Abstract
Inflammation, decreased levels of circulating endothelial nitric oxide (eNO) and brain-derived neurotrophic factor (BDNF), altered activity of hypothalamic neurotransmitters (including serotonin and vagal tone) and gut hormones, increased concentrations of free radicals, and imbalance in the levels of bioactive lipids and their pro- and anti-inflammatory metabolites have been suggested to play a role in diabetes mellitus (DM). Type 1 diabetes mellitus (type 1 DM) is due to autoimmune destruction of pancreatic β cells because of enhanced production of IL-6 and tumor necrosis factor-α (TNF-α) and other pro-inflammatory cytokines released by immunocytes infiltrating the pancreas in response to unknown exogenous and endogenous toxin(s). On the other hand, type 2 DM is due to increased peripheral insulin resistance secondary to enhanced production of IL-6 and TNF-α in response to high-fat and/or calorie-rich diet (rich in saturated and trans fats). Type 2 DM is also associated with significant alterations in the production and action of hypothalamic neurotransmitters, eNO, BDNF, free radicals, gut hormones, and vagus nerve activity. Thus, type 1 DM is because of excess production of pro-inflammatory cytokines close to β cells, whereas type 2 DM is due to excess of pro-inflammatory cytokines in the systemic circulation. Hence, methods designed to suppress excess production of pro-inflammatory cytokines may form a new approach to prevent both type 1 and type 2 DM. Roux-en-Y gastric bypass and similar surgeries ameliorate type 2 DM, partly by restoring to normal: gut hormones, hypothalamic neurotransmitters, eNO, vagal activity, gut microbiota, bioactive lipids, BDNF production in the gut and hypothalamus, concentrations of cytokines and free radicals that results in resetting glucose-stimulated insulin production by pancreatic β cells. Our recent studies suggested that bioactive lipids, such as arachidonic acid, eicosapentaneoic acid, and docosahexaenoic acid (which are unsaturated fatty acids) and their anti-inflammatory metabolites: lipoxin A4, resolvins, protectins, and maresins, may have antidiabetic actions. These bioactive lipids have anti-inflammatory actions, enhance eNO, BDNF production, restore hypothalamic dysfunction, enhance vagal tone, modulate production and action of ghrelin, leptin and adiponectin, and influence gut microbiota that may explain their antidiabetic action. These pieces of evidence suggest that methods designed to selectively deliver bioactive lipids to pancreatic β cells, gut, liver, and muscle may prevent type 1 and type 2 DM.
Highlights
The diabetes mellitus (DM) is classically divided into two types: type 1 diabetes that occurs because of autoimmune destruction of β cells that results in insulin insufficiency and so are insulin dependent and type 2 diabetes characterized by peripheral insulin resistance and consequent hyperinsulinemia.CLINICAL MANIFESTATIONS OF DMIn majority of the subjects with type 2 DM, no symptoms could be present at the time of detection of the disease
Based on the preceding discussion that PUFAs and their metabolites, hypothalamus and their peptides and neurotransmitters, brainderived neurotrophic factor (BDNF), insulin receptors in the brain, gut peptides/hormones, cytokines, and gut microbiota play a role in obesity and DM, it is evident that all these factors/events are interrelated
In a series of previous studies, we showed that oral feeding of oils rich in ω-3 EPA and DHA and ω-6 GLA and arachidonic acid (AA) or pure free fatty acids (FFAs) (GLA, AA, EPA, and DHA) prevent apoptosis of insulin-secreting rat insulinoma (RIN5F) cells in vitro and alloxan-induced type 1 DM and STZ-induced type 1 and type 2 DM in experimental animals [15,16,17,18, 137, 420]
Summary
The diabetes mellitus (DM) is classically divided into two types: type 1 diabetes that occurs because of autoimmune destruction of β cells that results in insulin insufficiency and so are insulin dependent and type 2 diabetes characterized by peripheral insulin resistance and consequent hyperinsulinemia
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