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Liraglutide reduces oxidative stress and restores heme oxygenase-1 and ghrelin levels in patients with type 2 diabetes: a prospective pilot study.

ABSTRACT: CONTEXT:Liraglutide is a glucagon-like peptide-1 analog and glucose-lowering agent whose effects on cardiovascular risk markers have not been fully elucidated. OBJECTIVE:We evaluated the effect of liraglutide on markers of oxidative stress, heme oxygenase-1 (HO-1), and plasma ghrelin levels in patients with type-2 diabetes mellitus (T2DM). DESIGN AND SETTING:A prospective pilot study of 2 months' duration has been performed at the Unit of Diabetes and Cardiovascular Prevention at University of Palermo, Italy. Patients and Intervention(s): Twenty subjects with T2DM (10 men and 10 women; mean age: 57 ± 13 y) were treated with liraglutide sc (0.6 mg/d for 2 wk, followed by 1.2 mg/d) in addition to metformin (1500 mg/d orally) for 2 months. Patients with liver disorders or renal failure were excluded. MAIN OUTCOME MEASURE(S):Plasma ghrelin concentrations, oxidative stress markers, and heat-shock proteins, including HO-1 were assessed. RESULTS:The addition of liraglutide resulted in a significant decrease in glycated hemoglobin (HbA1c) (8.5 ± 0.4 vs 7.5 ± 0.4%, P < .0001). In addition, plasma ghrelin and glutathione concentrations increased (8.2 ± 4.1 vs 13.6 ± 7.3 pg/ml, P = .0007 and 0.36 ± 0.06 vs 0.44 ± 0.07 nmol/ml, P = .0002, respectively), whereas serum lipid hydroperoxides and HO-1 decreased (0.11 ± 0.05 vs 0.04 ± 0.07 pg/ml, P = .0487 and 7.7 ± 7.7 vs 3.6 ± 1.8 pg/ml, P = .0445, respectively). These changes were not correlated with changes in fasting glycemia or HbA1c. CONCLUSIONS:In a 2-months prospective pilot study, the addition of liraglutide to metformin resulted in improvement in oxidative stress as well as plasma ghrelin and HO-1 concentrations in patients with T2DM. These findings seemed to be independent of the known effects of liraglutide on glucose metabolism.

SUBMITTER: Rizzo M

PROVIDER: S-EPMC4318909 | biostudies-literature | 2015 Feb

REPOSITORIES: biostudies-literature

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Liraglutide reduces oxidative stress and restores heme oxygenase-1 and ghrelin levels in patients with type 2 diabetes: a prospective pilot study.

Rizzo Manfredi M Abate Nicola N Chandalia Manisha M Rizvi Ali A AA Giglio Rosaria V RV Nikolic Dragana D Marino Gammazza Antonella A Barbagallo Ignazio I Isenovic Esma R ER Banach Maciej M Montalto Giuseppe G Li Volti Giovanni G

The Journal of clinical endocrinology and metabolism 20141113 2

<h4>Context</h4>Liraglutide is a glucagon-like peptide-1 analog and glucose-lowering agent whose effects on cardiovascular risk markers have not been fully elucidated.<h4>Objective</h4>We evaluated the effect of liraglutide on markers of oxidative stress, heme oxygenase-1 (HO-1), and plasma ghrelin levels in patients with type-2 diabetes mellitus (T2DM).<h4>Design and setting</h4>A prospective pilot study of 2 months' duration has been performed at the Unit of Diabetes and Cardiovascular Prevent ...[more]

PMID: 25393640

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Project description:Introduction: Heme oxygenase-1 (HO-1) is a 32 kDa stress-response protein implicated in the pathogenesis of Parkinson's disease (PD). Biliverdin is derived from heme through a reaction mediated by HO-1 and protects cells from oxidative stress. However, iron and carbon monoxide produced by the catabolism of HO-1 exert detrimental effects on patients with PD. The purpose of this study was to determine whether plasma HO-1 levels represent a biomarker of PD and to further explore the underlying mechanism of increased HO-1 levels by applying voxel-based morphometry (VBM).Methods: We measured plasma HO-1 levels using an enzyme-linked immunosorbent assay (ELISA) in 156 subjects, including 81 patients with early- and advanced-stage PD and 75 subjects without PD. The analyses were adjusted to control for confounders such as age, sex, and medication. We analyzed T1-weighted magnetic resonance imaging (MRI) data from 74 patients with PD using VBM to elucidate the association between altered brain volumes and HO-1 levels. Then, we compared performance on MMSE sub-items between PD patients with low and high levels of HO-1 using Mann-Whitney U tests.Results: Plasma HO-1 levels were significantly elevated in PD patients, predominantly those with early-stage PD, compared with controls (p < 0.05). The optimal cutoff value for patients with early PD was 2.245 ng/ml HO-1 [area under the curve (AUC) = 0.654]. Plasma HO-1 levels were unaffected by sex, age, and medications (p > 0.05). The right hippocampal volume was decreased in the subset of PD patients with high HO-1 levels (p < 0.05). A weak correlation was observed between right hippocampal volume and plasma HO-1 levels (r = -0.273, p = 0.018). There was no difference in total MMSE scores between the low- and high-HO-1 groups (p > 0.05), but the high-HO-1 group had higher language scores than the low-HO-1 group (p < 0.05).Conclusions: Plasma HO-1 levels may be a promising biomarker of early PD. Moreover, a high plasma concentration of the HO-1 protein is associated with a reduction in right hippocampal volume.

Project description:Endothelial cells (ECs) form the inner lining of blood vessels and are central to sensing chemical perturbations that can lead to oxidative stress. The degree of stress is correlated with divergent phenotypes such as quiescence, cell death, or senescence. Each possible cell fate is relevant for a different aspect of endothelial function, and hence, the regulation of cell fate decisions is critically important in maintaining vascular health. This study examined the oxidative stress response (OSR) in human ECs at the boundary of cell survival and death through longitudinal measurements, including cellular, gene expression, and perturbation measurements. 0.5 mM hydrogen peroxide (HP) produced significant oxidative stress, placed the cell at this junction, and provided a model to study the effectors of cell fate. The use of systematic perturbations and high-throughput measurements provide insights into multiple regimes of the stress response. Using a systems approach, we decipher molecular mechanisms across these regimes. Significantly, our study shows that heme oxygenase-1 (HMOX1) acts as a gatekeeper of cell fate decisions. Specifically, HP treatment of HMOX1 knockdown cells reversed the gene expression of about 51% of 2,892 differentially expressed genes when treated with HP alone, affecting a variety of cellular processes, including anti-oxidant response, inflammation, DNA injury and repair, cell cycle and growth, mitochondrial stress, metabolic stress, and autophagy. Further analysis revealed that these switched genes were highly enriched in three spatial locations viz., cell surface, mitochondria, and nucleus. In particular, it revealed the novel roles of HMOX1 on cell surface receptors EGFR and IGFR, mitochondrial ETCs (MTND3, MTATP6), and epigenetic regulation through chromatin modifiers (KDM6A, RBBP5, and PPM1D) and long non-coding RNA (lncRNAs) in orchestrating the cell fate at the boundary of cell survival and death. These novel aspects suggest that HMOX1 can influence transcriptional and epigenetic modulations to orchestrate OSR affecting cell fate decisions.

Project description:Purpose: Excess oxidative stress (OS) impairs endothelial function and plays an important role in vascular diseases, diabetes, and neuronal disorders. Several consequences of OS including cell recovery and apoptosis have been described previously. In this study, we report systems model of the temporal dynamics of the oxidative stress response in Human Umbilical Vein Endothelial Cells (HUVECs) and characterize HMOX1 as a master regulator in orchestrating the response to oxidative stress. Methods: Following stress induction by hydrogen peroxide (HP), we carried out dose-dependent phenotypic assays and time series measurements of transcripts in HUVECs. To explore the role of HMOX1, HUVECs were transfected with scrambled siRNA or si-HMOX1 and then treated with hydrogen peroxide. Total RNA was collected from Scrambled-untreated, scrambled-H2O2, and si-HMOX1-H2O2 samples for RNAseq. Novel findings were validated by qPCR and functional assays. Results: In this study we have identified three phases of stress response (acute response from 1-2 hours, the transition from 4-6 hours, and the chronic stress response from 8-16 hours). We observe stable cell cycle arrest and impaired DNA replication/repair from 8-16 hours along with and increased resistance to apoptosis from 2-16 hours. Knockdown of HMOX1 prior to HP treatment releases the resistance to apoptosis. Similarly, many cellular processes switch their direction of regulation in HMOX1 deficient cells upon HP treatment (i.e. autophagy, mitochondria, cell surface signaling, expression of histone modifying enzymes and long-noncoding RNAs etc). Conclusions: Endothelial cell fate decisions are critically important for vascular health. In this study we provide a temporal model characterizing the transition from the acute stress response to the chronic response. The nexus of cell function and dysfunction is characterized by the concurrent activation of survival and death pathways. We explore the master regulatory role of HMOX1 and identify novel mechanisms by which HMOX1 may regulate cell fate decisions.

Dataset Information

Liraglutide reduces oxidative stress and restores heme oxygenase-1 and ghrelin levels in patients with type 2 diabetes: a prospective pilot study.

Publications

Liraglutide reduces oxidative stress and restores heme oxygenase-1 and ghrelin levels in patients with type 2 diabetes: a prospective pilot study.

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