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Am J Physiol Endocrinol Metab 294: E558-E567, 2008. First published January 2, 2008; doi:10.1152/ajpendo.00167.2007
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HIV-protease inhibitors induce expression of suppressor of cytokine signaling-1 in insulin-sensitive tissues and promote insulin resistance and type 2 diabetes mellitus

Michael J. Carper,1 W. Todd Cade,1,2 Margaret Cam,3 Sheng Zhang,1 Anath Shalev,4 Kevin E. Yarasheski,1 and Sasanka Ramanadham1

1Department of Internal Medicine, Division of Endocrinology, Metabolism, and Lipid Research and 2Program in Physical Therapy, Washington University School of Medicine, St. Louis, Missouri; 3National Institute of Diabetes and Digestive and Kidney Diseases, National Institutes of Health, Bethesda, Maryland; and 4Department of Medicine, University of Wisconsin, Madison, Wisconsin

Submitted 14 March 2007 ; accepted in final form 28 December 2007

Insulin resistance, hyperglycemia, and type 2 diabetes are among the sequelae of metabolic syndromes that occur in 60–80% of human immunodeficiency virus (HIV)-positive patients treated with HIV-protease inhibitors (PIs). Studies to elucidate the molecular mechanism(s) contributing to these changes, however, have mainly focused on acute, in vitro actions of PIs. Here, we examined the chronic (7 wk) in vivo effects of the PI indinavir (IDV) in male Zucker diabetic fatty (fa/fa) (ZDF) rats. IDV exposure accelerated the diabetic state and dramatically exacerbated hyperglycemia and oral glucose intolerance in the ZDF rats, compared with vehicle-treated ZDF rats. Oligonucleotide gene array analyses revealed upregulation of suppressor of cytokine signaling-1 (SOCS-1) expression in insulin-sensitive tissues of IDV rats. SOCS-1 is a known inducer of insulin resistance and diabetes, and immunoblotting analyses revealed increases in SOCS-1 protein expression in adipose, skeletal muscle, and liver tissues of IDV-administered ZDF rats. This was associated with increases in the upstream regulator TNF-{alpha} and downstream effector sterol regulatory element-binding protein-1 and a decrease in IRS-2. IDV and other PIs currently in clinical use induced the SOCS-1 signaling cascade also in L6 myotubes and 3T3-L1 adipocytes exposed acutely to PIs under normal culturing conditions and in tissues from Zucker wild-type lean control rats administered PIs for 3 wk, suggesting an effect of these drugs even in the absence of background hyperglycemia/hyperlipidemia. Our findings therefore indicate that induction of the SOCS-1 signaling cascade by PIs could be an important contributing factor in the development of metabolic dysregulation associated with long-term exposures to HIV-PIs.

metabolic syndrome; insulin-signaling pathways; human immunodeficiency virus



Address for reprint requests and other correspondence: S. Ramanadham, Washington University School of Medicine, Department of Internal Medicine, Division of Endocrinology, Metabolism, and Lipid Research, Southwest Tower, Room #846A, Campus Box 8127, 660 South Euclid Drive, St. Louis, MO 63110 (e-mail: sramanad{at}im.wustl.edu)







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