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Endocrinology Vol. 138, No. 7 2674-2679
Copyright © 1997 by The Endocrine Society


ARTICLES

Acute and Chronic Exposure to Tumor Necrosis Factor-{alpha} Fails to Affect Insulin-Stimulated Glucose Metabolism of Isolated Rat Soleus Muscle1

Clemens Fürnsinn, Susanne Neschen, Oswald Wagner, Michael Roden, Marcel Bisschop and Werner Waldhäusl

Department of Medicine III (C.F., S.N., M.R., M.B., W.W.), Division of Endocrinology & Metabolism, and Department of Medical & Chemical Laboratory Diagnostics (O.W.), University of Vienna, Vienna, Austria A-1090

Address all correspondence and requests for reprints to: Clemens Fürnsinn, Ph.D., Department of Medicine III, Division of Endocrinology and Metabolism, Währinger Gürtel 18–20, A-1090 Vienna, Austria. E-mail: clemens.fuernsinn{at}akh-wien.ac.at


    Abstract
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
To better understand the effects of tumor necrosis factor-{alpha} (TNF{alpha}) on insulin sensitivity, direct interaction of the peptide with freshly isolated rat soleus muscle strips was investigated. Muscles were exposed to TNF{alpha} at concentrations ranging from 0.01–5 nmol/liter. Rates of insulin-stimulated (5 or 100 nmol/liter) glucose metabolism were determined after periods of TNF{alpha} preexposure of 30 min, 6 h, and 24 h. Independent of exposure time, TNF{alpha} failed to exert any significant effect on rates of 3H-2-deoxy-glucose transport (stimulation by 100 nmol/liter insulin after preincubation without vs. with 5 nmol/liter TNF{alpha}, cpm/mg·h: 30 min, 779 ± 29 vs. 725 ± 29; 6 h, 652 ± 56 vs. 617 ± 60; 24 h, 911 ± 47 vs. 936 ± 31) or glucose incorporation into glycogen (µmol/g·h: 30 min, 5.19 ± 0.22 vs. 5.25 ± 0.41; 6 h, 2.08 ± 0.10 vs. 2.09 ± 0.17; 24 h, 2.51 ± 0.21 vs. 2.41 ± 0.26). In parallel, TNF{alpha} neither affected insulin-stimulated rates of glucose oxidation (CO2 production) and anaerobic glycolysis (lactate release), nor muscle glycogen content. In conclusion, these findings do not support the hypothesis of muscle insulin desensitization by TNF{alpha} via autocrine or paracrine mechanisms. The obtained data favor the concept that TNF{alpha}-dependent muscle insulin resistance in vivo depends on indirect effects rather than direct interaction of the peptide with skeletal muscle.


    Introduction
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
INSULIN RESISTANCE is a widespread feature of common metabolic diseases including obesity and type 2 diabetes (1, 2). The biochemical mechanisms responsible for deranged insulin sensitivity in the obese are not well understood, and recently the hypothesis has been raised that tumor necrosis factor-{alpha} (TNF{alpha}) may play a key role in the etiology of obesity-associated insulin resistance (for review see Ref. 3). This hypothesis is based on the observations that expression and release of TNF{alpha} is increased in adipose tissue from obese rodents and humans (4, 5, 6) and that TNF{alpha} carries a distinct potential to induce insulin resistance as indicated by blunted insulin effects on whole body glucose uptake and hepatic glucose output in TNF{alpha}-infused rats in vivo (7, 8). It is of note that during TNF{alpha} infusion, glucose uptake by skeletal muscle and skin revealed to be primarily responsible for decreased insulin-mediated whole body glucose utilization (7, 8). Furthermore, neutralization of endogenous TNF{alpha} in genetically obese insulin resistant Zucker rats for 3 days led to a 2- to 3-fold increase in insulin-stimulated peripheral glucose utilization in vivo without any change in the rate of hepatic glucose output (4). In parallel, insulin-induced autophosphorylation of the insulin receptor as well as phosphorylation of insulin receptor substrate-1 were restored to near control values in muscle and fat, but not liver (9), which suggests that endogenous TNF{alpha} contributes considerably to peripheral insulin resistance in obese Zucker rats. In contrast to its effects in Zucker rats, TNF{alpha} neutralization over a period of 4 weeks did not affect insulin sensitivity in obese NIDDM patients (10). Whether blunting of whole body insulin sensitivity by exogenous and endogenous TNF{alpha} in vivo is due to its direct interaction with insulin target tissues or rather mediated via indirect mechanisms is, however, not completely understood.

Because up to 80% of insulin-stimulated glucose uptake is into muscle (2, 11), any major changes in whole body glucose clearance in response to infusion or neutralization of TNF{alpha} (4, 7, 8) have to involve considerable changes in muscle insulin sensitivity (7). Although a decrease in insulin action has been described in cultured L6 rat muscle cells preexposed to TNF{alpha} for 10 min to 12 h (12), no insulin resistance was observed in the same cell line after TNF{alpha} treatment for 4–8 days (13) or in cardiomyocytes after short-term exposure to the peptide (14). Hence, it is still unclear, whether TNF{alpha} is to influence glucose handling by direct interaction with native skeletal muscle.

This study, therefore, was designed to elucidate if TNF{alpha} is to directly affect insulin-stimulated glucose metabolism in freshly isolated rat soleus muscle strips. Because time dependency of TNF{alpha} action in vitro has been described in other experimental settings (15, 16, 17), insulin-stimulated rates of glucose metabolism were determined after muscle preexposure to TNF{alpha} for 30 min, 6 h, and 24 h.


    Materials and Methods
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Rats and muscle preparation
Male Sprague-Dawley rats were purchased from the breeding facilities of the University of Vienna (Himberg, Austria) and kept at an artificial 12-h light, 12-h dark cycle at constant room temperature. Conventional laboratory diet and tap water were provided ad libitum until the evening before killing, when only food was withdrawn. Five-week-old rats at fasted body weights of approximately 140 g were killed by cervical dislocation between 0830 h and 0930 h. Immediately after killing, two longitudinal soleus muscle strips per leg were prepared, weighed (approximately 25 mg), and tied under tension on stainless steel clips as previously described (18).

TNF{alpha}
Unless stated otherwise, human recombinant TNF{alpha} was from Sigma Chemical Co. (St. Louis, MO). Biological activity of the peptide was validated by TNF{alpha}-dependent accumulation of plasminogen activator inhibitor-1 in the supernatant of cultured human umbilical vein endothelial cells (ng/ml after 24 h: control, 56 ± 11, vs. 1.4 nmol/liter TNF{alpha}, 275 ± 23; P < 0.01; n = 3 each).

Muscle incubation procedures
Phase 1 (30 min, 6 h, or 24 h). Medium 199 (Sigma) supplemented with 5 mmol/liter HEPES, 25,000 U/liter penicillin G, 25 mg/liter streptomycin, and 0.25% (wt/vol) BSA was used as incubation medium (M199; pH 7.35). In the presence or absence of TNF-{alpha}, muscle strips were incubated for 30 min, 6 h, and 24 h, respectively. For short-term incubation (30 min), 25-ml Erlenmeyer flasks coated with Blue Slick solution (Serva, Heidelberg, Germany) and provided with 3 ml M199 were employed (1 strip/flask), whereas for long-term incubation (6 h and 24 h, respectively) muscles were put into coated 50-ml flasks provided with 20 ml M199 (6 strips/flask) so as not to touch the inner surface of the flask. Flasks were placed into a shaking water bath (37 C; 130 cycles/min) and an atmosphere of 95% O2:5% CO2 was continuously provided within the flasks. During 24-h incubation, M199 was renewed every 5–7 h.

Phase 2 (1 h). After phase 1, muscles were immediately transferred into a set of 25-ml flasks provided with 3 ml of M199 (1 strip/flask). In phase 2, M199 contained identical concentrations of TNF{alpha} as used in phase 1 and trace amounts of D-[U-14C] glucose or, alternatively, 2-deoxy-D-[2,6-3H] glucose plus [U-14C] sucrose (all from Amersham, Amersham, UK) to determine rates of glucose transport, glucose incorporation into glycogen, and glucose oxidation in the absence or presence of insulin (Actrapid, Novo, Bagsvaerd, Denmark). After 60-min muscle strips were quickly removed, blotted, and frozen in liquid N2. Later, muscle strips were lysed in 1 mol/liter KOH at 70 C and the lysate used for further analytical procedures as described below.

Experimental design
Before the effects of TNF{alpha} were investigated, a series of experiments was performed to confirm preservation of the stimulatory action of insulin on glucose metabolism in rat soleus muscle strips after long-term preincubation. To this end, muscle strips were preincubated for 30 min, 6 h, or 24 h in the absence of any exogenous peptide (phase 1) and selected parameters of glucose metabolism were then measured in the absence or presence of insulin (1, 10, and 100 nmol/liter; phase 2).

To examine the dose-dependent effects of short- and long-term exposure of isolated muscle to TNF{alpha} on insulin-stimulated glucose metabolism, muscle strips were preincubated for 30 min, 6 h, or 24 h in the absence of insulin and in the presence of 10, 100, or 1000 pmol/liter TNF{alpha} (phase 1). Subsequently, selected parameters of glucose metabolism were measured in the presence of a maximally stimulating concentration of insulin (100 nmol/liter; phase 2).

To investigate the effects of a concentration of 5 nmol/liter TNF{alpha} on glucose metabolism in the presence of submaximally and maximally insulin-stimulated glucose metabolism, muscle strips were preincubated for 30 min, 6 h, or 24 h in the absence vs. presence of 5 nmol/liter TNF{alpha} and in the absence of insulin (phase 1). Selected parameters of glucose metabolism were then measured in the presence of 5 nmol/liter and 100 nmol/liter insulin, respectively (phase 2).

To control for potential influence of peptide source and solubility, the short-term effects of TNF{alpha} (5 nmol/liter) on insulin-stimulated (100 nmol/liter) glucose metabolism were examined employing TNF{alpha} from another source (GIBCO, Gaitherburg, MD) or, alternatively, in the presence of 1% (vol/vol) dimethyl sulfoxide.

Analytical procedures
Net uptake rate of 2-deoxy-D-[2,6-3H] glucose, a glucose analogue that does not enter glycolysis and accumulates within the cell, was determined employing [14C] sucrose as an extracellular space marker by methods described previously (19). Glycogen synthesis is given as the net rate of conversion of [14C] glucose to [14C] glycogen as determined by methods described previously (18). Glucose oxidation, i.e. CO2 production, was calculated from conversion of [14C] glucose into 14CO2. To this end, the flasks were sealed during the last 45 min of muscle incubation, after which the muscle strips were quickly removed and the flasks were immediately resealed with a stopper carrying a hang-in container provided with 200 µl CO2-trapping solution (phenethylamine:methanol, 1:1). Using a syringe, 200 µl of 3 mmol/liter perchloric acid were injected into the incubation buffer within the flasks to quantitatively release CO2 from the medium. After incubation for at least 1 h at room temperature, the trapping solution was brought into scintillation fluid, which was vigorously shaken and counted for 14C-content. Anaerobic glycolysis, i.e. rate of lactate release, was calculated from M199 lactate concentration measured enzymatically by the lactate dehydrogenase method (20). For determination of muscle glycogen content, glycogen in the muscle lysate was completely degraded to glucose with amyloglucosidase (21). Glucose was then measured enzymatically by a commercial kit from Human (Taunusstein, Germany).

Statistics
All data are presented as means ± SEM and a P < 0.05 was considered significant. For comparison of two groups, P values were calculated by two-tailed paired Student’s t test. Multiple comparisons with a control were performed after logarithmic transformation of data according to the method of Dunnett (22), where the effect of individual rat was controlled.


    Results
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Results depicted in Fig. 1Go demonstrate that soleus muscle strips remained viable and well-responsive to insulin stimulation during incubation periods up to 24 h. Nevertheless, increased rates of glycolysis and glucose oxidation as well as decreased rates of glucose incorporation into glycogen were observed after prolonged incubation and were associated with lower muscle glycogen content.



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Figure 1. Effects of prolonged incubation on muscle glucose metabolism in vitro. Isolated rat soleus muscle strips were preincubated for 30 min, 6 h, and 24 h, respectively, before rates of 3H-2-deoxy-glucose transport (A), glucose incorporation into glycogen (B), CO2 production (C), and lactate release (D) were determined in the presence of the indicated concentrations of insulin. Muscle glycogen content was measured after incubation (E). Means ± SEM; n = 6 each; a: P < 0.05, b: P < 0.01 vs. absence of insulin.

 
Exposure to 10, 100, and 1000 pmol/liter TNF{alpha} failed to affect insulin-stimulated muscle glucose metabolism. Rates of insulin-stimulated glucose transport, glycogen synthesis, glycolysis, and glycogen accumulation were neither influenced by short-term nor by long-term treatment with TNF{alpha} (Fig. 2Go).



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Figure 2. Effects of 10, 100, and 1000 pmol/liter TNF{alpha} on insulin-stimulated muscle glucose metabolism. Isolated rat soleus muscle strips were preexposed to the indicated concentrations of TNF{alpha} for 30 min, 6 h, or 24 h before rates of 3H-2-deoxy-glucose transport (A; n = 6 each), glucose incorporation into glycogen (B; n = 5–12 each), CO2 production (C; n = 3–12 each), and lactate release (D; n = 6 each) were determined in the presence of 100 nmol/liter insulin. Muscle glycogen content was measured after incubation (E; n = 5–12 each). Means ± SEM; no significance for presence vs. absence of TNF{alpha}.

 
Table 1Go demonstrates glucose metabolic rates prevailing in soleus muscle strips, which were exposed to 5 nmol/liter TNF{alpha}, a peptide concentration employed previously to describe insulin desensitization by TNF{alpha} of isolated nonmuscle tissue (14, 15, 16, 23, 24). Both short- and long-term actions of TNF{alpha} on muscle glucose metabolism were not only tested with respect to insulin responsiveness (i.e. under maximal stimulation with 100 nmol/liter insulin), but also with respect to insulin sensitivity (i.e. under partial stimulation with 5 nmol/liter insulin). Under these experimental conditions, no influence on insulin sensitivity or insulin responsiveness of isolated rat soleus muscle was revealed, although muscles were exposed for up to 25 h to 5 nmol/liter TNF{alpha}.


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Table 1. Effects of 5 nmol/liter TNF{alpha} on insulin-stimulated glucose metabolism of isolated rat soleus muscle strips

 
Furthermore, no significant effects of short-term TNF{alpha} exposure on insulin-stimulated glucose metabolism were observed, when the effects of TNF{alpha} from an alternative source or in the presence of detergent were determined (Table 2Go).


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Table 2. Effects of TNF{alpha} on insulin-stimulated glucose metabolism of isolated rat soleus muscle strips using peptide from an alternative source, or in the presence of detergent.

 

    Discussion
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 
Infusion of TNF{alpha} in rats increases peripheral glucose uptake in the basal state but elicits a distinct loss in hepatic and peripheral insulin sensitivity in vivo, which includes decreased insulin-stimulated glucose uptake in rectus abdominus, gastrocnemius, and red as well as white quadriceps muscle (7, 8). Furthermore, experimental evidence has been provided that endogenous TNF{alpha} may be instrumental in the development of obesity-associated insulin resistance and derangement of glucose homeostasis in rats (3, 4). Because the circulating plasma levels of TNF{alpha} found in association with obesity are regarded too low to allow for endocrine effects on muscle tissue, it has been hypothesized that peptide release from fat cells located in the vicinity of muscle fibers may mediate TNF{alpha} action via paracrine mechanisms (3, 4, 25). Speculations also include potential autocrine mechanisms in spite of the observation that TNF{alpha} is expressed at much lower rates in muscle than in adipose tissue (25).

In this study, TNF{alpha} at concentrations ranging from 0.01–5 nmol/liter neither affected insulin-stimulated rates of glucose transport, glycogen synthesis, CO2 production, and lactate release, nor did TNF{alpha} exert any influence on glycogen content of isolated rat soleus muscle strips in vitro. Such failure of TNF{alpha} to directly affect insulin-stimulated soleus muscle glucose metabolism in vitro was substantiated under various experimental circumstances including TNF{alpha} pretreatment for 30 min, 6 h, and 24 h followed by both submaximal and maximal insulin stimulation. Although TNF{alpha} release from isolated muscle strips in vitro can not be excluded, it seems unlikely that autocrine mechanisms may have triggered maximal TNF{alpha}-stimulation in the control experiments and hence may have masked any effect of exogenous TNF{alpha} added to the incubation medium. Thus, in spite of such potential autocrine stimulation, others have found that plasma concentrations around 100 pmol/l TNF{alpha} were sufficient to induce distinct muscle insulin resistance in vivo (7) and that TNF{alpha}-induced insulin desensitization was well-describable for various other isolated tissues (12, 16, 23, 24, 26, 27, 28). Poor quality of employed TNF{alpha} was excluded as the cause of negative results by evaluation of its capability to release plasminogen activator inhibitor-1 from cultured human ubilical vein endothelial cells. The obtained data thus do not support the idea of TNF{alpha} to induce insulin resistance via direct interaction with skeletal muscle, which is known to express receptors for TNF{alpha} (29). Such lack of direct interaction with skeletal muscle glucose metabolism is in line with described effects on protein catabolism, which is markedly stimulated by TNF{alpha} in vivo (30, 31), whereas the peptide fails to directly affect protein breakdown of isolated muscle tissue in vitro (30, 32).

In agreement with a previous report (33), the applied method for incubation of freshly isolated rat soleus muscle strips displayed blunted rates of glycogen synthesis, increased glycolysis, and decreased glycogen content upon prolonged incubation in the absence of plasma, hormones, and innervation when compared with short-term incubation. Such time-dependent increase in the rate of carbohydrate catabolism may be caused by depletion of im lipid stores resulting in an enhanced requirement for glucose as a fuel substrate, or may reflect a general increase in the metabolic rate due to the artificial environment. Nevertheless, muscle tissue remained viable even after incubation for 24 h as indicated by its preserved ability to respond to insulin, which dose-dependently triggered increases in the rates of glucose transport, glycogen synthesis, and glycolysis. The employed rat soleus muscle preparation therefore appears adequate for the investigation of short- and long-term TNF{alpha} action on insulin-stimulated glucose metabolism.

Peptide concentrations and exposure periods applied in our experiments are in the range of that used to document TNF{alpha}-dependent insulin desensitization in isolated tissues including adipocytes, hepatoma cells, and the cultured rat skeletal muscle cell line L6 (12, 16, 23, 24, 26, 27, 28). Most studies describing TNF{alpha}-dependent insulin desensitization in vitro did, however, not determine insulin-stimulated rates of glucose metabolism, but rather focused on processes involved in intracellular insulin signal transduction (16, 17, 23, 24, 26, 27), whereby phosphorylation of insulin receptor substrate-1 serine residues (23, 26) and activation of phosphotyrosine phosphatases (17) have been suggested to mediate TNF{alpha}-induced insulin resistance.

In a limited number of in vitro-studies, the stimulatory effect of insulin on glucose metabolism was determined and glucose transport has been found blunted in isolated adipocytes exposed to TNF{alpha} (15, 27). In the cultured rat skeletal muscle cell line L6, no insulin resistance was induced by 4–8 d of exposure to TNF{alpha} (13), whereas a distinct decrease in insulin-stimulated glucose transport was observed after TNF{alpha}-pretreatment for 1 h or 12 h (12). The latter finding was associated with reduced glucose incorporation into glycogen and glycogen synthase activity (12) suggesting that major differences exist in the interaction of TNF{alpha} with insulin in cultured L6 muscle cells vs. freshly isolated soleus muscle. Such discrepancies can not be explained by different source of TNF{alpha}, since peptide both from GIBCO (used for L6 cells; 12) and Sigma (used in this study) did not affect soleus muscle glucose handling in vitro. Difference in responses to TNF{alpha} thus are likely to reflect different type of tissue employed with freshly isolated native muscle tissue relating closer to the physiological situation than a cultured muscle cell line. Even using freshly isolated muscle, however, direct conclusions to the physiological situation are subject to limitations principally applying in vitro studies, which include that full muscle sensitivity to the effects of insulin and/or TNF{alpha} may depend on innervation and normal blood perfusion. Although muscles dominated by white glycolytic fast-twitch fibers as well as muscles dominated by red oxidative slow-twitch fibers are affected by TNF{alpha}-dependent insulin desensitization in vivo (7, 8), deviations in metabolic response to TNF{alpha} in vitro may to some extent depend on muscle fiber type. In the case of soleus muscle fiber type is mainly slow-twitch, although presence of a small amount fast-twitch fibers can not be excluded. In that context it is of note that TNF{alpha} has also been described to inhibit insulin-dependent activation of phosphatidylinositol 3-kinase in adipocytes, but not in cardiomyocytes (14), which carry a high oxidative capacity and hence resemble red rather than white skeletal muscle fibers.

In conclusion, this study demonstrates failure of TNF{alpha} to affect insulin-stimulated glucose metabolism by direct interaction with rat soleus muscle in vitro and hence does not provide evidence for TNF{alpha}-dependent muscle insulin desensitization via autocrine or paracrine mechanisms as hypothesized by others (3, 4, 25). Our findings rather favour the concept that TNF{alpha}-dependent muscle insulin resistance in vivo is mediated indirectly via interaction with other tissues and may involve counterregulatory hormone release (7, 34) or lipid metabolism (9, 35).


    Acknowledgments
 
We appreciate the help of the staff at the Biomedical Research Center, University of Vienna, who took care of the rats.


    Footnotes
 
1 This work was supported by the Austrian Science Fund, Grant No. P11403-MED, and by the Diabetes Fund of the Netherlands (to M.B.). Back

Received December 30, 1996.


    References
 Top
 Abstract
 Introduction
 Materials and Methods
 Results
 Discussion
 References
 

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