Acute changes in systemic glycemia gate access and action of GLP-1R agonist on brain structures controlling energy homeostasis

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Bakker, Wineke | Imbernon, Monica | Salinas, Casper Gravesen | Moro Chao, Daniela Herrera | Hassouna, Rim | Morel, Chloe | Martin, Claire | Leger, Caroline | Denis, Raphael G.P. | Castel, Julien | Peter, Andreas | Heni, Martin | Maetzler, Walter | Nielsen, Heidi Solvang | Duquenne, Manon | Schwaninger, Markus | Lundh, Sofia | Johan Hogendorf, Wouter Frederic | Gangarossa, Giuseppe | Secher, Anna | Hecksher-Sørensen, Jacob | Pedersen, Thomas Åskov | Prevot, Vincent | Luquet, Serge

Edité par CCSD ; Elsevier Inc -

International audience. Therapies based on glucagon-like peptide-1 (GLP-1) long-acting analogs and insulin are often used in the treatment of metabolic diseases. Both insulin and GLP-1 receptors are expressed in metabolically relevant brain regions, suggesting a cooperative action. However, the mechanisms underlying the synergistic actions of insulin and GLP-1R agonists remain elusive. In this study, we show that insulin-induced hypoglycemia enhances GLP-1R agonists entry in hypothalamic and area, leading to enhanced whole-body fat oxidation. Mechanistically, this phenomenon relies on the release of tanycyctic vascular endothelial growth factor A, which is selectively impaired after calorie-rich diet exposure. In humans, low blood glucose also correlates with enhanced blood-to-brain passage of insulin, suggesting that blood glucose gates the passage other energy-related signals in the brain. This study implies that the preventing hyperglycemia is important to harnessing the full benefit of GLP-1R agonist entry in the brain and action onto lipid mobilization and body weight loss.

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