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Publication : Cyb5r3-based mechanism and reversal of secondary failure to sulfonylurea in diabetes.

First Author  Watanabe H Year  2023
Journal  Sci Transl Med Volume  15
Issue  681 Pages  eabq4126
PubMed ID  36724243 Mgi Jnum  J:334130
Mgi Id  MGI:7446920 Doi  10.1126/scitranslmed.abq4126
Citation  Watanabe H, et al. (2023) Cyb5r3-based mechanism and reversal of secondary failure to sulfonylurea in diabetes. Sci Transl Med 15(681):eabq4126
abstractText  Sulfonylureas (SUs) are effective and affordable antidiabetic drugs. However, chronic use leads to secondary failure, limiting their utilization. Here, we identify cytochrome b5 reductase 3 (Cyb5r3) down-regulation as a mechanism of secondary SU failure and successfully reverse it. Chronic exposure to SU lowered Cyb5r3 abundance and reduced islet glucose utilization in mice in vivo and in ex vivo murine islets. Cyb5r3 beta cell-specific knockout mice phenocopied SU failure. Cyb5r3 engaged in a glucose-dependent interaction that stabilizes glucokinase (Gck) to maintain glucose utilization. Hence, Gck activators can circumvent Cyb5r3-dependent SU failure. A Cyb5r3 activator rescued secondary SU failure in mice in vivo and restored insulin secretion in ex vivo human islets. We conclude that Cyb5r3 is a key factor in the secondary failure to SU and a potential target for its prevention, which might rehabilitate SU use in diabetes.
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