Abstract

Dipeptidyl peptidase IV (DPP-IV) inhibitors improve glycemic control by prolonging the action of glucagon-like peptide-1 (GLP-1). In contrast to GLP-1 analogues, DPP-IV inhibitors are weight-neutral. DPP-IV cleavage of PYY and NPY gives rise to PYY3-36 and NPY3-36 which exert potent anorectic action by stimulating Y2 receptor (Y2R) function. This invites the possibility that DPP-IV inhibitors could be weight-neutral by preventing conversion of PYY/NPY to Y2R-selective peptide agonists. We therefore investigated whether co-administration of an Y2R-selective agonist could unmask potential weight lowering effects of the DDP-IV inhibitor linagliptin. Male diet-induced obese (DIO) mice received once daily subcutaneous treatment with linagliptin (3 mg/kg), a Y2R-selective PYY3-36 analogue (3 or 30 nmol/kg) or combination therapy for 14 days. While linagliptin promoted marginal weight loss without influencing food intake, the PYY3-36 analogue induced significant weight loss and transient suppression of food intake. Both compounds significantly improved oral glucose tolerance. Because combination treatment did not further improve weight loss and glucose tolerance in DIO mice, this suggests that potential negative modulatory effects of DPP-IV inhibitors on endogenous Y2R peptide agonist activity is likely insufficient to influence weight homeostasis. Weight-neutrality of DPP-IV inhibitors may therefore not be explained by counter-regulatory effects on PYY/NPY responses.

Highlights

  • Dipeptidyl peptidase IV (DPP-IV) inhibitors improve glycemic control by prolonging the action of glucagon-like peptide-1 (GLP-1)

  • Combined GLP-1 and glucose-dependent insulinotropic polypeptide (GIP) receptor deficiency is necessary to fully eliminate the glucose-lowering action of DPP-IV inhibition in m­ ice[15], β-cell responsiveness to both GLP-17–36 and GIP is increased in type 2 diabetes (T2D) patients with improved glycemic ­control[16], and DPP-IV inhibition can partially restore the insulinotropic effect of GIP in T2D p­ atients[17]

  • Because linagliptin and Y2 receptor (Y2R) agonist co-administration demonstrated stronger inhibitory effects on DPP-IV activity as compared to linagliptin administration alone, we investigated whether the Y2R agonist influenced DPP-IV activity in human EDTA-plasma

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Summary

Introduction

Dipeptidyl peptidase IV (DPP-IV) inhibitors improve glycemic control by prolonging the action of glucagon-like peptide-1 (GLP-1). DPP-IV cleavage of PYY and NPY gives rise to ­PYY3-36 and ­NPY3-36 which exert potent anorectic action by stimulating Y2 receptor (Y2R) function This invites the possibility that DPP-IV inhibitors could be weight-neutral by preventing conversion of PYY/NPY to Y2R-selective peptide agonists. Because combination treatment did not further improve weight loss and glucose tolerance in DIO mice, this suggests that potential negative modulatory effects of DPP-IV inhibitors on endogenous Y2R peptide agonist activity is likely insufficient to influence weight homeostasis. In contrast to loss of insulinotropic GLP-1 and GIP-1 activity, DPP-IV induced degradation of PYY and NPY changes the receptor affinity and biological action of these peptides. It has been proposed that DPP-IV inhibitors are weight-neutral as the appetite-suppressive effects of enhanced GLP-1 activity may potentially be counterbalanced by accumulation of intact PYY/NPY resulting in attenuation of anorectic Y2R ­signaling[11]

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