Evaluating the antidiabetic effects of R-verapamil in type 1 and type 2 diabetes mellitus mouse models

PLoS One. 2021 Aug 6;16(8):e0255405. doi: 10.1371/journal.pone.0255405. eCollection 2021.

Abstract

The global incidence of diabetes mellitus (DM) is increasing. Types 1 and 2 DM are associated with declining β-cell function. Verapamil (50% S-verapamil and 50% R-verapamil) can treat DM by downregulating thioredoxin-interacting protein (TXNIP), which induces islet β-cell apoptosis. However, it may also induce cardiovascular side effects as S-verapamil is negatively inotropic. In contrast, R-verapamil only weakly induces adverse cardiac effects. In this study, we aimed to determine the antidiabetic efficacy and cardiovascular safety of R-verapamil. We examined R- and S-verapamil binding through in vitro studies. Streptozotocin-induced type 1 and db/db type 2 DM mouse models were used to assess the antidiabetic efficacy of verapamil. IL-6, blood glucose (BG), Txnip expression, and β-cells were evaluated in streptozotocin-induced diabetic mice, while body weight, BG, and serum insulin were measured in the db/db mice. In the type 1 DM study, 100 mg/kg/day R-verapamil and racemic verapamil lowered BG, downregulated Txnip expression, and reduced β-cell apoptosis. In the type 2 DM study, the optimal R-verapamil dosage was 60 mg/kg/day and it lowered BG and raised serum insulin. However, efficacy did not increase with R-verapamil dosage. R-verapamil combined with metformin/acarbose improved BG and serum insulin more effectively than metformin/acarbose alone or verapamil combined with acarbose. R-verapamil had weaker cardiovascular side effects than S-verapamil. R-verapamil was 9.0× and 3.4× less effective than S-verapamil at inhibiting atrial inotropy and ileal contractility, respectively. It was also 8.7× weaker than S-verapamil as an agonist of somatostatin receptor type 2 (SSTR2), inhibiting ileal neurogenic contraction. Hence, R-verapamil may be an optimal DM treatment as it is safe, improves glycemic control, and preserves β-cell function both as monotherapy and in combination with metformin or acarbose. R-Verapamil has potential for delaying or arresting DM progression and improving patients' quality of life.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Diabetes Mellitus, Experimental*
  • Diabetes Mellitus, Type 2
  • Hypoglycemic Agents*
  • Male
  • Mice
  • Quality of Life

Substances

  • Hypoglycemic Agents

Grants and funding

Center Laboratories Inc. was the funder for described experiments and publication. Center Laboratories Inc. provided support in the form of salaries for authors Yu-Syuan Chen, Meng-Ju Lee, Rou-Ying Li, Guang-Tzuu Shane, Jui- Pao Hsu, Ai-Ching Chang and Shu-Hsien Chang, but did not have any additional role in the study design, data collection and analysis, decision to publish, or preparation of the manuscript. Lumosa Therapeutics Co. was the commercial affiliation of Center Laboratories Inc. but was not the funder for described experiments and publication. Lumosa Therapeutics Co. only provided support in the form of salaries for authors Shao-Ju Weng and Sheng-Wen Yeh, who assisted with the statistical analysis and the interpretation of data. The specific roles of these authors are articulated in the ‘author contributions’ section.