A protein in the brain may link smoking and diabetes
Nicotine overrides the communication pathway between the brain and pancreas, causing high glucose levels in rats
by Megha Satyanarayana
OCTOBER 16, 2019 | APPEARED IN VOLUME 97, ISSUE 41
Smokers develop type 2 diabetes 30–40% more often than nonsmokers, and new research suggests that nicotine’s actions in the brain may be to blame.
Experiments in rats suggest that nicotine may needlessly turn on part of the body’s fight-or-flight mechanism, flooding it with useless glucose that would otherwise get used to run, punch, or kick. Over years of cigarette or vape-pen use, those useless glucose bumps wear out the insulin-signaling pathways in cells and eventually lead to diabetes, says Paul J. Kenny, the neuroscientist at the Icahn School of Medicine at Mount Sinai who led the study (Nature 2019, DOI: 10. 1038/s41586-019-1653-x).
Kenny’s team found that the main player in this signaling short circuit is a protein called TCF7L2, which influences two things: the motivation to take nicotine and a conversation between the brain and pancreas.
“It all converges on this one factor, ” Kenny says. “Ultimately, a disease like diabetes may be originating in the brain or may reflect dysregulated brain-body interactions, and I think that’s absolutely fascinating and absolutely terrifying. ” He wonders if other diseases have brain-body connections that can get similarly disrupted.
His team studies a part of the brain called the habenula, which is involved in our stress response and is chock full of nicotinic acetylcholine receptors, which nicotine binds to and activates, giving people a buzz when they smoke. Kenny’s group had previously reported that mutations that seem to lead to nicotine addiction in humans were often found in nicotinic acetylcholine receptors in the habenula.
Credit: Wikipedia/Emw
TCF7L2 is a transcription factor active in the brain and pancreas.
The habenula is also full of TCF7L2, which is a transcription factor that acts as an on-off switch for several genes. Rats missing this transcription factor “consume absolutely horrendous amounts of nicotine, ” Kenny says.
But TCF7L2 is also expressed elsewhere in the body and is associated with type 2 diabetes. People with certain gene sequences for TCF7L2 tend to get diabetes more often than people with other sequences. Kenny says his team thought TCF7L2 might be doing something in both the brain and pancreas to influence the role of nicotine in diabetes. The researchers found that after nicotine exposure, the nicotinic acetylcholine receptors in rats without TCF7L2 were less sensitive than those of normal rats. Under normal conditions, when nicotine or other molecules turn on the receptors, the proteins eventually enter a sleepy state in which the receptors can’t turn back on for some time. In rats without TCF7L2, the receptors couldn’t bounce back from this state as quickly as ones in rats with TCF7L2. Basically, their brains weren’t responding in quite the same way, Kenny says. And in an experiment that traced the path of neurons, the team found that neurons in the pancreas led to the habenula.
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Looking at different genes in the habenula that TCF7L2 is predicted to control, the team found that many were involved in the regulation of glucose metabolism. Given that nicotine is known to cause increases inblood-glucose levels, the team wondered if TCF7L2 might influence this action of nicotine. Lowering levels of TCF7L2 reduced nicotine’s ability to boost blood sugar. And after treating rats for 21 days with nicotine, the team found that the rats missing TCF7L2 had lower blood-sugar levels, suggesting that the transcription factor mediates some diabetes-like symptoms.
Kenny doesn’t think that high blood-glucose levels lead to nicotine addiction. Instead, it’s more likely that all the extra glucose is tamping down the activity of nicotinic acetylcholine receptors, making each puff less effective and leading people to take more puffs. He says one of the next big questions is whether the habenula is playing a role in normal glucose metabolism.
Kenny thinks the link between the stress-response function of the habenula and the nicotine override might lead to diabetes. In an actual fight-or-flight situation, “you’re stressed or you’re frightened, and you need to respond to that, ” he says. “You need to access energy reserves, and this stress affects the pancreas. ” Over time, this regular stress to the pancreas leads to diabetes. TCF7L2 helps regulate all that.
The team is now looking at drugs that modulate TCF7L2 activity directly or indirectly. One is sitagliptin, sold as Januvia. It’s a diabetes drug that prevents the breakdown of a protein called GLP-1, which is associated with TCF7L2. Mice given the drug tend to consume less nicotine, and Kenny says there are some anecdotal data that people taking Januvia stop smoking (Nat. Neurosci. 2017, DOI: 10. 1038/nn. 4540). There are several other drugs in this class, and Kenny thinks these drugs might make an excellent one-two punch in people who have diabetes and may want to stop smoking.
Marina Picciotto, a neuroscientist at Yale School of Medicine who was not involved in the research, says these experiments not only define a new way that the brain communicates with the body and vice versa but also help pinpoint how nicotine and smoking affect metabolism by overtaking this conversation.
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Rats are a fairly reliable model for nicotine use and overuse, she says, but it remains to be seen if the same things are happening in humans. Kenny’s team is looking at large databases of human genetics, searching for people who might have mutations in TCF7L2 and seeing whether they smoke and if they ever developed diabetes.
There are “all sorts of interactions between [TCF7L2], smoking, and diabetes from human genetics data, ” he says. “Nicotine is a major driver of both brain and body diseases. It’s a very problematic drug. ”
A protein in the
brain
may link
smoking
and diabetes
Nicotine overrides the communication pathway between the
brain
and pancreas, causing high glucose
levels
in rats
by
Megha
Satyanarayana
OCTOBER 16, 2019 | APPEARED IN VOLUME 97, ISSUE 41
Smokers develop type 2 diabetes 30–40% more
often
than nonsmokers, and new research suggests that nicotine’s actions in the
brain
may be to blame.
Experiments in rats suggest that nicotine may
needlessly
turn on part of the
body’s
fight-or-flight mechanism, flooding it with useless glucose that would
otherwise
get
used
to run, punch, or kick. Over years of cigarette or vape-pen
use
, those useless glucose bumps wear out the insulin-signaling pathways in cells and
eventually
lead
to diabetes,
says
Paul J. Kenny, the neuroscientist at the Icahn School of Medicine at Mount Sinai
who
led the study (Nature 2019, DOI: 10. 1038/s41586-019-1653-x).
Kenny’s
team
found
that the main player in this signaling short circuit is a protein called TCF7L2, which influences two things: the motivation to take nicotine and a conversation between the
brain
and pancreas.
“It all converges on this one
factor
,
”
Kenny
says
. “
Ultimately
, a disease like diabetes may be originating in the
brain
or may reflect
dysregulated
brain-body interactions, and I
think
that’s
absolutely
fascinating and
absolutely
terrifying. ” He wonders if
other
diseases have brain-body connections that can
get
similarly
disrupted.
His
team
studies a part of the
brain
called the
habenula
, which
is involved
in our
stress
response and is
chock full
of
nicotinic
acetylcholine receptors, which nicotine binds to and activates, giving
people
a buzz when they smoke. Kenny’s group had previously reported that mutations that seem to
lead
to nicotine addiction in
humans
were
often
found
in
nicotinic
acetylcholine receptors in the
habenula
.
Credit: Wikipedia/
Emw
TCF7L2 is a
transcription
factor
active in the
brain
and pancreas.
The
habenula
is
also
full of TCF7L2, which is a
transcription
factor
that acts as an on-off switch for several genes. Rats missing this
transcription
factor
“consume
absolutely
horrendous amounts of nicotine,
”
Kenny says.
But
TCF7L2 is
also
expressed elsewhere in the
body
and
is associated
with type 2 diabetes.
People
with certain gene sequences for TCF7L2 tend to
get
diabetes more
often
than
people
with
other
sequences. Kenny
says
his
team
thought
TCF7L2
might
be doing something in both the
brain
and pancreas to influence the role of nicotine in diabetes. The researchers
found
that after nicotine exposure, the
nicotinic
acetylcholine receptors in rats without TCF7L2 were less sensitive than those of normal rats. Under normal conditions, when nicotine or
other
molecules turn on the receptors, the proteins
eventually
enter a sleepy state in which the receptors can’t turn back on for
some
time. In rats without TCF7L2, the receptors couldn’t bounce back from this state as
quickly
as
ones
in rats with TCF7L2.
Basically
, their
brains
weren’t responding in quite the same way, Kenny
says
. And in an experiment that traced the path of neurons, the
team
found
that neurons in the pancreas led to the
habenula
.
ADVERTISEMENT
SCROLL TO CONTINUE WITH CONTENT
Looking at
different
genes in the
habenula
that TCF7L2
is predicted
to control, the
team
found
that
many
were involved
in the regulation of glucose metabolism.
Given
that nicotine
is known
to cause increases
inblood-glucose
levels
, the
team
wondered if TCF7L2
might
influence this action of nicotine. Lowering
levels
of TCF7L2
reduced
nicotine’s ability to boost blood sugar. And after treating rats for 21 days with nicotine, the
team
found
that the rats missing TCF7L2 had lower blood-sugar
levels
, suggesting that the
transcription
factor
mediates
some
diabetes-like symptoms.
Kenny doesn’t
think
that high blood-glucose
levels
lead
to nicotine addiction.
Instead
, it’s more likely that all the extra glucose is tamping down the activity of
nicotinic
acetylcholine receptors, making each puff less effective and leading
people
to take more puffs. He
says
one of the
next
big
questions is whether the
habenula
is playing a role in normal glucose metabolism.
Kenny
thinks
the link between the
stress
-response function of the
habenula
and the nicotine override
might
lead
to diabetes. In an actual fight-or-flight situation, “you’re
stressed
or you’re frightened, and you need to respond to that,
”
he
says
. “You need to access energy reserves, and this
stress
affects the pancreas. ” Over time, this regular
stress
to the pancreas leads to diabetes. TCF7L2
helps
regulate all that.
The
team
is
now
looking at
drugs
that modulate TCF7L2 activity
directly
or
indirectly
. One is
sitagliptin
, sold as
Januvia
. It’s a diabetes
drug
that
prevents
the breakdown of a protein called GLP-1, which
is associated
with TCF7L2. Mice
given
the
drug
tend to consume less nicotine, and Kenny
says
there are
some
anecdotal data that
people
taking
Januvia
stop
smoking
(Nat.
Neurosci
. 2017, DOI: 10. 1038/
nn
. 4540). There are several
other
drugs
in this
class
, and Kenny
thinks
these
drugs
might
make
an excellent one-two punch in
people
who
have diabetes and may want to
stop
smoking.
Marina
Picciotto
, a neuroscientist at Yale School of Medicine
who
was not involved in the research,
says
these experiments not
only
define a new way that the
brain
communicates with the
body
and vice versa
but
also
help
pinpoint how nicotine and
smoking
affect metabolism by overtaking this conversation.
SPONSORED CONTENT
New, Safer Automated Analysis of Ethylene Oxide
by
Metrohm
Rats are a
fairly
reliable model for nicotine
use
and overuse, she
says
,
but
it remains to be
seen
if the same things are happening in
humans
. Kenny’s
team
is looking at large databases of
human
genetics, searching for
people
who
might
have mutations in TCF7L2 and seeing whether they smoke and if they ever developed diabetes.
There are “all sorts of interactions between [TCF7L2],
smoking
, and diabetes from
human
genetics data,
”
he
says
. “Nicotine is a major driver of both
brain
and
body
diseases. It’s a
very
problematic
drug
. ”