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Biomedical subjects

A H Rubenstein

Publications and source records attributed to A H Rubenstein.

At least 91 records · Page 5Linked to original sources
PubMed1982

Surface receptors for pancreatic hormones in dog and rat hepatocytes: qualitative and quantitative differences in hormone-target cell interactions.

In order to evaluate potential differences in the kinetics of peptide hormone-receptor interactions in hepatocytes of different species, we developed a simple procedure for the isolation of canine hepatocytes. Cells (obtained by collagenase perfusion of an extirpated dog liver lobe) were isolated with uniform high viability and yield. In addition, isolated dog hepatocytes tolerated incubation for at least 4 hr in defined medium with only a slight decrease in viability and with no change in the kinetics of [125I]iodoinsulin or [125I]iodoglucagon binding to cell-surface receptors. Comparisons of peptide hormone interactions with isolated dog and rat hepatocytes showed that (i) [125I]iodoglucagon associated with specific membrane receptors more rapidly than did [125I]iodoinsulin, for both rat and dog hepatocytes and at both 30 degrees C and 37 degrees C; (ii) the steady-state binding of [125I]iodoglucagon at 30 degrees C was greater than that of [125I]iodoinsulin in dog hepatocytes, but the reverse relationship held in rat hepatocytes; (iii) the rate of dissociation of [125I]iodoinsulin from hepatocytes of both species was enhanced by the presence of the unlabeled hormone, whereas the rate of dissociation of receptor-bound [125I]iodoglucagon was enhanced by the presence of unlabeled glucagon only in hepatocytes derived from the dog; and (iv) [125I]iodopancreatic polypeptide bound to neither rat nor dog hepatocytes, although the [125I]iodotyrosylated peptide bound to rat hepatocytes with an unusually high apparent dissociation constant. While confirming essential findings of pancreatic hormone binding to isolated hepatocytes, this comparison suggests that both qualitative and quantitative aspects of hormone-target cell interactions can show interspecies variability.

Animals↗
PubMed1982

Central control of peripheral circulating somatostatin in dogs: effect of 2-deoxyglucose.

Circulating plasma somatostatin concentrations are known to fluctuate in response to nutrients and hormones. However, little is known about neural or central nervous system (CNS) control of somatostatin secretion. To test whether peripheral circulating somatostatin is influenced by a central stimulus, 2-deoxyglucose (37.5 mg/kg) was infused into a lateral cerebral ventricle of six conscious dogs over a period of 15 min. Plasma somatostatin levels rose from a base line of 105 +/- 6 pg/ml (mean +/- SE) to a peak of 154 +/- 10 pg/ml (P less than 0.005) at 30 min after the onset of the infusion. Somatostatin levels were still significantly elevated (P less than 0.025) at 60 min (119 +/- 6 pg/ml) and thereafter gradually returned toward base line. Plasma glucose and glucagon levels increased in response to intraventricular 2-deoxyglucose. Glucose concentrations rose from 105 +/- 5 mg/dl to peak at 203 +/- 16 mg/dl (P less than 0.005) at 80 min and remained elevated to 120 min. The concentration of plasma glucagon increased from 41 +/- 6 to 92 +/- 18 pg/ml at 60 min (P less than 0.05) and then declined. In marked contrast to intraventricular 2-deoxyglucose, similar concentrations of 2-deoxyglucose administered intravenously (n = 4) resulted in a slight fall in plasma somatostatin. Intraventricular saline did not result in a change in plasma somatostatin. It is concluded that peripheral circulating somatostatin may be susceptible to central nervous system control.

Animals↗
PubMed1982

Improvement of insulin secretion but not insulin resistance after short term control of plasma glucose in obese type II diabetics.

Insulin secretion and insulin resistance were examined in seven obese type II diabetics before and after control of plasma glucose levels without weight loss. Control was achieved by regular insulin injection (60-205 U/day in four doses). After 10 days of therapy, plasma insulin and C-peptide responses to oral glucose were significantly improved. Insulin-induced glucose rates, estimated by the glucose clamp technique, averaged 1.08 +/- 0.30 mg/kg. min (mean +/- SEM; n = 7) before treatment and were unchanged (1.08 +/- 0.25) after treatment. These indicate that short term control of plasma glucose improved insulin secretion but not insulin sensitivity. The impaired insulin secretion and insulin sensitivity in type II diabetics appears to be, in part, secondary to metabolic abnormalities associated with hyperglycemia.

Adult↗
PubMed1982

Insulin resistance and diabetes due to a genetic defect in insulin receptors.

A 14-yr-old woman presented with fasting hyperglycemia (269 mg/dl), fasting hyperinsulinemia (45 microU/ml), acanthosis nigricans, and insulin resistance. The patient's circulating insulin was normal by physical and biological criteria, and insulin receptor antibodies were not detected. Both the patient's in vivo dose-response curve for insulin-stimulated glucose transport in isolated adipocytes were shifted to the right and showed marked decreases in the maximal insulin response. Basal hepatic glucose output was significantly increased, and the in vivo dose-response curve for insulin-mediated suppression of basal hepatic glucose output was shifted to the right. Insulin binding to the patient's erythrocytes, monocytes, and adipocytes was markedly decreased. To confirm that the severe reduction in cellular insulin receptors was a primary rather than an acquired defect, similar studies were conducted using cultured fibroblasts. No detectable binding of insulin to these cells was observed. Further studies showed that the patient's mother and two sisters were hyperinsulinemic and insulin resistant, and had comparable, although less severe, changes in insulin binding. The patient was also demonstrated to have an insulin secretory defect both to both oral and iv glucose challenges. We thus conclude that this family demonstrates a genetic deficiency of insulin receptors, resulting in insulin resistance and, in this patient, severe diabetes mellitus.

Adipose Tissue↗
PubMed1982

Nonspecific blinding of insulin to gamma globulin in the serum of black patients with hepatocellular carcinoma and other forms of liver disease.

The study was prompted by the apparent detection of insulin antibodies in a black patient with HCC and recurrent hypoglycemia who had never received insulin. It consisted of two parts. Initially the sera of 30 individuals (six normoglycemic HCC patients, three with HCC and recurrent hypoglycemia, 11 patients with noncancerous liver diseases, and 10 healthy black controls) were analyzed for the presence of insulin (and glucagon) antibodies by precipitating the bound, labeled hormone with ethanol and also by the technique of radioimmunoelectrophoresis. In the nine HCC patients, binding of 125I-insulin averaged 13% by ethanol separation and 0.018 mU/ml with radioimmunoelectrophoresis, levels that were similar to those of patients with noncancerous liver disease and significantly higher than those of the healthy controls. Mean binding of 125I-glucagon was 11% in HCC sera. Serum binding of labeled hormones correlated significantly with IgG concentrations in the patients. The second part of the study attempted to define the nature of insulin binding in HCC and other forms of liver disease. After confirmation of the increased serum binding of labeled insulin by another method of precipitation, PEG, an attempt was made to compete with the labeled insulin for its serum binding sites by adding a large amount of unlabeled insulin. This binding was not displaceable, however, and was therefore considered nonspecific. When the same procedures were repeated using normal serum to which increasing amounts of gamma globulin were added, the nonspecific binding of insulin increased in a linear fashion. Furthermore, a similar degree of high nonspecific insulin binding occurred in six patients with multiple myeloma and raised serum IgG concentrations. We therefore conclude that in the many clinical situations where hypergammaglobulinemia exists, false positive tests for the detection of antibodies against insulin (and probably other peptide hormones) will emerge unless appropriate methods are used to check for nonspecific peptide binding.

Black People↗
PubMed1982

Hypoglycemic peripheral neuropathy in association with insulinoma: implication of glucopenia rather than hyperinsulinism. Case report and literature review.

A syndrome of peripheral polyneuropathy associated with islet cell tumors and hypoglycemia has been reported in 28 patients. Despite varying features in these patients, the clinical characteristics of this syndrome are remarkably similar. These consist of the development of a sensorimotor neuropathy during a protracted course of recurrent severe hypoglycemia, related to underlying insulinoma. Cerebral symptoms dominate the clinical picture and a predominantly or entirely motor, distal and symmetric, peripheral neuropathy ensures. Upper limb involvement is more frequent, accompanied by severe weakness and distal wasting, usually without fasciculations. Painful distal paresthesias without objective sensory loss are characteristic. Direct relationship to a single hypoglycemic insult is often absent. This report describes the clinical features and laboratory investigation of a new case with this condition, reviews the literature and discusses the syndrome with special regard to the etiology.

Adenoma, Islet Cell↗
PubMed1982

Insulin resistance and insulin receptors in hepatic cirrhosis.

To explore the influence of extrahepatic factors in the pathogenesis of insulin resistance in hepatic cirrhosis, we studied 125I-insulin binding to erythrocytes and monocytes of 14 clinically stable cirrhotic individuals and compared the results with a normal control group. All patients had fasting normoglycemia at the time of the study but abnormal glucose tolerance was detected in 7 of 9 cirrhotic patients after an oral glucose load. Seven patients (group N) had normal fasting serum insulin levels, and 7 patients (group H) manifested fasting hyperinsulinemia. However, all patients had elevated insulin levels after oral glucose. Insulin binding to erythrocytes was significantly decreased in both cirrhotic subgroups; monocyte studies in 5 hyperinsulinemic patients revealed a similar decrease in binding. Scatchard analysis in monocytes suggests that this decreased binding is secondary to a decrease in the receptor number per cell. No correlation between insulin binding and fasting plasma insulin, glucagon, or growth hormone levels was seen. Sera from 4 patients were examined for the presence of a non-specific inhibitor of insulin binding, but no evidence for such a factor was found. We conclude that the decrease in insulin binding is mediated in the monocyte by a reduction of receptor concentration; in the erythrocyte the mechanism for decreased binding could not be clearly delineated. The insulin resistance seen in cirrhosis may result in part from decreased binding of insulin to target tissues; an additional postreceptor defect cannot be excluded in hyperinsulinemic individuals.

Adult↗
PubMed1981

Prenatal assessment of fetal outcome by amniotic fluid C-peptide levels in pregnant diabetic women.

Amniotic fluid C-peptide (AFCP), insulin, and glucose levels were measured in 33 diabetic and 126 nondiabetic pregnant women at greater than or equal to 36 weeks' gestation. Levels of AFCP distinguished diabetic from nondiabetic patients more reliably than amniotic fluid (AF) insulin or glucose. Levels of AFCP in diabetic patients correlated well with infant birth weight adjusted for gestational age (large for gestational age greater than adequate for gestational age), degree of diabetic control (fair to poor control greater than good control), or diabetogenic infant morbidity, but did not correlate with classes of diabetes within the limits of the population studied. We conclude that AFCP is a useful prognostic index for predicting fetal outcome in diabetic pregnancies. A level of AFCP of greater than or equal to 1.0 pmoles/ml is associated with an increased risk of macrosomia in infants of diabetic mothers.

Adult↗
PubMed1981

Relationship between negative cooperativity and insulin action.

We have compared the respective abilities of porcine insulin and [LeuB25]insulin to enhance the rate of dissociation of receptor-bound [125I]insulin from IM-9 lymphocytes and isolated rat adipocytes and to increase the rate of adipocyte glucose transport and oxidation. Although porcine insulin (100 ng/mL) greatly enhanced the dissociation rate of previously bound [125I]insulin, [LeuB25]insulin (at a concentration yielding equivalent receptor occupancy) had no effect. Nevertheless, the analogue fully stimulated adipocyte glucose transport and oxidation at concentrations consistent with its reduced (1.7% of normal) intrinsic binding affinity. Activation of glucose transport by the analogue was rapid, and the corresponding rate of activation was indistinguishable from that produced by native insulin. The increased dissociation rate observed with increasing receptor occupancy by native porcine insulin has been interpreted as evidence for negative cooperative site-site interactions between occupied receptors. According to this formulation, [LeuB25]insulin is a "noncooperative" insulin analogue. Since this [LeuB25]insulin retains full biologic activity, the enhancement of the insulin dissociation rate at high levels of receptor occupancy does not reflect a phenomenon inherent in insulin's action to augment glucose metabolism.

3-O-Methylglucose↗
PubMed1981

Amniotic fluid C-peptide as an index for intrauterine fetal growth.

Amniotic fluid C-peptide (AFCP) was monitored as an indicator of the amount of insulin secreted by the fetus in utero. Levels of amniotic fluid and cord blood C-peptide, insulin, and glucose were measured in 103 nondiabetic infants at greater than or equal to 36 weeks's gestation. Infants were grouped according to birth weight and gestational age at delivery, as follows: small gestational age (SGA, less than or equal to 10%, n = 11), average for gestational age (AGA, 10% to 90%, n = 75), large for gestational age (LGA, greater than 90%, n = 17). AFCP correlated best with infant weight-gestational age percentile classification: low AFCP in SGA infants and high AFCP in LGA infants. The data from this study suggest that a persistently low production of insulin by SGA fetuses and a high production of insulin by LGA fetuses may lead to the different intrauterine growth rates observed.

Amniotic Fluid↗
PubMed1981

Human leukocyte interferon treatment of two children with insulin dependent diabetes.

Two patients with newly diagnosed insulin dependent diabetes mellitus were treated with human leukocyte interferon based on the hypothesis that the diabetes was induced by an active viral infection in the pancreatic islets and could be arrested. High peak levels of serum interferon were achieved (100-200 U/ml) with minimal systemic side effects. There was no sustained therapeutic benefit as measured by increased production of endogenous insulin, or of C-peptide, or by a lower requirement for exogenous insulin. Further trials with interferon treatment should be undertaken only if evidence of active viral infection (culture, antigen detection) can be associated with insulin dependent diabetes onset and these markers followed during treatment.

Blood Glucose↗