Type 2 diabetes mellitus (T2DM) is a major cause of morbidity and mortality among the U.S. population. Therefore, new and better ways to prevent and treat T2DM are urgently needed. Insulin resistance is one of the earliest and most significant abnormalities in the pathogenesis of T2DM. However, the molecular basis for the insulin resistance of T2DM is not fully understood. Toll-like receptor (TLR) 4 is a cell surface receptor that generates immune responses by activating a cascade of pro-inflammatory events. TLR4 is expressed on insulin-target (myocytes, hepatocytes, adipocytes) and inflammatory (monocytes/macrophages) cells. This receptor is activated by bacteria-derived lipopolysaccharide (LPS) and by saturated free fatty acids (FFA). Studies from various groups, including ours, have shown that TLR4 expression is elevated in muscle and inflammatory cells from insulin resistant subjects. Several studies also have demonstrated that the plasma concentration of two TLR4 ligands, FFA and LPS, is increased in obese and T2DM subjects. Moreover, emerging evidence from cell culture and animal studies suggest that TLR4 and downstream pathways [MAPKs and nuclear factor (NF)?B] could play an important role in the pathogenesis of insulin resistance and T2DM. Despite the considerable body of data linking TLR4 with insulin resistance, it is not known whether TLR4 is directly involved in the pathogenesis of insulin resistance in obese and T2DM human subjects. In this study, we will utilize a specific TLR4 inhibitor in vivo with the goals to (i) determine the role that TLR4 signalng plays in the pathogenesis of insulin resistance and T2DM in humans;and (ii) elucidate the mechanism/s by which TLR4 mediates insulin resistance in human subjects. We propose two Aims to test the following hypotheses: (1) Pharmacologic inhibition of TLR4 with E5564 will prevent lipid-induced insulin resistance in lean normal glucose-tolerant subjects;and (2) Pharmacologic inhibition of TLR4 with E5564 will reduce inflammation and improve glucose metabolism in insulin resistant (obese nondiabetic and obese T2DM) subjects. The results from this study will advance our understanding about the pathophysiology of insulin resistance in human subjects, and, if positive, will validate TLR4 as a viable target for T2DM prevention and treatment.

Public Health Relevance

The causes of type 2 diabetes are not fully understood. In this study we will test whether blocking a molecule called TLR4 with a pharmacologic agent can improve glucose (sugar) metabolism in obese and type 2 diabetic subjects. Our findings could help design new ways to prevent and treat type 2 diabetes.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
Project #
Application #
Study Section
Special Emphasis Panel (ZRG1-EMNR-R (02))
Program Officer
Abraham, Kristin M
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
University of Texas Health Science Center
Schools of Medicine
San Antonio
United States
Zip Code
Hussey, Sophie E; Lum, Helen; Alvarez, Andrea et al. (2014) A sustained increase in plasma NEFA upregulates the Toll-like receptor network in human muscle. Diabetologia 57:582-91
Hussey, Sophie E; Liang, Hanyu; Costford, Sheila R et al. (2013) TAK-242, a small-molecule inhibitor of Toll-like receptor 4 signalling, unveils similarities and differences in lipopolysaccharide- and lipid-induced inflammation and insulin resistance in muscle cells. Biosci Rep 33:37-47
Liang, Hanyu; Tantiwong, Puntip; Sriwijitkamol, Apiradee et al. (2013) Effect of a sustained reduction in plasma free fatty acid concentration on insulin signalling and inflammation in skeletal muscle from human subjects. J Physiol 591:2897-909
Liang, Hanyu; Hussey, Sophie E; Sanchez-Avila, Alicia et al. (2013) Effect of lipopolysaccharide on inflammation and insulin action in human muscle. PLoS One 8:e63983
Jensen, Jorgen; Tantiwong, Puntip; Stuenaes, Jorid T et al. (2012) Effect of acute exercise on glycogen synthase in muscle from obese and diabetic subjects. Am J Physiol Endocrinol Metab 303:E82-9
Martinez, H G; Quinones, M P; Jimenez, F et al. (2011) Critical role of chemokine (C-C motif) receptor 2 (CCR2) in the KKAy + Apoe -/- mouse model of the metabolic syndrome. Diabetologia 54:2660-8
Deepa, Sathyaseelan S; Zhou, Lijun; Ryu, Jiyoon et al. (2011) APPL1 mediates adiponectin-induced LKB1 cytosolic localization through the PP2A-PKCzeta signaling pathway. Mol Endocrinol 25:1773-85
Ghosh, Sangeeta; Lertwattanarak, Raweewan; Lefort, Natalie et al. (2011) Reduction in reactive oxygen species production by mitochondria from elderly subjects with normal and impaired glucose tolerance. Diabetes 60:2051-60
Joya-Galeana, J; Fernandez, M; Cervera, A et al. (2011) Effects of insulin and oral anti-diabetic agents on glucose metabolism, vascular dysfunction and skeletal muscle inflammation in type 2 diabetic subjects. Diabetes Metab Res Rev 27:373-82
Bokov, Alex F; Garg, Neha; Ikeno, Yuji et al. (2011) Does reduced IGF-1R signaling in Igf1r+/- mice alter aging? PLoS One 6:e26891

Showing the most recent 10 out of 16 publications