HIF-1α accumulation in response to transient hypoglycemia may worsen diabetic eye disease

Chuanyu Guo, Monika Deshpande, Yueqi Niu, Isha Kachwala, Miguel Flores-Bellver, Haley Megarity, Taylor Nuse, Savalan Babapoor-Farrokhran, Michael Ramada, Jaron Sanchez, Neelay Inamdar, Thomas V. Johnson, Maria Valeria Canto-Soler, Silvia Montaner, Akrit Sodhi

Research output: Contribution to journalArticlepeer-review

Abstract

Tight glycemic control (TGC), the cornerstone of diabetic management, reduces the incidence and progression of diabetic microvascular disease. However, TGC can also lead to transient episodes of hypoglycemia, which have been associated with adverse outcomes in patients with diabetes. Here, we demonstrate that low glucose levels result in hypoxia-inducible factor (HIF)-1-dependent expression of the glucose transporter, Glut1, in retinal cells. Enhanced nuclear accumulation of HIF-1α was independent of its canonical post-translational stabilization but instead dependent on stimulation of its translation and nuclear localization. In the presence of hypoxia, this physiologic response to low glucose resulted in a marked increase in the secretion of the HIF-dependent vasoactive mediators that promote diabetic retinopathy. Our results provide a molecular explanation for how early glucose control, as well as glycemic variability (i.e., oscillating serum glucose levels), contributes to diabetic eye disease. These observations have important implications for optimizing glucose management in patients with diabetes.

Original languageEnglish (US)
Article number111976
JournalCell Reports
Volume42
Issue number1
DOIs
StatePublished - Jan 31 2023

Keywords

  • Akt
  • CP: Cell biology
  • CP: Metabolism
  • angiogenesis
  • angiopoietin-like 4
  • diabetic retinopathy
  • glucose transporter
  • glycemic variability
  • hypoglycemia
  • hypoxia-inducible factor
  • mTOR
  • vascular endothelial growth factor

ASJC Scopus subject areas

  • General Biochemistry, Genetics and Molecular Biology

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