Abstract
γ-aminobutyric acid (GABA) or glucagon-like peptide-1 based drugs, such as sitagliptin (a dipeptidyl peptidase-4 inhibitor), were shown to induce beta cell regenerative effects in various diabetic mouse models. We propose that their combined administration can bring forth an additive therapeutic effect. We tested this hypothesis in a multiple low-dose streptozotocin (STZ)-induced beta cell injury mouse model (MDSD). Male C57BL/6J mice were assigned randomly into four groups: non-treatment diabetic control, GABA, sitagliptin, or GABA plus sitagliptin. Oral drug administration was initiated 1 week before STZ injection and maintained for 6 weeks. GABA or sitagliptin administration decreased ambient blood glucose levels and improved the glucose excursion rate. This was associated with elevated plasma insulin and reduced plasma glucagon levels. Importantly, combined use of GABA and sitagliptin significantly enhanced these effects as compared with each of the monotherapies. An additive effect on reducing water consumption was also observed. Immunohistochemical analyses revealed that combined GABA and sitagliptin therapy was superior in increasing beta cell mass, associated with increased small-size islet numbers, Ki67+ and PDX-1+ beta cell counts; and reduced Tunel+ beta cell counts. Thus, beta cell proliferation was increased, whereas apoptosis was reduced. We also noticed a suppressive effect of GABA or sitagliptin on alpha cell mass, which was not significantly altered by combining the two agents. Although either GABA or sitagliptin administration delays the onset of MDSD, our study indicates that combined use of them produces superior therapeutic outcomes. This is likely due to an amelioration of beta cell proliferation and a decrease of beta cell apoptosis.
Highlights
Type 1 diabetes is characterized by extensive beta cell loss as a result of apoptosis and lack of regeneration
Either γ-aminobutyric acid (GABA) or sitagliptin administration delays the onset of multiple low-dose STZ-induced diabetes (MDSD), our study indicates that combined use of them produces superior therapeutic outcomes
For low-dose STZ induced diabetic mouse model, 20 mice were randomly assigned into four groups after 1-week of adaptive housing: non-treatment diabetic control group (Water), GABA treatment group (GABA), sitagliptin treatment group (Sita), and GABA plus sitagliptin group (GABA+Sita) (Figure 1A)
Summary
Type 1 diabetes is characterized by extensive beta cell loss as a result of apoptosis and lack of regeneration. During the past two decades, intensive investigation of the incretin hormone GLP-1 has led to the development of two categories of novel therapeutic agents for T2D: GLP-1 agonists and DPP-4 inhibitors (Lee and Jun, 2014; Holst and Madsbad, 2016; Tian and Jin, 2016). The drugs in the latter category, with sitagliptin as an example, prevent the degradation of GLP-1 and another incretin GIP, and elevate endogenous incretin levels. GLP-1-based drugs were shown to ameliorate T2D (Wang and Brubaker, 2002; Buteau et al, 2003), they showed very marginal therapeutic effects for T1D subjects in both humans and rodent models, possibly due to their restricted immune regulatory effects (Hadjiyanni et al, 2008; Pettus et al, 2013; Wan et al, 2015)
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