Neural Regeneration Research ›› 2015, Vol. 10 ›› Issue (11): 1723-1724.doi: 10.4103/1673-5374.169611

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Efficacy of glucagon-like peptide-1 mimetics for neural regeneration

Kazunori Sango*, Kazunori Utsunomiya   

  1. Diabetic Neuropathy Project (Former ALS/Neuropathy project), Department of Sensory and Motor Systems, Tokyo Metropolitan Institute of Medical Science, Setagaya-ku, Tokyo, Japan (Sango K)
    Division of Diabetes, Metabolism & Endocrinology, Department of Internal Medicine, Jikei University School of Medicine, Minato-ku, Tokyo, Japan (Utsunomiya K)
  • Received:2015-10-08 Online:2015-12-07 Published:2015-12-07
  • Contact: Kazunori Sango, M.D., Ph.D.,sango-kz@igakuken.or.jp.
  • Supported by:

    This study was supported by a Grant-in-aid for Scientific Research from the Ministry of Education, Science, Sports and Culture of Japan (grant number: 25430056) and the fund from Nukada Institute for Medical and Biological Research, Chiba, Japan.

Abstract:

Glucagon-like peptide 1 (GLP-1) is secreted from enteroendocrine L cells in response to nutrient ingestion and exhibits insulinotropic properties by stimulating specific G protein-linked receptors (GLP-1Rs) on pancreatic β cells. Several GLP-1 mimetics, such as exenatide (exendin-4 (Ex-4)), liraglutide, and lixisenatide, have been developed and approved as treatments for patients with type 2 diabetes. These peptides show bioactivities almost identical to those of GLP-1 and have a substantially longer plasma half-lifethan GLP-1 because of their resistance to dipeptidyl peptidase-4, a GLP-1 degrading enzyme. GLP-1Rs are found in not only the pancreas but also the extrapancreatic tissues, including the nervous tissues. It is important to note that GLP-1 mimetics can cross the blood brain barrier and directly act on neurons in the central nervous system. In addition to the inhibition of appetite, the neuroprotective properties of GLP-1 have been receiving increasing attention. Recent studies have suggested that GLP-1 mimetics confer beneficial effects in neurodegenerative disorders, such as Parkinson’s disease (PD), Alzheimer’s disease, amyotrophic lateral sclerosis, ischemia and stroke, and multiple sclerosis. In particular, the neuroprotective properties of Ex-4 have been demonstrated inanimal and cell culture models of PD. A single-blinded clinical trial with 45 PD patients revealed that the treatment with Ex-4 significantly improved the cognition and memory of patients. The beneficial effects of GLP-1 mimetics on the peripheral nervous system (PNS) have also been reported. Both GLP-1 and Ex-4 delivered via osmotic minipumps prevented axonal degeneration in a rat model of pyridoxine-induced neuropathy. Treatment of streptozotocin (STZ)-induced diabetic mice with Ex-4 for 4 weeks restored reduced motor and sensory nerve conduction velocities and hypoalgesia without normalizing blood glucose levels. In addition, repeated intraperitoneal injections of Ex-4 significantly promoted axonal regeneration and functional recovery following sciatic nerve crush injury of normal adult rats. These findings are in agreement with in vitro studies that revealed that GLP-1 and Ex-4 promoted neurite outgrowth of rat pheochromocytoma-derived PC12 cells and adult mouse dorsal root ganglion (DRG) neurons. Together these results provide further evidence of the direct actions of Ex-4 on the PNS; however, the underlying mechanisms remain unclear. Our study aimed to elucidate the precise localization of GLP-1R in adult rat DRG in vivo and in vitro as well as determine the neurotrophic and neuroprotective properties of Ex-4 in adult rat DRG neurons.