Molecular Metabolism (Jan 2022)

Peptide-YY3-36/glucagon-like peptide-1 combination treatment of obese diabetic mice improves insulin sensitivity associated with recovered pancreatic β-cell function and synergistic activation of discrete hypothalamic and brainstem neuronal circuitries

  • Brandon B. Boland,
  • Rhianna C. Laker,
  • Siobhan O'Brien,
  • Sadichha Sitaula,
  • Isabelle Sermadiras,
  • Jens Christian Nielsen,
  • Pernille Barkholt,
  • Urmas Roostalu,
  • Jacob Hecksher-Sørensen,
  • Sara Rubek Sejthen,
  • Ditte Dencker Thorbek,
  • Arthur Suckow,
  • Nicole Burmeister,
  • Stephanie Oldham,
  • Sarah Will,
  • Victor G. Howard,
  • Benji M. Gill,
  • Philip Newton,
  • Jacqueline Naylor,
  • David C. Hornigold,
  • Jotham Austin,
  • Louise Lantier,
  • Owen P. McGuinness,
  • James L. Trevaskis,
  • Joseph S. Grimsby,
  • Christopher J. Rhodes

Journal volume & issue
Vol. 55
p. 101392

Abstract

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Objective: Obesity-linked type 2 diabetes (T2D) is a worldwide health concern and many novel approaches are being considered for its treatment and subsequent prevention of serious comorbidities. Co-administration of glucagon like peptide 1 (GLP-1) and peptide YY3-36 (PYY3-36) renders a synergistic decrease in energy intake in obese men. However, mechanistic details of the synergy between these peptide agonists and their effects on metabolic homeostasis remain relatively scarce. Methods: In this study, we utilized long-acting analogues of GLP-1 and PYY3-36 (via Fc-peptide conjugation) to better characterize the synergistic pharmacological benefits of their co-administration on body weight and glycaemic regulation in obese and diabetic mouse models. Hyperinsulinemic-euglycemic clamps were used to measure weight-independent effects of Fc-PYY3-36 + Fc-GLP-1 on insulin action. Fluorescent light sheet microscopy analysis of whole brain was performed to assess activation of brain regions. Results: Co-administration of long-acting Fc-IgG/peptide conjugates of Fc-GLP-1 and Fc-PYY3-36 (specific for PYY receptor-2 (Y2R)) resulted in profound weight loss, restored glucose homeostasis, and recovered endogenous β-cell function in two mouse models of obese T2D. Hyperinsulinemic-euglycemic clamps in C57BLKS/J db/db and diet-induced obese Y2R-deficient (Y2RKO) mice indicated Y2R is required for a weight-independent improvement in peripheral insulin sensitivity and enhanced hepatic glycogenesis. Brain cFos staining demonstrated distinct temporal activation of regions of the hypothalamus and hindbrain following Fc-PYY3-36 + Fc-GLP-1R agonist administration. Conclusions: These results reveal a therapeutic approach for obesity/T2D that improved insulin sensitivity and restored endogenous β-cell function. These data also highlight the potential association between the gut–brain axis in control of metabolic homeostasis.

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