The study of the mechanisms of action of bromocriptine and prolactin antagonists to treat Type 2 Diabetes Mellitus and Obesity.

Author(s)

Isadora Clivatti Furigo

• Document type: Doctoral Thesis
• Press: São Paulo.
• Institution: Universidade de São Paulo (USP). Instituto de Ciências Biomédicas (ICB/SDI)
• Defense date: 2016-10-21

Examining board members

José Donato Júnior; Luciano Freitas Felicio; William Tadeu Lara Festuccia; Celso Rodrigues Franci; Carlos Roberto Jorge Soares

• Advisor: José Donato Júnior

Abstract

Type 2 Diabetes mellitus (T2DM) is a syndrome characterized by dysfunctions in the metabolism of glucose, amino acids and free fat acids. Although most of the drugs currently used to treat T2DM targets peripheral organs, a growing interest in studying the Central Nervous System (CNS) as a potential target of antidiabetic drugs is appearing. The CNS possesses insulin receptors and plays a critical role in regulating glucose homeostasis. In this sense, Cycloset® (quick release bromocriptine mesylate) a drug that acts on CNS, was recently approved in United States to treat T2DM. Previous studies have shown beneficial effects of bromocriptine (Bromo) on hyperglycemia and hyperlipidemia in obese animal models. As a dopaminergic agonist, a possible mechanism of action of this drug could be caused by a decreased prolactin (Prl) production and release. High serum prolactin levels, as observed in patients bearing prolactinomas or individuals using drugs that induce hyperprolactinemia, generate abnormalities in carbohydrate and lipid metabolism, which can lead to metabolic syndrome. In the current thesis, we tested the hypothesis that part of bromocriptine antidiabetic effects is due to an inhibition of prolactin secretion. We evaluated Bromo effects in genetically obese and insulin resistant male and female mouse (ob/ob), as well as we tested whether replacing Prl could reverse the beneficial effects of Bromo. Males treated with Bromo showed lower insulin resistence, whereas Prl replacement decreased insulin sensitivity. Females treated with Bromo showed tendency towards an improvement in their insulin sensitivity and glucose tolerance. Prl replacement also reversed the beneficial effects of Bromo in this group. Thus, we demonstrated that at least part of the antidiabetic effects of Bromo is due to inhibition of Prl secretion. In another set of experiments, we tested whether central or peripheral treatment with prolactin antagonists (G129R-hPrlR) causes antidiabetic effects in ob/ob male mice. Both peripheral and central treatment decreased the glycemic curve during glucose and insulin tolerance tests, although we still did not obtain statistically significant values with our sample size. Lastly, we investigated whether metabolic Prl action occurs due to a putative interaction with estrogen receptor alpha (ERα). We found a wide co-expression between Prl receptor and ERα in the CNS. Additionally, changes in estrogen levels decrease prolactin sensitivity. Therefore, in the present study we identified the possible mechanism by which bromocriptine promotes improvements in glycemic control, and for the first time, we obtained evidence that the use of prolactin antagonists can have a potential effect in the treatment of T2DM. (AU)

• FAPESP's process: 13/21722-4 - Mechanism of action of bromocriptine and prolactin antagonists in the treatment of Diabetes and Obesity
• Grantee: Isadora Clivatti Furigo
• Support Opportunities: Scholarships in Brazil - Doctorate