Abstract

BackgroundThe effects of insulin on cardiomyocytes, such as positive inotropic action and glucose uptake are well described. However, in vitro studies comparing long-acting insulin analogues with regard to cardiomyocyte signalling and function have not been systematically conducted.MethodsInsulin receptor (IR) binding was assessed using membrane embedded and solubilised IR preparations. Insulin signalling was analysed in adult rat ventricular myocytes (ARVM) and HL-1 cardiac cells. Inotropic effects were examined in ARVM and the contribution of Akt to this effect was assessed by specific inhibition with triciribine. Furthermore, beating-rate in Cor.4U® human cardiomyocytes, glucose uptake in HL-1 cells, and prevention from H2O2 induced caspase 3/7 activation in cardiac cells overexpressing the human insulin receptor (H9c2-E2) were analysed. One-way ANOVA was performed to determine significance between conditions.ResultsInsulin degludec showed significant lower IR affinity in membrane embedded IR preparations. In HL-1 cardiomyocytes, stimulation with insulin degludec resulted in a lower Akt(Ser473) and Akt(Thr308) phosphorylation compared to insulin, insulin glargine and its active metabolite M1 after 5- and 10-min incubation. After 60-min treatment, phosphorylation of Akt was comparable for all insulin analogues. Stimulation of glucose uptake in HL-1 cells was increased by 40–60 %, with a similar result for all analogues. Incubation of electrically paced ARVM resulted for all insulins in a significantly increased sarcomere shortening, contractility- and relaxation–velocity. This positive inotropic effect of all insulins was Akt dependent. Additionally, in Cor.4U® cardiomyocytes a 10–20 % increased beating-rate was detected for all insulins, with slower onset of action in cells treated with insulin degludec. H9c2-E2 cells challenged with H2O2 showed a fivefold increase in caspase 3/7 activation, which could be abrogated by all insulins used.ConclusionsIn conclusion, we compared for the first time the signalling and functional impact of the long-acting insulin analogues insulin glargine and insulin degludec in cardiomyocyte cell models. We demonstrated similar efficacy under steady-state conditions relative to regular insulin in functional endpoint experiments. However, it remains to be shown how these results translate to the in vivo situation.Electronic supplementary materialThe online version of this article (doi:10.1186/s12933-016-0410-9) contains supplementary material, which is available to authorized users.

Highlights

  • The effects of insulin on cardiomyocytes, such as positive inotropic action and glucose uptake are well described

  • The IC50 of IGlaM1 and insulin degludec (IDeg) were 1.8- and 23.6-fold higher compared to Ins, reflecting a substantial lower binding affinity for IDeg

  • The IC50 value for Ins was 0.58 ± 0.10 nmol/L (Additional file 2: Table S1). Under these conditions binding of IDeg improved with a 5.4-fold higher IC50 compared to Ins

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Summary

Introduction

The effects of insulin on cardiomyocytes, such as positive inotropic action and glucose uptake are well described. Just recently the interim analysis of the dedicated cardiovascular outcome trial for IDeg (DEVOTE) (Trial number NCT01959529), requested in 2013 by the American Food and Drug Administration (FDA) [16] suggested non-inferiority to IGla, leading to approval of IDeg for the US market with a post marketing commitment to provide further non-inferiority data in major adverse cardiovascular events [17]. These clinical trials were designed to compare systemic metabolic effects of the analogues in patients. Our data show a very similar cardiomyocyte action profile for both IGla and IDeg, at least under steadystate conditions

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