A report in the July issue of the Journal of Clinical Investigation revealed
that a group of drugs currently under development for the treatment of
Type II diabetes causes both increased heart rate and elevated blood
pressure in animal studies.
These new findings regarding the category of drug known as a glucagon-like
peptide (GLP-1) receptor agonist suggest that the brain's GLP-1 system has
the ability to affect autonomic function, leading to changes in heart rate
and blood pressure.
A naturally occurring hormone that is produced by cells lining the
intestine, GLP-1 was first targeted as a diabetes treatment about 15 years
ago, according to the study's senior author Joel Elmquist, D.V.M., Ph.D.,
a neuroscientist and endocrinologist at Beth Israel Deaconess Medical
Center and Associate Professor of Neurology and Medicine at Harvard
Medical School.
"GLP-1 stimulates insulin secretion and controls feeding and
drinking behavior, and also regulates neuroendocrine responses to agents
that elicit illness-like behaviors," he explained. "The effect
on insulin secretion made the hormone an obvious target for treating
diabetes."
Diabetes develops when the body fails to either produce or to properly
use insulin, a hormone necessary to convert food -- including sugars and
starches -- into energy. Type II diabetes accounts for the majority of
cases of the disease, and is a huge public health problem. As many as 16
million individuals in the United States have Type II diabetes, which puts
them at risk for a number of serious complications, including stroke and
heart disease.
Although diabetes can often be controlled through diet and exercise,
pharmaceutical companies continue to develop medications that can be used
to manage the disease. However, as this latest study shows, scientists do
not yet understand enough about the functioning of the human brain and
body to ensure that these drugs are effective -- or safe.
"Despite accumulating data linking GLP-1 to autonomic and
neuroendocrine responses, the pathways [responsible] for the actions were
previously not well understood," explained Elmquist. "Although
these new findings in animals will need to be studied further, especially
in diabetic models, this research suggests that the central GLP-1 system
can regulate sympathetic outflow including raising heart rate and blood
pressure."
SOURCE: Journal of Clinical Investigation, July 2002.