Statins are primary drugs in the treatment of hyperlipidemias. This group of drugs is known for its beneficial pleiotropic effects (e.g., reduction of inflammatory state). However, a growing body of evidence suggests its diabetogenic properties. The culpable mechanism is not completely understood and might be related to the damage to pancreatic beta cells. Therefore, we conceived an in vitro study to explore the impact of atorvastatin on pancreatic islet beta cells line (1.1.E7). We evaluated the influence on viability, insulin, low-density lipoprotein (LDL) receptor, and proprotein convertase subtilisin/kexin type 9 (PCSK9) expression. A significant drop in mRNA for proinsulin and insulin expression was noted. Concurrently, a rise in LDL receptor at the protein level in cells exposed to atorvastatin was noted. Further experiments have shown that exenatide - belonging to glucagon-like peptide 1 (GLP-1) analogs that are used in a treatment of diabetes and known for its weight reducing properties - can alleviate the observed alterations. In this case, the mechanism of action of exenatide was dependent on a protein kinase A pathway. In conclusion, our results support the hypothesis that statin may have diabetogenic properties, which according to our study is related to reduced insulin expression. The concomitant use of GLP-1 receptor agonist seemed to successfully revert insulin expression.
- MeSH
- atorvastatin farmakologie metabolismus MeSH
- beta-buňky * MeSH
- exenatid farmakologie metabolismus MeSH
- inzulin metabolismus MeSH
- proproteinkonvertasa subtilisin/kexin typu 9 metabolismus farmakologie MeSH
- proteinkinasy závislé na cyklickém AMP metabolismus farmakologie MeSH
- receptory LDL metabolismus MeSH
- sekrece inzulinu MeSH
- statiny * farmakologie metabolismus MeSH
- Publikační typ
- časopisecké články MeSH
- Klíčová slova
- semaglutid,
- MeSH
- aplikace orální MeSH
- bezpečnost MeSH
- diabetes mellitus 2. typu farmakoterapie MeSH
- exenatid aplikace a dávkování MeSH
- glifloziny aplikace a dávkování MeSH
- glukagonu podobný peptid 1 agonisté MeSH
- glykovaný hemoglobin analýza účinky léků MeSH
- hmotnostní úbytek účinky léků MeSH
- hypoglykemika * aplikace a dávkování farmakologie škodlivé účinky MeSH
- inzulin glargin aplikace a dávkování MeSH
- inzuliny aplikace a dávkování MeSH
- kardiovaskulární nemoci epidemiologie MeSH
- kombinovaná farmakoterapie MeSH
- látky proti obezitě aplikace a dávkování farmakologie škodlivé účinky MeSH
- lidé MeSH
- liraglutid aplikace a dávkování MeSH
- multicentrické studie jako téma MeSH
- randomizované kontrolované studie jako téma * MeSH
- rizikové faktory kardiovaskulárních chorob MeSH
- sitagliptin fosfát aplikace a dávkování MeSH
- tělesná hmotnost účinky léků MeSH
- změny tělesné hmotnosti MeSH
- Check Tag
- lidé MeSH
PURPOSE OF REVIEW: To review the currently available data on the effect of Glucagon-like peptide 1 receptor agonists (GLP-1 RAs) on postprandial lipaemia. RECENT FINDINGS: Out of the available studies that examined the respective lipid parameter, exenatide reduced postprandial triacyglycerol (TAG) in 4/6, apolipoprotein B-48 in 3/3, non-esterified fatty acids in 2/2, and apolipoprotein C-III and very low-density lipoprotein cholesterol (VLDL-C) in 1/1 studies. Liraglutide reduced postprandial TAG in 2/2, apolipoprotein B-48 in 3/3 and apolipoprotein C-III, chylomicron-TAG and VLDL1-TAG in 1/1 studies. Lixisenatide reduced postprandial chylomicron-TAG and apolipoprotein B-48 in 1 study. Semaglutide reduced postprandial TAG, apolipoprotein B-48 and VLDL in 1 study. Dulaglutide reduced postprandial apolipoprotein B-48 in 1 study. GLP-1 RAs have consistent beneficial effects on postprandial lipaemia with most of the data coming from studies with exenatide and liraglutide. Reduction of postprandial lipaemia might be one of the mechanisms behind the pleiotropic effects of GLP-1 RAs.
- MeSH
- apolipoprotein B-48 MeSH
- apolipoprotein C-III MeSH
- chylomikrony MeSH
- diabetes mellitus 2. typu * MeSH
- exenatid terapeutické užití MeSH
- glukagonu podobný peptid 1 MeSH
- hyperlipidemie * farmakoterapie MeSH
- hypoglykemika MeSH
- lidé MeSH
- liraglutid farmakologie terapeutické užití MeSH
- receptor pro glukagonu podobný peptid 1 agonisté MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- přehledy MeSH
AIM: To assess the safety and efficacy of the short-acting glucagon-like peptide-1 receptor agonist exenatide on a population of patients with type 2 diabetes (T2D) mostly treated with continuous subcutaneous insulin injection (CSII). MATERIALS AND METHODS: A phase 2/3, multicentre, randomized, parallel-group, double-blind, placebo-controlled, 6-month trial was conducted. Patients were randomized to receive subcutaneous (SC) injections of exenatide (10 μg BID) or matched placebo. RESULTS: A total of 46 patients with T2D and elevated HbA1c were randomized (42% of the planned sample size): exenatide (n = 28) and placebo (n = 18). CSII treatment was used by 75% and 89% of patients of the exenatide and placebo groups, respectively. At 6 months, the change in HbA1c was -0.62% ± 0.94% and 0.08% ± 0.81% in the exenatide and placebo groups, respectively (difference, -0.70%; 95% CI [-1.24%; -0.15%], P = .014); body weight and body mass index decreased in the exenatide group (-2.55 ± 3.25 kg and -1.00 ± 1.31 kg/m2 ) and increased in the placebo group (1.29 ± 2.82 kg and 0.46 ± 1.16 kg/m2 ) (observed difference, -3.85 and -1.45, respectively, both P < .001); the postdinner capillary blood glucose value was lower in the exenatide group compared with the placebo group (162.4 ± 80.5 vs. 259.1 ± 94.4 mg/dL, respectively; observed difference, -96.7, P < .01). Hypoglycaemic risk, quality of life and overall safety were not different between the groups, apart from the expected occurrence of digestive effects in the exenatide group. CONCLUSIONS: Although we failed to reach our planned sample size, the addition of exenatide treatment 10 μg BID SC in T2D patients with uncontrolled HbA1c despite an intensified insulin regimen, resulted in a significant reduction of HbA1c and body weight with a good overall safety profile and acceptance.
- MeSH
- diabetes mellitus 2. typu * farmakoterapie MeSH
- dvojitá slepá metoda MeSH
- exenatid MeSH
- glykovaný hemoglobin analýza MeSH
- hypoglykemika škodlivé účinky MeSH
- inzulin MeSH
- krevní glukóza MeSH
- kvalita života MeSH
- lidé MeSH
- výsledek terapie MeSH
- živočišné jedy škodlivé účinky MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- multicentrická studie MeSH
- práce podpořená grantem MeSH
- randomizované kontrolované studie MeSH
V kazuistike prezentujeme priaznivý efekt exenatidu a neskôr dulaglutidu v liečbe 58-ročného pacienta, bývalého fajčiara bez kardiovaskulárnej anamnézy a obličkového ochorenia s trvaním diabetes mellitus 2. typu 15 rokov. GLP-1 (glucagon like peptide-1) receptorový agonista (RA) bol pridaný do liečby, keď sa pacient liečil 9. rok. Od nastavenia na GLP-1 analóg je pacient bez hypoglykémií. Za šesť rokov liečby GLP-1 RA maximálny pokles telesnej hmotnosti u pacienta bol 12,5 kg, trvalý pokles telesnej hmotnosti dosiahol 5 kg. U pacienta sme v priebehu liečby GLP-1 analógom zaznamenali kolísanie hodnôt glykovaného hemoglobínu (HbA1c) v dôsledku prechodného emočného prejedania vplyvom stresov, kedy prechodne neužíval pravidelne GLP-1 RA, ako aj pre dlhodobo limitovanú pohybovú aktivitu pri vertebrogénnom algickom syndróme.
In the case report, we present a beneficial effect of exenatide and later dulaglutide in the treatment of a 58-year-old former smoker with 15 years of type 2 diabetes mellitus, without a cardiovascular history and kidney disease. GLP-1 (glucagon like peptide-1) receptor agonist (RA) was added after 9 years of treatment. The patient is free of hypoglycaemia since the start of the treatment with GLP-1 analogue. During 6 years of GLP-1 RA treatment, the maximum weight loss in the patient was 12.5 kg, the permanent weight loss reached 5 kg. During the treatment with GLP-1 analogue, we observed fluctuations in glycated haemoglobin (HbA1c) levels in the patient due to transient emotional overeating due to stress, when he did not temporarily use GLP-1 RA regularly, as well as for long-term limited physical activity due to vertebrogenic algic syndrome.
- Klíčová slova
- dulaglutid,
- MeSH
- diabetes mellitus 2. typu * farmakoterapie MeSH
- exenatid aplikace a dávkování terapeutické užití MeSH
- glukagonu podobný peptid 1 * analogy a deriváty aplikace a dávkování terapeutické užití MeSH
- hypoglykemie prevence a kontrola MeSH
- hypoglykemika aplikace a dávkování terapeutické užití MeSH
- lidé středního věku MeSH
- lidé MeSH
- výsledek terapie MeSH
- Check Tag
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- Publikační typ
- kazuistiky MeSH
Activation of autophagy suppresses ovarian cancer (OC). This in vitro study investigated whether the anti-tumour effect of exendin-4 against OC involves modulation of autophagy and figured out the possible mechanisms of action. SKOV-3 and OVCAR-3 cells (1 × 105/ml) were cultured in DMEM medium and treated with exendin-4 in the presence or absence of chloroquine (CQ), an autophagy inhibitor. In some cases, cells were also treated with exendin- 4 with or without pre-treatment with compound C (CC), an AMPK inhibitor, or insulin-like growth factor (IGF-1), a PI3K/Akt activator. Exendin-4 increased expression of beclin-1 and LC3I/II, suppressed expression of p62, reduced cell survival, migration, and invasion, and increased cell apoptosis and LDH release in both SKOV-3 and OVCAR-3 cells. Besides, exendin-4 reduced phosphorylation of mTORC1, 6SK, 4E-BP1, and Akt but increased phosphorylation of AMPK in both cell lines. These effects were associated with down-regulation of Bcl-2, suppression of nuclear phosphorylation of NF-κB p65, and increased expression of Bax and cleaved caspases 3/8. Chloroquine completely prevented the inhibitory effects of exendin-4 on the cell survival, Bcl-2, NF-κB, and cell invasiveness and abolished its stimulation of cell apoptosis and LDH release. Moreover, only the combined treatment with IGF-1 and CC completely abolished the observed effect of exendin-4 on the expression of beclin-1, LC3I/II, p62, as well as on cell survival, apoptosis, and LDH release. Exendin-4 exhibits a potent anti-tumour cytotoxic effect in SKOV-3 and OVCAR-3 cells by activating the markers of autophagy, mediated by activation of AMPK and inhibition of Akt.
- MeSH
- apoptóza MeSH
- autofagie MeSH
- exenatid farmakologie MeSH
- fosfatidylinositol-3-kinasy MeSH
- lidé MeSH
- mechanistické cílové místo rapamycinového komplexu 1 MeSH
- nádorové buněčné linie MeSH
- nádory vaječníků * farmakoterapie MeSH
- proteinkinasy aktivované AMP MeSH
- protoonkogenní proteiny c-akt MeSH
- Check Tag
- lidé MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
Dietary supplementation with calanus oil, a novel wax ester-rich marine oil, has been shown to reduce adiposity in high-fat diet (HFD)-induced obese mice. Current evidence suggests that obesity and its comorbidities are intrinsically linked with unfavorable changes in the intestinal microbiome. Thus, in line with its antiobesity effect, we hypothesized that dietary supplementation with calanus oil should counteract the obesity-related deleterious changes in the gut microbiota. Seven-week-old female C57bl/6J mice received an HFD for 12 weeks to induce obesity followed by 8-week supplementation with 2% calanus oil. For comparative reasons, another group of mice was treated with exenatide, an antiobesogenic glucagon-like peptide-1 receptor agonist. Mice fed normal chow diet or nonsupplemented HFD for 20 weeks served as lean and obese controls, respectively. 16S rRNA gene sequencing was performed on fecal samples from the colon. HFD increased the abundance of the Lactococcus and Leuconostoc genera relative to normal chow diet, whereas abundances of Allobaculum and Oscillospira were decreased. Supplementation with calanus oil led to an apparent overrepresentation of Lactobacillus and Streptococcus and underrepresentation of Bilophila. Exenatide prevented the HFD-induced increase in Lactococcus and caused a decrease in the abundance of Streptococcus compared to the HFD group. Thus, HFD altered the gut microbiota composition in an unhealthy direction by increasing the abundance of proinflammatory genera while reducing those considered health-promoting. These obesity-induced changes were antagonized by both calanus oil and exenatide.
- MeSH
- Bacteria klasifikace genetika růst a vývoj MeSH
- dieta s vysokým obsahem tuků * MeSH
- dietní tuky nenasycené aplikace a dávkování MeSH
- exenatid farmakologie MeSH
- feces mikrobiologie MeSH
- hmotnostní přírůstek MeSH
- kolon mikrobiologie MeSH
- látky proti obezitě farmakologie MeSH
- metagenom MeSH
- myši inbrední C57BL MeSH
- myši MeSH
- obezita mikrobiologie patofyziologie terapie MeSH
- oleje aplikace a dávkování MeSH
- potravní doplňky * MeSH
- střevní mikroflóra * MeSH
- zvířata MeSH
- Check Tag
- myši MeSH
- ženské pohlaví MeSH
- zvířata MeSH
- Publikační typ
- časopisecké články MeSH
- práce podpořená grantem MeSH
- Klíčová slova
- Exenatid (Byetta),
- MeSH
- diabetes mellitus 2. typu * farmakoterapie komplikace MeSH
- dvojitá slepá metoda MeSH
- exenatid aplikace a dávkování MeSH
- glykovaný hemoglobin účinky léků MeSH
- hypoglykemika MeSH
- kardiovaskulární nemoci epidemiologie mortalita MeSH
- lidé MeSH
- placeba MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- klinické zkoušky MeSH
Inkretinový systém se stal důležitým cílem v léčbě diabetes mellitus 2. typu v nedávných letech a glukagonu podobný peptid-1 (GLP-1) je předmětem zájmu pro jeho účinek na snížení glykemie. Inkretinový efekt je u některých pacientů s diabetem 2. typu snížený, ale může být zvýšen podáním agonistů receptorů GLP-1. Agonisté receptoru GLP-1 jsou důležitou skupinou léků s prokázaným účinkem a bezpečnostním profilem, jsou odvozeny buď od exendinu 4, nebo jsou modifikací lidského GLP-1. Do této skupiny patří krátkodobě působící prandiální agonisté exenatid, podávaný dvakrát denně, lixisenatid, podávaný jedenkrát denně, a dlouhodobě působící liraglutid, podávaný rovněž jedenkrát denně, a jedenkrát týdně podávané léky albiglutid, dulaglutid, exenatid LAR a semaglutid. Článek popisuje jejich účinnost, kombinace s ostatními antidiabetickými léky a zařazení do posledních léčebných doporučení.
The incretin system has become an important target in the treatment of type 2 diabetes in recent years, and glucagon-like peptide 1 (GLP-1) is of particular interest for its glucose-lowering effects. The incretin effect is reduced in people with type 2 diabetes but may be augmented by administration of GLP-1 receptor agonists. Glucagon-like peptide-1 (GLP-1) receptor agonists are an important class of drugs with a well-established efficacy and safety profile in patients with type 2 diabetes. Agents in this class are derived from either exendin-4 or modifications of human GLP-1 active fragment. The GLP-1 receptor agonists currently approved for the treatment of DM type 2 include exenatide (administered twice daily), and lixisenatide and long-acting: liraglutide, the once-weekly agents exenatide extended-release, albiglutide, and dulaglutide and semaglutide. The article is describing their efficacy, possibilities of combination with other antidiabetic treatment including insulin and placement in the new therapeutic algorithm for diabetes mellitus type 2.
- MeSH
- ateroskleróza farmakoterapie komplikace MeSH
- diabetes mellitus 2. typu * farmakoterapie MeSH
- exenatid aplikace a dávkování farmakokinetika farmakologie MeSH
- farmakologické účinky - molekulární mechanismy MeSH
- glukagonu podobné peptidy aplikace a dávkování farmakokinetika farmakologie MeSH
- hypoglykemika terapeutické užití MeSH
- imunoglobuliny - Fc fragmenty aplikace a dávkování farmakologie MeSH
- inzulin analogy a deriváty aplikace a dávkování MeSH
- kardiorenální syndrom farmakoterapie komplikace MeSH
- kombinovaná farmakoterapie MeSH
- lidé MeSH
- liraglutid aplikace a dávkování farmakokinetika farmakologie MeSH
- peptidy aplikace a dávkování farmakokinetika farmakologie MeSH
- receptor pro glukagonu podobný peptid 1 agonisté aplikace a dávkování MeSH
- rekombinantní fúzní proteiny MeSH
- způsoby aplikace léků MeSH
- Check Tag
- lidé MeSH
Klinická studie EXSCEL porovnávající podání exenatidu – agonisty receptorů pro GLP-1 oproti placebu u nemocných s diabetes mellitus 2 typu a s či bez kardiovaskulárního rizika a testovala non-inferioritu pro bezpečnost a superioritu pro účinnost. Exenatid podaný 1× týdně byl noninferiorní ve srovnání s placebem s ohledem na bezpečnost (p < 0,001 pro noninferioritu), ale nebyl superiorní nad placebem s ohledem na účinnost (p = 0,06 pro superioritu).
The EXSCEL clinical trail compared exenatide, a GLP-1 receptor agonist, and placebo among patients with type-2 diabetes withor without previous cardiovascular disease. The trial tested the safety hypothesis (non inferiority) and efficacy hypothesis (superiority).Exenatide, administered once weekly, was noninferior to placebo with respect to safety (P < 0.001 for noninferiority) butwas not superior to placebo with respect to efficacy (P = 0.06 for superiority).
- MeSH
- cévní mozková příhoda farmakoterapie prevence a kontrola MeSH
- diabetes mellitus 2. typu farmakoterapie komplikace MeSH
- exenatid MeSH
- hypoglykemie farmakoterapie prevence a kontrola MeSH
- infarkt myokardu farmakoterapie prevence a kontrola MeSH
- kardiovaskulární systém * účinky léků MeSH
- komplikace diabetu diagnóza farmakoterapie MeSH
- lidé MeSH
- mortalita dějiny trendy MeSH
- nežádoucí účinky léčiv * komplikace prevence a kontrola MeSH
- pankreatitida prevence a kontrola MeSH
- randomizované kontrolované studie jako téma MeSH
- receptor pro glukagonu podobný peptid 1 * agonisté terapeutické užití účinky léků MeSH
- srdeční selhání farmakoterapie prevence a kontrola MeSH
- statistika jako téma MeSH
- Check Tag
- lidé MeSH