Hoda M. Eid

Stimulation of AMP-activated protein kinase and enhancement of basal glucose uptake in muscle cells by quercetin and quercetin glycosides, active principles of the antidiabetic medicinal plant Vaccinium vitis-idaea

Several medicinal plants that stimulate glucose uptake in skeletal muscle cells were identified from among species used by the Cree of Eeyou Istchee of northern Quebec to treat symptoms of diabetes. This study aimed to elucidate the mechanism of action of one of these products, the berries of Vaccinium vitis idaea, as well as to isolate and identify its active constituents using a classical bioassay-guided fractionation approach. Western immunoblot analysis in C2C12 muscle cells revealed that the ethanol extract of the berries stimulated the insulin-independent AMP-activated protein kinase (AMPK) pathway. The extract mildly inhibited ADP-stimulated oxygen consumption in isolated mitochondria, an effect consistent with metabolic stress and the ensuing stimulation of AMPK. This mechanism is highly analogous to that of Metformin. Fractionation guided by glucose uptake activity resulted in the isolation of ten compounds. The two most active, quercetin-3-O-glycosides, enhanced glucose uptake by 38-59% (50 muM; 18 h treatment) in the absence of insulin. Quercetin aglycone, a minor constituent, stimulated uptake by 37%. The quercetin glycosides and the aglycone stimulated the AMPK pathway at concentrations of 25-100 muM, but only the aglycone inhibited ATP synthase in isolated mitochondria (by 34 and 79% at 25 and 100 muM, respectively). This discrepancy suggests that the activity of the glycosides may require hydrolysis to the aglycone form. These findings indicate that quercetin and quercetin 3-O-glycosides are responsible for the antidiabetic activity of V. vitis crude berry extract mediated by AMPK. These common plant products may thus have potential applications for the prevention and treatment of insulin resistance and other metabolic diseases.

Structural constraints and the importance of lipophilicity for the mitochondrial uncoupling activity of naturally occurring caffeic acid esters with potential for the treatment of insulin resistance

Caffeic acid phenethyl ester (CAPE) has recently been shown to potently stimulate glucose uptake in cultured skeletal muscle cells through the AMPK pathway and therefore to have anti-diabetic potential. We report here that CAPE increases glucose uptake in C2C12 muscle cells by 225+/-21% at 50 microM, and that activation of AMPK is a consequence of the metabolic stress resulting from an uncoupling-type disruption of mitochondrial function (complete uncoupling at 50 microM). We also observe that the therapeutic potential of CAPE is offset by its high potential for toxicity. The purpose of this study was therefore to identify other active caffeic acid derivatives, evaluate their ratio of activity to toxicity, and elucidate their structure-activity relationship. Twenty naturally occurring derivatives were tested for glucose-uptake stimulating activity in C2C12 cells following 18 h of treatment and for uncoupling activity in isolated rat liver mitochondria. Cytotoxicity was assessed in C2C12 cells by the release of lactate dehydrogenase over 18 h. In addition to CAPE, four compounds were identified to be active, both stimulating glucose uptake and uncoupling isolated mitochondria. Activity required that the caffeic acid moiety be intact and that the compound not contain a strongly ionized group. Both activity and toxicity were found to be well-correlated to predicted lipophilicity. However, two compounds exhibited little to no toxicity while still stimulating glucose uptake by 65-72%. These results support a therapeutic potential for this family of compounds and provide the framework for the design of alternatives to Metformin with an optimized balance of safety and activity.

Significance of Microbiota in Obesity and Metabolic Diseases and the Modulatory Potential by Medicinal Plant and Food Ingredients

Metabolic syndrome is a cluster of three or more metabolic disorders including insulin resistance, obesity, and hyperlipidemia. Obesity has become the epidemic of the twenty-first century with more than 1.6 billion overweight adults. Due to the strong connection between obesity and type 2 diabetes, obesity has received wide attention with subsequent coining of the term “diabesity.” Recent studies have identified unique contributions of the immensely diverse gut microbiota in the pathogenesis of obesity and diabetes. Several mechanisms have been proposed including altered glucose and fatty acid metabolism, hepatic fatty acid storage, and modulation of glucagon-like peptide (GLP)-1. Importantly, the relationship between unhealthy diet and a modified gut microbiota composition observed in diabetic or obese subjects has been recognized. Similarly, the role of diet rich in polyphenols and plant polysaccharides in modulating gut bacteria and its impact on diabetes and obesity have been the subject of investigation by several research groups. Gut microbiota are also responsible for the extensive metabolism of polyphenols thus modulating their biological activities. The aim of this review is to shed light on the composition of gut microbes, their health importance and how they can contribute to diseases as well as their modulation by polyphenols and polysaccharides to control obesity and diabetes. In addition, the role of microbiota in improving the oral bioavailability of polyphenols and hence in shaping their antidiabetic and antiobesity activities will be discussed.

Lingonberry (Vaccinium vitis-idaea L.) Exhibits Antidiabetic Activities in a Mouse Model of Diet-Induced Obesity

Vaccinium vitis-idaea, commonly known as lingonberry, has been identified among species used by the Cree of Eeyou Istchee of northern Quebec to treat symptoms of diabetes. In a previous study, the ethanol extract of berries of V. vitis-idaea enhanced glucose uptake in C2C12 muscle cells via stimulation of AMP-activated protein kinase (AMPK) pathway. The purpose of this study was to examine the effect of plant extract in a dietary mouse model of mild type 2 diabetes. C57BL/6 mice fed a high-fat diet (HFD, ∼35% lipids) for 8 weeks that become obese and insulin-resistant (diet-induced obesity, DIO) were used. Treatment began by adding V. vitis-idaea extract to HFD at 3 different concentrations (125, 250, and 500 mg/Kg) for a subsequent period of 8 weeks (total HFD, 16 weeks). The plant extract significantly decreased glycemia and strongly tended to decrease insulin levels in this model. This was correlated with a significant increase in GLUT4 content and activation of the AMPK and Akt pathways in skeletal muscle. V. vitis-idaea treatment also improved hepatic steatosis by decreasing hepatic triglyceride levels and significantly activated liver AMPK and Akt pathways. The results of the present study confirm that V. vitis-idaea represents a culturally relevant treatment option for Cree diabetics and pave the way to clinical studies.

Mechanisms of Action of Indigenous Antidiabetic Plants from the Boreal Forest of Northeastern Canada

Indigenous populations in Canada possess a wealth of native traditional knowledge. However, their rates of Type 2 diabetes mellitus (T2DM), a disease that was unheard of in their midst 50 years ago, are the highest in the country. In an effort to cut the impact of T2DM epidemic on Indigenous health, the Canadian Institutes of Health Research funded the “CIHR Team in Aboriginal Antidiabetic Medicines (CIHR-TAAM).” The goal was to explore Boreal forest medicinal plants stemming from Indigenous Traditional Medicine to be included in T2DM care. Six out of nine communities of the Cree of Eeyou Istchee (CEI) participated in ethnobotanical studies that resulted in the identification of 17 potential antidiabetic plant species. These species were screened for antidiabetic activities using a platform of in vitro bioassays and in vivo models of T2DM. This paper summarizes results on the 10 most promising plant species, their active constituents, and the mechanisms behind their antidiabetic activities. In addition, potential herb-drug interactions were examined at the level of drug-metabolizing enzymes, notably the cytochrome P450 family. This review serves as a canvas onto which is discussed the value of Indigenous medicinal plants, future avenues of research, and the ethical approach required in this field.

A combination of (+)-catechin and (-)-epicatechin underlies the in vitro adipogenic action of Labrador tea (Rhododendron groenlandicum), an antidiabetic medicinal plant of the Eastern James Bay Cree pharmacopeia.

ETHNOPHARMACOLOGICAL RELEVANCE Rhododendron groenlandicum (Oeder) Kron & Judd (Labrador tea) was identified as an antidiabetic plant through an ethnobotanical study carried out with the close collaboration of Cree nations of northern Quebec in Canada. OBJECTIVES In a previous study the plant showed glitazone-like activity in a 3T3-L1 adipogenesis bioassay. The current study sought to identify the active compounds responsible for this potential antidiabetic activity using bioassay guided fractionation based upon an in vitro assay that measures the increase of triglycerides content in 3T3-L1 adipocyte. MATERIALS AND METHODS Isolation and identification of the crude extracts active constituents was carried out. The 80% ethanol extract was fractionated using silica gel column chromatography. Preparative HPLC was then used to isolate the constituents. The identity of the isolated compounds was confirmed by UV and mass spectrometry. RESULTS Nine chemically distinct fractions were obtained and the adipogenic activity was found in fraction 5 (RGE-5). Quercetins, (+)-catechin and (-)-epicatechin were detected and isolated from this fraction. While (+)-catechin and (-)-epicatechin stimulated adipogenesis (238±26% and 187±21% relative to vehicle control respectively) at concentrations equivalent to their concentrations in the active fraction RGE-5, none afforded biological activity similar to RGE-5 or the plants crude extract when used alone. When cells were incubated with a mixture of the two compounds, the adipogenic activity was close to that of the crude extract (280.7±27.8 vs 311± 30%). CONCLUSION Results demonstrate that the mixture of (+)-catechin and (-)-epicatechin is responsible for the adipogenic activity of Labrador tea. This brings further evidence for the antidiabetic potential of R. groenlandicum and provides new opportunities to profile active principles in biological fluids or in traditional preparations.

Root bark extracts of Myrianthus arboreus P. Beauv. (Cecropiaceae) exhibit anti-diabetic potential by modulating hepatocyte glucose homeostasis

ETHNOPHARMACOLOGICAL RELEVANCE Myrianthus arboreus P. Beauv. is a tropical tree used in African folk medicine, including for diabetes. However, little research has yet been conducted to support this ethnopharmacological use of this plant. The present study sought to determine the antidiabetic potential of root bark extracts through cell-based bioassays of liver and muscle glucose homeostasis. MATERIALS AND METHODS Four extracts were obtained from crude root bark powder: 1 aqueous (AQ), 2 ethanol (EtOH), 3 alkaloid enriched (Alk) (obtained from methanol extract) and 4 dichloromethane (Dic) extracts. Moreover, extract 2 was further separated into two fractions: 2.1 ethyl acetate (EAc) and 2.2 hexane (Hex). To assess the antidiabetic activity of the plant extracts, inhibition of glucose-6-phosphatase (G6Pase), stimulation of glycogen synthase (GS) and modulation of glucose uptake were determined in cultured H4IIE and HepG2 hepatocytes as well as C2C12 myocytes, respectively. Phosphorylation of three kinases, AMP-activated protein kinase (AMPK), Akt and Glycogen Synthase Kinase-3 (GSK-3) were probed by Western blot. RESULTS M. arboreus extracts/fractions did not stimulate glucose uptake in C2C12 cells albeit 2.2 (Hex) fraction showed a mild positive tendency. In contrast, extract 2 and its fractions as well as extract 3 were able to decrease hepatocyte G6Pase activity. Their effect on G6Pase activity involved both Akt and AMPK phosphorylation. No significant correlation was observed between activation of Akt and inhibition of G6Pase (R2 = 0.50 p < 0.14), whereas that between stimulation of AMPK and inhibition of G6Pase was statistically significant (R2 = 0.75 p < 0.05). On the other hand, extract 2, its fraction 2.2 and extract 3 were able to stimulate GS through GSK-3 phosphorylation. A high correlation was observed between the ability of M. arboreus extracts and fractions to phosphorylate GSK-3 and modulate GS activity (R2=0.81 p < 0.01). Extract 2 and its fraction 2.2 together with extract 3 were the only plant products to simultaneously and potently regulate G6Pase and GS, the key players of hepatic glucose homeostasis. CONCLUSION Overall, these data support the traditional antidiabetic uses of the root bark of M. arboreus.

Phenolic compounds isolated from fermented blueberry juice decrease hepatocellular glucose output and enhance muscle glucose uptake in cultured murine and human cells

BackgroundWe recently reported that blueberry juice fermented (FJ) with Serratia vaccinii bacterium has antidiabetic activities both in vivo and in vitro. The purpose of this project was to elucidate the effect of FJ on glucose homeostasis in liver and skeletal muscle cells and to identify active fractions/compounds responsible for this effect.MethodsFJ was fractionated using standard chromatography procedures. Hepatic (H4IIE, HepG2) and skeletal muscle cells (C2C12) were treated with maximum non-toxic concentrations of FJ, fractions and isolated compounds thereof. Glucose-6-phosphatase (G6Pase) activity was measured using glucose oxidase method. To measure glucose uptake and glycogen synthase (GS) activity, radioactive assays were used.ResultsFractionation of FJ yielded seven fractions. FJ and its phenolic fractions F2, F3-1 and F3-2 respectively inhibited G-6Pase by 31, 45, 51 and 26%; activated GS by 2.3-, 2.3-, 2.2- and 2-fold; and stimulated glucose uptake by 19, 25, 18 and 15%, as compared to DMSO vehicle control. Subfractionation of the active fractions yielded 4 compounds (catechol, chlorogenic, gallic and protocatechuic acid). Catechol, yielding the greatest bioactivity in G6Pase and glucose uptake assays, decreased G6Pase activity by 54%, increased GS by 2-fold and stimulated glucose uptake by 44% at 45.5 μM.ConclusionsThis study identifies novel potential antidiabetic compounds that can help standardize FJ.

Bioactive Phytochemicals from Canadian Boreal Forest Species Used Traditionally by Eastern James Bay Cree Aboriginals to Treat Diabetes Mellitus

Type-2 diabetes mellitus is a chronic metabolic disorder characterized by impaired insulin secretion and sensitivity, and is more pronounced among some indigenous populations due to their transition from traditional to modern diets, as well as their cultural disconnection from modern pharmacological treatment regimes. This is the case for the Cree Nations of Eeyou Istchee (CEI) of northern Quebec, where the age-adjusted prevalence of disease reached 29 %. The Canadian Institutes of Health Research Team in Aboriginal Antidiabetic Medicines is a multidisciplinary team aimed at alleviating the impact of this disease in the CEI by using a culturally adapted approach. A quantitative ethnobotanical study of traditional medicines conducted by our team in collaboration with Healers and Elders resulted in the identification of several potential antidiabetic plants. The crude extracts of these plants were tested in a comprehensive platform of in vitro bioassays designed to detect potential antidiabetic biological activities including: stimulation of glucose uptake in C2C12 muscle cells and potentiation of differentiation of 3T3-L1 pre-adipocytes indicating enhanced insulin sensitivity. These procedures allowed us to identify the most significant species from the biological activity viewpoint, and they were considered for further phytochemical characterization. The present report provides a comprehensive summary of the major biological activities and phytochemistry of these key Canadian boreal forest plants that demonstrated significant ethnobotanical evidence of antidiabetic activity and associated symptoms.

Bioactive Pentacyclic Triterpenes from the Root Bark Extract of Myrianthus arboreus, a Species Used Traditionally to Treat Type-2 Diabetes

Four new Δ12 ursene-type pentacyclic triterpenes containing the trans-feruloyl moiety (1-4), along with ursolic acid (5), were isolated from a Myrianthus arboreus root bark ethanol extract, after bioassay-guided subfractionation of its hexane fraction. The structures of 1-4 were established on the basis of the results of standard spectroscopic analytical methods (IR, HRESIMS, GC-MS, 1D and 2D NMR). The compounds 3β- O- trans-feruloyl-2α,19α-dihydroxyurs-12-en-28-oic acid (1), 2α-acetoxy-3β- O- trans-feruloyl-19α-hydroxyurs-12-en-28-oic acid (3), and 5 were determined to decrease the activity of hepatocellular glucose-6-phosphatase (G6Pase) and to activate glycogen synthase (GS). Their action on G6Pase activity implicated both Akt and AMPK activation. In addition, these compounds were determined to stimulate GS via the phosphorylation of glycogen synthase kinase-3. Compound 3 showed the most potent effect in modulating glucose homeostasis in liver cells. This is the first comprehensive report on novel phytochemical components of the root bark extract of M. arboreus based on the isolation of the principles responsible for its antidiabetic effects.