Inhibition of IKK 3 and TBK1 Improves Glucose Control in a Subset of Patients with Type 2 Diabetes


Oral E. A., Reilly S. M., Gomez A. V., Meral R., Butz L., Ajluni N., ...More

CELL METABOLISM, vol.26, no.1, pp.157-177, 2017 (SCI-Expanded) identifier identifier identifier

  • Publication Type: Article / Article
  • Volume: 26 Issue: 1
  • Publication Date: 2017
  • Doi Number: 10.1016/j.cmet.2017.06.006
  • Journal Name: CELL METABOLISM
  • Journal Indexes: Science Citation Index Expanded (SCI-EXPANDED), Scopus
  • Page Numbers: pp.157-177
  • Istanbul University Affiliated: No

Abstract

Numerous studies indicate an inflammatory link between obesity and type 2 diabetes. The inflammatory kinases IKK 3 and TBK1 are elevated in obesity; their inhibition in obese mice reduces weight, insulin resistance, fatty liver and inflammation. Here we studied amlexanox, an inhibitor of IKK 3 and TBK1, in a proof-of-concept randomized, double-blind, placebo-controlled study of 42 obese patients with type 2 diabetes and nonalcoholic fatty liver disease. Treatment of patients with amlexanox produced a statistically significant reduction in Hemoglobin A1c and fructosamine. Interestingly, a subset of drug responders also exhibited improvements in insulin sensitivity and hepatic steatosis. This subgroup was characterized by a distinct inflammatory gene expression signature from biopsied subcutaneous fat at baseline. They also exhibited a unique pattern of gene expression changes in response to amlexanox, consistent with increased energy expenditure. Together, these data suggest that dual-specificity inhibitors of IKK 3 and TBK1 may be effective therapies for metabolic disease in an identifiable subset of patients.