Mitogen-Activated Protein Kinase 3

丝裂原活化蛋白激酶 3
  • 文章类型: Clinical Trial, Phase I
    目的:我们评估了MK-8353(细胞外信号调节激酶1/2的小分子抑制剂)联合司美替尼(丝裂原激活的细胞外信号调节激酶1/2抑制剂)治疗晚期实体瘤的疗效。
    方法:此阶段1b,开放标签,剂量递增研究(NCT03745989)纳入有组织学/细胞学记录的成人,局部晚期/转移性实体瘤。MK-8353/司美替尼剂量组合旨在按以下顺序进行研究:50/25、100/50、150/75、200/75、200/100和250/100。每21天以重复周期口服BID给药4天/3天。主要目标是安全性和耐受性,并建立联合治疗的初步推荐2期剂量。
    结果:纳入30例患者。中位(范围)年龄为61.5(26-78)岁,93%曾接受过癌症治疗。在剂量限制性毒性[DLT]可评估人群中的28名患者中,8个有经验的DLT:MK-8353/selumetinib100/50-mg剂量水平的1/11(9%)经历了3级DLT(荨麻疹),和7/14(50%)在150/75毫克剂量水平经历2/3级DLT(n=2每个视力模糊,视网膜脱离,呕吐;腹泻各n=1,黄斑水肿,恶心,视网膜病变)。后一剂量水平的DLT率超过预定的目标DLT率(~30%)。26例患者(87%)经历了与治疗相关的不良事件(3级,30%;无4/5级)。最常见的腹泻(67%),恶心(37%),和痤疮样皮炎(33%)。三名患者(10%)经历了治疗相关的不良事件,导致治疗中止。最佳反应是14例患者的疾病稳定(n=10,MK-8353/selumetinib150/75mg)。
    结论:MK-8353/司美替尼50/25mg和100/50mg具有可接受的安全性和耐受性,而150/75mg则不能耐受。没有观察到反应。
    OBJECTIVE: We evaluated MK-8353 (small molecule inhibitor of extracellular signal-regulated kinase 1/2) plus selumetinib (mitogen-activated extracellular signal-regulated kinase 1/2 inhibitor) in patients with advanced solid tumors.
    METHODS: This phase 1b, open-label, dose-escalation study (NCT03745989) enrolled adults with histologically/cytologically documented, locally advanced/metastatic solid tumors. MK-8353/selumetinib dose combinations were intended to be investigated in sequence: 50/25, 100/50, 150/75, 200/75, 200/100, and 250/100. Each agent was administered orally BID 4 days on/3 days off in repeating cycles every 21 days. Primary objectives were safety and tolerability and to establish preliminary recommended phase 2 doses for combination therapy.
    RESULTS: Thirty patients were enrolled. Median (range) age was 61.5 (26-78) years and 93% had received previous cancer therapy. Among 28 patients in the dose-limiting toxicities [DLT]-evaluable population, 8 experienced DLTs: 1/11 (9%) in the MK-8353/selumetinib 100/50-mg dose level experienced a grade 3 DLT (urticaria), and 7/14 (50%) in the 150/75-mg dose level experienced grade 2/3 DLTs (n = 2 each of blurred vision, retinal detachment, vomiting; n = 1 each of diarrhea, macular edema, nausea, retinopathy). The DLT rate in the latter dose level exceeded the prespecified target DLT rate (~30%). Twenty-six patients (87%) experienced treatment-related adverse events (grade 3, 30%; no grade 4/5), most commonly diarrhea (67%), nausea (37%), and acneiform dermatitis (33%). Three patients (10%) experienced treatment-related adverse events leading to treatment discontinuation. Best response was stable disease in 14 patients (n = 10 with MK-8353/selumetinib 150/75 mg).
    CONCLUSIONS: MK-8353/selumetinib 50/25 mg and 100/50 mg had acceptable safety and tolerability, whereas 150/75 mg was not tolerable. No responses were observed.
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  • 文章类型: Journal Article
    本研究调查了突触可塑性背景下海马功能的性别差异,这是学习和记忆的细胞基础,以及在年轻成年大鼠中伴随可塑性的丝裂原活化蛋白激酶(MAPK)途径的差异。通过刺激穿通通路(PP)诱导长时程增强(LTP)和长期抑郁(LTD),并记录由场兴奋性突触后电位(fEPSP)和群体尖峰(PS)组成的场电位。齿状回(DG)。完成电生理记录后,海马被双侧切除,以及细胞外信号调节激酶1/2(ERK1/2)的蛋白质和基因表达水平,通过蛋白质印迹分析和实时PCR检测c-Jun氨基末端激酶(JNK)和P38-MAPK,分别。雄性和雌性大鼠在高频刺激之前(基础)和之后的突触和神经元功能没有发现显着差异。然而,女性,但不是男性,大鼠能够在PP-DG突触表达长期抑郁,这表明可塑性的性别差异是刺激范式特有的。男性MAPK1表达较高,女性MAPK3表达较高,但是这些差异在诱导两性可塑性后消失了。虽然MAPK8的表达受性别影响,独立于可塑性的感应,MAPK14表达在女性中被可塑性诱导下调,但不是男性。没有性别的影响,除磷酸化ERK1/2外,发现了MAPK的总水平和磷酸化水平的HFS和LFS。在雄性大鼠LFS后,ERK1/2的磷酸化上调,而在雌性大鼠中没有变化。这些发现表明,LFS诱导的可塑性在性别之间有差异地调节,可能是雄性大鼠ERK1/2激活增加的结果。
    The present study investigates sex differences in hippocampal functions in the context of synaptic plasticity, which is the cellular basis of learning and memory, and differences in the mitogen-activated protein kinase (MAPK) pathway that accompanies plasticity in young-adult rats. The long-term potentiation (LTP) and long-term depression (LTD) were induced by stimulating the perforant pathway (PP) and field potentials composed of the field excitatory post-synaptic potential (fEPSP) and population spike (PS) were recorded from the dentate gyrus (DG). Following the completion of the electrophysiological recordings, the hippocampi were removed bilaterally, and the protein and gene expression levels of the extracellular signal-regulated kinase 1/2 (ERK1/2), c-Jun N-terminal kinase (JNK) and P38-MAPK were determined by Western blot analysis and real-time PCR, respectively. No significant difference was found in synaptic and neuronal function before (basal) and after high-frequency stimulation between male and female rats. Nevertheless, female, but not male, rats were able to express long term depression at the PP - DG synapses, suggesting that sex differences in plasticity are stimulation paradigm specific. MAPK1 expression was higher in males and MAPK3 expression was higher in females, but these differences disappeared after induction of plasticity in both sexes. While the expression of MAPK8 is influenced by sex, independent of the induction of plasticity, MAPK14 expression was down regulated by plasticity induction in females, but not males. No effect of sex, HFS and LFS on total and phosphorylated levels of MAPKs was found except phosphorylated ERK1/2. Phosphorylation of ERK1/2 was up regulated after LFS in male rats but did not change in female rats. These findings indicate that LFS-induced plasticity is differentially modulated between sexes, probably as a result of increased activation of ERK1/2 in male rats.
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  • 文章类型: Journal Article
    Manzamines是复杂的多环海洋衍生的β-咔啉生物碱,具有抗癌报道,免疫刺激,抗炎,抗菌,抗病毒,抗疟药,神经源性,高脂血症,和动脉粥样硬化抑制生物活性,与糖原合酶激酶3,细胞周期蛋白依赖性激酶5,SIX1和液泡ATPases的抑制有关。我们假设额外的,然而,未被发现的分子靶标可能与ManzamineA(MZA)报告的药理特性有关。我们在这里报道,第一次,当针对一组30种蛋白激酶进行筛选时,MZA选择性地抑制90kDa核糖体蛋白激酶S6(RSK1),而体外RSK激酶测定表明,与RSK2相比,MZA对RSK1的效力具有10倍的选择性。在SiHa和CaSki人宫颈癌细胞系中验证了MZA对细胞RSK1和RSK2蛋白表达的抑制作用。计算对接实验也支持MZA对两种同工型的差异结合和选择性。具体来说,与RSK2-MZA相反,RSK1-MZA(N-和C-末端)复合物似乎具有更强的相互作用和优选的能量学。此外,我们的计算策略表明MZA与RSK1的N末端激酶结构域而不是C末端结构域结合.RSK是脊椎动物胞质丝氨酸-苏氨酸激酶家族,作用于ras-ERK1/2(细胞外信号调节激酶1/2)途径的下游,它磷酸化底物,以调节几个细胞过程,包括增长,生存,和扩散。因此,我们的发现使我们假设从几个海绵属中分离出的MZA和目前已知的manzamine型生物碱可能具有独特的分子靶标,MZA为涉及RSK1的化学生物学研究提供了新工具。
    Manzamines are complex polycyclic marine-derived β-carboline alkaloids with reported anticancer, immunostimulatory, anti-inflammatory, antibacterial, antiviral, antimalarial, neuritogenic, hyperlipidemia, and atherosclerosis suppression bioactivities, putatively associated with inhibition of glycogen synthase kinase-3, cyclin-dependent kinase 5, SIX1, and vacuolar ATPases. We hypothesized that additional, yet undiscovered molecular targets might be associated with Manzamine A\'s (MZA) reported pharmacological properties. We report here, for the first time, that MZA selectively inhibited a 90 kDa ribosomal protein kinase S6 (RSK1) when screened against a panel of 30 protein kinases, while in vitro RSK kinase assays demonstrated a 10-fold selectivity in the potency of MZA against RSK1 versus RSK2. The effect of MZA on inhibiting cellular RSK1 and RSK2 protein expression was validated in SiHa and CaSki human cervical carcinoma cell lines. MZA\'s differential binding and selectivity toward the two isoforms was also supported by computational docking experiments. Specifically, the RSK1-MZA (N- and C-termini) complexes appear to have stronger interactions and preferable energetics contrary to the RSK2-MZA ones. In addition, our computational strategy suggests that MZA binds to the N-terminal kinase domain of RSK1 rather than the C-terminal domain. RSK is a vertebrate family of cytosolic serine-threonine kinases that act downstream of the ras-ERK1/2 (extracellular-signal-regulated kinase 1/2) pathway, which phosphorylates substrates shown to regulate several cellular processes, including growth, survival, and proliferation. Consequently, our findings have led us to hypothesize that MZA and the currently known manzamine-type alkaloids isolated from several sponge genera may have novel pharmacological properties with unique molecular targets, and MZA provides a new tool for chemical-biology studies involving RSK1.
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  • 文章类型: Clinical Trial, Phase I
    ERK1/2 signaling can be dysregulated in cancer. GDC-0994 is an oral inhibitor of ERK1/2. A first-in-human, phase I dose escalation study of GDC-0994 was conducted in patients with locally advanced or metastatic solid tumors.
    GDC-0994 was administered once daily on a 21-day on/7-day off schedule to evaluate safety, pharmacokinetics, and preliminary signs of efficacy. Patients with pancreatic adenocarcinoma and BRAF-mutant colorectal cancer were enrolled in the expansion stage.
    Forty-seven patients were enrolled in six successive cohorts (50-800 mg). A single DLT of grade 3 rash occurred at 600 mg. The most common drug-related adverse events (AE) were diarrhea, rash, nausea, fatigue, and vomiting. Pharmacokinetic data showed dose-proportional increases in exposure, with a mean half-life of 23 hours, supportive of once daily dosing. In evaluable paired biopsies, MAPK pathway inhibition ranged from 19% to 51%. Partial metabolic responses by FDG-PET were observed in 11 of 20 patients across dose levels in multiple tumor types. Overall, 15 of 45 (33%) patients had a best overall response of stable disease and 2 patients with BRAF-mutant colorectal cancer had a confirmed partial response.
    GDC-0994 had an acceptable safety profile and pharmacodynamic effects were observed by FDG-PET and in serial tumor biopsies. Single-agent activity was observed in 2 patients with BRAF-mutant colorectal cancer.
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  • 文章类型: Journal Article
    Our previous studies indicated that a coculture system containing human amnion-derived mesenchymal stem cells (HAMSCs) and human bone marrow mesenchymal stem cells (HBMSCs) has the potential of application for bone regeneration. However, there is currently no enough comparative investigation between HAMSCs/HBMSCs transwell and mixed coculture systems. This study aimed to assess the phenotype and mechanisms regulated by indirect and direct coculture systems, respectively. Two in vitro models were employed with HAMSCs and HBMSCs at a ratio of 3:1, and then were analyzed by a series of processes, including flow cytometry, alkaline phosphatase (ALP) substrate assays, Alizarin red S staining, quantitative reverse transcription polymerase chain reaction (RT-qPCR), and Western blot analysis. We found that cell proliferation, ALP activity, mineralized matrix formation, and osteoblast-related mRNA expression were accelerated in transwell coculture system compared with mixed coculture system. Conditioned medium from transwell coculture system achieved an elevated level of vascular endothelial growth factor and induced more vascular structures in human umbilical vein endothelial cells than those of mixed coculture system. Moreover, we observed that transwell coculture system, promoted osteogenesis and angiogenesis by maintaining stemness through extracellular regulated protein kinases 1/2 (ERK1/2) mitogen-activated protein kinase (MAPK) signaling pathway. U0126, a selective inhibitor of ERK1/2 MAPK signaling, significantly suppressed maintaining of the stemness-based effects on transwell coculture system. Taken together, our results compared the merits of two different models and clarified the role of HAMSCs/HBMSCs transwell coculture system in the development of bone tissue engineering. © 2019 IUBMB Life, 2019.
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  • 文章类型: Journal Article
    肥胖和胰岛素抵抗是神经退行性疾病发展的危险因素。先前的工作表明,一次急性运动可能对肥胖小鼠具有有益的神经保护作用。淀粉样β肽生产中的限速酶,BACE1在运动后2小时在前额叶皮层中减少,然而,如果这些影响仍然随着时间的推移是未知的。我们的目的是确定运动诱发的改变在一次运动后在前额叶皮层和海马体中持续多长时间。雄性C57BL/6J小鼠饲喂低(LFD,来自猪油的10%kcals)或高脂肪饮食(HFD,来自猪油的60%kcals)持续7周。然后,HFD小鼠进行了一次急性跑步机跑步(15m/min,倾斜5%,120分钟),然后是2-,8-,或24小时的恢复。HFD增加了体重(LFD27.8±1.05vs.HFD41.7±0.60g;P<0.05)和葡萄糖不耐受(AUCLFD63.27±4.5vs.HFD128.9±4.6;P<0.05)。与久坐的HFD小鼠相比,运动后2小时和8小时前额叶皮质BACE1含量降低,然而24小时BACE1蛋白含量没有差异。运动后8小时和24小时海马BACE1含量降低。与LFD相比,HFD有更高的前额叶皮质磷酸化p38,JNK,和AMPK,表明神经元应激增加。运动后前额叶皮质p38和JNK磷酸化在HFD或LFD组之间没有差异,而ERK磷酸化在24小时内显著降低。HFD增加海马中的JNK磷酸化。这些结果证明了运动对降低BACE1前额叶皮质和海马含量的直接和有效作用。然而,前额叶皮层BACE1含量的减少是短暂的。
    Obesity and insulin resistance are risk factors in the development of neurodegenerative disorders. Previous work suggests that one acute bout of exercise may have beneficial neuro-protective effects in obese mice. The rate limiting enzyme in the production of amyloid-beta peptides, BACE1, was reduced in the prefrontal cortex 2 h post-exercise, however if these effects remain over time is unknown. We aimed to determine how long exercise-induced alterations persist in the prefrontal cortex and hippocampus following a single exercise bout. Male C57BL/6J mice were fed either a low (LFD, 10% kcals from lard) or a high fat diet (HFD, 60% kcals from lard) for 7 weeks. HFD mice then underwent an acute bout of treadmill running (15 m/min, 5% incline, 120 min) followed by 2-, 8-, or 24-h of recovery. The HFD increased body mass (LFD 27.8 ± 1.05 vs. HFD 41.7 ± 0.60 g; P < 0.05) and glucose intolerance (AUC LFD 63.27 ± 4.5 vs. HFD 128.9 ± 4.6; P < 0.05). Prefrontal cortex BACE1 content was reduced 2- and 8-h post-exercise compared to sedentary HFD mice, however BACE1 protein content at 24 h was not different. Hippocampal BACE1 content was reduced 8- and 24-h post-exercise. Compared to the LFD, the HFD had higher prefrontal cortex phosphorylation of p38, JNK, and AMPK, indicative of increased neuronal stress. Post-exercise prefrontal cortex p38 and JNK phosphorylation were no different between the HFD or LFD groups, while ERK phosphorylation was significantly reduced by 24 h. The HFD increased JNK phosphorylation in the hippocampus. These results demonstrate the direct and potent effects of exercise on reducing BACE1 prefrontal cortex and hippocampal content. However the reduction in prefrontal cortex BACE1 content is short lived.
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  • 文章类型: Journal Article
    目标:蛋白磷酸酶2A(PP2A),一种主要的丝氨酸/苏氨酸磷酸酶,也已知是ROS的靶标。亮氨酸羧甲基转移酶-1(LCMT1)可以催化PP2A的甲基化,调节PP2A活性和底物特异性。
    方法:在先前的研究中,我们已经表明LCMT1依赖性PP2Ac甲基化阻止H2O2诱导的细胞氧化应激损伤。为了探索可能的保护机制,我们对H2O2处理的载体对照和LCMT1过表达细胞进行了基于iTRAQ的比较定量蛋白质组学和磷酸蛋白质组学研究.
    结果:通过这种方法鉴定了总共4480种非冗余蛋白和3801种独特的磷酸肽。通过比较LCMT1过表达和载体对照细胞中H2O2调节的蛋白,我们发现这些差异主要与蛋白质磷酸化有关,基因表达,蛋白质成熟,细胞骨架和细胞分裂。在H2O2处理下对LCMT1过表达特异性调节蛋白的进一步研究支持LCMT1过表达诱导蛋白质的普遍去磷酸化并表明非红细胞血红蛋白表达增加的观点。MAPK3的失活和Rho信号转导相关蛋白的调节,已知与细胞骨架的调节有关。
    结论:这些数据提供了蛋白质组学和磷酸化蛋白质组学对LCMT1依赖性PP2Ac甲基化与氧化应激的关联的见解,并间接表明PP2A的甲基化在对抗氧化应激方面发挥了重要作用。
    OBJECTIVE: Protein phosphatase 2A (PP2A), a major serine/threonine phosphatase, is also known to be a target of ROS. The methylation of PP2A can be catalyzed by leucine carboxyl methyltransferase-1 (LCMT1), which regulates PP2A activity and substrate specificity.
    METHODS: In the previous study, we have showed that LCMT1-dependent PP2Ac methylation arrests H2O2-induced cell oxidative stress damage. To explore the possible protective mechanism, we performed iTRAQ-based comparative quantitative proteomics and phosphoproteomics studies of H2O2-treated vector control and LCMT1-overexpressing cells.
    RESULTS: A total of 4480 non-redundant proteins and 3801 unique phosphopeptides were identified by this means. By comparing the H2O2-regulated proteins in LCMT1-overexpressing and vector control cells, we found that these differences were mainly related to protein phosphorylation, gene expression, protein maturation, the cytoskeleton and cell division. Further investigation of LCMT1 overexpression-specific regulated proteins under H2O2 treatment supported the idea that LCMT1 overexpression induced ageneral dephosphorylation of proteins and indicated increased expression of non-erythrocytic hemoglobin, inactivation of MAPK3 and regulation of proteins related to Rho signal transduction, which were known to be linked to the regulation of the cytoskeleton.
    CONCLUSIONS: These data provide proteomics and phosphoproteomics insights into the association of LCMT1-dependent PP2Ac methylation and oxidative stress and indirectly indicate that the methylation of PP2A plays an important role against oxidative stress.
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  • 文章类型: Letter
    暂无摘要。
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  • 文章类型: Journal Article
    目的:本研究的目的是研究生物标志物FHIT的预测价值,p27和pERK1/ERK2在唾液腺癌中的作用。
    方法:FHIT的免疫组织化学染色,对265例涎腺癌患者进行p27和pERK1/ERK2,以及与临床组织病理学数据的关联,总生存率,并检查了疾病特异性生存率。
    结果:FHIT的表达(快速评分98.7与206.4)和p27(QS187.3与244.8)与非肿瘤对照组织相比,在癌中显着更低。ACC经常发生FHIT损失(55.2%),SDC(68.2%),SCC(100%)。在整个肿瘤中,在46.7%(106/227)中发现FHIT表达丧失,并且与晚期T期和UICC期显著相关,高级组织学,P27、PI3K、和幸存者。FHIT阳性伴随着显著更好的总体和疾病特异性生存率。p27阴性发生在28.7%(70/244)的肿瘤中,特别是在SDC(54.4%)和SCC(50%)中。在整个肿瘤中,p27与患者高龄相关,高级组织学,PI3K,survivin以及更好的总体和疾病特异性生存率(p<0.05)。pERK1/ERK2阳性表达与survivin阳性表达相关,但不影响整个肿瘤的总体生存率。在粘液表皮样癌中,pERK1/ERK2表达与低度恶性肿瘤相关,积极的核幸存者,和更好的疾病特异性生存。
    结论:在涎腺癌中,FHIT和p27的丢失表征了肿瘤的侵袭性生长和不良预后。
    结论:结果可能有助于根据个体肿瘤特征对患者特异性治疗进行分层。
    OBJECTIVE: The aim of this study was to investigate the predictive value of the biomarkers FHIT, p27, and pERK1/ERK2 in salivary gland carcinomas.
    METHODS: Immunohistochemical staining of FHIT, p27, and pERK1/ERK2 of 265 patients with salivary gland carcinomas was conducted, and associations with clinico-histopathological data, overall survival, and disease-specific survival were examined.
    RESULTS: Expression of FHIT (quick score 98.7 vs. 206.4) and p27 (QS 187.3 vs. 244.8) was significantly lower in carcinomas compared to non-tumor control tissue. Loss of FHIT frequently occurred in ACC (55.2%), SDC (68.2%), and SCC (100%). In the totality of tumors, loss of FHIT expression was found in 46.7% (106/227) and was significantly associated with advanced T stage and UICC stage, high-grade histology, loss of p27, PI3K, and survivin. FHIT positivity went along with significantly better overall and disease-specific survival. Negativity of p27 occurred in 28.7% (70/244) of tumors, particularly in SDC (54.4%) and SCC (50%). In the totality of tumors, p27 was associated with advanced patient age, high-grade histology, PI3K, survivin as well as better overall and disease-specific survival (p < 0.05). Positive pERK1/ERK2 expression correlated with positive survivin expression but did not affect overall survival in the totality of tumors. In mucoepidermoid carcinomas, pERK1/ERK2 expression was associated with low-grade malignancy, positive nuclear survivin, and better disease-specific survival.
    CONCLUSIONS: Loss of FHIT and p27 characterizes aggressive tumor growth and unfavorable prognosis in salivary gland cancer.
    CONCLUSIONS: The results may help to stratify patient-specific therapies according to individual tumor characteristics.
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  • 文章类型: Journal Article
    Exenatide, a glucagon-like peptide 1 agonist used in type 2 diabetes, was recently found to have beneficial effects on motor function in a randomized, placebo-controlled trial in Parkinson disease (PD). Accumulating evidence suggests that impaired brain insulin and protein kinase B (Akt) signaling play a role in PD pathogenesis; however, exploring the extent to which drugs engage with putative mechnisms in vivo remains a challenge.
    To assess whether participants in the Exenatide-PD trial have augmented activity in brain insulin and Akt signaling pathways.
    Serum samples were collected from 60 participants in the single-center Exenatide-PD trial (June 18, 2014, to June 16, 2016), which compared patients with moderate PD randomized to 2 mg of exenatide once weekly or placebo for 48 weeks followed by a 12-week washout period. Serum extracellular vesicles, including exosomes, were extracted, precipitated, and enriched for neuronal source by anti-L1 cell adhesion molecule antibody absorption, and proteins of interest were evaluated using electrochemiluminescence assays. Statistical analysis was performed from May 1, 2017, to August 31, 2017.
    The main outcome was augmented brain insulin signaling that manifested as a change in tyrosine phosphorylated insulin receptor substrate 1 within neuronal extracellular vesicles at the end of 48 weeks of exenatide treatment. Additional outcome measures were changes in other insulin receptor substrate proteins and effects on protein expression in the Akt and mitogen-activated protein kinase pathways.
    Sixty patients (mean [SD] age, 59.9 [8.4] years; 43 [72%] male) participated in the study: 31 in the exenatide group and 29 in the placebo group (data from 1 patient in the exenatide group were excluded). Patients treated with exenatide had augmented tyrosine phosphorylation of insulin receptor substrate 1 at 48 weeks (0.27 absorbance units [AU]; 95% CI, 0.09-0.44 AU; P = .003) and 60 weeks (0.23 AU; 95% CI, 0.05-0.41 AU; P = .01) compared with patients receiving placebo. Exenatide-treated patients had elevated expression of downstream substrates, including total Akt (0.35 U/mL; 95% CI, 0.16-0.53 U/mL; P < .001) and phosphorylated mechanistic target of rapamycin (mTOR) (0.22 AU; 95% CI, 0.04-0.40 AU; P = .02). Improvements in Movement Disorders Society Unified Parkinson\'s Disease Rating Scale part 3 off-medication scores were associated with levels of total mTOR (F4,50 = 5.343, P = .001) and phosphorylated mTOR (F4,50 = 4.384, P = .04).
    The results of this study are consistent with target engagement of brain insulin, Akt, and mTOR signaling pathways by exenatide and provide a mechanistic context for the clinical findings of the Exenatide-PD trial. This study suggests the potential of using exosome-based biomarkers as objective measures of target engagement in clinical trials using drugs that target neuronal pathways.
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