Glucokinase is a key regulatory enzyme in the pancreatic beta-cell. It plays a crucial role in the regulation of insulin secretion and has been termed the glucose sensor in pancreatic beta-cells. Given its central role in the regulation of insulin release it is understandable that mutations in the gene encoding glucokinase (GCK) can cause both hyper- and hypoglycemia. Heterozygous inactivating mutations in GCK cause maturity-onset diabetes of the young (MODY) subtype glucokinase (GCK), characterized by mild fasting hyperglycemia, which is present at birth but often only detected later in life during screening for other purposes. Homozygous inactivating GCK mutations result in a more severe phenotype presenting at birth as permanent neonatal diabetes mellitus (PNDM). A growing number of heterozygous activating GCK mutations that cause hypoglycemia have also been reported. A total of 620 mutations in the GCK gene have been described in a total of 1,441 families. There are no common mutations, and the mutations are distributed throughout the gene. The majority of activating mutations cluster in a discrete region of the protein termed the allosteric activator site. The identification of a GCK mutation in patients with both hyper- and hypoglycemia has implications for the clinical course and clinical management of their disorder.

https://onlinelibrary.wiley.com/doi/pdf/10.1002/humu.21110

Update on mutations in glucokinase (GCK), which cause maturity-onset diabetes of the young, permanent neonatal diabetes, and hyperinsulinemic hypoglycemia.

Glucokinase, a unique isoform of the hexokinase enzymes, which are known to phosphorylate D-glucose and other hexoses, was identified during the past three to four decades as a new, promising drug target for type 2 diabetes. Glucokinase serves as a glucose sensor of the insulin-producing pancreatic islet beta-cells, controls the conversion of glucose to glycogen in the liver and regulates hepatic glucose production. Guided by this fundamental knowledge, several glucokinase activators are now being developed, and have so far been shown to lower blood glucose in several animal models of type 2 diabetes and in initial trials in humans with the disease. Here, the scientific basis and current status of this new approach to diabetes therapy are discussed.

Assessing the potential of glucokinase activators in diabetes therapy

Acute otitis media and otitis media with effusion are common childhood disorders, a source of significant morbidity, and a leading cause of antibiotic prescription in primary health care. Although effective treatments are available, some shortcomings remain, and thus better treatments would be welcome. Recent discoveries within the field of otitis media research relating to its etiology and pathogenesis have led to further investigation aimed at developing novel treatments. This article provides a review of the latest evidence relating to the understanding of acute otitis media and otitis media with effusion, current treatment strategies, their limitations, new areas of research, and novel strategies for treatment.

/pdf/update-on-otitis-media-prevention-and-treatment-2s4yqobi4t.pdf

Update on otitis media – prevention and treatment

New hepatic targets for glycaemic control in diabetes.

Sulfonyl group-containing compounds constitute an important class of therapeutical agents in medicinal chemistry presumably because of the tense chemical structure and functionality of the sulfonyl, which could not only form hydrogen bonding interactions with active site residues of biological targets but also, as incorporated into core ring structure, constrain the side chains and allowed their specific conformations that fit the active sites. This review focuses on sulfonamides and sulfones, which cover more than 40 series and are associated with at least 10 potential pharmaceutical targets in pathways of glucose metabolism and insulin signaling. A large number of such compounds have been reported as pharmaceuticals every year in the last decade. In particular, increasing studies suggest that sulfonamides and sulfones play a key role in the design of pharmaceutical agents with potential application for the treatment of diabetes and its complications. First, they are inhibitors of a variety of enzymes including 11β-hydroxysteroid dehydrogenase type 1, α- glucosidase, carnitine palmitoyltransferase and cytosolic phosphoenolpyruvate carboxykinase, and in turn involved in the regulation of the metabolism of glucose. In addition, they are active as activators of glucokinase and as antagonists of ghrelin receptors. These enzyme and receptors are tightly associated with the regulation of glucose metabolism and the improvement of insulin resistance. Secondly, sulfonamides and sulfones act in the insulin secretion. As agonists, they activate insulin receptor tyrosine kinase and thus increase insulin sensitivity. Moreover, they as inhibitors suppress protein tyrosine phosphatase 1B and dipeptidyl peptidase IV, and thus normalize the insulin signaling pathway. Finally, a number of sulfonamides and sulfones are inhibitors of aldose reductase, which have been linked to diabetic complications.

Sulfonyl Group-Containing Compounds in the Design of Potential Drugs for the Treatment of Diabetes and Its Complications

The glucose-sensing enzyme glucokinase (GK) plays a key role in glucose metabolism. We report here the effects of a novel glucokinase activator, LY2121260. The activator enhanced GK activity via binding to the allosteric site located in the hinge region of the enzyme. LY2121260 stimulated insulin secretion in a glucose-dependent manner in pancreatic beta-cells and increased glucose use in rat hepatocytes. In addition, incubation of beta-cells with the GK activator resulted in increased GK protein levels, suggesting that enhanced insulin secretion on chronic treatment with a GK activator may be due to not only changed enzyme kinetics but also elevated enzyme levels. Animals treated with LY2121260 showed an improved glucose tolerance after oral glucose challenge. These results support the concept that GK activators represent a new class of compounds that increase both insulin secretion and hepatic glucose use and in doing so may prove to be effective agents for the control of blood glucose levels in patients with type 2 diabetes.

/pdf/a-novel-glucokinase-activator-modulates-pancreatic-islet-and-48bbzdk17r.pdf

A novel glucokinase activator modulates pancreatic islet and hepatocyte function

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A novel glucokinase activator modulates pancreatic islet and hepatocyte function