内质网应激致肠-胰轴功能紊乱在2型糖尿病中的研究进展
The role of endoplasmic reticulum stress in gut-pancreas axis dysfunction in type 2 diabetes
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摘要: 2型糖尿病(type 2 diabetes mellitus, T2DM) 是以高血糖、高血脂和胰岛素抵抗为主要特征的代谢性疾病。内质网应激(endoplasmic reticulum stress, ERS) 是机体细胞的一种适应性调节反应。在T2DM发展过程中, 长期高血糖会导致机体多种组织细胞持续发生ERS, 进而引起蛋白质合成功能紊乱。其中, 具有激素分泌功能的上皮细胞或内分泌细胞, 更易受ERS影响而发生功能紊乱。肠-胰轴在调控机体代谢及T2DM发展过程中具有重要作用。肠道上皮L细胞作为肠道屏障的一部分, 负责分泌肠道激素胰高血糖素样肽1 (glucagon-like peptide-1, GLP-1), 其促胰岛β细胞分泌的胰岛素对糖代谢稳态维持具有重要意义。近年研究表明, ERS与肠-胰轴激素分泌及功能稳态密切相关。ERS通过影响肠道激素分泌、肠道屏障完整性以及β细胞的分泌功能和数量, 参与T2DM的发生与发展。因此, 本文将以肠-胰轴功能稳态为切入点, 探讨ERS对肠-胰轴激素分泌功能与肠道屏障完整性的影响, 并概述当前几类抗糖尿病药物通过调节肠-胰轴中ERS状态, 进而改善糖脂代谢的作用及机制研究进展。Abstract: Type 2 diabetes mellitus (T2DM) is a complex metabolic disorder characterized by chronic hyperglycemia, hyperlipidemia, and peripheral insulin resistance. Endoplasmic reticulum stress (ERS), a response to cellular stress, is activated across various tissues during the progression of T2DM, leading to disruptions in protein synthesis. Notably, epithelial and endocrine cells with hormone-secreting functions are particularly vulnerable to functional impairments induced by ERS. The gut-pancreas axis is essential for regulating metabolism and the progression of T2DM. Intestinal epithelial L cells, integral to the intestinal barrier, can secrete the glucagon-like peptide-1 (GLP-1). This hormone promotes insulin secretion from pancreatic β-cells and plays a critical role in glucose metabolism. Importantly, ERS plays a critical role in regulating glucolipid-induced dysfunction of gut-pancreas axis. For instance, ERS is involved in regulating the intestinal barrier and the secretion of GLP-1 as well as insulin. Therefore, ERS can be a potential target for T2DM treatment. In this paper, we review the regulatory roles of ERS in the gut-pancreas axis during the development of T2DM, and summarize the therapeutic drugs and strategies targeting ERS for T2DM treatment.
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