Sarsasapogenin improves adipose tissue inflammation and ameliorates insulin resistance in high-fat diet-fed C57BL/6J mice

Insulin resistance is a major cause of type 2 diabetes and metabolic syndrome.Macrophage infiltration into obese adipose tissue promotes inflammatory responses that contribute to the pathogenesis of insulin resistance.Suppression of adipose tissue inflammatory responses is postulated to increase insulin sensitivity in obese patients and animals.Sarsasapogenin(ZGY)is one of the metabolites of timosaponin AIII in the gut,which has been shown to exert anti-inflammatory action.In this study,we investigated the effects of ZGY treatment on obesity-induced insulin resistance in mice.We showed that pretreatment with ZGY(80 mg·kg^?1·d^?1,ig,for 18 days)significantly inhibited acute adipose tissue inflammatory responses in LPS-treated mice.In high-fat diet(HFD)-fed obese mice,oral administration of ZGY(80 mg·kg^?1·d^?1,for 6 weeks)ameliorated insulin resistance and alleviated inflammation in adipose tissues by reducing the infiltration of macrophages.Furthermore,we demonstrated that ZGY not only directly inhibited inflammatory responses in macrophages and adipocytes,but also interrupts the crosstalk between macrophages and adipocytes in vitro,improving adipocyte insulin resistance.The insulin-sensitizing and anti-inflammatory effects of ZGY may result from inactivation of the IKK/NF-κB and JNK inflammatory signaling pathways in adipocytes.Collectively,our findings suggest that ZGY ameliorates insulin resistance and alleviates the adipose inflammatory state in HFD mice,suggesting that ZGY may be a potential agent for the treatment of insulin resistance and obesity-related metabolic diseases.     

In vivo imaging reveals adipose tissue inflammation in obesity and multi-cellular processes of developing thrombus

The metabolic syndrome is a major risk factor of cardiovascular events, and obese visceral adipose tissue remodeling based on chronic inflammation plays a central role. To assess dynamic interplay between multiple cell types in obese adipose tissue, a visualization technique in vivo was developed. By this technique we identified inflammatory cell clusters associated with angiogenesis and adipogenesis in obese adipose tissue. We also found increased leukocyte-platelet-endothelial cell interactions in obese adipose tissue microcirculation, which were indicative of local chronic inflammation. Moreover, we found that large numbers of CD8(+) effector T cells infiltrated into obese adipose tissue. Immunological and genetic depletion of CD8(+) T cells reduced inflammatory (M1) macrophage infiltration and adipose tissue inflammation, and ameliorated systemic insulin resistance. Infiltration of CD8(+) T cells is essential for inflammatory macrophage recruitment into obese adipose tissue, and the initiation and development of inflammation therein. Our results clearly demonstrate the power of our imaging technique to analyze complex cellular interplay in vivo, especially parenchymal and stromal cell crosstalk, and to evaluate new therapeutic interventions against conditions arising from these interactions.     

肥胖SD 幼鼠脂肪组织血红素加氧酶-1 表达与炎症状态和抗炎机制的探讨

摘要：目的探讨肥胖SD 幼鼠内脏脂肪组织中血红素加氧酶（HO）-1 表达的变化及其与脂肪组织巨噬细胞浸润、极化间的关系。方法3 周龄雄性SD 大鼠24 只,随机均分为对照组和实验组,分别给予标准饮食和高脂饮食,喂养至7 周龄,检测三酰甘油（TG）、高密度脂蛋白胆固醇（HDL-C）、空腹血糖及胰岛素水平,定量PCR 检测肾周脂肪组织中HO-1、白介素（IL）-6、IL-10、单核细胞趋化蛋白（MCP）-1 基因表达变化,F4/80、CD206 免疫组化观察脂肪组织中巨噬细胞浸润和极化情况。结果实验组幼鼠已经存在空腹血糖和胰岛素升高,胰岛素抵抗情况明显,HO-1 表达明显高于对照组,炎症因子IL-6、MCP-1 基因表达明显高于对照组,抗炎症因子IL-10 低于对照组,差异有统计学意义（P＜0.05）。实验组巨噬细胞浸润明显多于对照组（P＜0.05）,实验组F4/80 免疫组化平均光密度（MOD）值与 CD206 免疫组化MOD 值差异无统计学意义（P＞0.05）。结论肥胖幼年SD 大鼠的内脏脂肪组织出现炎症反应,伴有HO-1 反应性的增加,后者影响巨噬细胞极化起到抗炎作用。     

Thiazolidinediones and type 2 diabetes: from cellular targets to cardiovascular benefit

The prevalence of type 2 diabetes is evolving globally at an alarming rate. This fact is mainly the result of our global lifestyle "modernization" that has resulted in overweight and obesity. Dysfunction of peroxisome proliferator activated receptor-gamma (PPAR-gamma) has been implicated in the development of insulin resistance, while a reduce expression of many PPAR-gamma regulated genes has been observed in an obese diabetic state. Thiazolidinediones (TZDs) are potent exogenous agonists of PPAR-gamma, which augment the effects of insulin to its cellular targets and mainly at the level of adipose tissue. Preclinical and clinical studies have demonstrated that apart from their glucose-lowering activity, these drugs also regulate the production of inflammatory mediators by cells that play a pivotal role in the pathogenesis of atherosclerosis. This paper summarizes the evolving changes observed in an enlarged adipose tissue and examines the activity of TZDs in their main cellular targets. It also discusses whether these cellular pleiotropic effects can result in a clinically meaningful outcome, in terms of cardiovascular benefit, in this population.     

The mechanisms by which PPARgamma and adiponectin regulate glucose and lipid metabolism

Obesity, a state of increased adipose tissue mass, is a major cause for type 2 diabetes, hyperlipidemia, and hypertension, resulting in clustering of risk factors for atherosclerosis. Heterozygous PPARgamma knockout mice and KKA(y) mice administered with a PPARgamma antagonist were protected from high-fat diet-induced adipocyte hypertrophy and insulin resistance. Moderate reduction of PPARgamma activity prevented adipocyte hypertrophy, thereby diminution of TNFalpha, resistin, and FFA and upregulation of adiponectin and leptin. These alterations led to reduction of tissue TG content in muscle/liver, thereby ameliorating insulin resistance. Insulin resistance in the lipoatrophic mice and KKA(y) mice were ameliorated by replenishment of adiponectin. Moreover, adiponectin transgenic mice ameliorated insulin resistance and diabetes, but not the obesity of ob/ob mice. Furthermore, targeted disruption of the adiponectin gene caused moderate insulin resistance and glucose intolerance. In muscle, adiponectin activated AMP kinase and PPARgamma pathways, thereby increasing beta-oxidation of lipids, leading to decreased TG content, which ameliorated muscle insulin resistance. In the liver, adiponectin also activated AMPK, thereby downregulating PEPCK and G6Pase, leading to decreased glucose output from the liver. In conclusion, PPARgamma plays a central role in the regulation of adipocyte hypertrophy and insulin sensitivity. The upregulation of the adiponectin pathway by PPARgamma may play a role in the increased insulin sensitivity of heterozygous PPARgamma knockout mice, and activation of adiponectin pathway may provide novel therapeutic strategies for obesity-linked disorders such as type 2 diabetes and metabolic syndrome.     

From excess adiposity to insulin resistance: The role of free fatty acids

With a positive caloric balance, adipocytes undergo excessive hypertrophy, which causes adipocyte dysfunction, as well as adipose tissue endocrine and immune responses. A preferential site of fat accumulation is the abdominal-perivisceral region, due to peculiar factors of the adipose tissue in such sites, namely an excess of glucocorticoid activity, which promotes the accumulation of fat; and the greater metabolic activity and sensitivity to lipolysis, due to increased number and activity of β3-adrenoceptors and, partly, to reduced activity of α2-adrenoceptors. As a consequence, more free fatty acids (FFA) are released into the portal system. Hypertrophic adipocytes begin to secrete low levels of TNF-α, which stimulate preadipocytes and endothelial cells to produce MCP-1, in turn responsible for attracting macrophages to the adipose tissue, thus developing a state of chronic low-grade inflammation which is causally linked to insulin resistance. Excess of circulating FFA, TNF-α and other factors induces insulin resistance. FFA cause insulin resistance by inhibiting insulin signaling through the activation of serin-kinases, i.e. protein kinase C-Θ, and the kinases JNK and IKK, which promote a mechanism of serine phosphorylation of Insulin Receptor Substrates (IRS), leading to interruption of the downstream insulin receptor (IR) signaling. TNF-α, secreted by hypertrophic adipocytes and adipose tissue macrophages, also inhibits IR signaling by a double mechanism of serine-phosphorylation and tyrosine-dephosphorylation of IRS-1, causing inactivation and degradation of IRS-1 and a consequent stop of IR signaling. Such mechanisms explain the transition from excess adiposity to insulin resistance, key to the further development of type 2 diabetes.     

Biomimetic carbon monoxide delivery based on hemoglobin vesicles ameliorates acute pancreatitis in mice via the regulation of macrophage and neutrophil activity

Macrophages play a central role in various inflammatory disorders and are broadly divided into two subpopulations, M1 and M2 macrophage. In the healing process in acute inflammatory disorders, shifting the production of M1 macrophages to M2 macrophages is desirable, because M1 macrophages secrete pro-inflammatory cytokines, whilst the M2 variety secrete anti-inflammatory cytokines. Previous findings indicate that when macrophages are treated with carbon monoxide (CO), the secretion of anti-inflammatory cytokine is increased and the expression of pro-inflammatory cytokines is inhibited, indicating that CO may have a potential to modulate the production of macrophages toward the M2-like phenotype. In this study, we examined the issue of whether CO targeting macrophages using a nanotechnology-based CO donor, namely CO-bound hemoglobin vesicles (CO-HbV), modulates their polarization and show therapeutic effects against inflammatory disorders. The results showed that the CO-HbV treatment polarized a macrophage cell line toward an M2-like phenotype. Furthermore, in an in vivo study using acute pancreatitis model mice as a model of an inflammatory disease, a CO-HbV treatment also tended to polarize macrophages toward an M2-like phenotype and inhibited neutrophil infiltration in the pancreas, resulting in a significant inflammation. In addition to the suppression of acute pancreatitis, CO-HbV diminished a subsequent pancreatitis-associated acute lung injury. This could be due to the inhibition of the systemic inflammation, neutrophil infiltration in the lungs and the production of HMGB-1. These findings suggest that CO-HbV exerts superior anti-inflammatory effects against inflammatory disorders via the regulation of macrophage and neutrophil activity.     

Adipocyte-derived exosomal miR-27a induces insulin resistance in skeletal muscle through repression of PPARγ

OBJECTIVE To explore increasingly exosomal serum miR-27 a derived from adipocytes could be taken up by skeletal muscle tissue and induce insulin resistance in skeletal muscle in obese state. METHODS The association between miR-27 a and insulin resistance in skeletal muscle was determined in obese children,high-fat diet-induced miR-27 a knockdown obese mice,db/db mice and C2C12 cells overexpressing miR-27 a.The crosstalk mediated by exosomal miR-27 a between adipose tissue and skeletal muscle was determined in C2C12 cel s incubated with conditioned medium prepared from palmitate-treated 3 T3-L1 adipocytes. RESULTS After knockdown miR-27 a in obese insulin resistance mice,impaired insulin resistance, glucose intolerance and insulin resistance of skeletal muscle were partly restored. In high-fat diet group, the expressions of IRS-1 and GLUT4 in glucose uptake signal pathway of skeletal muscle were significantly decreased, while the expression of IRS-1 and GLUT4 was restored after miR-27 a knockdown. The content of FABP4, a marker specific for exosomes from adipocytes, was detected in sera, skeletal muscle, supernatant of adipocytes and co-cultured C2C12 cells; furthermore,exosomal miR-27 a in serum and adipocyte supernatants were detect, and fluorescence co-localization experiments were conducted to detect whether the exosomal miR-27 a in serum is mainly derived from adipocyte; finally,we used the supernatant of adipose tissue to construct conditioned media to treat with C2C12 cells, and detected whether adipocytes derived exosomal miR-27 a could impaired glucose uptake signaling pathway of skeletal muscle. the expressions of PPARγ silencing high-fat diet induced C57 BL/6 J obese mouse model and adenovirus intervention miR-27 a knockdown model were examined,and a C2C12 cell model overexpressing miR-27 a in the absence or presence with rosiglitazone(PPARγ activator)were established to test glucose consumption, glucose uptake, and glucose uptake signaling pathways of skeletal muscle cells. CONCLUSION These results identify a novel crosstalk signaling pathway between adipose tissue and skeletal muscle in the development of insulin resistance, and indicate that adipose tissue-derived miR-27 a may play a key role in the development of obesity-triggered insulin resistance in skeletal muscle.     

Role and mechanism of ORM in adipose tissue fibrosis and insulin resistance in obese mice

OBJECTIVE During the development of obesity, adipose tissue fibrosis occurs as a hallmark of adipose tissue dysfunction, leading to metabolic dysfunction such as insulin resistance. We previously reported adipokine orosomucoid(ORM) could be a negative feedback signal in energy homeostasis, and its level was significantly elevated in response to obese state. Here we aimed to explore the role of ORM in adipose tissue fibrosis and insulin resistance during obesity, and its possible mechanism. METHODS MRI was used to assess the distribution of fat and the fat or lean mass in ORM1 knockout mice. HE staining, masson staining, qPCR, and Western blotting were used to assess the fibrosis status of mice. And we used glucose tolerance test(GTT) and insulin tolerance test(ITT) to evaluate the regulation of blood glucose and insulin sensitivity in mice. Leptin receptor-deficient db/db mice and high fat diet-induced obese mice were used as obese models. 3 T3-L1 cells were used in vitro. RESULTS ORM1-deficient mice exhibited an obese phenotype with adipose tissue fibrosis and insulin resistance. The m RNA and protein levels of the fibrogenic genes encoding Col1a1, Col3a1, Col6a3 and ECM regulators MMP-2, MMP-13, MMP-14 TIMP-1,TIMP-2, and TIMP-3 in ORM1-deficient mice were significantly increased. GTT and ITT showed abnormal glucose tolerance and insulin resistance in ORM1-deficient mice.Moreover, exogenous administration of ORM attenuated excessive expression of type Ⅵ collagen, MMP-13 and TIMP-1 induced by adipose fibrosis in obese db/db(lep Rdeficient) mice. GTT and ITT showed ORM treatment improved insulin resistance in db/db mice. Moreover,ORM synergized with insulin to activate Akt in adipose tissue of db/db mice. Further studies found that ORM could bind to C-C chemikine receptor 5(CCR5) and ORM improves insulin resistance in high fat diet-induced obese mice, which could be blocked by maraviroc, an antagonist against CCR5. In addition, the effect of ORM in synergy with insulin to activate Akt in adipose tissue of db/db mice was also abolished by maraviroc. We also found that ORM stimulated AMPK activity and inhibits the TGF-β_1 expression in adipose tissue of db/db mice,thereby attenuating adipose tissue fibrosis. In vitro, ORM treatment also alleviated abnormal expression of fibrogetic genes in 3 T3-L1 fibroblasts induced by TGF-β_1. Of note,the inhibitory effects of ORM on fibrosis were abolished by dorsomorphin, a selective inhibitor of AMPK. CONCLUSION ORM alleviates adipose tissue fibrosis and insulin resistance through CCR5. ORM is expected to be a novel target for the treatment of obesity and its related diseases.     

Regulation of stem cell differentiation in adipose tissue by chronic inflammation

1. Recent studies suggest that a local hypoxic response leads to chronic inflammation in the adipose tissue of obese individuals. The adipose tissue hypoxia may reflect a compensatory failure in the local vasculature system in response to obesity. 2. Studies suggest that inflammation stimulates angiogenesis and inhibits adipocyte activities in a feedback manner within the obese adipose tissue. Adipose-derived stem cells (ASC) are able to differentiate into multiple lineages of progenitor cells for adipocytes, endothelial cells, fibroblasts and pericytes. Differentiation of ASC into those progenitors is regulated by the adipose tissue microenvironment. 3. As a major factor in the microenvironment, inflammation may favour ASC differentiation into endothelial cells through the induction of angiogenic factors. At the same time, inflammation inhibits ASC differentiation into adipocytes by suppressing peroxisome proliferator-activated receptor γ activity and the insulin signalling pathway. In this context, inflammation may serve as a signal mediating the competition between adipocytes and endothelial cells for the limited source of ASC. 4. It is a new concept that inflammation mediates signals in the competition between adipocytes and endothelial cells for the limited ASC in obesity. There is a lot of evidence that inflammation promotes endothelial cell differentiation. However, this activity of inflammation remains to be established in adipose tissue. The present article reviews the literature in support of this conclusion.     

Adiponectin and its role in cardiovascular diseases

Studies performed during the last decade indicate that adipose tissue is not only a site of triglyceride storage but also an active endocrine organ which secretes many biologically active mediators referred to as "adipokines". In contrast to many adipokines which are overproduced in obese individuals and exert deleterious effects on insulin sensitivity, lipoprotein metabolism and cardiovascular system, such as leptin, tumor necrosis factor-alpha, plasminogen activator inhibitor-1, resistin, etc., adiponectin seems to be a unique adipokine which is produced in lower amounts in obese than in lean subjects and possesses predominantly beneficial activities, i.e. increases insulin sensitivity, stimulates fatty acid oxidation, inhibits inflammatory reaction and induces endothelium-dependent nitric oxide-mediated vasorelaxation. Adiponectin binds two receptors, AdipoR1 and AdipoR2. Adiponectin knockout mice exhibit various manifestations of the metabolic syndrome such as insulin resistance, glucose intolerance, hyperlipidemia, impaired endothelium-dependent vasorelaxation and hypertension, as well as augmented neointima formation after vascular injury. Clinical studies indicate that plasma adiponectin concentration is lower in patients with essential hypertension and ischemic heart disease. Raising endogenous adiponectin level or increasing the sensitivity to this hormone may be a promising therapeutic strategy for patients with metabolic and cardiovascular diseases. Among currently used drugs, thiazolidinediones (peroxisome proliferator activated receptor gamma agonists) are most effective in elevating adiponectin level.     

Central role of the adipocyte in insulin resistance

Mechanisms of insulin resistance in subjects at risk for type 2 diabetes remain to be elucidated. Insulin acts slowly in vivo, but rapidly in vitro, suggesting that the pathway insulin traverses from B-cell to insulin sensitive tissue may be altered in diabetes. An important component of that pathway is transport of insulin across the capillary endothelium. Several groups have demonstrated that insulin resistance may result from reduced capillary permeability to insulin--it remains to be determined whether reduced permeability contributes to insulin resistance in any stage leading to type 2 diabetes. Interestingly, the transport of insulin across the endothelial barrier not only limits the rate of insulin to stimulate glucose uptake by skeletal muscle, but appears also to determine the rate at which insulin suppresses liver glucose output. Because the liver circulation is fenestrated, it is not possible that insulin transport into the liver is the rate determining step for suppression of liver glucose output. An alternative hypothesis was considered--that insulin is transported into an extrahepatic tissue. A "second signal" is generated by the extrahepatic tissue, the signal is released into the blood, and the signal in turn controls hepatic glucose output. Several lines of evidence suggest that the second signal is free fatty acids (FFA): 1) There is a strong correlation between FFA and liver glucose output under a variety of experimental conditions. 2) If FFA are maintained at basal concentrations during insulin administration, glucose output fails to decline. 3) If FFA are reduced independent of insulin administration, glucose output is reduced. These three points support the concept that insulin, by regulating adipocyte lipolysis, controls liver glucose production. Thus, the adipocyte is a critical mediator between insulin and liver glucose output. Evidence that FFA also suppress skeletal muscle glucose uptake and insulin secretion from the B-cell supports the overall central role of the adipocyte in the regulation of glycemia. Insulin resistance at the fat cell may be an important component of the overall regulation of glycemia because of the relationships between FFA and glucose production, glucose uptake, and insulin release. It is possible that insulin resistance at the adipocyte itself can be a major cause of the dysregulation of carbohydrate metabolism in the prediabetic state.     

Quantitative comparison of adipocytokine gene expression during adipocyte maturation in non-obese and obese rats

Adipocytokines secreted from adipocytes have been extensively analyzed due to their role as key factors in various complications of obesity, including arterial sclerosis, liver steatosis, insulin resistance, and diabetes. Several in vivo and in vitro studies have suggested that adipocyte maturation is related to fluctuations in adipocytokine secretion. However, the relationship between adipocyte maturation and adipocytokine levels has not been fully elucidated. Therefore, we sought to clarify the link between adipocytokine gene expression and adipocyte maturation through systematic analysis. We quantified mRNA for six adipocytokine genes: adiponectin, resistin, leptin, plasminogen activator inhibitor 1 (PAI-1), heparin-binding epidermal growth factor (EGF)-like growth factor (HB-EGF), and visfatin, in adipose tissue, in primary cultured adipocytes obtained from an obese Zucker rat, and in the preadipocyte cell line 3T3-L1. Moreover, to elucidate the role of adipocytokines in adipocyte maturation, adipocytokine expression levels were analyzed during maturation. Although fluctuations in adipocytokine gene expression were heterogeneous, gene expression was highly similar during maturation of primary cultured adipocytes from obese and non-obese rats, suggesting that the maturation process is independent from processes that lead to obesity. Moreover, the expression patterns of adiponectin, resistin and leptin mRNA in 3T3-L1 cells were highly similar to those in primary cultured adipocytes, indicating that these adipocytokines could be common maturation markers for primary cultured adipocytes obtained from obese and non-obese rats, and for preadipocyte cell lines.     

Pentamethoxyflavanone regulates macrophage polarization and ameliorates sepsis in mice

Macrophages, owning variable phenotypes and diverse functions, were becoming the target cells in inflammatory, infectious and autoimmune diseases. In the present study, we evaluated the effect of 5,7,3′,4′,5′-pentamethoxyflavanone (abbreviated as PMFA), a kind of flavonoid, on macrophage polarization, and investigated the underlying mechanism. We found that PMFA significantly inhibited M1 macrophage polarization and diminished the proinflammatory cytokines, meanwhile it greatly enhanced M2 macrophage related molecules. Moreover, PMFA facilitated the phenotype shift from M1 to M2. However, PMFA only slightly inhibited the activation of T and B cells. Further researches showed that the mechanisms can be attributed to PMFA's down-regulation on p-STAT1 and up-regulation on p-STAT6, the pivotal regulatory molecules for M1 and M2 polarization, respectively. In addition, PMFA ameliorated LPS- and cecal ligation and puncture (CLP)-induced sepsis in mice, as assessed by the raise of survival rate, descend of tissue damage and bronchoalveolar lavage fluid (BALF) cytokines. PMFA significantly decreased the expression of IL-1β, IL-6 and TNF-α and reduced the infiltration of M1 macrophages in lung. As expected, adoptive transfer of PMFA-pretreated M1 macrophages significantly increased survival rate of LPS-challenged mice compared with control mice. Taken together, the results indicate that PMFA regulates macrophage polarization via targeting the STAT1/STAT6 signals and its potential use in treatment of inflammatory disease.