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Originally published In Press as doi:10.1074/jbc.M108594200 on September 17, 2001
J. Biol. Chem., Vol. 276, Issue 47, 43748-43755, November 23, 2001
Excessive Hexosamines Block the Neuroprotective Effect of
Insulin and Induce Apoptosis in Retinal Neurons*
Makoto
Nakamura ,
Alistair J.
Barber ,
David A.
Antonetti §,
Kathryn F.
LaNoue§,
Katherine A.
Robinson¶,
Maria G.
Buse¶, and
Thomas W.
Gardner §
From the Pennsylvania State Retina Research Group, The Ulerich
Ophthalmology Research Center, the Departments of
Ophthalmology and § Cellular and Molecular
Physiology, Pennsylvania State University College of Medicine,
Hershey, Pennsylvania 17033 and ¶ Division of Endocrinology,
Diabetes and Medical Genetics, Department of Medicine, Medical
University of South Carolina, Charleston, South Carolina 29425
In addition to microvascular
abnormalities, neuronal apoptosis occurs early in diabetic retinopathy,
but the mechanism is unknown. Insulin may act as a neurotrophic factor
in the retina via the phosphoinositide 3-kinase/Akt pathway. Excessive
glucose flux through the hexosamine biosynthetic pathway (HBP) is
implicated in the development of insulin resistance in peripheral
tissues and diabetic complications such as nephropathy. We tested
whether increased glucose flux through the HBP perturbs insulin action and induces apoptosis in retinal neuronal cells. Exposure of R28 cells,
a model of retinal neurons, to 20 mM glucose for
24 h attenuated the ability of 10 nM insulin to rescue
them from serum deprivation-induced apoptosis and to phosphorylate Akt
compared with 5 mM glucose. Glucosamine not only impaired
the neuroprotective effect of insulin but also induced apoptosis in R28
cells in a dose-dependent fashion. UDP-N-acetylhexosamines (UDP-HexNAc), end products of the
HBP, were increased ~2- and 15-fold after a 24-h incubation in 20 mM glucose and 1.5 mM glucosamine,
respectively. Azaserine, a glutamine:fructose-6-phosphate amidotransferase inhibitor, reversed the effect of 20 mM
glucose, but not that of 1.5 mM glucosamine, on attenuation
of the ability of insulin to promote cell survival and phosphorylate
Akt as well as accumulation of UDP-HexNAc. Glucosamine also impaired
insulin receptor processing in a dose-dependent manner but
did not decrease ATP content. By contrast, in L6 muscle cells,
glucosamine impaired insulin receptor processing but did not induce
apoptosis. These results suggest that the excessive glucose flux
through the HBP may direct retinal neurons to undergo apoptosis in a
bimodal fashion; i.e. via perturbation of the
neuroprotective effect of insulin mediated by Akt and via induction of
apoptosis possibly by altered glycosylation of proteins. The HBP may be
involved in retinal neurodegeneration in diabetes.
*
This work was supported by the Pennsylvania Lions Sight
Conservation and Eye Research Foundation (to M. N.), National
Institutes of Health Grants EY12021 (to T. W. G.) and DK02001 (to
M. G. B.), Juvenile Diabetes Research Foundation (to T. W. G.,
D. A. A., and K. F. L), American Diabetes Association (to
T. W. G.), Research to Prevent Blindness, and Jack and Nancy
Turner, Athens, GA.The costs of publication of this
article were defrayed in part by the
payment of page charges. The article
must therefore be hereby marked
"advertisement" in
accordance with 18 U.S.C. Section
1734 solely to indicate this fact.
To whom correspondence should be addressed: Ulerich
Ophthalmology Research Center, Dept. of Ophthalmology, H166,
Pennsylvania State University College of Medicine, 500 University Dr.,
Hershey, PA 17033. Tel.: 717-531-5542; Fax: 717-531-7667; E-mail:
tgardner@psu.edu.
Copyright © 2001 by The American Society for Biochemistry and Molecular Biology, Inc.

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Copyright © 2001 by the American Society for Biochemistry and Molecular Biology.
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