Article(id=1198656351967736480, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1198656343151313891, articleNumber=null, orderNo=null, doi=10.16438/j.0513-4870.2023-1274, pmid=null, cstr=null, oa=null, hot=null, price=null, onlineType=0, articleFormat=0, articleType=null, articleTypeStr=null, receivedDate=1699545600000, receivedDateStr=2023-11-10, revisedDate=1700668800000, revisedDateStr=2023-11-23, acceptedDate=null, acceptedDateStr=null, onlineDate=1763711544266, onlineDateStr=2025-11-21, pubDate=1702310400000, pubDateStr=2023-12-12, doiRegisterDate=null, doiRegisterDateStr=null, onlineIssueDate=1763711544266, onlineIssueDateStr=2025-11-21, onlineJustAcceptDate=null, onlineJustAcceptDateStr=null, onlineFirstDate=null, onlineFirstDateStr=null, sourceXml=null, magXml=null, createTime=1763711544266, creator=13701087609, updateTime=1763711544266, updator=13701087609, issue=Issue{id=1198656343151313891, tenantId=1146029695717560320, journalId=1189982191388893191, year='2023', volume='58', issue='12', pageStart='3477', pageEnd='3726', issueExtLink='null', onlineDate='null', pubDate='null', beforeIssueId=null, nextIssueId=null, price=null, status=1, issueComplete=1, articleOrder=1, issueType=-1, specialIssue=null, createTime=1763711542164, creator=13701087609, updateTime=1763711721609, updator=13701087609, preIssue=null, nextIssue=null, ext={EN=IssueExt(id=1198657095835943176, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1198656343151313891, language=EN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=), CN=IssueExt(id=1198657095840137481, tenantId=1146029695717560320, journalId=1189982191388893191, issueId=1198656343151313891, language=CN, specialIssueTitle=, coverIllustrator=null, specialIssueEditor=, specialIssueAbout=)}, issueFiles=null}, startPage=3637, endPage=3643, ext={EN=ArticleExt(id=1198656352307475122, articleId=1198656351967736480, tenantId=1146029695717560320, journalId=1189982191388893191, language=EN, title=The effects and mechanisms of trimethylamine-N-oxide on insulin sensitivity in insulin target cells, columnId=null, journalTitle=Acta Pharmaceutica Sinica, columnName=null, runingTitle=null, highlight=null, articleAbstract=

Gut microbial metabolite trimethylamine-N-oxide (TMAO) is associated with type 2 diabetes (T2DM). Decreased insulin sensitivity is a significant etiological factor of T2DM. Adipocytes, myocytes, and hepatocytes are the three major target cells for insulin. This study aims to investigate the effects and mechanisms of TMAO on the insulin sensitivity of these target cells. Research results indicate that in different ages of db/db diabetic mice, plasma TMAO levels were increased. TMAO significantly inhibits the insulin signaling pathways in these three major insulin target cells, reduces glucose uptake in 3T3-L1 adipocytes and L6 myocytes and downregulates genes related to gluconeogenesis in primary mouse hepatocytes. Furthermore, in mice with normal insulin sensitivity, elevating plasma TMAO levels to those seen in db/db mice using a minipump results in impaired glucose tolerance and hyperinsulinemia. All animal experiments were carried out with approval of the Experimental Animal Welfare Ethics Committee of the Institute of Materia Medica (Chinese Academy of Medical Sciences and Peking Union Medical College). Mechanistic studies suggest that TMAO exposure increases the levels of endoplasmic reticulum stress-related proteins in these three major insulin target cells. In summary, TMAO directly attenuates insulin sensitivity in insulin target cells, and its mechanism of action may involve enhancing endoplasmic reticulum stress.

, correspAuthors=Ping-ping LI, authorNote=null, correspAuthorsNote=null, copyrightStatement=Copyright ©2023 Acta Pharmaceutica Sinica. All rights reserved., copyrightOwner=null, extLink=null, articleAbsUrl=null, sourceXml=null, magXml=null, pdfUrl=null, pdf=null, pdfFileSize=null, pdfExtLink=null, richHtmlUrl=null, mobilePdfUrl=null, reviewReport=null, pdfFirstPage=null, abstractGraph=null, abstractGraphContent=null, abstractVideo=null, citation=null, cebUrl=null, magXmlContent=null, mapNumber=null, authorCompany=null, fund=null, authors=null, authorsList=Li-juan KONG, Xiao-jing JIANG, Ping-ping LI), CN=ArticleExt(id=1198656353850979084, articleId=1198656351967736480, tenantId=1146029695717560320, journalId=1189982191388893191, language=CN, title=氧化三甲胺干扰胰岛素靶细胞胰岛素敏感性的作用和机制研究, columnId=1190335348896011050, journalTitle=药学学报, columnName=研究论文, runingTitle=null, highlight=null, articleAbstract=

肠源性菌群代谢物氧化三甲胺(trimethylamine-N-oxide, TMAO) 与2型糖尿病(type 2 diabetes, T2DM) 相关, 胰岛素敏感性下降是T2DM的一个重要发病原因。脂肪细胞、肌肉细胞和肝细胞是胰岛素的三大靶细胞, 本研究旨在探讨TMAO对这些靶细胞胰岛素敏感性的作用和机制。研究结果表明, 在不同周龄db/db糖尿病小鼠中, 血浆TMAO水平升高, TMAO显著抑制胰岛素三大靶细胞的胰岛素信号通路, 降低3T3-L1脂肪细胞和L6肌肉细胞的葡萄糖摄取, 下调小鼠原代肝细胞糖异生相关基因的水平。此外, 对于胰岛素敏感性正常的小鼠, 通过使用皮下微渗透泵将血浆TMAO水平升高至db/db小鼠水平, 小鼠表现为糖耐量异常, 诱发高胰岛素血症。所有动物实验操作均遵循中国医学科学院、北京协和医学院药物研究所实验动物伦理与动物福利委员会的规定。机制研究表明, TMAO处理增加三大胰岛素靶细胞内质网应激相关蛋白的水平。综上, TMAO直接减弱胰岛素三大靶细胞的胰岛素敏感性, 其作用机制可能是通过增强内质网应激。

, correspAuthors=李平平, authorNote=null, correspAuthorsNote=
*李平平, Tel: 86-10-50927273, E-mail:
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J Agric Food Chem, 2023, 71: 14263-14275., articleTitle=Ginsenoside F4 alleviates skeletal muscle insulin resistance by regulating PTP1B in type II diabetes mellitus, refAbstract=null)], funds=[Fund(id=1198960222493573308, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, awardId=81622010, language=CN, fundingSource=国家自然科学基金资助项目(81622010), fundOrder=null, country=null), Fund(id=1198960222581653706, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, awardId=BJJWZYJH01201910023028, language=CN, fundingSource=北京高校卓越青年科学家计划项目(BJJWZYJH01201910023028), fundOrder=null, country=null), Fund(id=1198960222724260054, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, awardId=2021-I2M-1-016, language=CN, fundingSource=中国医学科学院医学与健康科技创新工程(2021-I2M-1-016), fundOrder=null, country=null), Fund(id=1198960222887837931, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, awardId=2018PT350004, language=CN, fundingSource=中国医学科学院中央级公益性科研院所基本科研业务费(2018PT350004), fundOrder=null, country=null)], companyList=[AuthorCompany(id=1198960217842090795, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, xref=null, ext=[AuthorCompanyExt(id=1198960217854673709, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, companyId=1198960217842090795, language=EN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China), AuthorCompanyExt(id=1198960217875645230, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, companyId=1198960217842090795, language=CN, country=null, province=null, city=null, postcode=null, companyName=null, departmentName=null, remark=中国医学科学院、北京协和医学院药物研究所, 天然药物活性物质与功能国家重点实验室, 北京 100050)])], figs=[ArticleFig(id=1198960220857794564, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, language=EN, label=null, caption=null, figureFileSmall=NofXNRLB8PBXxfaBwauocw==, figureFileBig=Upexu7j+IdLiG4GkiPoy3A==, tableContent=null), ArticleFig(id=1198960220962652171, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, language=CN, label=Figure 1, caption= Trimethylamine-<i>N</i>-oxide (TMAO) was elevated in 7, 9, 11, 14-week-old diabetic mice. <i>n</i> = 3, mean ± SEM. <sup>*</sup><i>P</i> < 0.05, <sup>**</sup><i>P</i> < 0.01 , figureFileSmall=NofXNRLB8PBXxfaBwauocw==, figureFileBig=Upexu7j+IdLiG4GkiPoy3A==, tableContent=null), ArticleFig(id=1198960221084287002, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, language=EN, label=null, caption=null, figureFileSmall=yqbNUxkPi7okvRLIyqBsvg==, figureFileBig=hxqKRw6eWwLmesRICpXJTA==, tableContent=null), ArticleFig(id=1198960221256253482, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, language=CN, label=Figure 2, caption= TMAO reduced insulin sensitivity and increased ER stress in 3T3-L1 adipocytes. A, B: p-Akt protein levels (A) and glucose uptake (B) in 3T3-L1 adipocytes treated with or without TMAO (18 h) under basal or insulin conditions; C: ER stress related protein levels in 3T3-L1 adipocytes treated with or without TMAO (100 nmol·L<sup>-1</sup>, 10 days). <i>n</i> = 3-4, mean ± SEM. <sup>*</sup><i>P</i> < 0.05, <sup>**</sup><i>P</i> < 0.01, <sup>***</sup><i>P</i> < 0.001. ER: Endoplasmic reticulum; Akt: Protein kinase B; eIF2<i>α</i>: Eukaryotic translation initiation factor 2<i>α</i>; Xbp1s: Spliced X-box binding protein 1; IRE1: Inositol-requiring enzyme 1; ATF6: Activating transcription factor 6 , figureFileSmall=yqbNUxkPi7okvRLIyqBsvg==, figureFileBig=hxqKRw6eWwLmesRICpXJTA==, tableContent=null), ArticleFig(id=1198960221365305399, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, language=EN, label=null, caption=null, figureFileSmall=FGHqtOeDlaEi+dD6LcV0yw==, figureFileBig=S28+BGTrBmYkytNmYb9OTw==, tableContent=null), ArticleFig(id=1198960221470163014, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, language=CN, label=Figure 3, caption= TMAO reduced insulin sensitivity and increased ER stress in L6 myocytes. A, B: p-Akt protein levels (A) and glucose uptake (B) in L6 myocytes treated with or without TMAO (18 h) under basal or insulin conditions; C: ER stress related protein levels in L6 myocytes treated with or without TMAO (100 nmol·L<sup>-1</sup>, 10 days). <i>n</i> = 3-4, mean ± SEM. <sup>*</sup><i>P</i> < 0.05, <sup>**</sup><i>P</i> < 0.01, <sup>***</sup><i>P</i> < 0.001 , figureFileSmall=FGHqtOeDlaEi+dD6LcV0yw==, figureFileBig=S28+BGTrBmYkytNmYb9OTw==, tableContent=null), ArticleFig(id=1198960221583409235, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, language=EN, label=null, caption=null, figureFileSmall=RLvVUvnb7nBIFmNObF34iw==, figureFileBig=a8VKKzhlUdeAdLTtGRp3Ow==, tableContent=null), ArticleFig(id=1198960221734404194, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, language=CN, label=Figure 4, caption= TMAO reduced insulin sensitivity and increased ER stress in mouse primary hepatocytes. A, B: p-Akt protein levels (A) and gluconeogenesis genes mRNA levels (B) in mouse primary hepatocytes treated with or without TMAO (18 h) under basal or insulin conditions; C: ER stress related protein levels in mouse primary hepatocytes treated with or without TMAO (100 nmol·L<sup>-1</sup>, 2 days). <i>n</i> = 3-4, mean ± SEM. <sup>*</sup><i>P</i> < 0.05, <sup>**</sup><i>P</i> < 0.01, <sup>***</sup><i>P</i> < 0.001 , figureFileSmall=RLvVUvnb7nBIFmNObF34iw==, figureFileBig=a8VKKzhlUdeAdLTtGRp3Ow==, tableContent=null), ArticleFig(id=1198960221885399153, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, language=EN, label=null, caption=null, figureFileSmall=iFTtwWczVisbe95eVdF4Ig==, figureFileBig=gl1Apz7MGtdC7PRGw2qa4g==, tableContent=null), ArticleFig(id=1198960222002839678, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, language=CN, label=Figure 5, caption= TMAO promoted glucose intolerance. A: TMAO concentration after TMAO minipump treatment; B: Oral glucose tolerance test (OGTT) of vehicle and TMAO-treated mice; C: Fasting plasma insulin levels of vehicle and TMAO-treated mice. <i>n</i> = 6-8, mean ± SEM. <sup>*</sup><i>P</i> < 0.05, <sup>**</sup><i>P</i> < 0.01, <sup>***</sup><i>P</i> < 0.001 , figureFileSmall=iFTtwWczVisbe95eVdF4Ig==, figureFileBig=gl1Apz7MGtdC7PRGw2qa4g==, tableContent=null), ArticleFig(id=1198960222120280210, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, language=EN, label=null, caption=null, figureFileSmall=null, figureFileBig=null, tableContent=
Gene Primer
Pepck F (5′-3′) CTGCATAACGGTCTGGACTTC
R (5′-3′) CAGCAACTGCCCGTACTCC
G6pase F (5′-3′) CGACTCGCTATCTCCAAGTGA
R (5′-3′) GTTGAACCAGTCTCCGACCA
), ArticleFig(id=1198960222225137822, tenantId=1146029695717560320, journalId=1189982191388893191, articleId=1198656351967736480, language=CN, label=Table 1, caption=

The primer sequences for quantitative real-time PCR. Pepck: Phosphoenolpyruvate carboxykinase; G6pase: Glucose 6-phosphatase

, figureFileSmall=null, figureFileBig=null, tableContent=
Gene Primer
Pepck F (5′-3′) CTGCATAACGGTCTGGACTTC
R (5′-3′) CAGCAACTGCCCGTACTCC
G6pase F (5′-3′) CGACTCGCTATCTCCAAGTGA
R (5′-3′) GTTGAACCAGTCTCCGACCA
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氧化三甲胺干扰胰岛素靶细胞胰岛素敏感性的作用和机制研究
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孔丽娟 , 姜晓静 , 李平平 *
药学学报 | 研究论文 2023,58(12): 3637-3643
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药学学报 | 研究论文 2023, 58(12): 3637-3643
氧化三甲胺干扰胰岛素靶细胞胰岛素敏感性的作用和机制研究
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孔丽娟, 姜晓静, 李平平*
作者信息
  • 中国医学科学院、北京协和医学院药物研究所, 天然药物活性物质与功能国家重点实验室, 北京 100050

通讯作者:

*李平平, Tel: 86-10-50927273, E-mail:
The effects and mechanisms of trimethylamine-N-oxide on insulin sensitivity in insulin target cells
Li-juan KONG, Xiao-jing JIANG, Ping-ping LI*
Affiliations
  • State Key Laboratory of Bioactive Substance and Function of Natural Medicines, Institute of Materia Medica, Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing 100050, China
出版时间: 2023-12-12 doi: 10.16438/j.0513-4870.2023-1274
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肠源性菌群代谢物氧化三甲胺(trimethylamine-N-oxide, TMAO) 与2型糖尿病(type 2 diabetes, T2DM) 相关, 胰岛素敏感性下降是T2DM的一个重要发病原因。脂肪细胞、肌肉细胞和肝细胞是胰岛素的三大靶细胞, 本研究旨在探讨TMAO对这些靶细胞胰岛素敏感性的作用和机制。研究结果表明, 在不同周龄db/db糖尿病小鼠中, 血浆TMAO水平升高, TMAO显著抑制胰岛素三大靶细胞的胰岛素信号通路, 降低3T3-L1脂肪细胞和L6肌肉细胞的葡萄糖摄取, 下调小鼠原代肝细胞糖异生相关基因的水平。此外, 对于胰岛素敏感性正常的小鼠, 通过使用皮下微渗透泵将血浆TMAO水平升高至db/db小鼠水平, 小鼠表现为糖耐量异常, 诱发高胰岛素血症。所有动物实验操作均遵循中国医学科学院、北京协和医学院药物研究所实验动物伦理与动物福利委员会的规定。机制研究表明, TMAO处理增加三大胰岛素靶细胞内质网应激相关蛋白的水平。综上, TMAO直接减弱胰岛素三大靶细胞的胰岛素敏感性, 其作用机制可能是通过增强内质网应激。

氧化三甲胺  /  胰岛素信号通路  /  葡萄糖摄取  /  糖异生  /  内质网应激

Gut microbial metabolite trimethylamine-N-oxide (TMAO) is associated with type 2 diabetes (T2DM). Decreased insulin sensitivity is a significant etiological factor of T2DM. Adipocytes, myocytes, and hepatocytes are the three major target cells for insulin. This study aims to investigate the effects and mechanisms of TMAO on the insulin sensitivity of these target cells. Research results indicate that in different ages of db/db diabetic mice, plasma TMAO levels were increased. TMAO significantly inhibits the insulin signaling pathways in these three major insulin target cells, reduces glucose uptake in 3T3-L1 adipocytes and L6 myocytes and downregulates genes related to gluconeogenesis in primary mouse hepatocytes. Furthermore, in mice with normal insulin sensitivity, elevating plasma TMAO levels to those seen in db/db mice using a minipump results in impaired glucose tolerance and hyperinsulinemia. All animal experiments were carried out with approval of the Experimental Animal Welfare Ethics Committee of the Institute of Materia Medica (Chinese Academy of Medical Sciences and Peking Union Medical College). Mechanistic studies suggest that TMAO exposure increases the levels of endoplasmic reticulum stress-related proteins in these three major insulin target cells. In summary, TMAO directly attenuates insulin sensitivity in insulin target cells, and its mechanism of action may involve enhancing endoplasmic reticulum stress.

trimethylamine-N-oxide  /  insulin signaling pathway  /  glucose uptake  /  gluconeogenesis  /  endoplasmic reticulum stress
孔丽娟, 姜晓静, 李平平. 氧化三甲胺干扰胰岛素靶细胞胰岛素敏感性的作用和机制研究. 药学学报, 2023 , 58 (12) : 3637 -3643 . DOI: 10.16438/j.0513-4870.2023-1274
Li-juan KONG, Xiao-jing JIANG, Ping-ping LI. The effects and mechanisms of trimethylamine-N-oxide on insulin sensitivity in insulin target cells[J]. Acta Pharmaceutica Sinica, 2023 , 58 (12) : 3637 -3643 . DOI: 10.16438/j.0513-4870.2023-1274
2型糖尿病的发生源于胰岛素抵抗和β细胞功能障碍。胰岛素抵抗是一种胰岛素敏感性降低的状态, 即胰岛素无法有效地刺激肌肉和脂肪组织摄取葡萄糖, 也无法有效地抑制肝脏产生葡萄糖, 从而导致血浆葡萄糖水平升高[1, 2]。在许多糖尿病前期的胰岛素抵抗个体中, β细胞通常会过度分泌胰岛素, 以弥补胰岛素抵抗的效应。因此, 尽管胰岛素敏感性持续下降, 这些高胰岛素血症个体仍能保持正常或接近正常的血糖水平。然而, 随着时间的推移, 胰岛素抵抗的逐渐增加, 胰岛素分泌无法继续进行有效的补偿, 这导致进行性高血糖的发展, 最终演变为2型糖尿病[3]
内质网是合成各种分泌蛋白和膜蛋白的细胞器。在内质网中, 伴侣分子正确折叠和组装蛋白质。在应激条件下, 如错误折叠的蛋白质水平增加, 伴侣蛋白过载, 内质网无法折叠和输出新合成的蛋白质, 就会发生内质网应激。大量文献[4, 5]报道肝脏、骨骼肌、脂肪组织胰岛素抵抗的发生与内质网应激反应有关, 改善这些组织的内质网应激水平可以相应改善组织胰岛素的敏感性, 进而改善糖尿病时的血糖水平。
氧化三甲胺(trimethylamine-N-oxide, TMAO) 是一种肠道菌群代谢物, 主要由肠道菌群代谢饮食中的胆碱和肉碱而产生。在肠道内, 肠道菌群将未被吸收的胆碱或肉碱转化为三甲胺(trimethylamine, TMA), 随后TMA被吸收并进入循环系统, 通过门静脉输送到肝脏, 宿主的肝黄素单加氧酶3 (flavin-containing monooxygenase 3, FMO3) 将其快速氧化成三甲胺N-氧化物(TMAO)。TMAO被认为是一种重要的致动脉粥样硬化和促血栓形成的化合物, 这促使心血管疾病的发病[6, 7], TMAO促进动脉粥样硬化的潜在机制包括增加泡沫细胞的形成、减少反向胆固醇的运输和增加血小板的聚集[8-10], 肠道菌群的gbu基因簇负责将饮食中的成分L-肉碱代谢分解成TMAO, 从而增加了心血管疾病的风险[11]
随着研究的深入, 人们逐渐认识到在糖尿病中, 肠道菌群相关的代谢产物TMAO扮演着重要的角色。临床研究发现, 2型糖尿病患者的血浆TMAO水平明显升高, 并且这种升高与疾病的严重程度呈剂量依赖关系[12]。动物实验中的研究发现, 在12周龄的瘦素受体缺陷的糖尿病db/db小鼠中, 其TMAO水平(大约10 μmol·L-1) 比非糖尿病小鼠(大约1 μmol·L-1) 高10倍[13]。胰岛素抵抗是糖尿病发生的重要原因之一。在高脂饮食喂养的小鼠实验中, 添加TMAO (血TMAO浓度约17 μmol·L-1) 加剧糖耐量受损、恶化胰岛素抵抗, 并干扰肝脏中胰岛素的信号传导途径, 进一步引发脂肪组织中的炎症反应[14]。研究还表明, TMAO可以结合并激活蛋白激酶R-样内质网激酶(protein kinase R-like endoplasmic reticulum kinase, PERK), 从而促使叉头框转录因子O亚族1 (forkhead box transcription factor O1, FoxO1) 发生磷酸化和激活, 导致胰岛素抵抗及其他代谢功能障碍的发生[15]。越来越多的临床研究显示, TMAO水平与糖尿病及其并发症密切相关[16], 最近的前瞻性研究表明高水平的膳食磷脂酰胆碱与血浆中TMAO的升高密切相关, 而且与糖尿病的风险独立相关。此外, TMAO的前体胆碱减少与2年内血糖水平和胰岛素抵抗的改善显著相关[17]。因此, TMAO及其相关代谢产物的异常升高可能对血糖水平和胰岛素抵抗产生不利影响, 并可能影响糖尿病的发生。有文献报道表明, 产生TMAO的酶FMO3在胰岛素抵抗的小鼠和人类肝脏中上调, 而减少FMO3可以减轻胰岛素抵抗[18]。FMO3与肥胖相关, 抑制FMO3刺激白色脂肪棕色化, 可抵抗肥胖[12]。然而, 目前尚未看到有关TMAO如何直接影响胰岛素靶细胞敏感性的研究。
本研究对不同周龄的db/db小鼠的血浆TMAO水平进行了检测, 并评估了TMAO对3T3-L1脂肪细胞、L6肌肉细胞和原代肝细胞的胰岛素敏感性的影响, 发现内质网应激是TMAO干扰胰岛素敏感性的重要机制。
细胞与主要试剂  小鼠胚胎成纤维细胞3T3-L1 (清华大学馈赠), 大鼠成肌细胞L6 (温州医科大学馈赠); TMAO (317594)、胎牛血清(Sigma公司); DMEM培养基、双抗、GlutaMAX (Gibco公司); Western及IP细胞裂解液(Beyotime公司, P0013); 蛋白激酶B (protein kinase B, Akt) 抗体(4691)、p-Akt抗体(4060)、真核细胞翻译起始因子2α (eukaryotic translation initiation factor 2α, eIF2α) 抗体(5324)、p-eIF2α抗体(3398)、剪接型X-盒结合蛋白1 (spliced X-box binding protein 1, Xbp1s) 抗体(40435)、需肌醇酶1 (inositol-requiring enzyme 1, IRE1) 抗体(3294) (Cell Signaling Technology公司); 活化转录因子6 (activating transcription factor 6, ATF6) 抗体(ab124945)、p-IRE1抗体(ab124945) (Abcam公司); β-actin抗体(Proteintech公司, 66009-1-Ig); 3H-2-脱氧-D-葡萄糖(PerkinElmer公司, NET549); Trizol (Invitrogen公司, 15596026CN); 反转录试剂盒(Applied Biosystems公司, 362271); 小鼠胰岛素ELISA试剂盒(ALPCO公司, 80-INSMSU-E-10); d9-TMAO (Cambridge Isotopes公司, DML-4779-1)。
实验仪器  质谱仪(Waters公司); 化学发光成像仪(GE公司, AI600); qPCR仪(Applied Biosystems公司, QuantStudio 3); 血糖仪(罗氏公司); 多功能酶标仪(Biotek公司, Synergy H1); 微渗透泵(Alzet公司)。
细胞培养  小鼠胚胎成纤维细胞3T3-L1、大鼠成肌细胞L6和小鼠原代肝细胞均用含10%胎牛血清和GlutaMAX的DMEM培养基培养, 所有细胞培养基中均加入1%双抗, 置于37 ℃、5% CO2的培养箱中培养。3T3-L1用分化培养基分化成脂肪细胞, L6用分化培养基分化成肌肉细胞。
原代肝细胞的分离  将两管50 mL Krebs-Ringer碳酸氢盐缓冲液(Krebs-Ringer bicarbonate HEPES buffer, KRG, NaCl 120 mmol·L-1, NaHCO3 20 mmol·L-1, glucose 20 mmol·L-1, HEPES 5 mmol·L-1, KCl 4.8 mmol·L-1, MgSO4·7H2O 1.2 mmol·L-1, KH2PO4 1.2 mmol·L-1) 预热至37 ℃, 使用时, 一管加入100 μL 50 mmol·L-1 EGTA, 另一管加入100 μL 1 mol·L-1 CaCl2和1 mL 25 mg·mL-1胶原酶IV。小鼠称重后腹腔注射三溴乙醇麻醉, 打开腹腔暴露肝脏、门静脉和下腔静脉; 将静脉留置针插入门静脉, 打开输液阀, 随后剪断下腔静脉, 使用含有EGTA的KRG缓冲液灌注肝脏。待血液冲洗干净后, 使用含有胶原酶和CaCl2的KRG缓冲液继续灌注肝脏; 待肝脏变大变疏松时, 剪下肝脏置于10 cm细胞培养皿中, 加入管中剩余约20 mL KRG缓冲液。撕碎并吹打肝组织使肝细胞充分释放, 用70 μm细胞筛过滤至50 mL离心管中, 加满4 ℃预冷的DMEM培养基, 4 ℃、50 ×g离心5 min, 弃上清, 重复上述步骤3次, 使用含10% FBS的DMEM培养基悬浮细胞, 以合适的密度接种到细胞培养板中。
实验动物  雄性db/db小鼠, 购自江苏集萃药康有限公司, 许可证编号为SCXK (苏) 2023-0009; 雄性C57BL/6J小鼠, 购自北京维通利华实验动物技术有限公司, 许可证编号为SCXK (京) 2021-0006, 均饲养于中国医学科学院药物研究所SPF级动物房。动物实验操作获得中国医学科学院药物研究所实验动物管理与动物福利伦理委员会批准(批准号00005082)。
TMAO测定  标准曲线建立: TMAO以纯净水溶解, 并稀释成浓度为0.2、0.5、1、5、10、20、50、100 μmol·L-1工作液, 不同浓度TMAO工作液10 μL加入含内标(d9-TMAO, 50 ng·mL-1) 乙腈40 μL, 混旋后取上清液3 μL进行液相色谱-串联质谱(liquid chromatography-tandem mass spectrometry, LC/MS/MS) 分析。血浆样品处理: 血浆样品10 μL加入含内标(d9-TMAO, 50 ng·mL-1) 乙腈40 μL, 混旋后离心(14 000 r·min-1×5 min) 两次, 取上清液5 μL进行LC/MS/MS分析, 超标线样品稀释100倍后进行测定。LC/MS/MS条件色谱柱: Zorbax C18 (100 mm×2.1 mm, 3.5 μm); 柱温: 37 ℃, 流动相: 乙腈/水(含0.1%甲酸) 梯度; 流速: 0.2 mL·min-1; 多反应检测(multiple reaction monitoring, MRM) 正离子方式检测m/z 76→58 (TMAO), m/z 85→85 (内标d9-TMAO)。
Western blot  将细胞接种于24孔板中, 3T3-L1脂肪细胞、L6肌肉细胞和小鼠原代肝细胞均用DMEM/0.25% fatty acid free BSA培养基饥饿过夜, 同时给予不同浓度TMAO处理18 h, 加入胰岛素刺激30 min。收集细胞, 裂解, 进行SDS-PAGE凝胶电泳。湿转法将目的蛋白转移到PVDF膜上, 然后将膜在5%脱脂奶粉的TBS-T中室温封闭1 h。随后加入一抗, 4 ℃孵育过夜, 二抗孵育后进行显色。
实时荧光定量PCR (quantitative real-time PCR, qPCR)  将小鼠原代肝细胞接种于6孔板中, 用DMEM/0.25% fatty acid free BSA培养基饥饿过夜, 同时给予不同浓度TMAO处理18 h, 加入胰岛素刺激30 min。收集细胞, 用Trizol提取细胞总RNA, 反转录成cDNA后, 采用SYBR Green法进行实时荧光定量PCR, 条件为: 95 ℃预变性5 min; 95 ℃ 15 s, 60 ℃ 30 s, 72 ℃ 30 s, 共40个循环。引物设计如表 1
葡萄糖摄取  将细胞接种于24孔板中, 3T3-L1脂肪细胞和L6肌肉细胞用DMEM/0.25% fatty acid free BSA培养基饥饿过夜, 同时给予不同浓度TMAO处理18 h, 加入100 nmol·L-1胰岛素刺激20 min, 然后加入 3H-2-脱氧-D-葡萄糖于37 ℃孵育10 min。冷PBS洗4次, 弃净残留3H-2-脱氧-D-葡萄糖, 1 mol·L-1 NaOH裂解细胞, 测定细胞内3H放射性值, 同时测定蛋白浓度进行校正。
口服葡萄糖耐量(oral glucose tolerance test, OGTT)  小鼠禁食6 h, 口服葡萄糖剂量为2 g·kg-1体重, 给葡萄糖0、15、30、60、90、120 min尾尖取血测血糖。
血浆胰岛素测定  小鼠禁食6 h, 尾尖取血, 4 ℃、4 000 ×g离心10 min, 上清即为血浆, ELISA试剂盒测定胰岛素水平。
统计学处理  采用均数±标准误(mean ± SEM) 表示, 采用t检验进行显著性检验, 使用GraphPad Prism 8.0.2软件进行数据统计和计算。P < 0.05为差异具有统计学显著意义。
db/db小鼠是由于瘦素受体缺陷引起的先天性肥胖型2型糖尿病模型, 其发病过程与人类2型糖尿病非常相似, 因此是目前最为理想的2型糖尿病动物模型之一。与对照组小鼠相比, 7、9、11周龄的db/db糖尿病小鼠血浆中TMAO水平明显升高, 14周龄时也呈上升趋势。不同周龄的对照组小鼠血浆中TMAO水平相对稳定, 约在2 μmol·L-1左右, 而7周龄的db/db小鼠血浆中TMAO水平可达到13.5 μmol·L-1, 比对照组小鼠增加了4.7倍(图 1)。这一结果表明, TMAO可能在2型糖尿病的发病过程中发挥着重要作用。
胰岛素抵抗即胰岛素敏感性下降, 是2型糖尿病的一个主要发病原因。鉴于2型糖尿病小鼠的血浆TMAO水平升高, 那么TMAO是否直接作用于胰岛素靶组织。为此, 本文研究了TMAO在3T3-L1脂肪细胞、L6肌肉细胞和原代肝细胞上的作用。当胰岛素与胰岛素受体结合后, 信号最终传递到Akt, 从而促进葡萄糖转运。用不同浓度TMAO (0.01、0.1、1、10和100 nmol·L-1) 处理3T3-L1脂肪细胞, 结果发现, TMAO (100 nmol·L-1) 显著降低了胰岛素刺激下的p-Akt蛋白水平(图 2A), 表明TMAO抑制3T3-L1脂肪细胞内胰岛素信号通路的激活。与此一致, TMAO (10和100 nmol·L-1) 使3T3-L1脂肪细胞胰岛素诱导下的葡萄糖摄取明显减少(23%~26%, 图 2B)。由于TMAO与内质网应激密切相关, 而内质网应激是胰岛素抵抗和2型糖尿病的重要病理机制之一[4], 因此本研究评价了TMAO对内质网应激的影响。TMAO处理显著增加3T3-L1脂肪细胞内质网应激相关蛋白p-eIF2α/eIF2α、ATF6、Xbp1s、p-IRE1/IRE1的水平(图 2C)。以上结果提示, TMAO通过增强内质网应激直接降低胰岛素靶细胞3T3-L1脂肪细胞的胰岛素敏感性。
L6肌肉细胞中, 胰岛素刺激下的p-Akt蛋白水平大幅上升, 与未加TMAO组相比, 10和100 nmol·L-1 TMAO组的p-Akt蛋白显著减少(图 3A)。100 nmol·L-1 TMAO明显降低L6肌肉细胞胰岛素刺激的葡萄糖摄取(图 3B)。TMAO处理显著增加L6肌肉细胞内质网应激相关蛋白p-eIF2α/eIF2α、ATF6、Xbp1s、p-IRE1/IRE1的水平(图 3C)。以上结果提示, TMAO通过增强内质网应激的方式直接降低胰岛素靶细胞L6肌肉细胞的胰岛素敏感性。
在分离的小鼠原代肝细胞中, 胰岛素刺激后p-Akt蛋白水平上升, TMAO (10和100 nmol·L-1) 处理18 h后, 胰岛素刺激的p-Akt蛋白水平降低(图 4A)。此结果表明, TMAO干扰了原代肝细胞的胰岛素信号通路, 导致胰岛素敏感性降低。糖异生是肝脏葡萄糖产生的关键途径, 磷酸烯醇式丙酮酸羧化酶(phosphoenolpyruvate carboxykinase, Pepck) 和葡萄糖-6-磷酸酶(glucose 6-phosphatase, G6pase) 是糖异生过程的重要酶, TMAO (100 nmol·L-1) 处理18 h后, 胰岛素刺激条件下, PepckG6pase的mRNA水平被上调(图 4B), 这表明TMAO促进原代肝细胞的糖异生过程。TMAO处理明显增加小鼠原代肝细胞中与内质网应激相关蛋白p-eIF2α/eIF2α、ATF6、p-IRE1/IRE1的水平(图 4C)。以上结果提示, TMAO通过增强内质网应激的方式直接降低小鼠原代肝细胞的胰岛素敏感性。
为了研究TMAO在动物体内的作用, 本研究直接使用皮下植入微渗透泵来持续注射TMAO给胰岛素敏感性正常的小鼠。设计的TMAO注射剂量(100 mg·kg-1) 使血浆中TMAO水平升高到类似于db/db糖尿病小鼠的水平(约10 μmol·L-1, 图 5A)。与体外细胞实验的结果一致, 持续注射TMAO 15天后, 小鼠糖耐量明显异常(图 5B), 禁食6 h的血胰岛素水平明显升高(图 5C)。以上结果表明, TMAO诱发小鼠葡萄糖不耐受和高胰岛素血症。
在小鼠和人中, 糖尿病的发生与TMAO水平升高相关[13, 19], 在STZ小鼠和ob/ob小鼠的肝脏中, FMO3 mRNA和蛋白表达都显著增加[18]。在糖尿病状态下, 肠道微生态失调的特征是微生物组成发生变化, 比如Lachnospiraceae在2型糖尿病时明显富集[20], 而Lachnospiraceae的增加与血浆高TMAO水平相关[10]。因此, 高FMO3和肠道菌群水平是TMAO浓度升高的原因。
在体内, TMAO血浆水平呈现昼夜节律, 在白天相对低, 夜晚达到峰值[21]。本研究观察到, TMAO作用是在10或100 nmol·L-1浓度范围, 作用时间为18 h或更长时间(10天)。在这种情况下, TMAO浓度保持在正常范围内, 但TMAO处理是持续存在的。这可能解释了TMAO在低浓度下的有害作用。
有研究者指出, TMAO可以缓解内质网应激, 发挥有益作用, 但他们使用的浓度(100 mmol·L-1, 通过皮下泵达到2.78 mmol·L-1) 远高于体内水平[22, 23]。TMAO已被证明可以通过影响水中的氢键来间接纠正蛋白质折叠缺陷, 它增强了水-水氢键的强度, 最终稳定了蛋白质中酰胺基团之间的氢键, 并有利于蛋白质折叠。在1 mol·L-1 TMAO模拟中, 约54%的水位于TMAO的空间影响范围内, 这可以解释为什么只有高剂量的TMAO对内质网应激有缓解作用。
本研究揭示了肠源代谢物TMAO对胰岛素的三大靶细胞产生直接影响, 并提出内质网应激可能是介导TMAO引起胰岛素抵抗的机制。随着对内质网应激的深入认识, 发现内质网应激可诱导肝脏、肌肉和脂肪组织的胰岛素抵抗的形成, 促进2型糖尿病的发生。在内质网应激条件下, 通过激活JNK和IKK, 促进形成IRE1-TRAF2复合物, 间接促进JNK的磷酸化和激活, 促进胰岛素受体底物丝氨酸磷酸化, 从而降低Akt磷酸化, 抑制胰岛素信号, 加重胰岛素抵抗[24, 25]。本研究发现填补了TMAO诱发胰岛素抵抗在体外细胞研究方面的欠缺, 为开发以TMAO/FMO3为靶标的药物提供了新的理论基础。
作者贡献: 孔丽娟负责实验部分、数据整理和论文撰写; 姜晓静负责细胞培养和原代肝细胞的分离; 李平平指导实验设计及论文修改。
利益冲突: 全体作者声明不存在任何利益冲突。
  • 国家自然科学基金资助项目(81622010)
  • 北京高校卓越青年科学家计划项目(BJJWZYJH01201910023028)
  • 中国医学科学院医学与健康科技创新工程(2021-I2M-1-016)
  • 中国医学科学院中央级公益性科研院所基本科研业务费(2018PT350004)
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2023年第58卷第12期
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doi: 10.16438/j.0513-4870.2023-1274
  • 接收时间:2023-11-10
  • 首发时间:2025-11-21
  • 出版时间:2023-12-12
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  • 收稿日期:2023-11-10
  • 修回日期:2023-11-23
基金
国家自然科学基金资助项目(81622010)
北京高校卓越青年科学家计划项目(BJJWZYJH01201910023028)
中国医学科学院医学与健康科技创新工程(2021-I2M-1-016)
中国医学科学院中央级公益性科研院所基本科研业务费(2018PT350004)
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    中国医学科学院、北京协和医学院药物研究所, 天然药物活性物质与功能国家重点实验室, 北京 100050

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2种不同金属材料的力学参数

Family
属数
Number of
genus
种数
Number of
species
占总种数比例
Percentage of
total species (%)

Genus
种数
Number of
species
占总种数比例
Percentage of total
species (%)
鹅膏菌科Amanitaceae 2 11 5.26 鹅膏菌属 Amanita 10 4.78
小菇科 Mycenaceae 2 12 5.74 丝盖伞属 Inocybe 5 2.39
多孔菌科 Polyporaceae 8 14 6.70 蜡蘑属 Laccaria 5 2.39
红菇科 Russulaceae 3 23 11.00 小皮伞属 Marasmius 6 2.87
小菇属 Mycena 11 5.26
光柄菇属 Pluteus 5 2.39
红菇属 Russula 17 8.13
栓菌属 Trametes 5 2.39
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