Effective treatment with combination of peripheral 5-hydroxytryptamine synthetic inhibitor and 5-hydroxytryptamine 2 receptor antagonist on glucocorticoid-induced whole-body insulin resistance with hyperglycemia

外周5-羟色胺合成抑制剂与5-羟色胺2受体拮抗剂联合应用对糖皮质激素所致全身胰岛素抵抗伴高血糖的有效治疗

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作者:Shaoxin Ma, Tao Li, Keke Guo, Xin Li, Shanshan An, Shanshan Hou, Ru Chen, Bo Yang, Siyu Liu, Jihua Fu

Conclusion

Inhibitions of both peripheral 5-HT synthesis and 5-HT2 R are expected to be a dependable target for treatment of steroid-induced diabetes.

Methods

Male rats were exposed to dexamethasone for 10 days, then treated with or without a 5-HT2 R antagonist, sarpogrelate, a 5-HT synthetic inhibitor, carbidopa, alone or in combination for 20 days.

Results

Dexamethasone-induced whole-body IR, with glucose intolerance, decreased insulin sensitivity, hyperglycemia, hyperinsulinemia and dyslipidemia, could be effectively abolished by sarpogrelate or/and carbidopa, whereas IR-related actions of dexamethasone in tissues were accompanied by increased 5-HT synthesis in the liver and visceral adipose, and upregulated 5-HT2 R (5-HT2A R and 5-HT2B R) expression in these two tissues as well as in skeletal muscle. Sarpogrelate or/and carbidopa treatment significantly abolished dexamethasone-caused tissue-specific IR. In the liver, increased gluconeogenesis, triglycerides and very low-density lipoprotein syntheses with steatosis, and downregulated expression of plasmalemmal glucose transporter-2 were markedly reversed. In the visceral adipose and skeletal muscle, downregulated expression of plasmalemmal glucose transporter-4 was significantly reversed, and increased lipolysis was also reversed in the visceral adipose. Dexamethasone-induced activations of hepatic mammalian target of rapamycin serine2448 , and S6K threonine389/412 phosphorylation were also abolished markedly by sarpogrelate or/and carbidopa. Co-treatment with sarpogrelate and carbidopa showed a synergistic effect on suppressing dexamethasone actions.

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