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We thus proposed that the formation of cytoplasmatic lipids could reduce fatty acid-induced toxicity by Keywords cytotoxicity; fibrate; free fatty acid; pancreatic beta-cells; peroxisome

Trang 1

Peroxisome proliferator-activated receptor a–retinoid X receptor agonists induce beta-cell protection against

palmitate toxicity

Karine Hellemans1, Karen Kerckhofs1, Jean-Claude Hannaert1, Geert Martens1,

Paul Van Veldhoven2and Daniel Pipeleers1

1 Diabetes Research Center (DRC), Brussels Free University-VUB, Belgium

2 Afdeling Farmakologie, Departement Moleculaire Celbiologie, K U Leuven, Belgium

Under normal circumstances, long-chain fatty acids

serve as regulators of beta-cell function [1,2] At

sus-tained, elevated concentrations, they can exert

cyto-toxic actions on beta-cells, and this has led to the view

that they could be, at least in part, responsible for the

loss of beta-cells in diabetes [3,4] Several in vitro and

in vivostudies have supported this lipotoxicity concept

and extended into experiments aimed at pharmacologic

prevention of this process [3,5] We previously reported

that pancreatic beta-cells possess defense mechanisms

against oxidative damage [6] and could be induced to

provide cytoprotection [7] It is still uncertain whether they also exhibit such properties when exposed to cyto-toxic fatty acid concentrations, and if so, whether they can be activated through similar or other mechanisms Indirect evidence for the presence of such a protective mechanism comes from the observation that fatty acid-induced toxicity was limited to a subpopulation of beta-cells, and apparently related to the cellular ability

to accumulate neutral lipids in the cytoplasm [7] We thus proposed that the formation of cytoplasmatic lipids could reduce fatty acid-induced toxicity by

Keywords

cytotoxicity; fibrate; free fatty acid;

pancreatic beta-cells; peroxisome

proliferator-activated receptor a

Correspondence

K Hellemans, Diabetes Research Center,

Brussels Free University-VUB,

Laarbeeklaan 103, 1090 Brussels, Belgium

Fax: +32 2 4774545

Tel: +32 2 4774541

E-mail: karine.hellemans@vub.ac.be

(Received 11 July 2007, revised 1 October

2007, accepted 8 October 2007)

doi:10.1111/j.1742-4658.2007.06131.x

Fatty acids can stimulate the secretory activity of insulin-producing cells At elevated concentrations, they can also be toxic to isolated beta-cells This toxicity varies inversely with the cellular ability to accumulate neutral lipids in the cytoplasm To further examine whether cytoprotection can be achieved by decreasing cytoplasmic levels of free acyl moieties, we investigated whether palmitate toxicity is also lowered by stimulating its b-oxidation Lower rates of palmitate-induced beta-cell death were mea-sured in the presence of l-carnitine as well as after addition of peroxisome proliferator-activated receptor a (PPARa) agonists, conditions leading to increased palmitate oxidation In contrast, inhibition of mitochondrial b-oxidation by etomoxir increased palmitate toxicity A combination of PPARa and retinoid X receptor (RXR) agonists acted synergistically and led to complete protection; this was associated with enhanced expression levels of genes involved in mitochondrial and peroxisomal b-oxidation, lipid metabolism, and peroxisome proliferation PPARa–RXR protection was abolished by the carnitine palmitoyl transferase 1 inhibitor etomoxir These observations indicate that PPARa and RXR regulate beta-cell susceptibility to long-chain fatty acid toxicity by increasing the rates of b-oxidation and by involving peroxisomes in fatty acid metabolism

Abbreviations

CPT1, carnitine palmitoyl transferase 1, liver; GPAT, glycerol-3-phosphate acyltransferase, mitochondrial; Pex2, peroxisomal biogenesis factor 2; Pex3, peroxisomal biogenesis factor 3; Pex11a, peroxisomal biogenesis factor 11a; Pex14, peroxisomal biogenesis factor 14; Pex16, peroxisomal biogenesis factor 16; PPARa, peroxisome proliferator-activated receptor a; PMP70, peroxisomal membrane protein 70;

RA, retinoic acid; RXRa, retinoid X receptor; SCD1, stearoyl-CoA desaturase 1; SCD2, stearoyl-CoA desaturase 2.

Trang 2

preventing a rise in toxic free acyl moieties [7] and⁄ or

fatty acid metabolites such as ceramides [8,9] Along

this line, one can further hypothesize that an increased

rate of fatty acid oxidation also lowers the formation

of these cytotoxic mediators and could thus also act as

a cytoprotective mechanism To test this hypothesis,

we examined whether palmitate toxicity can be reduced

by increasing its oxidation rates We first assessed

whether protection could be conferred by l-carnitine, a

rate-limiting component for long-chain fatty acid

transport into the mitochondria, or suppressed by

etomoxir, an irreversible carnitine palmitoyl

transfer-ase 1 (CPT1) inhibitor [10] In a second set of

experi-ments, we assessed the effects of agonists for

peroxisome proliferator-activated receptor a (PPARa)

and retinoid X receptor (RXR) PPARa–RXR dimers

can be activated by both PPARa and RXR agonists

PPARa–RXR dimers typically regulate the expression

of multiple genes involved in mitochondrial and

perox-isomal b-oxidation as well as lipoprotein metabolism

[11] PPARa is expressed in primary rat beta-cells [12],

and has been shown to activate fatty acid oxidation

[13,14] PPARa agonists have been reported to prevent

fatty acid-induced beta-cell dysfunction and apoptosis

in human islets [15], and improve beta-cell function in

insulin-resistant rodent models [16]

Results

Specificity of palmitate toxicity

When rat beta-cells were cultured with palmitate,

time-and concentration-dependent cytotoxicity was

mea-sured At 50 and 100 lm, no toxic effect was detected

after 2 days, and only 10–20% cells were damaged

after 8 days (data not shown) At 250 and 500 lm,

cytotoxicity was noticed after 2 days and resulted,

after 8 days, in, respectively, 38 ± 2% and 75 ± 4%

dead cells (Fig 1) It was noticed that with exposure

longer than 3 days at 500 lm, the slope of the toxicity

curve declined The percentage of surviving cells

tended to stabilize around 25% after 6 days, despite

administration of a new bolus of fatty acid every 48 h

With 250 lm, the fraction of cell survival stabilized

around 60% The cytotoxic effect of palmitate did not

vary with the glucose concentration in the medium

(comparison of 5, 10 and 20 mm glucose, data not

shown) Subsequent studies were conducted at 10 mm

glucose for 2 days with 500 lm palmitate (acute

toxic-ity) and for 8 days at 250 lm (chronic toxictoxic-ity)

Islet endocrine nonbeta-cells exhibited lower

suscep-tibility to palmitate toxicity: cytotoxicity was

9 ± 0.5% after 2 days at 500 lm, and 16 ± 3% after

8 days at 250 lm After 8 days at 500 lm, the cytotox-icity increased to 46 ± 8% (results not shown) In the latter condition, more than 95% of purified beta-cells died, which means that approximately 20% of the dead cells in the nonbeta-cell fraction correspond to beta-cells, as the nonbeta-cell fraction is contaminated

to this extent by beta-cells; consequently, the palmitate toxicity for the islet nonbeta-cells is calculated to be about 25% after 8 days at 500 lm

Palmitate toxicity in beta-cells was compared with that of equimolar concentrations of other fatty acids

in the presence of 1% BSA (Table 1) Oleate, an unsat-urated long-chain fatty acid, was less toxic, and the shorter-chain molecules butyrate (C4), hexanoate (C6) and octanoate (C8) were only marginally toxic The 2-methyl and 3-methyl derivatives of palmitate were virtually nontoxic: < 5% after 2 days and < 10% after 8 days, both at 250 and at 500 lm, whereas

2 4 6 8 10 0

25 50 75

100 250 M C16:0

500 M C16:0

Days of exposure

Fig 1 Time course analysis for palmitate cytotoxicity Primary rat beta-cells were exposed to 250 or 500 l M palmitate Cytotoxicity was measured on a daily basis (n ¼ 4, vertical bars represent SEM).

Table 1 Cytotoxicity of fatty acids for rat beta-cells Beta-cells were exposed to the following fatty acids at 500 l M for 2 days or

at 250 l M for 8 days: palmitate (C16:0), oleate (C18:1), butyrate (C4:0), hexanoate (C6:0), octanoate (C8:0), 2-methylhexadecanoic acid (2-Me-C16:0), 3-methylhexadecanoic acid (3-Me-C16:0), 2-bromopalmitate (Br-C16:0) Data represent means ± SD (n ¼ 3–6) *P < 0.001 as compared to C16:0 (student’s t-test).

Fatty acid

Percentage cytotoxicity

500 l M for 2 days 250 l M for 8 days

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2-bromopalmitate was markedly more toxic than

palm-itate There was no difference in the percentage of

liv-ing cells followliv-ing vehicle treatment when compared to

the standard control

Palmitate and glucose metabolism by beta-cells

and islet nonbeta-cells

Palmitate and glucose metabolism was measured in

freshly isolated beta-cells and in islet nonbeta-cells that

were incubated for 2 h with 50 lm [14C]palmitate or

5 lCi of d-[U-14C]glucose.14C incorporation was

mea-sured in CO2and small metabolic intermediates, as well

as in the lipid and protein fractions (Table 2) After

incubation with [14C]palmitate at 3.3 mm glucose, the

largest amount was recovered in the lipid-soluble

frac-tion (55%) and the lowest in the protein fracfrac-tion,

whereas comparable amounts were converted to CO2

(17%) and to small metabolic intermediates (20%); at

20 mm glucose, the total amounts in the lipid fraction

(representing 82%) and protein fraction were not

sig-nificantly different from those at 3 mm glucose, but the

production of 14CO2 and of 14C intermediates was,

respectively, five- and 10-fold lower (Table 2) Analysis

of the fate of [14C]glucose indicated that, at 3.3 mm

glucose, the tracer was converted to CO2 and to small

intermediates, and that high glucose increased this rate

five-fold, and also increased seven-fold the14C

incorpo-ration into the lipid and protein fraction

Islet endocrine nonbeta-cells exhibit much lower

rates of glucose oxidation and utilization than islet

beta-cells; the values shown in Table 2 are an overesti-mation, in view of the contamination of this fraction

by 20–25% beta-cells; the CO2 production from glu-cose that is calculated for islet nonbeta-cells is thus less than 10% of that in beta-cells On the other hand, their level of CO2production from palmitate is higher,

in particular at 20 mm glucose, where four-fold higher rates were measured than in beta-cells (Table 2) In contrast to the situation in beta-cells, 30% of the labeled palmitate was converted to CO2 independently

of the glucose concentration

Effect of regulators of palmitate metabolism on palmitate toxicity in beta-cells

When beta-cells were precultured for 24 h with the CPT1 activator l-carnitine before measurement of their palmitate oxidation during 2 h of incubation in the further presence of l-carnitine, 14CO2 formation was six-fold higher (to 0.83 ± 0.14 pmol per 2 h per

103cells, n¼ 4, P < 0.05) than in control cells cultured and incubated with the solvent (0.12 ± 0.03) This stimulatory effect was preserved when 250 lm palmitate was added to the preculture medium (0.78 ± 0.19 pmol per 2 h per 103cells,

n¼ 4, P < 0.01) (Fig 2A) It was associated with

an eight-fold elevation of 14C incorporation into metabolic intermediates (from 0.15 ± 0.05 to 0.95 ± 0.07 pmol per 2 h per 103cells, P < 0.05) (results not shown) Preculture with 1 mm l-carnitine protected beta-cells from palmitate toxicity during a

Table 2 Metabolism of [ 14 C]palmitate and [ 14 C]glucose in beta-cells and islet nonbeta-cells at 3.3 and 20 m M glucose Palmitate and glucose metabolism was measured in freshly isolated beta-cells and islet nonbeta-cells incubated for 2 h with 50 l M [14C]palmitate or 5 lCi of

D -[U- 14 C]glucose 14 C incorporation was measured in CO2and small metabolic intermediates, as well as in the lipid and protein fractions and expressed as (pmol per 2 h per 10 3 cells) Data are indicated as mean ± SD (n ¼ 5) Italic: P < 0.05 for 20 m M glucose as compared to 3.3 m M glucose *P < 0.05 for nonbeta-cells as compared to beta-cells, **P < 0.001 for nonbeta-cells as compared to beta-cells (Student’s t-test).

14

C recovery as:

From [ 14 C]palmitate

Beta-cells

Nonbeta-cells

From [ 14 C]glucose

Beta-cells

Nonbeta-cells

Trang 4

subsequent exposure to 500 lm palmitate for 2 days

or 250 lm for 8 days by, respectively, 70% and 40%

(Fig 2B)

On the other hand, when beta-cells were exposed to

palmitate in the presence of the CPT1 inhibitor

etom-oxir (200 lm) (Fig 2C), their survival was further

decreased Lower concentrations of etomoxir (1, 5 and

50 lm), which are known to stimulate PPARa, failed

to show an effect on palmitate toxicity Etomoxir

(200 lm) did not affect beta-cell survival in the

pres-ence of butyrate (C4), which is known to enter

mito-chondria independently of CPT1

Addition of l-cycloserine (100 lm), an inhibitor of

serine palmitoyl transferase, was also found to reduce

palmitate toxicity, both after 2 days at 500 lm (from

24 ± 2% to 10 ± 1%), and after 8 days at 250 lm

(from 38 ± 2% to 20 ± 4%), but not that of oleate

(results not shown)

Effect of PPARa–RXR agonists on palmitate cytotoxicity

The effects of PPARa–RXR agonists clofibrate, cipro-fibrate and 9-cis-retinoic acid (9-cis-RA) were examined

by adding these compounds to the 2 and 8 day culture media Clofibrate alone (tested at 100, 250 and

500 lm, two-way ANOVA, P < 0.001) reduced palmi-tate toxicity at both time points, with a maximal effect

at 250 lm (Fig 3A) Protection from palmitate toxicity was also observed after treatment with 9-cis-RA alone

at all tested concentrations (0.5, 2 or 5 lm, two-way ANOVA, P < 0.001); at 5 lm, the effect was compa-rable to that of 250 lm clofibrate, namely 60% protec-tion after 2 days at 500 lm and 70% after 8 days at

250 lm (Fig 3A) Combinations of different con-centrations of both agents further reduced palmitate toxicity; the maximal level of protection, reducing palmitate-induced cell death to only 5%, was reached using a combination of 5 lm 9-cis-RA and 100 lm clo-fibrate Higher clofibrate concentrations in the pres-ence of 9-cis-RA did not lower palmitate toxicity any further (Fig 3A) For all further experiments, a combi-nation of 250 lm clofibrate and 2 lm 9-cis-RA was used, resulting in a reduction of palmitate toxicity by 90% (Fig 3B) The efficacy of this combination did not significantly differ from that of 250 lm clofibrate plus 5 lm 9-cis-RA The same level of protection as found in the presence of 10 mm glucose was found at low (5 mm) and high (20 mm) glucose concentrations (results not shown) Under the same conditions, clofi-brate and 9-cis-RA were also found to protect against oleate toxicity (from 25 ± 3% to 13 ± 2% for

500 lm after 2 days, and from 32 ± 3% to 14 ± 4% for 250 lm after 8 days, P < 0.01, results not shown) Ciprofibrate (10, 50 and 100 lm) mimicked the effect

of clofibrate, with a maximal effect at 100 lm, and similar additive protection by 9-cis-RA (Fig 3B) Addition of fibrate and⁄ or 9-cis-RA to palmitate-free control medium did not influence cell survival during culture (data not shown)

When endocrine nonbeta-cells were exposed to

500 lm palmitate for 8 days with or without 250 lm clofibrate plus 2 lm 9-cis-RA, no differences in toxicity were noticed, indicating the absence of a protective effect of the supplement (results not shown)

Effect of PPARa–RXR agonists on palmitate metabolism

Preculture (24 h) of beta-cells with 250 lm clofibrate plus 2 lm 9-cis-RA increased palmitate oxidation during a subsequent 2 h incubation with 50 lm

vehicle

0.00

0.50

1.50

0 10 20 30 40 50

C16:0

***

***

Fatty acid

Fatty acid + etomoxir

0

40

60

C16:0

C4:0 20

***

**

C

Fig 2 Effect of regulators of fatty acid metabolism on fatty acid

toxicity (A) Effect of L -carnitine on palmitate oxidation Beta-cells

were precultured for 24 h with the CPT1 activator L -carnitine

(1 m M ) in the absence or presence of 250 l M palmitate before

measurement of [ 14 C]palmitate oxidation during a 2 h incubation in

the further presence of L -carnitine (B) Effect of L -carnitine on

palmi-tate cytotoxicity Cells were exposed for 2 or 8 days to 500 or

250 l M palmitate in the presence of L -carnitine following 24 h of

preculture with 1 m M L -carnitine (C) Effect of a CPT1 inhibitor on

fatty acid toxicity Cells were exposed for 2 or 8 days to 500 or

250 l M butyrate or palmitate alone, or in combination with 200 l M

etomoxir Data are presented as mean ± SEM (n > 4); **P < 0.01,

***P < 0.001 (Student’s t-test).

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[14C]palmitate by 80% (P < 0.001) (Table 3) This

effect was also seen when palmitate (250 lm) was

present during preculture (Table 3) The lower 14CO2

values measured in this condition when compared with

the control reflect isotopic dilution in

palmitate-pre-treated cells No differences were found for the

incor-poration of label in lipids, intermediates or proteins

Effect of PPARa–RXR agonists on gene

expression of enzymes involved in fatty acid

metabolism and peroxisomal membrane proteins

RT-PCR analysis was performed to investigate

whether the agonist combination (250 lm clofibrate

plus 2 lm 9-cis-RA) increased expression of genes cod-ing for enzymes involved in peroxisomal or mitochon-drial lipid metabolism or of peroxisomal membrane proteins (Table 4) Palmitate 250 lm alone induced the mRNA expression of CPT1 (two-fold increase over control, P < 0.05), and decreased that of PPARa, ste-aroyl-CoA desaturase 1 (SCD1), steste-aroyl-CoA desatur-ase 2 (SCD2), and the peroxisomal membrane proteins peroxisomal biogenesis factor 2 (Pex2) and peroxi-somal biogenesis factor 14 (Pex14) (P < 0.05) Addi-tion of clofibrate plus 9-cis-RA further increased mRNA levels of CPT1 (1.7-fold, P < 0.001) and induced the expression of the mitochondrial enzymes acyl-CoA dehydrogenase (medium chain), acyl-CoA dehydrogenase (long chain), and mitochondrial acetyl-CoA acetyltransferase 2 (P < 0.01), as well as of the peroxisomal enzymes peroxisomal CoA acetyl-transferase 1, palmitoyl-CoA oxidase 1, and prista-noyl-CoA oxidase (P < 0.01), and the prolipogenic endoplasmatic reticulum enzymes glycerol-3-phosphate acyltransferase, mitochondrial (GPAT), SCD1 and SCD2 (P < 0.01) This combination was also found to increase the mRNA levels of peroxisomal biogenesis factor 3 (Pex3), peroxisomal biogenesis factor 16 (Pex16), and peroxisomal biogenesis factor 11a (Pex11a), as well as of Pex2, Pex14 and peroxisomal membrane protein 70 (PMP70) Comparable changes

in expression were also found after stimulation with clofibrate and 9-cis-RA in the absence of palmitate

500

0 10 20

500

0.5 2 5 9-cis RA

0 10 20 30 40

100

10 20 30 40

C16:0 + Clofibrate + Ciprofibrate + 9-cis RA + Clofibrate / 9-cis RA + Ciprofib / 9-cis RA

#

#

#

#

#

#

# $

# $

A

B

Fig 3 Effect of PPARa and RXR agonists on palmitate toxicity (A) Effect of clofibrate and 9-cis-RA on palmitate toxicity Primary rat beta-cells were exposed to 500 l M palmitate for 2 days, or to 250 l M palmitate for 8 days, in the presence or absence of clofibrate (100, 250,

500 l M ) and ⁄ or 9-cis-RA (0.5, 2, 5 l M ) (n ¼ 4–8) Vertical bars represent SEM (B) Comparison between the protective effect of clofibrate (250 l M ) and of ciprofibrate (100 l M ) against palmitate toxicity, alone or in combination with 2 l M 9-cis-RA Data are indicated as mean ± SEM (n > 5) # P < 0.001 as compared to palmitate; $ P < 0.001 as compared to single agonist treatment (clofibrate, ciprofibrate or 9-cis-RA) (two-way ANOVA).

Table 3 Effect of palmitate and PPARa–RXR agonists on

[ 14 C]palmitate metabolism Beta-cells were precultured for 24 h in

the presence or absence of 250 l M palmitate and ⁄ or 250 l M

clofi-brate (Clof) plus 2 l M 9-cis-RA (RA) Incorporation of the 14 C label

into CO2, lipid intermediates, lipids and proteins was measured

dur-ing a 2 h incubation with 50 l M [14C]palmitate, and expressed as a

percentage of the control condition (vehicle only, 10 m M glucose).

*P < 0.001 as compared to control, **P < 0.001 as compared to

cytochrome P250, Student’s t-test (n ¼ 5).

Treatment

14

C-recovery as

CO2 Intermediates Lipid Protein

C16:0 + Clof ⁄ RA 94 ± 12** 78 ± 10 94 ± 7 77 ± 27

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Effect of etomoxir on palmitate toxicity in the

presence of PPARa–RXR agonists

In the presence of etomoxir, the protective effect of

clofibrate and 9-cis-RA was abolished, and the

cytotoxicity of palmitate 500 lm for 2 days increased

four-fold, i.e from 4 ± 3% to 17 ± 5% (Fig 4)

This toxicity was also increased when the cells were

precultured for 24 h with 200 lm etomoxir prior to

their incubation with the palmitate⁄ clofibrate ⁄ RA

mix-ture for 2 days (19 ± 3%, P < 0.05 versus 5 ± 2%)

The effect of preculture with etomoxir was lost after

prolonged subsequent culture in its absence (250 lm

palmitate for 8 days)

Discussion

This study confirms that sustained exposure to

palmi-tate causes time- and dose-dependent toxicity on rat

beta-cells Over an 8 day culture period, palmitate, at

250 or 500 lm, progressively reduced the number of

surviving cells, involving both necrotic and apoptotic

pathways [7], but a significant fraction remained

resis-tant These survival curves show that primary

beta-cells can be less susceptible or even resistant to fatty

acid toxicity, and that this property is heterogeneously expressed, like other cell functions [17,18] We previ-ously reported that addition of oleate increases the

Table 4 Effect of palmitate and PPARa–RXR agonists on mRNA expression levels Beta-cells were exposed for 2 days to 250 l M palmitate and ⁄ or 250 l M clofibrate plus 2 l M 9-cis-RA or vehicle (control) qPCR values were normalized to actin and calculated as DDCt values relative

to the indicated control conditions Unpaired student t-test, two-tailed, mean ± SD, n ¼ 4–6, *P < 0.05, **P < 0.01, ***P < 0.001.

Protein

C16:0, compared

to control

Clofibrate +9-cis-RA, compared to control

C16:0 + clofibrate + 9-cis-RA, compared to C16:0

Gene transcription

Mitochondrial b-oxidation

Peroxisomal fatty acid oxidation

Lipid synthesis

Peroxisomal membrane proteins

***

***

0 10 20 30 40

***

$

$

C16:0 + Clofibrate / 9-cis RA C16:0 + Clof / 9RA + etomoxir C16:0

Fig 4 Effect of etomoxir on PPARa–RXR protection against palmi-tate toxicity Primary beta-cells were cultured with 500 l M palmi-tate for 2 days, or 250 l M palmitate for 8 days, in the absence or presence of 250 l M clofibrate plus 2 l M 9-cis-RA, or in combination with 200 l M etomoxir Data are presented as mean ± SEM (n ¼ 4).

***P < 0.001 as compared to palmitate; $ P < 0.01 for etomoxir as compared to clofibrate plus 9-cis-RA (Student’s t-test).

Trang 7

resistance of rat beta-cells to palmitate-induced cell

death [7] This oleate effect was also observed in

human beta-cells [19] and in other cell types [20–23] It

appeared to be correlated with the formation of

trigly-cerides, supporting the view that fatty acid

incorpora-tion into neutral lipids prevents the accumulaincorpora-tion of

toxic free palmitoyl acyl moieties [22], and⁄ or ceramide

derivatives [24,25] A role of ceramides in palmitate

toxicity is supported by the observed protection by

l-cycloserine, an inhibitor of serine palmitoyl

transfer-ase and thus of ceramide synthesis

At variance with other cytotoxic conditions [26], no

protective effect could be attributed to glucose, as

simi-lar palmitate toxicities were measured following culture

at 5 or 10 mm glucose The percentage of dead cells was

not increased when palmitate exposure was assessed at

excessive glucose levels (20 mm), which contrasts with

observations in beta-cell lines [27–30] The latter

dis-crepancy might be related to differences in experimental

protocols, such as free fatty acid concentrations, free

fatty acid⁄ BSA ratios [7], or the use of serum, but could

also result from differences between primary beta-cells

and cell lines Glucose cytotoxicity has also been seen in

cell lines [27,31], whereas increased glucose exerts

cyto-protective effects in primary beta-cells, at least in

condi-tions that cause an oxidative shift in their metabolic

state [32–35] Our data suggest that glucose-induced

changes in the cellular metabolic redox state do not alter

cellular susceptibility to palmitate toxicity At a

nontoxic palmitate concentration (50 lm), glucose

suppresses its oxidation, probably due to dynamic

regulation of the malonyl-CoA⁄ CPT1 axis [3], but this

seems not to be accompanied by a toxic effect; in fact,

this may lead to the formation of fatty acid derivatives

with physiologic action in the presence of glucose [36–

38], or in protective accumulation in the form of neutral

lipids [7,39] Furthermore, palmitate induced the

expres-sion of CPT1 two-fold, suggesting that beta-cells have

the inherent capacity to adapt their oxidation rate to

elevated fatty acid levels, independently of the

suppres-sive effect of glucose

Our data indicate that palmitate toxicity can be

reduced by increasing its oxidation through

mitochon-drial and⁄ or peroxisomal pathways Mitochondrial

oxidation of long-chain fatty acids is known to be rate

limited at the level of CPT1 [10] Viral overexpression

of CPT1 has been shown to enhance palmitate

oxida-tion in INS-1 cells and islets [40,41] In our study,

cul-ture with l-carnitine, an essential component of CPT1,

stimulated palmitate oxidation and reduced its toxicity,

while etomoxir, an inhibitor of CPT1, increased the

toxicity of palmitate (C16:0) but not of butyrate

(C4:0), which enters mitochondria independently of

CPT1 In fact, no toxicity was measured for any of the tested shorter-chain fatty acids, raising the possibility that shortening the palmitate chain represents another and perhaps more important mechanism for inducing cytoprotection

It is so far unclear to what extent peroxisomes in beta-cells contribute to fatty acid metabolism That they could be involved is suggested by the absence of cytotoxicity for the 2-methyl and 3-methyl derivatives

of palmitate Like other branched fatty acids, these compounds are known to be preferentially transported

to the peroxisomes, where 2-methyl-C16 undergoes b-oxidation and 3-methyl-C16 will be a-oxidized before being transported to the mitochondria [42]

Fibrates are known to regulate genes involved in mitochondrial, as well as peroxisomal, fatty acid oxi-dation and to induce peroxisome proliferation and maturation in multiple cell types [11] Both clofibrate and ciprofibrate were found to increase palmitate breakdown and to reduce its toxicity; their combina-tion with 9-cis-RA resulted in complete proteccombina-tion This protective action of 9-cis-RA against palmitate toxicity contrasts with the proapoptotic effect observed

in MIN6 cells at a 10-fold higher concentration [43] Clofibrate plus 9-cis-RA was found to provide the same level of protection at all examined glucose con-centrations This effect correlated with induced expres-sion of CPT1 and mitochondrial and peroxisomal b-oxidation enzymes, and resulted in normalization of palmitate oxidation In further support of this, inhibi-tion of CPT1 by etomoxir was found to abolish the protective action of clofibrate plus 9-cis-RA PPARa:RXR agonists also induced expression of GPAT, SCD1 and SCD2 mRNA, which might medi-ate incorporation of the fatty acid into (phospho)lipids [44] Increased SCD1 expression has been previously noticed in palmitate-resistant MIN6 cells but has not yet been directly correlated with a cytoprotective diver-sion of palmitate into lipid formation [39]; esterifica-tion of palmitate was shown to result in accumulaesterifica-tion

of insoluble tripalmitin and to correlate with endoplas-mic reticulum stress and apoptosis [45,46]

The PPARa–RXR agonists were also found to act at

a third level of potential relevance, namely the expres-sion of proteins involved in peroxisome biogenesis (Pex3 and Pex16), proliferation (Pex11a) and matura-tion (PMP70, Pex2 and Pex14) [47] By inducing the peroxisomal compartment, they might indeed increase the channeling of palmitate through the first cycles of chain shortening before further breakdown in mito-chondria This view is consistent with the virtual absence of toxicities for short-chain fatty acids Peroxi-somes might thus represent a key site for reducing the

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toxicity of palmitate in primary beta-cells Their

activ-ity might be low in normal circumstances, as judged by

the low catalase activity in islet beta-cells [48,49]

Addi-tion of clofibrate was shown to increase catalase

activ-ity in INS-1 cells together with palmitate oxidation

[50] Clofibrate plus 9-cis-RA did not provide

protec-tion in the nonbeta-cells where, independently of

glu-cose, a substantially higher proportion of palmitate was

converted to CO2

Our data supplement previous in vivo findings or

observations in cell lines, and more specifically indicate

to what extent they reflect effects on the survival of

pri-mary beta-cells and, if so, through which mechanism

these can then be explained Although fatty acids, and

particularly palmitate, are classically seen as mediators

of lipotoxicity at the level of the beta-cells, it is often

not clear whether the reported derangements are the

result of beta-cell death and⁄ or dysfunction

Conse-quently, the protective action of PPARa agonists with

or without RXR agonists was not always well specified

in these terms [51] Adenoviral coexpression of PPARa

and RXRa synergistically – and in a dose- and

ligand-dependent manner) potentiated glucose-stimulated

insulin secretion from INS-1E cells while increasing

their expression of genes involved in free fatty acid

uptake and b-oxidation [52,53] An increase of

PPARa-driven b-oxidation in response to topiramate was also

found to protect INS-1E cells from oleate toxicity [54]

When administered in vivo, PPAR–RXR ligands

induced expression of b-oxidation enzymes and

stimu-lated palmitate oxidation in isostimu-lated islets [13] Fibrate

treatment restored the coupling between insulin

secre-tion and acsecre-tion in glucose-intolerant rats on a high-fat

diet [55] and prevented diabetes in obese OLETF rats

[56,57] Combination therapy with PPARa and

a-agon-ists, or dual agona-agon-ists, ameliorated insulin secretion and

increased insulin stores in genetically obese diabetic

db⁄ db mice [58] The present work has shown that

PPARa–RXR agonists can protect primary beta-cells

against the cytodestructive effects of palmitate It has

provided evidence that this protection is achieved by

stimulating mitochondrial and peroxisomal pathways

for palmitate breakdown Further work is needed to

assess the functional properties of these protected

beta-cells and to evaluate the influence of the agonists

at nontoxic palmitate concentrations

Experimental procedures

Materials

Palmitate, oleate, butyrate, hexanoate, octanoate (sodium

salts), 2-bromohexadecanoic acid, clofibrate, ciprofibrate,

9-cis-RA, l-carnitine and l-cycloserine were purchased from Sigma-Aldrich (Bornem, Belgium) Branched 2-meth-ylhexadecanoic acid and 3-meth2-meth-ylhexadecanoic acid were prepared as described previously [59,60] Stock solutions of fatty acids (25 mm, 50 mm) were made in 90% ethanol by heating to 60C, except for 2-bromopalmitate, which was dissolved at room temperature Stock solutions of clofibrate (200 mm), ciprofibrate (20 mm) and 9-cis-RA (10 mm) were dissolved in absolute ethanol Etomoxir was a gift from

V Grill (Trondheim University, Norway) and dissolved in saline d-[U-14C]glucose (287–311 mCiÆmmol)1; 1 mCi per

5 mL) was purchased from Amersham Biosciences (Roose-ndaal, Belgium), and [U-14C]palmitic acid (850 mCiÆ mmol)1; 0.1 mCiÆmL)1) from Perkin Elmer Life Sciences (Zaventem, Belgium)

Preparation and culture of rat beta-cells

Adult male Wistar rats were bred according to Belgian reg-ulations on animal welfare Experiments were carried out in accordance with the European Communities Council Direc-tive (86/609/EEC) Pancreatic islets were isolated, dissoci-ated and purified into single beta-cells (purity 88 ± 4% insulin-positive cells) and endocrine nonbeta-cells (70 ± 11% alpha-cells, 23 ± 3% beta-cells) by autofluores-cence-activated cell sorting [61] For studies on cytoxicity, isolated cells were cultured in polylysine-coated microtiter plates (2500–3000 cells per well) with Ham’s F10 medium containing 10 mm glucose (unless stated otherwise), 1% charcoal-extracted BSA (fraction V, radioimmunoassay grade; Sigma-Aldrich), 2 mm l-glutamine, 50 mm 3-iso-butyl-1-methylxanthine, 0.075 mgÆmL)1 penicillin and 0.1 mgÆmL)1streptomycin [7] Test reagents were added to the culture medium, with control conditions receiving simi-lar dilutions of solvent After 2 and 5 days of culture, the medium was changed and fresh reagents were added Per-centages of living and dead cells were determined by vital staining using neutral red [7] For metabolic and gene expression studies, freshly isolated cells were reaggregated and cultured in suspension as previously described [62]

Measurement of glucose and palmitate metabolism

Duplicate samples of 5· 104rat beta-cells were incubated for 2 h at 37C using Ham’s F10 medium containing 0.5% BSA, 2 mm l-glutamine and 10 mm Hepes for measuring glucose metabolism (5 lCi of d-[U-14C]glucose with different concentrations of unlabeled d-glucose) [63] Palmi-tate metabolism was measured using KRBH medium, containing 0.2% BSA (fraction V), 2 mm calcium chloride, and 10 mm Hepes (0.5 lCi of [U-14C]palmitic acid, with unlabeled palmitate up to 50 lm in order to achieve the same ratio of free fatty acid over BSA as in the cytotoxicity experiments with 250 lm palmitate) The rate of

Trang 9

d-[U-14C]glucose or [U-14C]palmitic acid oxidation was

assessed through the formation of 14CO2 [63] Cells were

incubated in a siliconized tube trapped in an airtight glass

vial After 2 h, 20 lL of 1 m HCl was injected, and 250 lL

of Hyamine (Packard Bioscience, Groningen, the

Nether-lands) added to capture14CO2for 1 h at room temperature

The 14C incorporation into lipids, proteins and metabolic

intermediates was measured as previously described [64]

Gene expression analysis

Total beta-cell RNA was extracted with TRIzol Reagent

(Gibco BRL, Carlsbad, CA, USA) and its quality was

assessed on a 2100 Bioanalyzer (Agilent, Waldbronn,

Ger-many), taking a minimal cutoff RNA integrity number of

8 RNA clean-up was performed with the Turbo DNA Free

Kit (Ambion, Austin, TX, USA) and cDNA prepared with

the High-Capacity cDNA Archive Kit (Applied Biosystems,

Foster City, CA, USA) Real-time PCR was performed

using an ABI Prism Sequence Detector (Applied

Biosys-tems) Primers were obtained from Applied Biosystems

(Table 4) For each RT-PCR reaction, the cycle threshold

(Ct) was determined with sds 1.9.1 software DDCt values

were calculated versus b-actin Fold changes were

calcu-lated starting from DDCt values of a minimum of four

independent experiments performed in duplicate

Data analysis

Data are presented as mean ± SEM, or as mean ± SD

of n independent experiments Statistical analysis was

performed using Student’s t-test, unless stated otherwise

Differences were considered significant for P < 0.05

Acknowledgements

This work was supported by the Research Foundation

Flanders (Fonds Voor Wetenschappelijk

Onderzoek-Vlaanderen, Grant FWO-G.0357.03, Grant

FWO-1.5.195.05 and PhD grant FWOTM277 to K

Kerckhofs) and by the Inter-University Poles of

Attraction Program (IUAP P5⁄ 17) from the Belgian

Science Policy The Diabetes Research Center is a

partner of the Juvenile Diabetes Research Center for

Beta Cell Therapy in Diabetes

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