the pancreas. From the IHC slides hormone fractions, staining intensity and distribution were determined as indication of islet composition and architecture. Despite apparent morphological recovery in the islet 30 days post-PDL, islet composition and architecture remained disrupted. Compared to diabetic animals, the proximal portion of the pancreas in experimental animals had a decreased beta cell fraction and increased delta cell fraction thirty days following PDL. These observed changes in islet composition in the part of the pancreas proximal to the ligature are novel findings. There was no change in the diabetic islet composition in the portion of the pancreas distal to the ligature thirty days following PDL. Furthermore, pancreatic duct ligation did not restore body weight or normoglycemia. We conclude that STZ disrupts islet composition and architecture and this could not be restored using PDL; we therefore suggest that a comparative study using a Type 2 diabetic model, where there is limited damage to pre-existing beta cells, may yield different results. / AFRIKAANSE OPSOMMING: Diabetes Mellitus is ʼn metaboliese siekte wat deur die verlies van beta selle uit die eilande van Langerhans gekarakteriseer word. Hierdie verlies van beta selle ontwrig eiland komposisie en argitektuur, twee belangrike komponente van eiland funksie. Die eksperimentele tegnieke van pankreatiese buisafbinding (in Engels PDL), wat moontlik beta sel regenerasie in die volwasse pankreas kan induseer, is ondersoek as behandelings-strategie vir diabetes. Hierdie studie het ten doel gehad om die moontlikheid te ondersoek dat die PDL model die kapasiteit het om normale eiland komposisie en argitektuur te herstel in diabetiese diere, wat dit ʼn effektiewe benadering vir die omkeer van diabetes kan maak. Manlike Wistar rotte (n=55) was in 3 studie groepe verdeel: die normale kontrole (NC) groep, die diabetiese kontrole (DC) groep wat uit vyf subgroepe bestaan (dag 0, 3, 5, 10 en 30) en die eksperimentele (EX) groep wat uit vier subgroepe bestaan (dag 3, 5, 10 en 30). Die eksperimentele groep is aan PDL blootgestel. Alle pankreata is verdeel in ʼn P1 porsie (proksimaal tot die afbinding) en ʼn P2 porsie (distaal tot die afbinding) vir histologiese assessering. Die diere se nie-vastende bloed glukose vlakke en liggaamsgewig is gemonitor. Die algemene morfologie van die pankreas weefsel is bestudeer, terwyl ’n immunohistochemiese (IHC) studie gedoen is om insulien, pankreatiese polipeptied, glukagon en somatostatien proteïen uitdrukking in die P1 en P2 porsies van die pankreas te bepaal. Vanaf die IHC snitte is hormoon fraksie, kleur intensiteit en verspreiding bepaal as aanduidings van eiland komposisie en argitektuur. Ten spyte van ooglopende morfologiese herstel in die eilande op dag 30 na PDL, het eiland komposisie en argitektuur versteur gebly. In vergelyking met die diabetiese diere, het die proksimale deel van die pankreas van eksperimentele diere verlaagde beta sel fraksie en verhoogde delta sel fraksie getoon dertig dae na PDL. Die waarneming van veranderde komposisie in die deel van die pankreas proksimaal tot die afbinding is nuut. Daar was geen verandering in diabetiese eiland komposisie in die deel van die pankreas distaal tot die afbinding dertig dae na PDL nie. Verder het PDL nie liggaamsgewig of bloedsuiker genormaliseer nie. Ons gevolgtrekking is dat STZ eiland komposisie en argitektuur ontwrig en dat dit nie met PDL herstel kon word nie; daarom stel ons ʼn vergelykende studie in ʼn tipe 2 diabetes model voor, waar die skade aan reeds bestaande beta selle beperk is, wat ander resultate mag lewer.

Transplantation of pancreatic islets is a potential treatment of type 1 diabetes that aims to restore normal blood glucose control. By encapsulating the islets in alginate, they can be protected from rejection. The aim of this thesis was to study the biology of encapsulated islets and to use the technique of microencapsulation to study the effect of transplantation in a system that is separated from direct contact with the vascular system and the host tissue at the transplantation site. Encapsulated islets can effectively reverse hyperglycaemia after transplantation into the peritoneal cavity of diabetic mice. A period of culture before encapsulation and transplantation did not affect their insulin release or curative capability. Pre-culture with exendin-4 improved insulin secretion, but not to the extent that the long term outcome in our transplantation model was improved. Despite being able to reach and retain normoglycaemia, microencapsulated islets transplanted intraperitoneally decreased in size. More specifically the number of beta cells in each individual islet was decreased. However, in contrast to previous studies using non-encapsulated islets, the alpha cell number was maintained, and thus the capsule seems to protect these peripherally located and otherwise exposed cells. As the capsule also prevents revascularisation of the islets, the model was used to study the importance of vascular supply for islet amyloid formation. Islet amyloid is a possible reason for the long-term failure of transplanted islets. It is likely that their low vascular density causes a disturbed local clearance of IAPP and insulin that starts the aggregation of IAPP. Indeed, encapsulated islets had an accelerated amyloid formation compared to normal islets, and might serve as a model for further studies of this process. In conclusion, although revascularisation is not a prerequisite for islet graft function, it plays an important role for islet transplantation outcome.

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