臨牀透析 Vol.17 No.1(1-3)


特集名 糖尿病性腎症の最前線
題名 インスリン作用 -- 最近の話題
発刊年月 2001年 01月
著者 小川 渉 神戸大学医学部第二内科
【 要旨 】 生体工学的手法により作製された各種の遺伝子欠損マウスの解析から,各臓器におけるインスリン抵抗性と生体レベルでの代謝異常の関連が明らかになりつつある.インスリン受容体を骨格筋特異的に欠損したマウスでは耐糖能に変化が生じないが,肝のインスリン受容体の欠損では,食後に顕著な血糖上昇が起こる.β細胞特異的インスリン受容体欠損マウスの解析から,グルコース依存性のインスリン分泌にインスリン受容体のシグナルが関与する可能性が示された.IRS-1欠損マウスやIRS-2欠損マウスはインスリン抵抗性を呈するが,前者は骨格筋に,後者は肝に顕著なインスリン抵抗性が生じる.IRS-3を単独で欠損させても糖代謝に影響は生じないが,IRS-1とIRS-3をともに欠損させると,脂肪細胞の形成障害と強いインスリン抵抗性が生じる.IRS-4欠損マウスでは軽度の耐糖能障害を認めるが,いずれの臓器におけるシグナルの障害を反映するかは明らかではない.
Theme Forefront of Diabetic Nephropathy
Title Insulin action -- Current topics
Author Wataru Ogawa Second Department of Internal Medicine, Kobe University School of Medicine
[ Summary ] Recently, various mouse models, in which genes involved in insulin signaling disruption have been created. These mouse models help us to understand the impact of insulin resistance on those tissues associated with the development of imbalances in energy homeostasis. With the use of Cre-loxP-mediated gene recombination, various tissue-specific insulin receptor knockout mice have been produced. Muscle-specific disruption of the insulin receptor gene did not lead to any alteration in glucose homeostasis. Liver-specific insulin receptor knockout mice exhibited insulin resistance, with mild hyperglycemia, in a fasting state and marked postprandial hyperglycemia. Moreover, analysis of beta cell-specific insulin receptor knockout mice reveled that signals transmitted through the insulin receptor were involved in glucose-induced insulin secretion in beta cells. Both IRS-1 and IRS-2 knockout mice showed insulin resistance; the former exhibited more severe insulin resistance in muscle tissue, whereas the latter were in the liver. Although disruption of the IRS-3 gene did not affect either morphology of adipocytes or glucose homeostasis in vivo, IRS-1/IRS-3 double knockout mice exhibited severe reduction in adipocyte mass, as well as marked insulin resistance and glucose intolerance. Disruption of the IRS-4 gene lead to mild glucose intolerance. It is not currently known which signal disuption, in which organ, reflects the phenotype.
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