The effect of succinic acid monoethyl esteron plasma and tissue glycoproteins in streptozotocin-nicotinamide induced diabetic rats Leelavinothan Pari, Ramalingam Saravanan
Department of Biochemistry and Biotechnology, Faculty of Science, Annamalai University, Annamalai Nagar,
Received 28th July 2006. Revised 18th August 2006. Published online 22nd October 2006.
Summary Succinic acid monoethyl ester (EMS) was recently proposed as an insulinotropic agent for the treatment of non-insulin dependent diabetes mellitus. The present study investigated the effect of EMS and Metformin on dearrangement in glycoprotein levels in the streptozotocin-nicotinamide induced type 2 diabeteic model. Succinic acid monoethyl ester was administered intraperitoneally for 30 days to normal and diabetic rats. The effect of EMSon glucose, insulin, and plasma and tissue glycoproteins were studied. The effect of EMS was compared with Metformin, a reference drug. The levels of glucose, glycosylated haemoglobin and plasma glycoproteins containing hexose, hexosamine and fucose were increased significantly whereas the level of plasma insulin and haemoglobin were decreased significantly in diabetic rats. There was a significant decrease in the level of sialic acid and elevated levels of hexose, hexosamine and fucose in the liver and kidney of streptozotocin-nicotinamide diabetic rats. Administration of EMS to diabetic rats was followed by a decreased level of glucose, glycosylated haemoglobin and plasma glycoproteins. The levels of plasma insulin, haemoglobin and tissue sialic acid were increased whereas the levels of tissue hexose, hexosamine and fucose were near normal. The present study indicates that the EMS possesses a significantly beneficial effect on the glycoprotein moiety in addition to its antidiabetic effect. Keywords: succinic acid monoethyl ester − nicotinamide − streptozotocin − glycoprotein components
INTRODUCTION
insulin deficiency; insulin resistance accompanied
by decreased glucose transport into muscle and fat
Type 2 diabetes mellitus typically involves an
cells, and increased hepatic glucose output. All of
abnormal beta-cell function that results in relative
these contribute to hyperglycaemia, resulting in the
impairment of the metabolism of glucose, lipids,
proteins and glycoproteins (Hawan et al. 1996).
* L. Pari, Department of Biochemistry and
The level of different types of serum glycoproteins
Biotechnology, Faculty of Science, Annamalai
are maintained within a narrow range in health
University, Annamalai Nagar-608 002, Tamil
(Sharma and Sur 1967), but is elevated in many
pathological conditions, cardiovascular disease
(Tandon et al. 1983), diabetes mellitus (Anand et
al. 1985). Defects in insulin secretion and insulin
action are universally present in type 1 diabetes,
and also type 2 diabetes, in both human patients
Pari and Saravanan : The effect of succinic acid monoethyl ester on plasma
and animal models. Glycoproteins are carbohydrate
of a number of new oral agents for the treatment of
linked protein macromolecules found in the cell
type 2 diabetes with the hope of achieving better
surface, which is the principal component of animal
glycemic control. Metformin is a biguanide, which
cells. Abnormal levels of glycoproteins are
has been in clinical use for the treatment of type 2
important in the pathogenesis of liver and kidney
diabetes for over 40 years. Metformin enhances the
sensitivity of both hepatic and peripheral tissues to
Glycoproteins are rich in extra cellular matrix
insulin. The drug also inhibits gluconeogenesis in
and they contribute a major source to the structure
of the matrix (Begum et al. 1978). It is well
documented that the oligosaccharide moieties of
investigations had been carried out on the effect of
glycoproteins: hexose, hexosamine, fucose and
succinic acid monoethyl ester in streptozotocin-
sialic acid have an important role in protein
nicotinamide diabetic rats on glycoproteins status,
stability, function, and turnover (Wiese et al. 1997).
so the present investigation was carried out to study
In the diabetic state, glucose is utilized by the
the effect of a nonglucidic nutrient such as EMS on
insulin independent pathways leading to the
plasma and tissue glycoproteins.in streptozotocin-
synthesis of glycoproteins, and even a mild
deficiency of insulin influences the thickening of
the basement membrane (Konukoglu et al. 1999).
The raised levels of glycoproteins in diabetics may
also be a predictor of angiopathic complications
MATERIALS AND METHODS
(Konukoglu et al. 1999). The therapy of non-insulin
dependent diabetes mellitus presently relies upon
compounds from a number of chemical classes:
Succinic acid monoethyl ester (Fig. 1), and all other
sulfonylureas, non-sulfonylureas and biguanides
biochemicals and chemicals used in this experiment
etc. A wide variety of structurally distinct
were purchased from Sigma, USA. The chemicals
molecules stimulate insulin secretion from
pancreatic â cells by different mechanisms of
Esters of succinic acid are new potent insulin
secretagogues (Fahien et al.1988, MacDonald and Fahien 1988, Picton et al. 2001) and have been
proposed as a novel antidiabetic agent for type 2
diabetes. It has been previously shown that succinic
acid ester can be taken up and metabolized by
pancreatic â cells, leading to increased pro-insulin
Fig.1. Succinic acid monoethyl ester
biosynthesis (Alarcon and Wicksteed 2002), insulin
secretion and lower blood glucose (Zawalich and
Zawalich 1992, GarciaMartinez et al. 1998). The
possible mechanism of action of EMS could be
Male albino Wistar strain rats (200 − 220g b.w.
correlated with the reminiscent effect of the
obtained from Central Animal House, Rajah
hypoglycaemic sulphonylureas that promote insulin
Muthiah Medical College, Annamalai University
secretion by closure of K+-ATP channels,
were used in the present study. The rats were fed on
membrane depolarization and stimulation of Ca2+
pellet diet (Hindustan Lever Limited, Mumbai,
influx − an initial key step in insulin secretion
India) and water ad libitum. The rats used in the
(Fahien et al.1988, MacDonald and Fahien 1988).
present study were maintained in accordance with
These esters also protect pancreatic islets in vivo
the guidelines of the National Institute of Nutrition,
Indian Council of Medical Research, Hyderabad,
streptozotocin (Akkan and Malaisse 1993),
India and the study approved by the ethical
interleukin 1â ( (Eizirik et al. 1994), and nitric
committee (Vide. No: 285, 2005), Annamalai
oxide donors (Eizirik et al. 1996). Previously we
had reported that EMS has a plasma glucose
lowering effect in experimental type 2 diabetes
Experimental Induction of Type 2 Diabetes in Rats
Non-Insulin dependent diabetes mellitus (NIDDM)
In non-insulin-dependent or type-2 diabetes
was induced in rats fasted overnight by a single
mellitus, oral hypoglycaemic agents are used to
intraperitonial injection of 45 mg/kg streptozotocin,
stimulate the pancreatic beta cells to secrete insulin
15 min after the i.p. administration of 110 mg/kg
and/or increase the sensitivity of peripheral insulin
b.w. of nicotinamide. Streptozotocin (STZ) was
receptors to the action of endogenous insulin (Elson
dissolved in citrate buffer (pH 4.5) and
and Meredith 1998, Reusch 1998, Lebovitz 2001).
nicotinamide was dissolved in normal saline. The
The last few years have witnessed the introduction
elevated glucose levels in plasma determined at
Pari and Saravanan : The effect of succinic acid monoethyl ester on plasma
72 h, and then on day 7 after injection, confirmed
contained 0.5 ml of aliquot/ plasma, 0.5 ml of 5%
hyperglycaemia. The rats found with permanent
phenol and 2.5 ml of conc. H2SO4 and boiled for 20
NIDDM were used for the study (Masiello et al.
Hexosamine was estimated by the method of
Elson and Morgan (1933) with slight modifications
by Niebes (1972). Briefly, the reaction mixture
In the experiment, a total of 42 rats (36 surviving
contained 0.5 ml plasma/ 1.0 ml aliquot, and 2.5 ml
diabetic rats, and 6 control rats) were used. The rats
of 3N HCl. It was boiled over 6 h and neutralized
were divided into seven groups of six rats each.
with 6N NaOH. To 0.8 ml of the neutralized
Group I were control rats (vehicle treated).
sample was added 0.6 ml of acetyl acetone reagent
and it was boiled for 30 min. The mixture was
intraperitoneally with EMS 8 µmol/g bw for 30
treated with 2.0 ml of Ehrlich’s reagent. The colour
days. Group III were diabetic control rats, and
developed was read at 540 nm colorimetrically.
Sialic acid and fucose were determined by the
intraperitoneally with EMS 2 µmol/g bw for 30
method of Warren (1959), Dische and Shettles
days. Group V were diabetic rats administered
(1948). In brief, 0.5 ml of aliquot/ plasma, was
intraperitoneally with EMS 4 µmol/g bw for 30
treated with 0.5 ml of water and 0.25 ml of periodic
days, and GroupVI were diabetic rats administered
acid, and incubated at 37 °C for 30 min. 0.2 ml of
intraperitoneally with EMS 8 µ mol/g bw for 30
sodium meta arsenate and 2.0 ml of thiobarbituric
days (Pari and Saravanan 2005). Group VII were
acid were added to the reaction mixture which was
diabetic rats given Metformin 25 mg/kg bw/day in
heated for 6 min. 5.0 ml of acidified butanol was
1 ml of saline for 30 days (Yanardag et al. 2005).
then added. The absorbance was read at 540 nm.
At the end of the experimental period, the rats
For fucose estimation, 0.5 ml of aliquot/
were deprived of food overnight and blood was
plasma were treated with 4.5 ml of H2SO4 and
collected in a tube containing potassium oxalate
boiled for 3 min. 0.1 ml of cysteine hydrochloride
and sodium fluoride for the estimation of plasma
reagent was then added. After 75 min in the dark,
the absorbance was read at 393 and 430 nm.
haemoglobin. Plasma was separated for the assay of
insulin. Liver and kidney were dissected out,
washed in ice-cold saline, patted dry and weighed.
The data for various biochemical parameters were
analyzed using analysis of variance (ANOVA) and
the group means were compared by Duncan’s
Determination of plasma glucose and insulin
Plasma glucose was estimated colorimetrically
considered statistically significant when P< 0.05.
Diagnostics (I) Pvt Ltd., Baroda, India) (Trinder
1969). Plasma insulin was assayed using an enzyme
linked immunosorbent assay (ELISA) kit (Roche
Determination of haemoglobin and glycosylated Plasma glucose and insulin levels
Fig. 2 demonstrates the levels of plasma glucose
The level of haemoglobin was estimated by using
and insulin in control and experimental animals. In
the cyanmethaemoglobin method described by
diabetic rats the level of plasma glucose was
Drabkin and Austin (1932). The glycosylated
significantly increased whereas the plasma insulin
haemoglobin level was estimated according to the
was significantly decreased. The administration of
method of Sudhakar Nayak and Pattabiraman
EMS significantly reversed the changes in a dose
(1981) with modifications according to Bannon
dependent manner. EMS at a dose of 8 µmol/g bw
showed a highly significant effect compared to 2
and 4 µmol/g bw. Administration of EMS was
Determination of glycoproteins levels
compared with metformin, a reference drug. The
For the estimation of glycoproteins, the tissues
effect of EMS at a dose 8 µmol/g bw was used for
were defatted by the method of Folch et al. (1957)
and the defatted tissues were treated with 0.1N
Haemoglobin and glycosylated haemoglobin levels
2SO4, hydrolysed at 80 °C and aliquot was used
for sialic acid estimation. To the remaining
Fig. 3 shows the levels of haemoglobin and
solution, 0.1 N NaOH was added. The aliquots
glycosylated haemoglobin in the blood of control
were used for fucose, hexose, and hexosamine
and experimental rats. The diabetic rats showed a
estimation. Hexose was estimated by the method
significant decrease in the level of total
described by Niebes (1972). The reaction mixture
haemoglobin and a significant increase in the level
Pari and Saravanan : The effect of succinic acid monoethyl ester on plasma
of glycosylated haemoglobin. The administration of
changes in total haemoglobin and glycosylated
EMS and metformin to diabetic rats reversed the
C N+EMS DC D+EMS D+EMS D+EMS D+ Met (8 µmol/g) (2 µmol/g) (4 µmol/g) ( 8 µmol/g) (25 mg/kg) Fig. 2. Changes in the levels of plasma glucose and insulin in control and experimental animals. C, control; N, normal; DC, diabetic control; EMS, succinic acid monoethyl ester; MET, Metformin.Values are given as mean ± S.D for 6 rats in each group. Values not sharing a common superscript letter differ significantly at p<0.05 (DMRT). Effect of EMS on plasma and tissue glycoproteins
this disorder increases, more appropriate therapies
Fig. 4 shows the changes in the level of plasma
are required (Bailey and Flalt 1986). The esters of
glycoproteins of control and experimental rats.
selected carboxylic metabolites, which are
There was a significant increase of plasma
mediating the Krebs cycle, or their precursors such
glycoproteins in diabetic rats. Administration of
as pyruvic acid, succinic acid, and glutamic acid,
EMS and Metformin significantly decreased the
are currently under investigation as potent
insulinotropic tools in the treatment of non insulin
The levels of liver and kidney glycoprotein
of control and experimental rats are shown in Figs.
insulinotropic capacity of succinic acid monoethyl
5−8. The levels of glycoprotens containing hexose,
ester was first disclosed in pancreatic islets
hexosamine and fucose were significantly increased
(Malaisse 1995). The nutritional value of this ester
whereas the level of sialic acid was significantly
when infused into starved rats has been recently
decreased in diabetic rats. Administration of EMS
documented (Ladriere and Malaisse 1997). In the
and metformin significantly reversed these changes
present investigation, treatment with EMS showed
in the glycoproteins levels in the liver and kidney
significant antihyperglycaemic activity. The
of diabetic rats. The effect of EMS was compared
administration of EMS and metformin to decrease
the increased blood glucose concentration to
normal glycaemic concentration is an essential
trigger for the liver to revert to its normal
homeostasis during experimental diabetes.
DISCUSSION
It is well documented that EMS triggers a
proinsulin synthesis and insulin release similar to
Diabetes mellitus is a heterogeneous endocrine
glucose induced insulin synthesis and release
disorder in which hyperglycaemia is the unifying
(Maechler and Wollheim 2000). MacDonald and
feature and, as knowledge of the heterogeneity of
Fahien (1988) found that initiation of insulin
Pari and Saravanan : The effect of succinic acid monoethyl ester on plasma
release by esters of succinate by mitochondrial
1979). Glycosylated haemoglobin is found to be
metabolisms is sufficient to initiate and support
significantly increased in diabetic animals and the
insulin release from β cells (Ainscow et al. 2000).
amount of this increase is directly proportional to
Hyperglycaemia is the clinical hallmark of poorly
the fasting blood glucose level (Peters et al. 1996,
controlled diabetes, which is known to cause
Koening et al. 1978). The level of total
protein glycation, also known as non - enzymatic
haemoglobin is found to be decreased in the
glycosylation (Zhang and Swaan 1999). It has been
diabetic group and this may be due to the increased
reported that various proteins, including
formation of glycosylated haemoglobin. This was
haemoglobin, albumin, collagen, low-density
well correlated with earlier studies, which reported
lipoprotein, a crystalline of lens and fibronectin,
that there was a decrease in the level of
undergo non enzymatic glycation in diabetes
haemoglobin in experimental diabetic rats
(Koyama et al. 1998, Kumar et al. 2005). In long-
(Shirwaukar et al. 2006). The increase in the level
term diabetes, the glycosylated form of Hb has an
of haemoglobin in animals given EMS may be due
altered affinity for oxygen and this may be a factor
to the decreased level of blood glucose.
in tissue anoxia (Yiping et al. 2004, Bunn et al.
C N+EMS DC D+EMS D+ Met (8 µmol/g) (8 µmol/g) (25mg/kg)
Fig. 3. Changes in the levels of plasma hemoglobin and glycosylated hemoglobin in control and experimental animals. Symbols as in Fig. 2.
protein degradation and renewal. Glycation of the
glucose and other saccharide derivatives with
extracellular matrix produces changes in
proteins, nucleotides and lipids (Brownlee 2001).
macromolecular structure affecting matrix-matrix
Non-enzymatic glycation (Maillard reaction) is a
and matrix cell interactions associated with
complex series of reactions between reducing
decreased elasticity and increased fluid filtration
sugars and amino groups of proteins, which leads to
across the arterial wall, and endothelial cell
browning, fluorescence and cross-linking of the
proteins. The reaction is initiated by the reversible
concentration of AGEs increased above a critical
formation of a Schiff base, which undergoes a
level, cell surface AGE receptors become activated.
rearrangement to form a relatively stable Amadori
This is associated with increased expression of
product. The Amadori product further undergoes a
extracellular matrix proteins, vascular adhesion
series of reactions through dicarbonyl intermediates
molecules, cytokines and growth factor. Depending
to form AGE (advanced glycation end-products).
on the cell type and concurrent signalling, this can
Formation of some AGEs combines both the
be associated with chemotaxis, angiogenesis,
glycation and oxidative steps in a process termed
oxidative stress, and cell proliferation or apoptosis
glycoxidation (Thornalley 2002). Glycation occurs
(Thornalley 2004). These processes are thought to
inside and outside cells. Glycation of cellular
contribute to disease mechanisms associated with
proteins produces changes in structure and loss of
the development of diabetic complications (Vlassar
enzymatic activity. These effects are countered by
Pari and Saravanan : The effect of succinic acid monoethyl ester on plasma
The biochemical markers hexose, hexosamine,
secreted into the blood. The present experiment
sialic acid, and fucose have been measured in the
attempts to extract the protective role of EMS on
liver and serum because liver is responsible for the
glycoprotein levels in control and experimental
synthesis of all major proteins, which are then
Fig. 4. Changes in the levels of plasma glycoproteins in control and experimental animals. Symbols as in Fig. 2.
Fig. 5. Changes in the levels of tissues hexose in control and experimental animals. Symbols as in Fig. 2.
Generalized abnormalities in the metabolism of
significant modification in the connective tissue
glycoproteins are observed in both naturally
macromolecule. The requirement of insulin for the
occurring and experimental diabetes (Mc Millan
biosynthesis of the carbohydrate moiety of
1970, Latha and Pari 2005). Berenson et al (1972)
mucoproteins from glucose is thus evident.
reported that streptozotocin diabetic rats exhibited a
Decreased incorporation of the carbohydrate
moieties in diabetic rats may be due to insulin
structure and composition to those in circulation
deficiency. The increases in plasma glycoprotein
(Latha and Pari 2003). Therefore, vascular
components have been reported to be associated
complications that involve complex protein-
with the severity and duration of diabetes.
carbohydrate molecules could contribute to an
Glycoproteins found in a variety of tissues
including the arterial wall are very similar in
Pari and Saravanan : The effect of succinic acid monoethyl ester on plasma Fig. 6. Changes in the levels of tissues hexosamine in control and experimental animals. Symbols as in Fig. 2.
Fig. 7. Changes in the levels of tissues sialic acid in control and experimental animals. Symbols as in Fig. 2.
The biosynthesis of the carbohydrate moieties
in the hyperglycaemic state accelerates the
of glycoprotein forms the insulin independent
synthesis of basement membrane components, i.e.,
pathways for the utilization of glucose-6-phosphate.
glycoproteins (Radhakrishnamoorthy et al. 1973).
But the deficiency of insulin during diabetes
This is due to the depressed utilization of glucose
produces a dearrangement of glycoprotein
by insulin dependent pathways, thereby enhancing
metabolism, resulting in the thickening of basal
the formation of hexose, hexosamine and fucose for
membranes. The increased availability of glucose
the accumulation of glycoproteins (Spiro et al.
fucose content. Yorek (1993) found that fucose was
An earlier study has shown that in normal
significantly increased in serum from a more
circulation, fucose concentration increase as much
severely diabetic set of rats compared with the
as 8 fold in diabetes (Radhakrishnamurthy et al.
more moderately diabetic rats. Recent reports have
1976). In diabetes, three serum proteins
also indicated that hepatic and serum fucosidase
(haptoglobin, á-1 acid glycoprotein and
activities are increased in streptozotocin induced
á1-antitrypsin) synthesized in the liver are mainly
diabetic rats. Our results suggest that the increased
responsible for the increase in bound fucose levels
fucosylated proteins in diabetic rats could be due to
an increase in the synthesis and/or decrease in
metabolism and synthesis of these proteins may be
altered in diabetes leading to changes in serum
Pari and Saravanan : The effect of succinic acid monoethyl ester on plasma Fig. 8. Changes in the levels of tissues fucose in control and experimental animals. Symbols as in Fig. 2.
Sialic acid is an acylated derivative of
levels of the carbohydrate moieties of glycoproteins
neuraminic acid and exists as a terminal component
with inhibition of the excessive glycosylation,
of the non-reducing end of carbohydrate chains of
which indicates the therapeutic value of
glycoprotein in mammals. Their implications in a
nonglucidic nutrient EMS in type 2 diabetes.
variety of surface-related vital cell function in
numerous tissues are well documented (Patti et al.
1999). The sialic acid moiety of carbohydrate
epitope is important for biological interactions
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Measuring Risk and Utility of Anonymized Data Using Information Theory Department of Computer Engineering and Mathssevere that the anonymized data become useless, i.e., thatBefore releasing anonymized microdata (individual data) itall information contained in the data is lost. The problemis essential to evaluate whether: i) their utility is high enoughof optimizing the trade-off between
ALFRED HEALTH, Alfred Pathology Service Alfred Hospital, Caulfield Hospital, Sandringham Hospital THE COLLECTOR MUST LABEL AND SIGN or INITIAL EVERY SPECIMEN (TUBE) and MUST COMPLETE THE DECLARATION ON THE REQUEST FORM. Tube Guide for Common Tests HEPARIN PLASMA with GEL, 5.0 mL EDTA , 3 mL • Essential for — FBE, Hb, DCT, Retics Most urgent BI