title: Intranasal insulin prevents cognitive decline, cerebral atrophy and white matter changes in murine type I diabetic encephalopathy.
abstract: Insulin deficiency in type I diabetes may lead to cognitive impairment, cerebral atrophy and white matter abnormalities. We studied the impact of a novel delivery system using intranasal insulin (I-I) in a mouse model of type I diabetes (streptozotocin-induced) for direct targeting of pathological and cognitive deficits while avoiding potential adverse systemic effects. Daily I-I, subcutaneous insulin (S-I) or placebo in separate cohorts of diabetic and non-diabetic CD1 mice were delivered over 8 months of life. Radio-labelled insulin delivery revealed that I-I delivered more rapid and substantial insulin levels within the cerebrum with less systemic insulin detection when compared with S-I. I-I delivery slowed development of cognitive decline within weekly cognitive/behavioural testing, ameliorated monthly magnetic resonance imaging abnormalities, prevented quantitative morphological abnormalities in cerebrum, improved mouse mortality and reversed diabetes-mediated declines in mRNA and protein for phosphoinositide 3-kinase (PI3K)/Akt and for protein levels of the transcription factors cyclic AMP response element binding protein (CREB) and glycogen synthase kinase 3beta (GSK-3beta) within different cerebral regions. Although the murine diabetic brain was not subject to cellular loss, a diabetes-mediated loss of protein and mRNA for the synaptic elements synaptophysin and choline acetyltransferase was prevented with I-I delivery. As a mechanism of delivery, I-I accesses the brain readily and slows the development of diabetes-induced brain changes as compared to S-I delivery. This therapy and delivery mode, available in humans, may be of clinical utility for the prevention of pathological changes in the diabetic human brain.
authors.affiliation: Department of Clinical Neurosciences and the Hotchkiss Brain Institute, University of Calgary, Calgary, Alberta, Canada.
authors.forename: George J
authors.initials: GJ
authors.lastname: Francis
authors.forename: Jose A
authors.initials: JA
authors.lastname: Martinez
authors.forename: Wei Q
authors.initials: WQ
authors.lastname: Liu
authors.forename: Kevin
authors.initials: K
authors.lastname: Xu
authors.forename: Amit
authors.initials: A
authors.lastname: Ayer
authors.forename: Jared
authors.initials: J
authors.lastname: Fine
authors.forename: Ursula I
authors.initials: UI
authors.lastname: Tuor
authors.forename: Gordon
authors.initials: G
authors.lastname: Glazner
authors.forename: Leah R
authors.initials: LR
authors.lastname: Hanson
authors.forename: William H
authors.initials: WH
authors.lastname: Frey
authors.forename: Cory
authors.initials: C
authors.lastname: Toth
mesh_terms: D000281:Administration, Intranasal; D000818:Animals; D001284:Atrophy / Q000209:etiology / Q000517:prevention & control; D001921:Brain / Q000473:pathology*; D003072:Cognition Disorders / Q000209:etiology / Q000517:prevention & control*; D003921:Diabetes Mellitus, Experimental / Q000150:complications* / Q000523:psychology; D003922:Diabetes Mellitus, Type 1 / Q000150:complications* / Q000523:psychology; D004353:Drug Evaluation, Preclinical / Q000379:methods; D004660:Encephalitis / Q000209:etiology / Q000473:pathology / Q000517:prevention & control; D005786:Gene Expression Regulation / Q000187:drug effects; D006624:Hippocampus / Q000378:metabolism; D007328:Insulin / Q000008:administration & dosage / Q000627:therapeutic use*; D008279:Magnetic Resonance Imaging / Q000379:methods; D008297:Male; D051379:Mice; D009419:Nerve Tissue Proteins / Q000096:biosynthesis / Q000235:genetics; D012333:RNA, Messenger / Q000235:genetics
chemical_list: D007328:Insulin; D009419:Nerve Tissue Proteins; D012333:RNA, Messenger