Glucagon-like peptide-1 (GLP-1) receptor agonists, obesity and psoriasis: diabetes meets dermatology

Department of Medicine, Samuel Lunenfeld Research Institute, Mount Sinai Hospital, University of Toronto, 600 University Ave TCP5-1004, Toronto, ON M5G 1X5, Canada.
Diabetologia (Impact Factor: 6.88). 09/2011; 54(11):2741-4. DOI: 10.1007/s00125-011-2297-z
Source: PubMed

ABSTRACT Type 2 diabetes mellitus is characterised by beta cell failure, which frequently develops in the setting of insulin resistance. Inflammation contributes to the pathophysiology of type 2 diabetes by impairing insulin action in peripheral tissues and via reduction of beta cell function. Inflammation may also play an important role in the development of complications that arise in patients with type 2 diabetes. Hence, the anti-inflammatory actions of commonly used glucose-lowering drugs may contribute, indirectly, to their mechanisms of action and therapeutic benefit. Herein we highlight the anti-inflammatory actions of glucagon-like peptide-1 (GLP-1), which exerts direct and indirect actions on immune function. The observations that GLP-1 receptor agonists exert anti-inflammatory actions in preclinical studies, taken together with case reports linking improvements in psoriasis with GLP-1 receptor agonist therapy, illustrates the emerging clinical implications of non-classical anti-inflammatory actions of incretin-based therapeutics.

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    ABSTRACT: Glucagon-like peptide-1 (GLP-1) agonists are a class of drugs used for the treatment of type 2 diabetes mellitus. GLP-1 is released in response to meal intake; these classes of drugs enhance glucose-dependent insulin secretion and exhibit other antihyperglycemic effects following their release into the circulation from the gut. Psoriasis is a chronic skin condition affecting approximately 2% of the Western population. It is considered to be an autoimmune disease that involves the Th1 pathway and is associated with metabolic syndrome and its components, such as obesity, diabetes, and hypertension. We have reviewed reports in the literature that indicate a beneficial anti-inflammatory effect of GLP-1 in patients with diabetes or who have insulin resistance and psoriasis.
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    ABSTRACT: The wide ubiquity of GLP-1 receptors in the body has stimulated the search for different extrapancreatic actions of GLP-1 and its receptor agonists. Thus, severe cardioprotective effects directed on myocardial ischaemia and dysfunction as well as diverse antiaterogenic actions have been reported. Also, native and GLP-1 receptor agonists have demonstrated significant beneficial effects on liver steatosis and fibrosis and on neuronal protection in experimental models of Alzheimer, and Parkinson's disease as well as on cerebral ischaemia. Recent evidences suggest that these drugs may also be useful for prevention and treatment of diabetic retinopathy, nephropathy and peripheral neuropathy. Good results have also been reported in psoriasis. Despite we still need confirmation that these promising effects can be applied to clinical practice, they offer new interesting perspectives for treatment of type 2 diabetes associated complications and give to GLP-1 receptor agonists an even more integral position in diabetes therapy.


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