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J. Biol. Chem., Vol. 280, Issue 48, 39723-39731, December 2, 2005
Physiological and Pathological Changes in Glucose Regulate Brain Akt and Glycogen Synthase Kinase-3*From the Department of Psychiatry and Behavioral Neurobiology, University of Alabama at Birmingham, Birmingham, Alabama 35294-0017
Received for publication, August 10, 2005
Insulin regulates the phosphorylation and activities of Akt and glycogen synthase kinase-3 (GSK3) in peripheral tissues, but in the brain it is less clear how this signaling pathway is regulated in vivo and whether it is affected by diabetes. We found that Akt and GSK3 are sensitive to glucose, because fasting decreased and glucose administration increased by severalfold the phosphorylation of Akt and GSK3 in the cerebral cortex and hippocampus of non-diabetic mice. Brain Akt and GSK3 phosphorylation also increased after streptozotocin administration (3 days), which increased blood glucose and depleted blood insulin, indicating regulation by glucose availability even with deficient insulin. Changes in Akt and GSK3 phosphorylation and activities in epididymal fat were opposite to those of brain after streptozotocin treatment. Streptozotocin-induced hyperglycemia and increased brain Akt and GSK3 phosphorylation were reversed by lowering blood glucose with insulin administration. Long term hyperglycemia also increased brain Akt and GSK3 phosphorylation, both 4 weeks after streptozotocin and in db/db insulin-resistant mice. Thus, the Akt-GSK3 signaling pathway is regulated in mouse brain in vivo in response to physiological and pathological changes in insulin and glucose.
Insulin resistance and diabetes represent increasingly prevalent conditions that involve impaired regulation of glucose production and utilization (1). Recently much has been learned about insulin resistance in insulin-sensitive peripheral tissues, such as fat and skeletal muscle (2, 3). In contrast, little is understood about diabetes-induced changes in insulin-linked signaling activities in the brain even though cognition is often impaired in diabetic subjects (4), and the brain accounts for 20% of the energy utilization in the body of adult humans (5). Glucose is the predominant substrate of the brain, and its consumption is tightly linked to neuronal activity, leaving neuronal function highly dependent on a continual supply of glucose (6). Because of this high demand for glucose, neurons have developed energy-efficient designs (7) and specialized glucose uptake mechanisms (8) to ensure adequate supply even at times when circulating glucose levels are low. Incumbent upon a system relying almost exclusively on glucose are mechanisms to sense and respond to fluctuations in the level of glucose, such as the well known regulation of blood flow by the brain that constricts or dilates arterioles to regulate local blood flow in accordance with demands of neuronal activity (9, 10). However, the brain is largely insulated from changes of insulin in the blood (11), so little is known about how insulin-coupled signaling systems within the brain either sense, or respond to, fluctuations in the circulating level of glucose or if they are buffered from such fluctuations.
Insulin receptors in virtually all vertebrate tissues, including the brain, are coupled to the prominent signaling pathway encompassing Akt (also known as protein kinase B) and glycogen synthase kinase-3 (GSK3).2 In insulin-responsive tissues, insulin signaling activates Akt, which inactivates GSK3 (12). Akt is activated by dual phosphorylation on threonine 308 and serine 473 carried out by 3-phosphoinositide-dependent kinase-1 (PDK1) and an unidentified kinase often called PDK2, respectively (13). Conversely, the activity of GSK3 is inhibited by N-terminal serine phosphorylation of the two GSK3 isoforms, serine 9 in GSK3
Animals and TreatmentsAdult, male C57BL/6 mice (Frederick Cancer Research, Frederick, MD), 67 weeks old, were injected intraperitoneally (ip) with streptozotocin (150 mg/kg in citrate buffer, pH 4.6) or vehicle for controls, either 3 days or 4 weeks before sacrifice. Adult male BKS.Cg-m+/+Leprdb/J mice (Jackson Laboratories), 78 weeks old, were used for a type II diabetic model animal. All mice were allowed to drink ad libitum and kept on a 12 h light/dark cycle. Where indicated, mice were given intraperitoneal injections of D-glucose (2 g/kg) or insulin (5 international units/kg bovine pancreas insulin; Sigma) in phosphate-buffered saline after overnight food withdrawal. Blood glucose levels were measured using a glucose monitor (True Track Smart System). Insulin concentrations were measured using an ultrasensitive mouse insulin enzyme-linked immunosorbent assay (ELISA) assay (Mercodia, Winston Salem, NC). Body temperatures were measured rectally using a CyQ model 111 thermocouple (CyperSense Inc, Nicholasville, KY). Tissue PreparationMice were decapitated, and brains were rapidly dissected in ice-cold saline. Brain regions were homogenized in ice-cold lysis buffer containing 10 mM Tris-HCl, pH 7.4, 150 mM NaCl, 1 mM EDTA, 1 mM EGTA, 0.5% Nonidet P-40, 10 µg/ml leupeptin, 10 µg/ml aprotinin, 5 µg/ml pepstatin, 1 mM phenylmethylsulfonyl fluoride, 1 mM sodium vanadate, 50 mM sodium fluoride, and 100 nM okadaic acid. The lysates were centrifuged at 20,800 x g for 10 min to remove insoluble debris. Protein concentrations in the supernatants were determined in triplicate using the Bradford (19) protein assay.
ImmunoblottingExtracts were mixed with Laemmli sample buffer (2% SDS) and placed in a boiling water bath for 5 min. Proteins were resolved in SDS-polyacrylamide gels, and transferred to nitrocellulose. Blots were probed with antibodies to phospho-Ser9-GSK3
Enzyme ActivitiesAkt activity in the cerebral cortex was measured after immunoprecipitation of Akt from 100 µg of protein with 3.5 µgof monoclonal Akt antibody. Immobilized immune complexes were washed twice with lysis buffer and twice with kinase buffer (10 mM MOPS, pH 7.4, 1 mM EDTA, 10 mM magnesium acetate, 20 mM magnesium chloride, 1 mM dithiothreitol, 1 µg/ml aprotinin, 1 mM benzamidine, 50 mM
Brain Akt and GSK3 Are Dephosphorylated during FastingTo test if the Akt-GSK3 coupled signaling pathway in mammalian brain is sensitive to peripheral glucose availability, we first examined if food withdrawal for 24 h affected the phosphorylation levels of Akt and GSK3 in mouse brain. These measurements used immunoblot analyses with phosphospecific antibodies to Akt or each of the two isoforms of GSK3 in samples of cerebral cortex and hippocampus obtained from adult, male C57BL/6 mice, with four mice per group. Food withdrawal significantly reduced blood glucose concentrations to 66 ± 4% of control levels, reduced blood insulin levels to 51 ± 3% of controls, but did not significantly change body weight or temperature (TABLE ONE). It has been reported that hypothermia during hypoglycemia caused by three days of starvation increased phospho-Ser9-GSK3 levels in mouse brain (21); thus, in the present study, temperature was monitored to ensure that hypothermia did not occur to obscure the effects of changes in glucose. In both brain regions food withdrawal resulted in large decreases of the dual phosphorylation of Akt, phospho-Thr308-Akt (in the cortex to 24 ± 6% of control, means ± S.E.; n = 4) and phospho-Ser473-Akt (in the cortex to 41 ± 8% of control), but the total level of Akt was unaffected (Fig. 1A). There were also large decreases in the serine phosphorylation of both isoforms of GSK3, phospho-Ser9-GSK3 (in the cortex to 38 ± 9% of control) and phospho-Ser21-GSK3 (in the cortex to 30 ± 5% of control), whereas phosphotyrosine and total levels of GSK3 and GSK3 were unaltered (Fig. 1B). Thus, decreased blood glucose and insulin concentrations caused by food withdrawal for 24 h were associated with decreases in the phosphorylation of Akt and GSK3 in two regions of mouse brain.
Brain Akt and GSK3 Are Phosphorylated after Glucose Administration Because food withdrawal indicated there was an inverse relationship between blood glucose and/or insulin levels and the phosphorylation of brain Akt and GSK3, the converse experiment was carried out in which a bolus of glucose was administered to mice. To provide a consistent baseline blood glucose level in all of the mice, the glucose was administered after a 14-h period of food withdrawal. Following treatment with 2 g/kg glucose, the blood glucose and insulin levels rapidly increased and reached peak levels after 10 and 5 min, respectively, (Fig. 2A) whereas body temperature was not changed. Glucose administration caused rapid and substantial increases in the levels of phospho-Thr308-Akt, phospho-Ser473-Akt, phospho-Ser21-GSK3 , and phospho-Ser9-GSK3 in both the cerebral cortex and the hippocampus (Fig. 2, B and C). Taken together, the results of food deprivation and of glucose administration show that the phosphorylation states of Akt and GSK3 in two regions of mouse brain are regulated by both decreases and increases in the circulating levels of glucose and insulin. Brain Akt and GSK3 Are Transiently Phosphorylated after Insulin AdministrationTo test if increased insulin was sufficient to trigger changes in brain Akt and GSK3 phosphorylation, insulin was administered to mice. Administration of 5 international units/kg insulin caused a large increase in blood insulin and a subsequent decrease in blood glucose (Fig. 3A). The rapid increase in insulin concentration caused a rapid but transient increase in the dual phosphorylation of Akt in cerebral cortex and hippocampus (Fig. 3B). Akt phosphorylation reached a peak 5 min after insulin administration, which rapidly reverted to basal levels as the glucose concentration plummeted, although the insulin concentration remained elevated. Similar patterns of changes in the phosphorylation of both GSK3 isoforms occurred in both brain regions (Fig. 3C). These results suggest that both glucose and insulin contribute to regulating the phosphorylation states of Akt and GSK3 in the brain in vivo. Overall, these experiments demonstrate that the regulatory phosphorylation states of Akt and GSK3 in mouse cerebral cortex and hippocampus are modulated in an inverse manner by fluctuations in the blood glucose concentration, such that the kinases are dephosphorylated when blood glucose levels are below normal, and are phosphorylated when blood glucose levels are elevated, and that circulating insulin is also able to modulate Akt and GSK3 in the brain. This raised the question of whether changes in circulating glucose in the absence of insulin is sufficient to regulate these kinases in the brain, which can occur in pathological states of hyperglycemia associated with diabetes.
Diabetes Increases Brain Akt and GSK3 PhosphorylationHyperglycemic conditions in mouse models of diabetes were used to test if short and long term pathological increases in circulating glucose levels regulate the phosphorylation of brain Akt and GSK3. The first group of experiments employed streptozotocin treatment to induce hyperglycemia resulting from insulin depletion. Streptozotocin administered to mice causes a rapid degeneration of insulin-producing
To ensure that streptozotocin-induced insulin depletion decreased signaling by insulin receptors, epididymal fat samples were examined as a control tissue. As expected, and in marked contrast to brain tissue, 3 days after streptozotocin treatment epididymal fat displayed large decreases in the levels of phospho-Thr308-Akt and phospho-Ser473-Akt, whereas the total levels of Akt remained unchanged (Fig. 5A). There were also large decreases in phospho-Ser21-GSK3 and phospho-Ser9-GSK3 in fat from treated mice compared with controls, but no changes in the tyrosine-phosphorylated or total levels of GSK3 (Fig. 5B). Thus, the phosphorylation of Akt and GSK3 in fat exhibited the large decreases predicted to occur following insulin depletion.
The activities of Akt and GSK3
The effects of sustained streptozotocin-induced hyperglycemia were measured by examining phosphorylation levels of Akt and GSK3 in the brain 4 weeks after streptozotocin treatment. Large increases in the levels of phospho-Ser473-Akt and phospho-Thr308-Akt were present in both the cerebral cortex and hippocampus of mice 4 weeks after treatment with streptozotocin (Fig. 7A). These mice also displayed increased levels of phospho-Ser21-GSK3
To determine if the phosphorylation levels Akt and GSK3 in the brain were increased in a second mouse model of diabetes associated with hyperglycemia, male db/db mice that develop an insulin resistance phenotype (22), were examined. The db/db mice were hyperglycemic and insulinopenic, with blood glucose concentrations 390 ± 7% of control levels and insulin concentrations 280 ± 12% of controls, and their body weights were significantly increased (TABLE THREE). In db/db mice, compared with control mice, there were large increases in phospho-Thr308-Akt and phospho-Ser473-Akt (Fig. 8A) and in phospho-Ser21-GSK3 and phospho-Ser9-GSK3 (Fig. 8B) in the cerebral cortex and hippocampus. There were no differences in total protein levels of Akt or GSK3 in db/db brain regions compared with controls. These results show that in two mouse models of diabetes, hyperglycemia was associated with large chronic increases in the phosphorylation states of Akt and GSK3 in the brain.
To test if the hyperglycemic-induced increases in phosphorylation of brain Akt and GSK3 could be reversed by lowering the glucose level, and to confirm that the glucose was regulatory, 3 days after streptozotocin treatment, blood glucose levels were reduced by acute insulin treatment. Administration of 5 international units/kg insulin caused a rapid increase in blood insulin and a corresponding decrease in blood glucose (Fig. 9A). Insulin treatment resulted in decreases in the dual phosphorylation of Akt (Fig. 9A) and in the serine phosphorylation of both GSK3 isoforms (Fig. 9B). These results show that the increased phosphorylation of Akt and GSK3 in the brain caused by streptozotocin-induced hyperglycemia could be rapidly reversed by lowering the blood glucose concentration.
This investigation found a surprisingly strong role for physiological and pathological changes in the circulating concentration of glucose, in addition to insulin, in regulating the Akt-GSK3 signaling pathway in mouse brain. In both the cerebral cortex and the hippocampus, the phosphorylation states of Akt and GSK3 were found to be influenced by physiological fluctuations in the blood glucose concentration, by acutely administered glucose or insulin, by short term (3 days) and long term (4 weeks) hyperglycemia caused by pathological insulin depletion after streptozotocin administration, and by hyperglycemia linked to insulin resistance in type 2 diabetic db/db mice. Hyperglycemia in the presence of normal or deficient insulin levels caused large increases in the phosphorylation levels of Akt and GSK3 in the brain, as did acute insulin administration, whereas they were reduced by fasting-induced hypoglycemia or by lowering hyperglycemic glucose levels by insulin administration to streptozotocin-treated mice. Taken together, these results show that glucose as well as insulin contributes to the in vivo regulation of the phosphorylation of Akt and GSK3 in two regions of mouse brain, indicating that a glucose-sensing mechanism regulates brain Akt and GSK3.
The present results extend previous studies of the effects of diabetes-related conditions on the phosphorylation of Akt or GSK3 in mouse brain. The IRS-2-deficient mouse model of diabetes previously was found to have increased brain levels of phospho-Ser9-GSK3
The glucose-sensing regulation of brain Akt and GSK3 differentiates the responses of these enzymes in the brain from changes in peripheral tissues under insulin-resistant conditions. In our study, Akt and GSK3 in epididymal fat were dephosphorylated following streptozotocin treatment while the phosphorylation levels of Akt and GSK3 in the brain were dramatically increased in the same animals. There have been only a limited number of studies of the in vivo phosphorylation states of Akt and GSK3 in peripheral tissues in insulin-resistant animal models, but these previous studies have reported results consistent with decreased or unchanged phosphorylation of GSK3 and/or Akt in contrast to the large increases in brain-phosphorylated Akt and GSK3. In epididymal fat of mice with high fat diet-induced diabetes, the activity of GSK3 was increased 2-fold, likely indicative of decreased phosphorylation, whereas the activity of Akt was not changed (27). In these same mice there was a small decrease of GSK3 activity in liver and no change in skeletal muscle, demonstrating that regulation differs among tissues even in the periphery. Studies of streptozotocin-treated rats and Zucker diabetic fatty (ZDF) rats also reported no differences in skeletal muscle GSK3 activity (28, 29). However, in human patients with type 2 diabetes, the GSK3 activity was elevated 2-fold in skeletal muscle, consistent with a decrease in the inhibitory serine phosphorylation of GSK3 (30). The myocardium of streptozotocin-treated rats displayed decreased basal phosphorylation of Akt on Thr308, but not on Ser473, and decreased insulin-induced serine phosphorylation of both GSK3 isoforms (31). Overall, these studies indicate that the effects of insulin resistance on Akt and GSK3 vary considerably among different tissues and that changes in the brain are relatively large, as well as opposite to, changes in peripheral tissues.
During the last few years increasing attention has been focused on GSK3 as a potential therapeutic target in diabetes because inhibition of GSK3 facilitates control of glucose levels in animal models of insulin resistance (32). Although as noted above there is limited data indicating that GSK3 in peripheral tissues is abnormally activated in diabetes, this is not a requirement for inhibitors to contribute to the control of glucose levels. However, overexpression of GSK3
Considering the central roles of Akt and GSK3 in many cellular processes, and the critical role that glucose plays in neuronal function, one goal of this investigation was to test if changes in circulating levels of glucose affected the regulatory phosphorylation states of these kinases. The coupling of these kinases is an interesting, somewhat novel, signaling pathway because phosphorylation increases Akt activity but decreases GSK3 activity, so the signal strength has opposite effects on the two kinases (39). When cells are adequately stimulated the activation-inducing phosphorylation of Akt is enhanced, as is the consequential Akt-induced inhibitory serine phosphorylation of GSK3. Both physiological and pathological changes in circulating glucose levels were found to regulate the phosphorylation levels of Akt and GSK3 in mouse brain in vivo. Because these were altered by both fasting and acute glucose administration, it appears that the phosphorylation levels of Akt and GSK3 are perpetually fluctuating in response to food intake or deprivation. This is rather surprising considering previous notions that these enzymes are tightly controlled and primarily regulated by neurohormones such as growth factors (13, 14). With pathological hyperglycemia, these fluctuations are eliminated and the enzymes are maintained in a persistent state of hyperphosphorylation. It is possible that loss of normal fluctuations of these two key kinases contributes to cognitive impairments that can occur in patients with diabetes, especially when glucose is poorly controlled or in elderly diabetic patients (4). Although only short term glucose deprivation was studied here, it may be relevant that a number of psychiatric disorders are linked with hypoglycemic states. For example, depression is frequently associated with impaired appetite and weight loss, and anorexia nervosa represents a more severe hypoglycemic state of long duration. Hypoglycemia is associated with decreased serine phosphorylation of GSK3, which is correlated with increased enzymatic activity, so it is of interest that agents therapeutic for depressive mood disorders can increase GSK3 phosphorylation in mouse brain in vivo (40, 41). Thus, the phosphorylation of Akt and GSK3 is regulated by integrated signals derived from glucose as well as neurohormones such as insulin. This allows the linked Akt-GSK3 signaling pathway to act as a cellular glucose sensor and integrator of multiple signals, responses that may contribute to neuronal dysfunction in diabetes and other disorders involving altered glucose availability.
* This research was supported by National Institutes of Health Grants NS37768 and AG021045. The costs of publication of this article were defrayed in part by the payment of page charges. This article must therefore be hereby marked "advertisement" in accordance with 18 U.S.C. Section 1734 solely to indicate this fact. 1 To whom correspondence should be addressed: Dept. of Psychiatry, 1720 Seventh Ave. S., SC1057, University of Alabama at Birmingham, Birmingham, AL 35294-0017. Tel.: 205-934-7023; Fax: 205-934-3709; E-mail: jope{at}uab.edu.
2 The abbreviations used are: GSK3, glycogen synthase kinase-3; ip, intraperitoneally; ZDF, Zucker diabetic fatty; MOPS, 4-morpholinepropanesulfonic acid.
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