@phdthesis{Kodandaraman2021,
  author    = {Kodandaraman, Geema},
  title     = {Influence of insulin-induced oxidative stress in genotoxicity and disease},
  doi       = {10.25972/OPUS-24200},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-242005},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2021},
  abstract  = {Hormones are essential components in the body and their imbalance leads to pathological consequences. T2DM, insulin resistance and obesity are the most commonly occurring lifestyle diseases in the past decade. Also, an increased cancer incidence has been strongly associated with obese and T2DM patients. Therefore, our aim was to study the influence of high insulin levels in accumulating DNA damage in in vitro models and patients, through the induction of oxidative stress. The primary goal of this study was to analyze the genotoxicity induced by the combined action of two endogenous hormones (insulin and adrenaline) with in vitro models, through the induction of micronuclei and to see if they cause an additive increase in genomic damage. This is important for multifactorial diseases having high levels of more than one hormone, such as metabolic syndrome and conditions with multiple pathologies (e.g., T2DM along with high stress levels). Furthermore, the combination of insulin and the pharmacological inhibition of the tumor suppressor gene: PTEN, was to be tested in in vitro models for their genotoxic effect and oxidative stress inducing potential. As the tumor suppressor gene: PTEN is downregulated in PTEN associated syndromes and when presented along with T2DM and insulin resistance, this may increase the potential to accumulate genomic damage. The consequences of insulin action were to be further elucidated by following GFP-expressing cells in live cell-imaging to observe the ability of insulin, to induce micronuclei and replicative stress. Finally, the detrimental potential of high insulin levels in obese patients with hyperinsulinemia and pre-diabetes was to be studied by analyzing markers of oxidative stress and genomic damage. In summary, the intention of this work was to understand the effects of high insulin levels in in vitro and in patients to understand its relevance for the development of genomic instability and thus an elevated cancer risk.},
  subject      = {Insulin},
  language  = {en}
}
@phdthesis{Joseph2011,
  author    = {Joseph, Julie},
  title     = {Studying the role of Th17 cells in autoimmune diabetes and generation of a beta cell reporter mouse by lentiviral transgenesis},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-66571},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2011},
  abstract  = {Type 1 diabetes affects around 0.5\% of the population in developed countries and the incidence rates have been rising over the years. The destruction of beta cells is irreversible and the current therapy available to patients only manages the symptoms and does not prevent the associated pathological manifestations. The patients need lifelong therapy and intensive research is being carried out to identify ways to eliminate autoimmune responses directed against pancreatic beta cells and to replace or regenerate beta cells. The work presented herein aimed at analyzing the role of the Th17 T cell subset, characterized by secretion of the pro- inflammatory cytokine IL-17A, in autoimmune diabetes and also at generating a beta cell reporter mouse line in the NOD background, the most widely- used mouse model for type 1 diabetes. We generated IL- 17A knockdown (KD) NOD mice, using RNAi in combination with lentiviral transgenesis. We analyzed diabetes frequency in IL-17A deficient mice and found that the loss of IL-17A did not protect the transgenic mice from diabetes. Based on these observations, we believe that Th17 cells do not play a critical role in type 1 diabetes through the IL-17A pathway, though they might still be involved in the disease process through alternate pathways. We also generated NOD and NOD-SCID mice with a transgene that drives the beta cell specific expression of a luciferase reporter gene. We used a lentiviral construct, which combined a luciferase sequence and a short- hairpin RNA (shRNA) expression cassette, allowing gene- knockdown under the beta cell specific rat insulin promoter (RIP). These mice will be of use in studying beta cell phenotypes resulting from the knockdown of target genes, using non- invasive bioimaging. We believe that the generation of these reporter mouse lines for diabetes studies will prove valuable in future investigations. Furthermore, the demonstration that the loss of IL-17A does not alter susceptibility to type 1 diabetes should help clarify the controversial involvement of Th17 cells in this disease.},
  subject      = {Diabetes mellitus},
  language  = {en}
}
@phdthesis{Eman2013,
  author    = {Eman, Maher Othman Sholkamy},
  title     = {In Vitro and In Vivo Analysis of Insulin-Induced Oxidative Stress and DNA Damage},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-69274},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2013},
  abstract  = {Hyperinsulinemia, a condition with excessively high insulin blood levels, is related to an increased cancer incidence. Diabetes mellitus, metabolic syndrome, obesity and polycystic ovarian syndrome are the most common of several diseases accompanied by hyperinsulinemia. Since an elevated cancer risk especially for colon and kidney cancers, was reported for those patients, we investigated for the first time the induction of genomic damage by insulin mainly in HT29 (human colon cells), LLC-PK1 (pig kidney cells), HK2 (human kidney cells) and peripheral lymphocytes, and to confirm the genotoxicity of insulin in other cells from different tissues. To ascertain that the insulin effects were not only limited to permanent cell lines, rat primary colon, kidney, liver and fatty tissue cells were also studied. To connect the study and the findings to in vivo conditions, two in vivo models for hyperinsulinemia were used; Zucker diabetic fatty rats in a lean and diabetic state infused with different insulin concentrations and peripheral lymphocytes from type 2 diabetes mellitus patients. First, the human colon adenocarcinoma cells (HT29) showed significant elevation of DNA damage using comet assay and micronucleus frequency analysis upon treatment with 5 nM insulin in standard protocols. Extension of the treatment to 6 days lowered the concentration needed to reach significance to 0.5-1 nM. Insulin enhanced the cellular ROS production as examined by the oxidation of the dyes 2´,7´-dichlorodihydrofluorescein diacetate (H2DCF-DA) and dihydroethidium (DHE). The FPG modified comet assay and the reduction of damage by the radical scavenger tempol connected the insulin-mediatedDNA damage to ROS production. To investigate the sources of ROS upon insulin stimulation, apocynin and VAS2870 as NADPH oxidase inhibitors and rotenone as mitochondrial inhibitor were applied in combination with insulin and all of them led to a reduction of the genomic damage. Investigation of the signaling pathway started by evaluation of the binding of insulin to its receptor and to the IGF-1 receptor. The results showed the involvement of both receptors in the signaling mechanism. Following the activation of both receptors, PI3K activation occurs leading to phosphorylation of AKT which in turn activates two pathways for ROS production, the first related to mitochondria and the second through activation of Rac1 , resulting in the activation of Nox1. Both pathways could be activated through AKT or through the mitochondrial ROS which in turn could activates Nox1. Studying another human colon cancer cell line, Caco-2 and rat primary colon cells in vitro confirmed the effect of insulin on cellular chromatin. We conclude that pathophysiological levels of insulin can cause DNA damage in colon cells, which may contribute to the induction or progression of colon cancer. Second, in kidney cells, insulin at a concentration of 5 nM caused a significant increase in DNA damage in vitro. This was associated with the formation of reactive oxygen species (ROS). In the presence of antioxidants, blockers of the insulin and IGF-1 receptors, and a phosphatidylinositol 3-kinases (PI3K) inhibitor, the insulin mediated DNA damage was reduced. Phosphorylation of AKT was increased and p53 accumulated. Inhibition of the mitochondrial and NADPH oxidase related ROS production reduced the insulin mediated damage. In primary rat cells insulin also induced genomic damage. HK2 cells were used to investigate the mechanistic pathway in the kidney The signaling is identical to the one in the colon cells untill the activation of the mitochondrial ROS production, because after the activation of PI3K activation of Nox4 occurs at the same time across talk between mitochondria and Nox4 activation has been suggested and might play a role in the observed effects. In the in vivo model, kidneys from healthy, lean ZDF rats, which were infused with insulin to yield normal or high blood insulin levels, while keeping blood glucose levels constant, the amounts of ROS and p53 were elevated in the high insulin group compared to the control level group. ROS and p53 were also elevated in diabetic obese ZDF rats. The treatment of the diabetic rats with metformin reduced the DNA oxidation measured as 8-oxodG as well as the ROS production in that group. HL60 the human premyelocytic cells and cultured lymphocytes as models for the hemopoietic system cells showed a significant induction for DNA damage upon treatment with insulin. The diabetic patients also exhibited an increase in the micronucleus formation over the healthy individuals. In the present study, we showed for the first time that insulin induced oxidative stress resulting in genomic damage in different tissues, and that the source of the produced ROS differs between the tissues. If the same mechanisms are active in patients, hyperinsulinemia might cause genomic damage through the induction of ROS contributing to the increased cancer risk, against which the use of antioxidants as well as mitochondrial and NADPH oxidase inhibitors might exert protective effects with cancer preventive potential under certain conditions. Normal healthy human plasma insulin concentrations are in the order of 0.04 nM after overnight fasting and increase to less than about 0.2 nM after a meal. Pathophysiological levels can reach 1 nM and can stay above 0.2 nM for the majority of the daytime yielding condictions close to the insulin concentrations determined in the present study. Whether the observed effects also occur in vivo and whether they actually initiate or promote tumor formation remains to be determined. However, if proof of that can be obtained, our experiments with inhibitors indicate chances for pharmacological intervention applying antioxidants or enzyme inhibitors. It will not be the aim to reduce ROS in any case or as much as possible because ROS have now been recognized as important signaling molecules and participatants in immune defense, but a reduction to physiological levels instead of pathophysiological levels in the context of a disease associated with ROS overproduction might be beneficial.},
  subject      = {Insulin},
  language  = {en}
}
@phdthesis{Awad2019,
  author    = {Awad, Eman Da'as},
  title     = {Modulation of insulin-induced genotoxicity in vitro and genomic damage in gestational diabetes},
  doi       = {10.25972/OPUS-16186},
  url       = {http://nbn-resolving.de/urn:nbn:de:bvb:20-opus-161866},
  school      = {Universit{\"a}t W{\"u}rzburg},
  year      = {2019},
  abstract  = {Diabetes mellitus is a global health problem, where the risk of diabetes increases rapidly due to the lifestyle changes. Patients with type II diabetes have many complications with increased risk of morbidity and mortality. High levels of insulin may lead to DNA oxidation and damage. Several studies proposed that hyperinsulinemia may be an important risk factor for various types of cancer. To investigate insulin signaling pathway inducing oxidative stress and genomic damage, pharmaceutical and natural compounds which can interfere with the insulin pathway including PI3K inhibitors, resveratrol, lovastatin, and RAD-001 were selected due to their beneficial effects against metabolic disorder. Thus, the anti-genotoxic potential of these compounds regarding insulin-mediated oxidative stress were investigated in normal rat kidney cells in vitro. Our compounds showed protective effect against genotoxic damage and significantly decreased reactive oxygen specious after treatment of cells with insulin with different mechanisms of protection between the compounds. Thus, these compounds may be attractive candidates for future support of diabetes mellitus therapy. Next, we explored the link between gestational diabetes mellitus and genomic damage in cells derived from human blood. Moreover, we investigated the influence of estradiol, progesterone, adrenaline and triiodothyronine on insulin-induced genomic damage in vitro. First, we studied the effect of these hormones in human promyelocytic leukemia cells and next ex vivo with non-stimulated and stimulated peripheral blood mononuclear cells. In parallel, we also measured the basal genomic damage using three conditions (whole blood, non-stimulated and stimulated peripheral blood mononuclear cells) in a small patient study including non-pregnant controls with/without hormonal contraceptives, with a subgroup of obese women, pregnant women, and gestational diabetes affected women. A second-time point after delivery was also applied for analysis of the blood samples. Our results showed that GDM subjects and obese individuals exhibited higher basal DNA damage compared to lower weight nonpregnant or healthy pregnant women in stimulated peripheral blood mononuclear cells in both comet and micronucleus assays. On the other hand, the DNA damage in GDM women had decreased at two months after birth. Moreover, the applied hormones also showed an influence in vitro in the enhancement of the genomic damage in cells of the control and pregnant groups but this damage did not exceed the damage which existed in obese and gestational diabetes mellitus patients with high level of genomic damage. In conclusion, insulin can induce genomic damage in cultured cells, which can be modulated by pharmaceutical and naturals substances. This may be for future use in the protection of diabetic patients, who suffer from hyperinsulinemia during certain disease stages. A particular form of diabetes, GDM, was shown to lead to elevated DNA damage in affected women, which is reduced again after delivery. Cells of affected women do not show an enhanced, but rather a reduced sensitivity for further DNA damage induction by hormonal treatment in vitro. A potential reason may be an existence of a maximally inducible damage by hormonal influences.},
  subject      = {Gestationsdiabetes},
  language  = {en}
}