BackgroundDecline in insulin action is a metabolic feature of aging and is involved in the development of age-related diseases including Type 2 Diabetes Mellitus (T2DM) and Alzheimer's disease (AD). A novel mitochondria-associated peptide, Humanin (HN), has a neuroprotective role against AD-related neurotoxicity. Considering the association between insulin resistance and AD, we investigated if HN influences insulin sensitivity.Methods and FindingsUsing state of the art clamp technology, we examined the role of central and peripheral HN on insulin action. Continuous infusion of HN intra-cerebro-ventricularly significantly improved overall insulin sensitivity. The central effects of HN on insulin action were associated with activation of hypothalamic STAT-3 signaling; effects that were negated by co-inhibition of hypothalamic STAT-3. Peripheral intravenous infusions of novel and potent HN derivatives reproduced the insulin-sensitizing effects of central HN. Inhibition of hypothalamic STAT-3 completely negated the effects of IV HN analog on liver, suggesting that the hepatic actions of HN are centrally mediated. This is consistent with the lack of a direct effect of HN on primary hepatocytes. Furthermore, single treatment with a highly-potent HN analog significantly lowered blood glucose in Zucker diabetic fatty rats. Based upon the link of HN with two age-related diseases, we examined if there were age associated changes in HN levels. Indeed, the amount of detectable HN in hypothalamus, skeletal muscle, and cortex was decreased with age in rodents, and circulating levels of HN were decreased with age in humans and mice.ConclusionsWe conclude that the decline in HN with age could play a role in the pathogenesis of age-related diseases including AD and T2DM. HN represents a novel link between T2DM and neurodegeneration and along with its analogues offers a potential therapeutic tool to improve insulin action and treat T2DM.

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IFX-CL is significantly influenced by patient factors, specifically, albumin, body weight, and ATI. There should be a decreasing IFX dose interval strategy, particularly for low albumin patients. Higher starting doses may benefit low body weight patients. Pharmacokinetic models and therapeutic drug monitoring may ensure that patients maintain measurable concentrations throughout dose intervals. Individualized dosing may improve outcomes for IFX-treated patients with Crohn's disease and ulcerative colitis.

SummaryCaloric restriction (CR) can delay many age-related diseases and extend lifespan, while an increase in adiposity is associated with enhanced disease risk and accelerated aging. Among the various fat depots, the accrual of visceral fat (VF) is a common feature of aging, and has been shown to be the most detrimental on metabolic syndrome of aging in humans. We have previously demonstrated that surgical removal of VF in rats improves insulin action; thus, we set out to determine if VF removal affects longevity. We prospectively studied lifespan in three groups of rats: ad libitum -fed (AL-fed), CR (Fed 60% of AL) and a group of AL-fed rats with selective removal of VF at 5 months of age (VF-removed rats). We demonstrate that compared to AL-fed rats, VF-removed rats had a significant increase in mean ( p < < < < 0.001) and maximum lifespan ( p < < < < 0.04) and significant reduction in the incidence of severe renal disease ( p < < < < 0.01). CR rats demonstrated the greatest mean and maximum lifespan ( p < < < < 0.001) and the lowest rate of death as compared to AL-fed rats (0.13). Taken together, these observations provide the most direct evidence to date that a reduction in fat mass, specifically VF, may be one of the possible underlying mechanisms of the antiaging effect of CR. Key words: aging; lifespan; obesity; caloric restriction; visceral fat removal.Caloric restriction (CR) extends lifespan in a variety of species (Weindruch, 1996). In contrast, obesity is a major risk factor for several age-related diseases and has been estimated to markedly lessen life expectancy (Fontaine et al ., 2003). Visceral fat (VF) accretion occurs in obesity and with aging, and a reduction in VF is a common phenotypic change in calorie-restricted mammals (Barzilai & Gupta, 1999). VF has been shown to be the single most important determinant of metabolic syndrome (Carr et al ., 2004), and its removal in rats results in improved insulin action and delays the onset of diabetes Gabriely et al ., 2002). Given the hazards associated with abdominal obesity, it seems plausible that the beneficial effects of CR on longevity may be due at least in part to an attenuation of VF (Barzilai & Gupta, 1999). Here we study the effects of VF removal on the lifespan of rats.We prospectively studied lifespan in three groups of rats: ad libitum -fed (AL-fed), CR (Fed 60% of AL) and a group of AL-fed rats with selective removal of VF at 5 months of age (VF-removed rats). At 20 months of age, a subgroup of animals ( n = 8 per group) were killed to assess body fat distribution. There was no significant difference in body weights among all three groups at the beginning of the study (8 weeks of age) nor were body weights significantly different between AL-fed and VF-removed rats throughout their lifespan (Fig. 1A). However, maximal body weight was achieved at an earlier age in AL-fed rats (69 ± 3 weeks; mean ± SD) than in VF-removed rats (79 ± 3 weeks; p < 0.001), indicating a delay in the age-related weight decline in VF-removed animals. Although V...