Abstract

Growing evidence suggests that GLP-1 protects beta cells against various cellular injuries by modulating autophagy. In this study, we examined whether exendin-4 (Ex-4), a GLP-1 analog, had preventive effects on tacrolimus (Tac)-induced beta cell injury by improving autophagy clearance. Rats with Tac-induced diabetes mellitus exhibited increased autophagy-associated protein expression, light chain 3B levels, and autophagic vacuole numbers in pancreatic beta cells. Additionally, Tac increased autophagy in a dose- and time-dependent manner in vitro, and inhibition of autophagosome using 3-methyladenine reduced Tac-induced islet cell injury by decreasing reactive oxygen species production and apoptosis. Ex-4 treatment decreased Tac-induced hyperglycaemia, oxidative stress, and apoptosis, accompanied by decreased autophagy-associated protein expression and autophagosome numbers. In vivo and in vitro studies showed that Tac treatment impaired lysosomal function and autophagosome-lysosome fusion; these processes were improve by Ex-4 treatment. Moreover, addition of bafilomycin A1, an inhibitor of lysosomal function, abolished the protective effects of Ex-4. Our findings reveal that Tac-induced diabetes mellitus was a state of excessive burden of autophagosomes and impairment of autophagy clearance and that Ex-4 protected against Tac-induced pancreatic islet injury by reducing the burden of autophagosomes via activation of autophagosome clearance. Thus, Ex-4 had therapeutic effects on Tac-induced pancreatic beta cell injury.

Highlights

  • Tacrolimus (Tac) is a widely used maintenance immunosuppressant in renal transplant recipients (KTRs)

  • Rats treated with Tac exhibited symptoms of diabetes mellitus, as demonstrated by increased area under the curve of glucose (AUCg) values and lower levels of serum insulin as compared with those in rats treated with vehicle (VH)

  • Islets treated with Tac showed lower immunoreactivity for insulin and decreased numbers of beta cells compared with those in rats treated with VH; these effects were reversed by Ex-4 (Fig. 1d,e)

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Summary

Introduction

Tacrolimus (Tac) is a widely used maintenance immunosuppressant in renal transplant recipients (KTRs). New-onset diabetes after transplantation (NODAT) occurs in 10–25% of patients receiving Tac[3,4]. This condition reduces graft survival and increases the risk of infectious and cardiovascular diseases. The use of DPP IV inhibitors may be ideal in patients with Tac-induced diabetes; it remains unclear whether the tissue-protective effects of DPP IV inhibitors are effective in Tac-induced pancreatic islet cell injury. The role of autophagy in Tac-induced pancreatic islet cell injury is still not clear. Using experimental rats and INS-1 cells, we studied the status of autophagy in Tac-induced pancreatic islet cell injury and the effects of Ex-4 on modulating Tac-induced autophagy. The results of our study clearly demonstrated the rationale for use of Ex-4 in the management of Tac-induced diabetes mellitus based on autophagy regulation

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