Type 2 diabetes is one of the fastest growing public health problems worldwide, resulting from both genetic factors and inadequate adaptation to environmental changes. It is characterized by abnormal glucose and lipid metabolism due in part to resistance to the actions of insulin in skeletal muscle, liver and fat. AMP-activated protein kinase (AMPK), a phylogenetically conserved serine/threonine protein kinase, acts as an integrator of regulatory signals monitoring systemic and cellular energy status. The growing realization that AMPK regulates the coordination of anabolic and catabolic metabolic processes represents an attractive concept for type 2 diabetes therapy. Recent findings showing that pharmacological activation of AMPK improves blood glucose homeostasis, lipid profile and blood pressure in insulin-resistant rodents suggest that this kinase could be a novel therapeutic target in the treatment of type 2 diabetes. Consistent with these results, physical exercise and major classes of antidiabetic drugs have recently been reported to activate AMPK. In the present review, we update these topics and discuss the concept of targeting the AMPK pathway for the treatment of type 2 diabetes.

Hsp90, a molecular chaperone required for the functioning of glucocorticosteroid receptor (GR), ensures, by direct interaction, the conformational competence of the steroid-binding pocket. In addition to having this positive function, Hsp90 maintains steroid receptors in an inactive form in the absence of hormone. However, neither the participation of Hsp90 once the pathway has been activated by the ligand nor the importance of increased Hsp90 levels in determining the amplitude of the response has ever been assessed directly. Here, by increasing the Hsp90͞GR ratio in the nuclear compartment, we found an attenuation of the response to glucocorticosteroids that was not due to a nonspecific or toxic effect of the Hsp90 modified by nuclear targeting. Since this negative effect was more pronounced at high levels of hormone, when receptor and Hsp90 are maximally dissociated, the possibility of an interaction between Hsp90 and GR, already activated to a DNA-binding form, was directly investigated. Indeed GR, after in vivo activation by ligand, was still able to reassociate with Hsp90, suggesting that this interaction plays a role in vivo, possibly in receptor recycling. Moreover, the GR binding to its DNA response element was inhibited by an excess of Hsp90, pointing to a function of Hsp90 in the nuclear compartment. It is thus proposed that an increased Hsp90͞GR ratio inf luences the responsiveness to ligand at a step that is after receptor activation. This increased ratio may be of pathophysiological relevance in the different circumstances that lead to an elevated level of nuclear Hsp90.

To better understand how leukemia inhibitory factor (LIF) activates proopiomelanocortin (POMC) gene transcription in pituitary corticotrophs, time-course studies of the induction of POMC promoter activity and specific tyrosine phosphorylation of signal transducer and activator of transcription 1 (STAT1) and STAT3 were performed. It was found that both phosphorylation of STAT1 and -3 and activation of the promoter activity rapidly and transiently take place within minutes and 2-6 h, respectively, in favor of a direct effect of the LIF pathway on POMC promoter. Activated STAT1 and -3 form homo-/heterodimers able to bind the Sis-inducible element. The most abundant Sis-inducible element binding dimers are STAT3/3 and STAT1/3. Degenerated STAT1/3-binding sites from the POMC promoter were tested for their ability to bind activated STAT1 and 3; only the -390/-379 site, partially overlapping the Nur response element, binds with low affinity activated STAT1 and -3. Analysis of the three domains and subregions of the POMC promoter showed that two subregions are specifically responsive to LIF. The response of the distal subregion requires the intact STAT1 and -3 DNA-binding site -390/-379, whereas the responsiveness of the proximal subregion takes place despite the absence of direct STAT1 and -3 DNA binding and may imply interaction of activated STAT with basal transcription factors.