Stimulation of autophagy improves endoplasmic reticulum stress-induced diabetes

Diabetes. 2013 Apr;62(4):1227-37. doi: 10.2337/db12-1474. Epub 2012 Dec 28.

Abstract

Accumulation of misfolded proinsulin in the β-cell leads to dysfunction induced by endoplasmic reticulum (ER) stress, with diabetes as a consequence. Autophagy helps cellular adaptation to stress via clearance of misfolded proteins and damaged organelles. We studied the effects of proinsulin misfolding on autophagy and the impact of stimulating autophagy on diabetes progression in Akita mice, which carry a mutation in proinsulin, leading to its severe misfolding. Treatment of female diabetic Akita mice with rapamycin improved diabetes, increased pancreatic insulin content, and prevented β-cell apoptosis. In vitro, autophagic flux was increased in Akita β-cells. Treatment with rapamycin further stimulated autophagy, evidenced by increased autophagosome formation and enhancement of autophagosome-lysosome fusion. This was associated with attenuation of cellular stress and apoptosis. The mammalian target of rapamycin (mTOR) kinase inhibitor Torin1 mimicked the rapamycin effects on autophagy and stress, indicating that the beneficial effects of rapamycin are indeed mediated via inhibition of mTOR. Finally, inhibition of autophagy exacerbated stress and abolished the anti-ER stress effects of rapamycin. In conclusion, rapamycin reduces ER stress induced by accumulation of misfolded proinsulin, thereby improving diabetes and preventing β-cell apoptosis. The beneficial effects of rapamycin in this context strictly depend on autophagy; therefore, stimulating autophagy may become a therapeutic approach for diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Autophagy / drug effects*
  • Autophagy / physiology
  • Diabetes Mellitus / drug therapy*
  • Diabetes Mellitus / etiology
  • Endoplasmic Reticulum / physiology*
  • Female
  • Immunosuppressive Agents / pharmacology
  • Immunosuppressive Agents / therapeutic use*
  • Insulin-Secreting Cells / drug effects
  • Insulin-Secreting Cells / pathology
  • Insulin-Secreting Cells / physiology
  • Male
  • Mechanistic Target of Rapamycin Complex 1
  • Mice
  • Mice, Inbred C57BL
  • Mice, Inbred Strains
  • Multiprotein Complexes
  • Mutation
  • Naphthyridines / pharmacology
  • Proinsulin / chemistry
  • Proinsulin / genetics
  • Proinsulin / metabolism
  • Protein Folding
  • Proteins / antagonists & inhibitors
  • Proteins / metabolism
  • Sirolimus / pharmacology
  • Sirolimus / therapeutic use*
  • Stress, Physiological
  • TOR Serine-Threonine Kinases / antagonists & inhibitors

Substances

  • 1-(4-(4-propionylpiperazin-1-yl)-3-(trifluoromethyl)phenyl)-9-(quinolin-3-yl)benzo(h)(1,6)naphthyridin-2(1H)-one
  • Immunosuppressive Agents
  • Multiprotein Complexes
  • Naphthyridines
  • Proteins
  • Proinsulin
  • mTOR protein, mouse
  • Mechanistic Target of Rapamycin Complex 1
  • TOR Serine-Threonine Kinases
  • Sirolimus