Dimeric Fc receptor (FcR) nonbinding anti-CD3 antibodies have been developed to minimize toxicities associated with classical anti-CD3 monoclonal antibodies (e.g., OKT3). Studies with murine analogs of non-FcR–binding antibodies have shown reduced mitogenicity compared to OKT3. In a trial of an FcR nonbinding humanized anti-CD3 mAb hOKT3γ1(Ala-Ala) for treatment of patients with type 1 diabetes, we found significant increases in IL-10 and IL-5 in the serum of 63% and 72% of patients, respectively, and TNF-α and IL-6 levels that were lower than those previously reported following OKT3 therapy. The activation signal delivered by hOKT3γ1(Ala-Ala) was associated with calcium signaling and cytokine production by previously activated human cells in vitro. However, the production of IL-10, compared to IFN-γ on a molar basis, was greater after culture with hOKT3γ1(Ala-Ala) than with OKT3. Flow cytometric studies confirmed that OKT3 induced IFN-γ and IL-10 production, but hOKT3γ1(Ala-Ala) induced only detectable IL-10 production in CD45RO+ cells. Moreover, in vivo, we found IL-10+CD4+ T cells after drug treatment. These cells were heterogeneous but generally CD45RO+, CTLA-4–, and expressed CCR4. A subgroup of these cells expressed TGF-β. Thus, the non-FcR binding anti-CD3 mAb, hOKT3γ1(Ala-Ala) delivers an activation signal to T cells that is quantitatively and qualitatively different from OKT3. It leads to the generation of T cells that might inhibit the autoimmune response and may be involved in the beneficial effect on β cell destruction in Type 1 diabetes.
Kevan C. Herold, Joshua B. Burton, Fleur Francois, Ena Poumian-Ruiz, Mariela Glandt, Jeffrey A. Bluestone
The adipose-derived hormone resistin is postulated to link obesity to insulin resistance and diabetes. Here, the infusion of either resistin or the resistin-like molecule–β (RELMβ) rapidly induced severe hepatic but not peripheral insulin resistance. In the presence of physiologic hyperinsulinemia, the infusion of purified recombinant resistin, increasing circulating resistin levels by approximately twofold to 15-fold, inhibited glucose metabolism such that lower rates of glucose infusion were required to maintain the plasma glucose concentration at basal levels. The effects of resistin and RELMβ on in vivo insulin action were completely accounted for by a marked increase in the rate of glucose production. These results support the notion that a novel family of fat- and gut-derived circulating proteins modulates hepatic insulin action.
Michael W. Rajala, Silvana Obici, Philipp E. Scherer, Luciano Rossetti
AMP-activated protein kinase (AMPK) is viewed as a fuel sensor for glucose and lipid metabolism. To better understand the physiological role of AMPK, we generated a knockout mouse model in which the AMPKα2 catalytic subunit gene was inactivated. AMPKα2–/– mice presented high glucose levels in the fed period and during an oral glucose challenge associated with low insulin plasma levels. However, in isolated AMPKα2–/– pancreatic islets, glucose- and L-arginine–stimulated insulin secretion were not affected. AMPKα2–/– mice have reduced insulin-stimulated whole-body glucose utilization and muscle glycogen synthesis rates assessed in vivo by the hyperinsulinemic euglycemic clamp technique. Surprisingly, both parameters were not altered in mice expressing a dominant-negative mutant of AMPK in skeletal muscle. Furthermore, glucose transport was normal in incubated isolated AMPKα2–/– muscles. These data indicate that AMPKα2 in tissues other than skeletal muscles regulates insulin action. Concordantly, we found an increased daily urinary catecholamine excretion in AMPKα2–/– mice, suggesting altered function of the autonomic nervous system that could explain both the impaired insulin secretion and insulin sensitivity observed in vivo. Therefore, extramuscular AMPKα2 catalytic subunit is important for whole-body insulin action in vivo, probably through modulation of sympathetic nervous activity.
Benoit Viollet, Fabrizio Andreelli, Sebastian B. Jørgensen, Christophe Perrin, Alain Geloen, Daisy Flamez, James Mu, Claudia Lenzner, Olivier Baud, Myriam Bennoun, Emmanuel Gomas, Gaël Nicolas, Jørgen F.P. Wojtaszewski, Axel Kahn, David Carling, Frans C. Schuit, Morris J. Birnbaum, Erik A. Richter, Rémy Burcelin, Sophie Vaulont
Kazuhiko Takahashi, Hiroaki Suwa, Tomoo Ishikawa, Hidehito Kotani
Tadahiro Kitamura, Jun Nakae, Yukari Kitamura, Yoshiaki Kido, William H. Biggs III, Christopher V.E. Wright, Morris F. White, Karen C. Arden, Domenico Accili
Blake B. Rasmussen, Ulf C. Holmbäck, Elena Volpi, Beatrice Morio-Liondore, Douglas Paddon-Jones, Robert R. Wolfe
Kazuaki Miyake, Wataru Ogawa, Michihiro Matsumoto, Takehiro Nakamura, Hiroshi Sakaue, Masato Kasuga
Georg M.N. Behrens, Anne-Rose Boerner, Klaus Weber, Joerg van den Hoff, Johann Ockenga, Georg Brabant, Reinhold E. Schmidt
I. Sadaf Farooqi, Giuseppe Matarese, Graham M. Lord, Julia M. Keogh, Elizabeth Lawrence, Chizo Agwu, Veronica Sanna, Susan A. Jebb, Francesco Perna, Silvia Fontana, Robert I. Lechler, Alex M. DePaoli, Stephen O’Rahilly
Jia Li-Hawkins, Mats Gåfvels, Maria Olin, Erik G. Lund, Ulla Andersson, Gertrud Schuster, Ingemar Björkhem, David W. Russell, Gosta Eggertsen