title: Hepatic insulin gene expression as treatment for type 1 diabetes mellitus in rats.
abstract: Type 1 diabetes mellitus is caused by a lack of insulin that results from the autoimmune destruction of the pancreatic beta-cells. Severe diabetes, if not controlled by periodic insulin injections, can lead to ketoacidosis and death. We have previously shown that sustained low level production of insulin in the liver of diabetic rats prevented their death from complications of diabetes. To test the hypothesis that there is a window of serum insulin concentrations that can prevent ketoacidosis without significant risk of hypoglycemia secondary to hyperinsulinemia, rats were infused with various doses of a recombinant retrovirus encoding an engineered rat preproinsulin-1 gene. The gene was engineered to allow processing into mature insulin by the protease furin. At the lower doses tested, fatal ketoacidosis was prevented, but the rats exhibited nonfasting hyperglycemia. At intermediate doses, which resulted in serum insulin concentrations of 1.6 mg/ml, the rats achieved near-normoglycemia and no serum ketones. These rats did not exhibit hypoglycemia even during a 24-h fast. At high virus doses, the animals achieved nonfasting normoglycemia but exhibited hypoglycemia during the fast. In conclusion, we have defined a therapeutic window of hepatic insulin expression that provides protection against ketoacidosis without significant risk of hypoglycemia. This window of sustained hepatic insulin expression might permit its development into a novel treatment modality for the prevention of ketoacidosis in patients with severe insulin-dependent diabetes mellitus.
authors.affiliation: Department of Cell Biology, Baylor College of Medicine, Houston, Texas 77030, USA.
authors.forename: P
authors.initials: P
authors.lastname: Muzzin
authors.forename: R C
authors.initials: RC
authors.lastname: Eisensmith
authors.forename: K C
authors.initials: KC
authors.lastname: Copeland
authors.forename: S L
authors.initials: SL
authors.lastname: Woo
mesh_terms: D000818:Animals; D001786:Blood Glucose / Q000032:analysis*; D003921:Diabetes Mellitus, Experimental / Q000097:blood / Q000188:drug therapy* / Q000378:metabolism; D003922:Diabetes Mellitus, Type 1 / Q000097:blood / Q000139:chemically induced / Q000188:drug therapy* / Q000378:metabolism; D015870:Gene Expression; D007004:Hypoglycemic Agents / Q000627:therapeutic use*; D007328:Insulin / Q000032:analysis / Q000235:genetics / Q000627:therapeutic use*; D007659:Ketones / Q000097:blood*; D008099:Liver / Q000378:metabolism*; D011384:Proinsulin / Q000235:genetics / Q000627:therapeutic use*; D011498:Protein Precursors / Q000235:genetics / Q000627:therapeutic use*; D051381:Rats; D013311:Streptozocin / Q000494:pharmacology
chemical_list: D001786:Blood Glucose; D007004:Hypoglycemic Agents; D007328:Insulin; D007659:Ketones; D011498:Protein Precursors; D013311:Streptozocin; C013737:preproinsulin; D011384:Proinsulin