Identification and characterization of a small molecule AMPK activator that treats key components of type 2 diabetes and the metabolic syndrome.

AMP-activated protein kinase (AMPK) is a key sensor and regulator of intracellular and whole-body energy metabolism. We have identified a thienopyridone family of AMPK activators. A-769662 directly stimulated partially purified rat liver AMPK (EC50 = 0.8 microM) and inhibited fatty acid synthesis in primary rat hepatocytes (IC50 = 3.2 microM). Short-term treatment of normal Sprague Dawley rats with A-769662 decreased liver malonyl CoA levels and the respiratory exchange ratio, VCO2/VO2, indicating an increased rate of whole-body fatty acid oxidation. Treatment of ob/ob mice with 30 mg/kg b.i.d. A-769662 decreased hepatic expression of PEPCK, G6Pase, and FAS, lowered plasma glucose by 40%, reduced body weight gain and significantly decreased both plasma and liver triglyceride levels. These results demonstrate that small molecule-mediated activation of AMPK in vivo is feasible and represents a promising approach for the treatment of type 2 diabetes and the metabolic syndrome.

[1]  B. Viollet,et al.  The AMP-activated protein kinase alpha2 catalytic subunit controls whole-body insulin sensitivity. , 2003, The Journal of clinical investigation.

[2]  R. Brownsey,et al.  5-Aminoimidazole-4-carboxamide 1-beta -D-ribofuranoside (AICAR) stimulates myocardial glycogenolysis by allosteric mechanisms. , 2003, American journal of physiology. Regulatory, integrative and comparative physiology.

[3]  D. Carling,et al.  AMP-activated Protein Kinase Inhibits the Glucose-activated Expression of Fatty Acid Synthase Gene in Rat Hepatocytes* , 1998, The Journal of Biological Chemistry.

[4]  M. Vincent,et al.  Inhibition by AICA Riboside of Gluconeogenesis in Isolated Rat Hepatocytes , 1991, Diabetes.

[5]  E. Kraegen,et al.  Pioglitazone treatment activates AMP-activated protein kinase in rat liver and adipose tissue in vivo. , 2004, Biochemical and biophysical research communications.

[6]  David Carling,et al.  The AMP-activated protein kinase cascade--a unifying system for energy control. , 2004, Trends in biochemical sciences.

[7]  B. Viollet,et al.  Short-term overexpression of a constitutively active form of AMP-activated protein kinase in the liver leads to mild hypoglycemia and fatty liver. , 2005, Diabetes.

[8]  B. Kemp,et al.  Dealing with energy demand: the AMP-activated protein kinase. , 1999, Trends in biochemical sciences.

[9]  D. Hardie Printed in U.S.A. Copyright © 2003 by The Endocrine Society doi: 10.1210/en.2003-0982 Minireview: The AMP-Activated Protein Kinase Cascade: The Key Sensor of Cellular Energy Status , 2022 .

[10]  D. Hargrove,et al.  Isozyme-nonselective N-Substituted Bipiperidylcarboxamide Acetyl-CoA Carboxylase Inhibitors Reduce Tissue Malonyl-CoA Concentrations, Inhibit Fatty Acid Synthesis, and Increase Fatty Acid Oxidation in Cultured Cells and in Experimental Animals* , 2003, Journal of Biological Chemistry.

[11]  S. Hawley,et al.  Characterization of the AMP-activated Protein Kinase Kinase from Rat Liver and Identification of Threonine 172 as the Major Site at Which It Phosphorylates AMP-activated Protein Kinase* , 1996, The Journal of Biological Chemistry.

[12]  Y. Uchijima,et al.  Role of hepatic AMPK activation in glucose metabolism and dexamethasone-induced regulation of AMPK expression. , 2006, Diabetes research and clinical practice.

[13]  J. McGarry,et al.  The mitochondrial carnitine palmitoyltransferase system. From concept to molecular analysis. , 1997, European journal of biochemistry.

[14]  J. Nishioka,et al.  Metformin-induced suppression of glucose-6-phosphatase expression is independent of insulin signaling in rat hepatoma cells. , 2005, International journal of molecular medicine.

[15]  G. Radda,et al.  Activation of glycogen phosphorylase and glycogenolysis in rat skeletal muscle by AICAR — an activator of AMP‐activated protein kinase , 1996, FEBS letters.

[16]  G. Cooney,et al.  AICAR administration causes an apparent enhancement of muscle and liver insulin action in insulin-resistant high-fat-fed rats. , 2002, Diabetes.

[17]  M. Prentki,et al.  Activation of Malonyl-CoA Decarboxylase in Rat Skeletal Muscle by Contraction and the AMP-activated Protein Kinase Activator 5-Aminoimidazole-4-carboxamide-1-β-d-ribofuranoside* , 2000, The Journal of Biological Chemistry.

[18]  D. Hardie,et al.  AMP-activated protein kinase, a metabolic master switch: possible roles in Type 2 diabetes. , 1999, American journal of physiology. Endocrinology and metabolism.

[19]  M. Prentki,et al.  AMP kinase and malonyl-CoA: targets for therapy of the metabolic syndrome , 2004, Nature Reviews Drug Discovery.

[20]  D. Hardie,et al.  Role of the AMP-activated protein kinase in the cellular stress response , 1994, Current Biology.

[21]  G. Ronnett,et al.  C75, a Fatty Acid Synthase Inhibitor, Reduces Food Intake via Hypothalamic AMP-activated Protein Kinase* , 2004, Journal of Biological Chemistry.

[22]  D. Hardie,et al.  Management of cellular energy by the AMP‐activated protein kinase system , 2003, FEBS letters.

[23]  Jérôme Boudeau,et al.  Complexes between the LKB1 tumor suppressor, STRADα/β and MO25α/β are upstream kinases in the AMP-activated protein kinase cascade , 2003, Journal of biology.

[24]  David Carling,et al.  The Anti-diabetic Drugs Rosiglitazone and Metformin Stimulate AMP-activated Protein Kinase through Distinct Signaling Pathways* , 2002, The Journal of Biological Chemistry.

[25]  Javier García-Villafranca,et al.  Involvement of nitric oxide/cyclic GMP signaling pathway in the regulation of fatty acid metabolism in rat hepatocytes. , 2003, Biochemical pharmacology.

[26]  D. Hardie,et al.  CBS domains form energy-sensing modules whose binding of adenosine ligands is disrupted by disease mutations. , 2004, The Journal of clinical investigation.

[27]  D. Hardie,et al.  5-aminoimidazole-4-carboxamide riboside mimics the effects of insulin on the expression of the 2 key gluconeogenic genes PEPCK and glucose-6-phosphatase. , 2000, Diabetes.

[28]  R. Coleman,et al.  AMP-activated kinase reciprocally regulates triacylglycerol synthesis and fatty acid oxidation in liver and muscle: evidence that sn-glycerol-3-phosphate acyltransferase is a novel target. , 1999 .

[29]  Mengwei Zang,et al.  AMP-activated Protein Kinase Is Required for the Lipid-lowering Effect of Metformin in Insulin-resistant Human HepG2 Cells* , 2004, Journal of Biological Chemistry.

[30]  J. W. Rush,et al.  AMPK expression and phosphorylation are increased in rodent muscle after chronic leptin treatment. , 2003, American journal of physiology. Endocrinology and metabolism.

[31]  H. Motoshima,et al.  Involvement of AMP-activated protein kinase in glucose uptake stimulated by the globular domain of adiponectin in primary rat adipocytes. , 2003, Diabetes.

[32]  D. Hardie,et al.  AMP-activated protein kinase: ancient energy gauge provides clues to modern understanding of metabolism. , 2005, Cell metabolism.

[33]  D. Carling,et al.  Tissue distribution of the AMP-activated protein kinase, and lack of activation by cyclic-AMP-dependent protein kinase, studied using a specific and sensitive peptide assay. , 1989, European journal of biochemistry.

[34]  F. Bontemps,et al.  Purine catabolism in isolated rat hepatocytes. Influence of coformycin. , 1980, The Biochemical journal.

[35]  S. Wakil,et al.  Acetyl-CoA carboxylase 2 mutant mice are protected against obesity and diabetes induced by high-fat/high-carbohydrate diets , 2003, Proceedings of the National Academy of Sciences of the United States of America.

[36]  Y. Minokoshi,et al.  Role of AMP-activated protein kinase in leptin-induced fatty acid oxidation in muscle. , 2001, Biochemical Society transactions.

[37]  W. Winder,et al.  Activation of AMP-activated protein kinase increases mitochondrial enzymes in skeletal muscle. , 2000, Journal of applied physiology.

[38]  O. Pedersen,et al.  Long-term AICAR administration reduces metabolic disturbances and lowers blood pressure in rats displaying features of the insulin resistance syndrome. , 2002, Diabetes.

[39]  R. Ulrich,et al.  Cultured hepatocytes as investigational models for hepatic toxicity: practical applications in drug discovery and development. , 1995, Toxicology letters.

[40]  M. Erion,et al.  Hypoglycaemic effect of AICAriboside in mice , 1996, Diabetologia.

[41]  B. Viollet,et al.  Induced adiposity and adipocyte hypertrophy in mice lacking the AMP-activated protein kinase-alpha2 subunit. , 2004, Diabetes.

[42]  E. Kraegen,et al.  Minireview: malonyl CoA, AMP-activated protein kinase, and adiposity. , 2003, Endocrinology.

[43]  D. Walsh,et al.  The cyclin-dependent kinase (CDK) inhibitor flavopiridol inhibits glycogen phosphorylase. , 2001, Archives of biochemistry and biophysics.

[44]  D. Hardie,et al.  AMP‐activated protein kinase: the energy charge hypothesis revisited , 2001, BioEssays : news and reviews in molecular, cellular and developmental biology.

[45]  B. Goldstein,et al.  Adiponectin: A novel adipokine linking adipocytes and vascular function. , 2004, The Journal of clinical endocrinology and metabolism.

[46]  P. Richardson,et al.  Microarrayed Compound Screening (μARCS) to Identify Activators and Inhibitors of AMP-Activated Protein Kinase , 2004, Journal of biomolecular screening.

[47]  W. G. Wiles,et al.  Activation of the AMP-activated Protein Kinase by the Anti-diabetic Drug Metformin in Vivo , 2004, Journal of Biological Chemistry.

[48]  J. Zierath,et al.  5-Aminoimidazole-4-carboxamide ribonucleoside treatment improves glucose homeostasis in insulin-resistant diabetic (ob/ob) mice , 2002, Diabetologia.

[49]  Olle Ljunqvist,et al.  Metformin increases AMP-activated protein kinase activity in skeletal muscle of subjects with type 2 diabetes. , 2002, Diabetes.

[50]  H. Lodish,et al.  Enhanced muscle fat oxidation and glucose transport by ACRP30 globular domain: Acetyl–CoA carboxylase inhibition and AMP-activated protein kinase activation , 2002, Proceedings of the National Academy of Sciences of the United States of America.

[51]  D. Carling,et al.  AMP-activated Protein Kinase Plays a Role in the Control of Food Intake* , 2004, Journal of Biological Chemistry.

[52]  S. Uchida,et al.  Adiponectin stimulates glucose utilization and fatty-acid oxidation by activating AMP-activated protein kinase , 2002, Nature Medicine.

[53]  Young-Bum Kim,et al.  Leptin stimulates fatty-acid oxidation by activating AMP-activated protein kinase , 2002, Nature.

[54]  David Carling,et al.  A common bicyclic protein kinase cascade inactivates the regulatory enzymes of fatty acid and cholesterol biosynthesis , 1987, FEBS letters.

[55]  A. Sim,et al.  Location and function of three sites phosphorylated on rat acetyl-CoA carboxylase by the AMP-activated protein kinase. , 1990, European journal of biochemistry.

[56]  Margaret S. Wu,et al.  Role of AMP-activated protein kinase in mechanism of metformin action. , 2001, The Journal of clinical investigation.