Receptor and post-receptor abnormalities contribute to insulin resistance in myotonic dystrophy type 1 and type 2 skeletal muscle

PLoS One. 2017 Sep 15;12(9):e0184987. doi: 10.1371/journal.pone.0184987. eCollection 2017.

Abstract

Myotonic dystrophy type 1 (DM1) and type 2 (DM2) are autosomal dominant multisystemic disorders caused by expansion of microsatellite repeats. In both forms, the mutant transcripts accumulate in nuclear foci altering the function of alternative splicing regulators which are necessary for the physiological mRNA processing. Missplicing of insulin receptor (IR) gene (INSR) has been associated with insulin resistance, however, it cannot be excluded that post-receptor signalling abnormalities could also contribute to this feature in DM. We have analysed the insulin pathway in skeletal muscle biopsies and in myotube cultures from DM patients to assess whether downstream metabolism might be dysregulated and to better characterize the mechanism inducing insulin resistance. DM skeletal muscle exhibits alterations of basal phosphorylation levels of Akt/PKB, p70S6K, GSK3β and ERK1/2, suggesting that these changes might be accompanied by a lack of further insulin stimulation. Alterations of insulin pathway have been confirmed on control and DM myotubes expressing fetal INSR isoform (INSR-A). The results indicate that insulin action appears to be lower in DM than in control myotubes in terms of protein activation and glucose uptake. Our data indicate that post-receptor signalling abnormalities might contribute to DM insulin resistance regardless the alteration of INSR splicing.

MeSH terms

  • Adult
  • Aged
  • Aged, 80 and over
  • Alternative Splicing*
  • Antigens, CD* / biosynthesis
  • Antigens, CD* / genetics
  • Female
  • Gene Expression Regulation*
  • Humans
  • Insulin Resistance / genetics*
  • Male
  • Middle Aged
  • Muscle Proteins / genetics
  • Muscle Proteins / metabolism
  • Myotonic Dystrophy* / genetics
  • Myotonic Dystrophy* / metabolism
  • Receptor, Insulin* / biosynthesis
  • Receptor, Insulin* / genetics
  • Signal Transduction*

Substances

  • Antigens, CD
  • Muscle Proteins
  • INSR protein, human
  • Receptor, Insulin

Grants and funding

This work is supported by MDF-Myotonic Dystrophy Foundation and Wyck Foundation Postdoctoral Research Award to LVR, and by FMM-Fondazione Malattie Miotoniche to RC. The Italian Registry for Myotonic Dystrophy Type 1 and Type 2 is funded by the Italian Ministry of Health (RF-2010-2314711) to GM. The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.