Il sistema dell'ossido nitrico come mediatore della biogenesi mitocondriale e della sensibilità insulinica

Background and aim: It has been hypothesized the existence of an impairment in mitochondrial function among the several effects that may be implicated in the pathogenesis of obesity, insulin resistance and their progression towards type 2 diabetes. Furthermore, insulin resistance is associated with a reduction in mitochondrial content and eNOS enzymatic activity. Physical exercise has been shown to induce important physiological adaptations, involving not only skeletal and cardiac muscle, but also vascular and metabolic systems. Two major events induced by physical activity are the induction of eNOS gene expression and the increase of tissue nitric oxide production, which in turn could influence mitochondrial biogenesis and glucose uptake. All these aspects suggest to further study the mechanisms involved in physical exercise-inducing mitochondrial biogenesis and nitric oxide production in order to better understand the cellular signalling and the gene expression regulation. I studied the effects of chronic aerobic exercise in different tissues obtained from eNOS-/- mice in terms of evaluation of biochemical parameters, mitochondrial biogenesis and capability of glucose uptake and I studied the effects of the treatment with a nitric oxide donor (DETA-NONOate) on HL-1 and 3T3-L1 cells in terms of mitochondrial biogenesis and glucose uptake. Materials and Methods: I performed a biochemical analysis, an expression analysis of genes involved in mitochondrial biogenesis, a mtDNA quantification and an analisys of the capability of glucose uptake in different tissues obtained from eNOS-/- and wild type mice after a 6 weeks period of exercise training. I set up a protocol for an in vitro treatment with a nitric oxide donor (DETA-NONOate 100µM for 72 hours) of HL-1 cardiomyocites and 3T3-L1 adipocytes and then I performed a gene expression analysis, a measurement of the capability of basal and insulin stimulated glucose uptake, an immunofluorescence analysis of mitochondrial biogenesis and a quantification of GLUT4 translocation after insulin stimulation. Results and conclusions: I observed an increase in gene expression, mtDNA content and capability of both basal and insulin-stimulated glucose uptake in different tissues obtained from wild type but not eNOS-/- mice after the exercise training protocol. In cells treated with DETA-NONOate I observed an increase in gene expression, mitochondrial biogenesis, capability of basal and insulin- stimulated glucose uptake and GLUT4 translocation compared to those without treatment. These results suggest that nitric oxide is a key molecule in the regulation of energy balance and glucose metabolism, and it may be involved in the activation of mitochondrial function and biogenesis. Further studies are needed to better clarify the role of NO and mitochondrial biogenesis in the pathogenesis of cardiovascular abnormalities linked with obesity and type 2 diabetes.Stato dell'arte e scopo della tesi: Tra i differenti meccanismi implicati nella patogenesi dell'obesità , della resistenza insulinica e della loro progressione verso il diabete di tipo 2 è stata ipotizzata l'esistenza di un danno della funzione mitocondriale. Inoltre l'insulino resistenza è associata ad un ridotto contenuto mitocondriale e ad una riduzione dell'attività  dell'enzima eNOS che si presume essere il primo fattore implicato nella catena di signalling. Partendo dal presupposto che l'esercizio fisico aumenta la sensibilità  insulinica e la produzione di ossido nitrico, e che l'ossido nitrico è in grado di stimolare la biogenesi mitocondriale si è voluto analizzare se l'aumento della sensibilità  insulinica e della mitocondriogenesi mediato dall'esercizio fisico fosse correlato al metabolismo dell'ossido nitrico. Durante il mio dottorato di ricerca mi sono occupata dello studio degli effetti dell'esercizio fisico in alcuni tessuti di topi eNOS-/- in seguito a un protocollo di allenamento cronico di tipo aerobico. Ho studiato questi effetti in termini di dosaggi plasmatici, espressione genica e aumento del DNA mitocondriale e capacità  di captazione del glucosio in tessuto cardiaco, muscolare e adiposo. Mi sono inoltre occupata della valutazione degli effetti della somministrazione di ossido nitrico su cellule in coltura, cardiomiociti HL1 e adipociti 3T3-L1. Materiali e Metodi: Ho eseguito analisi biochimche mediante saggi enzimatici e misurazioni di parametri endocrino-metabolici, analisi di espressione genica, quantificazione di mtDNA e della capacità  di captazione di glucosio in diversi tessuti ottenuti da topi eNOS-/- e wild type dopo un periodo di 6 settimane di allenamento. Ho allestito un protocollo per il trattamento in vitro con un donatore di ossido nitrico (DETA-NONOato 100µM per 72 ore) su cellule HL-1 e 3T3-L1 e in seguito ho valutato l'espressione genica, la capacità  di captazione del glucosio sia in condizioni basali che insulino stimolate, l'analisi in immunofluorescenza della biogenesi mitocondriale e la traslocazione del trasportatore GLUT4 di queste cellule. Risultati e conclusioni: Ho osservato un aumento dell'espressione genica, del contenuto di mtDNA e della capacità  di captazione del glucosio in diversi tessuti dei topi wild type ma non di quelli eNOS-/- in seguito al periodo di allenamento. Nelle cellule trattate con DETA-NONOato ho osservato un aumento dell'espressione genica, della biogenesi mitocondriale, della capacità di captazione di glucosio sia basale che insulino-stimolata e della traslocazione di GLUT4 rispetto alle cellule di controllo che non erano state sottoposte al trattamento. Questi risultati suggeriscono che l'ossido nitrico abbia un ruolo chiave nella regolazione del bilancio energetico e del metabolismo del glucosio e confermano un suo coinvolgimento nell'attivazione della biogenesi mitocondriale. Saranno necessari ulteriori studi per indagare ulteriormente il suo ruolo nella patogenesi di complicanze cardiovascolari legate all'obesità  e al diabete di tipo 2

Prognostic value of stem cell markers in esophageal and esophagogastric junction cancer: a meta-analysis

Background: Esophageal cancer is an aggressive tumor, with poor prognosis and low survival rates. Although diagnosis and treatment have improved considerably, more efficient prognostic factors are urgently needed to prevent postoperative recurrence and metastasis. Cancer stem cells are key players in tumor progression and several studies have investigated the association between the expression of stemness genes and clinical outcome. However, the prognostic value of stemness markers in esophageal cancer remains controversial. We identified six factors involved in angiogenesis, anti-apoptosis and self-renewal that have been associated to poor prognosis in other types of cancer. We conducted a review of the literature and a meta-analysis to assess their potential prognostic role in this malignancy. Material and Methods: The database of PMC, PubMed, Web of Science, Embase and The Cochrane Library were searched to investigate the association between CD34, CD133, Nucleostemin, OCT-4, NANOG and CD90, and the survival of patients affected by esophageal squamous cell carcinoma or esophageal adenocarcinoma. Among the 615 eligible studies, a total of 19 articles (including 1586 patients) met the inclusion criteria for the meta-analysis, and the pooled hazard ratio and 95% confidence intervals were calculated. Results: Data showed that high expression of CD34 (HR 2.10; 95%CI 1.41-3.14; I2=56%; p=0.0003), CD133 (HR 1.91; 95%CI 1.15-3.19; I2=55%; p=0.01) and Nucleostemin (HR 2.97; 95%CI 1.11-7.98; I2=0%; p=0.03) were associated with poor prognosis in patients affected by esophageal cancer. The expression of NANOG and OCT-4 showed no significant association with survival of patients, whereas no study involving CD90 was included in this meta-analysis. Conclusion: CD34, CD133 and Nucleostemin might represent useful prognostic markers in patients affected by esophageal cancer

A Novel Loss of Function Melanocortin-4-Receptor Mutation (MC4R-F313Sfs*29) in Morbid Obesity

CONTEXT: Melanocortin receptor-4 (MC4R) gene mutations are associated with early-onset severe obesity and the identification of potential pathological variants is crucial for the clinical management of patients with obesity.OBJECTIVE: To explore whether and how a novel heterozygous MC4R variant (MC4R-F313Sfs*29), identified in a young boy (BMI 38.8kg/m 2) during a mutation analysis conducted in a cohort of patients with obesity, plays a determinant pathophysiological role in the obesity development.DESIGN SETTING AND PATIENTS: The genetic screening was carried out in a total of 209 unrelated patients with obesity (BMI\u202f 65\u202f35\u202fkg/m 2). Structural and functional characterization of the F313Sfs*29-mutated MC4R was performed using computational approaches and in vitro, using HEK293 cells transfected with genetically-encoded biosensors for cAMP and Ca 2+.RESULTS: The F313Sfs*29 was the only variant identified. In vitro experiments showed that HEK293 cells transfected with the mutated form of MC4R did not increase intracellular cAMP or Ca 2+ levels after the stimulation with a specific agonist in comparison with HEK293 cells transfected with the wild type form of MC4R ( 06R/R0= -90%\ub18%; p<0,001). In silico modelling showed that the F313Sfs*29 mutation causes a major reorganization cytosolic domain of the MC4R, thus reducing the affinity of the putative GalphaS binding site.CONCLUSIONS: The newly discovered F313Sfs*29 variant of MC4R may be involved in the impairment of alpha-MSH-induced cAMP and Ca 2+ signaling, blunting intracellular G protein mediated signal transduction. This alteration might have led to the dysregulation of satiety signaling, resulting in hyperphagia and early onset of obesity

Exercise training induces mitochondrial biogenesis and glucose uptake in subcutaneous adipose tissue through eNOS-dependent mechanisms

Insulin resistance and obesity are associated with a reduction of mitochondrial content in various tissues of mammals. Moreover, a reduced nitric oxide (NO) bioavail-ability impairs several cellular functions, including mito-chondrial biogenesis and insulin-stimulated glucose uptake, two important mechanisms of body adaptation in response to physical exercise. Although these mechanisms have been thoroughly investigated in skeletal muscle and heart, fewstudieshave focused on theeffectsofexercise on mitochondria and glucose metabolism in adipose tissue. In this study, we compared the in vivo effects of chronic exercise in subcutaneous adipose tissue of wild-type (WT) and endothelial NO synthase (eNOS) knockout (eNOS2/2) mice after a swim training period. We then investigated the in vitro effects of NO on mouse 3T3-L1 and human subcutaneous adipose tissue-derived adipocytes after a chronic treatment with anNO donor: diethylenetriamine-NO (DETA-NO). We observed that swim training increases mitochon-drial biogenesis, mitochondrial DNA content, and glucose uptake in subcutaneous adipose tissue of WT but not eNOS 2/2 mice. Furthermore, we observed that DETA-NO promotes mitochondrial biogenesis and elongation, glucose uptake, and GLUT4 translocation in cultured murine and human adipocytes. These results point to the crucial role of the eNOS-derived NO in the metabolic adaptation of subcutaneous adipose tissue to exercise training