Introduction: What they say
A study from the Department of Physiology-Cellular Biophysics, College of Physicians and Surgeons, Columbia University, New York, New York, USA shows that “MC4R-dependent suppression of appetite by bone-derived lipocalin 2.” This research paper was published, in the 8 March 2017 issue of the journal “Nature” [One of the best research journals in General Science with an I.F of 43 plus], by Dr. Stavroula Kousteni and Mosialou and others.
What we say:
On the foundation of this interesting finding, Dr L Boominathan PhD, Director-cum-chief Scientist of GBMD, reports that: Curing, preventing and reversing diabetes with a commonly available antiasthmatic drug Montelukast: Montelukast-based therapy for TIIDM and obesity-associated metabolic deficits: Montelukast (trade name: Singulair and others), a vasodilator used in the treatment of asthma, increases Lipocalin 2 (LCN2) expression, activates an MC4R-dependent anorexigenic pathway, decreases TXNIP expression, suppresses appetite and weight gain, increases insulin secretion, improves glucose tolerance, promotes glucose homeostasis, improves obesity-associated metabolic deficits and prevents progression to TIIDM, via down-regulation of its target gene, 9/March/2020, 11.08 pm
From significance of the study to public health relevance:
Given that: (1) more than 387 million people worldwide are affected by Diabetes mellitus (DM); (2) diabetic disease results in a number of health complications, including diabetic cardiomyopathy (DCM), diabetic nephropathy, diabetic retinopathy, and diabetic neuropathy; (3) one third of people with diabetes suffer from diabetic kidney disease (DKD); and one third of them will develop kidney failure; (4) Obesity plays a central role in the development of TIIDM; (5) Diabetes is going to be one of the top 10 causes of death by 2030; (6) the life-long painful injection/drug treatment is required to treat DM; (7) the global economic cost spent for diabetes treatment in 2014 was little more than 600 billion US dollars, there is an urgent need to find: (i) a way to induce regeneration of adult ß-cells that were lost in DM; (ii) a cheaper alternative to the existing expensive weight-loss drugs; (iii) a side-effect-free natural product-based drug; and (iv) a way to cure, not just treat, diabetes.
What is known?
Dr. Stavroula Kousteni’s research team has recently shown, using loss-and gain-of-function experiments, that Lipocalin 2 (LCN2): (1) induces insulin release; (2) improves glucose tolerance; and (3) augments insulin sensitivity. Further, they have shown that LCN2: (1) binds and activates the melanocortin 4 receptor (MC4R) in the neurons of the hypothalamus; (2) activates an MC4R-dependent appetite-suppressing pathway; (3) suppresses appetite and body weight gain; (4) levels are low in TIIDM patients and they are inversely correlated with body weight gain and blood A1c levels; and (5) levels are higher in patients with lower body weight gain and blood A1c levels, suggesting that increasing the expression of LCN2 may alleviate metabolic deficits in diabetic patients.
From research findings to Therapeutic opportunity:
This study suggests, for the first time, that anti-asthmatic drug Montelukast (trade name: Singulair) may aid in the treatment of insulin resistance, weight loss and obesity-associated TIIDM.
Montelukast, by increasing the expression of its target gene, it may increase the expression of LCN2 (Lipocalin 2). Thereby, it may: (1) induce insulin release; (2) increase the expression of components of the Insulin-PI3K pathway; (3) promote glucose tolerance; (4) improve insulin sensitivity; (5) activate the MC4R (Melanocortin-4-receptor-MC4R)-dependent appetite-suppressing pathway in hypothalamus; (6) decrease Thioredoxin-interacting protein (TXNIP) expression; (7) suppress appetite; and weight gain; (8) improve metabolic deficits; and (9) promote glucose homeostasis (Fig.1).
Given the detailed mechanistic basis as to how anti-asthmatic drug Montelukast may decrease blood glucose levels, medical practitioners/diabetologists may consider taking this interesting finding into a clinical trial or adopting this as a mode of therapy for asthmatic patients with diabetes mellitus and Obesity-associated metabolic deficits/abnormalities (Figure 2), as this drug has an added advantage of promoting stress resistance and turning on the expression of longevity-promoting genes.
Details of the research findings:
Idea Proposed/Formulated (with experimental evidence) by: Dr L Boominathan Ph.D.
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Undisclosed mechanistic information: How does Montelukast increase the expression of LCN2 and MC4R and down regulate the expression of TXNIP?
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Citation: Boominathan, L., Curing, preventing and reversing diabetes with a commonly available antiasthmatic drug Montelukast: Montelukast-based therapy for TIIDM and obesity-associated metabolic deficits: Montelukast (trade name: Singulair and others), a vasodilator used in the treatment of asthma, increases Lipocalin 2 (LCN2) expression, activates an MC4R-dependent anorexigenic pathway, decreases TXNIP expression, suppresses appetite and weight gain, increases insulin secretion, improves glucose tolerance, promotes glucose homeostasis, improves obesity-associated metabolic deficits and prevents progression to TIIDM, via down-regulation of its target gene, 9/March/2020, 11.08 pm, Genome-2-BioMedicine Discovery center (GBMD), http://genomediscovery.org
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