Neuraminidase causes endothelial phosphatidylserine externalization and ADAM17 activation: implications for shedding of insulin receptor and endothelial insulin resistance

Endothelial insulin resistance represents a causal factor in the pathogenesis of type 2 diabetes (T2D) and vascular disease, thus underscoring the need to identify molecular mechanisms underlying defects in endothelial insulin signaling. We previously showed that a disintegrin and metalloproteinase-17 (ADAM17) is increased while insulin receptor α-subunit (IRα) is decreased in the vasculature of patients with T2D, leading to impaired insulin-induced vasodilation. We also showed that ADAM17 is a sheddase that targets IRα. Externalization of phosphatidylserine (PS) from the inner to the outer leaflet of cell membranes has been proposed as a pivotal step in the activation of ADAM17. However, whether PS externalization increases ADAM17 sheddase activity and, consequently, shedding of endothelial IRα in T2D is not known. Herein, we hypothesized that neuraminidase (Neu), an enzyme we showed is upregulated in diabetes, leads to PS externalization via activation of Ca2+ influx and subsequent induction of ADAM17 sheddase activity. All reported differences are significant at P<0.05. In support of this hypothesis, we report that Neu and ADAM17 activities are increased in plasma of individuals with T2D, relative to non-T2D subjects. In experiments using cultured endothelial cells, we show that exposure to Neu increases Ca2+ influx and ADAM17 activity. We also find that augmenting endothelial Ca 2+ influx using a calcium ionophore (A23187) increases adhesion of lactadherin (a peptide that binds externalized PS) to the surface of endothelial cells, as does treatment with the ADAM17 activator, PMA, which also reduces IRα on the cells. Importantly, overexpression of ADAM17 in endothelial cells reduces IRα in cell lysates and this coincides with a tendency towards increased IRα in the cell culture supernatant, indicative of protein shedding. Collectively, these findings suggest that Neu causes Ca 2+ influx in endothelial cells, favoring PS externalization and, consequently, increased ADAM17 activity and shedding of IRα. Hence, inhibition of Neu and ADAM17 sheddase activities should be considered as novel potential strategies to improve endothelial insulin signaling in T2D. R01HL151384 (to LAML and JP), R01HL153264 (to LAML and JP), and R01HL137769 (to JP). This is the full abstract presented at the American Physiology Summit 2023 meeting and is only available in HTML format. There are no additional versions or additional content available for this abstract. Physiology was not involved in the peer review process.