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C-Peptid

Neuer Therapieansatz bei mikrovaskulären Komplikationen des Typ-1-Diabetes?

C-peptide

Novel therapeutic approach to microvascular complications of type 1 diabetes?

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Zusammenfassung

Zahlreiche Forschungsergebnisse zur Physiologie des C-Peptids wurden in den vergangenen 20 Jahren publiziert. Nachweislich bindet C-Peptid spezifisch an Zellmembranen und setzt die intrazelluläre Signaltransduktion über G-Protein- und Ca2+-abhängige Signalwege in Gang. Dies führt zur Aktivierung und gesteigerten Expression der endothelialen Stickstoffmonoxid-Synthase, der Na+/K+-ATPase und mehrerer Transkriptionsfaktoren, die für antiinflammatorische und zytoprotektive Mechanismen wichtig sind. Tiermodelle des Diabetes und frühe klinische Studien an Typ-1-Diabetikern zeigen, dass C-Peptid in Substitutionsdosis einen positiven Effekt auf frühe Stadien diabetesinduzierter funktioneller und struktureller Anomalien peripherer Nerven, des autonomen Nervensystems und der Nieren hat. Der Forschungsbedarf in Bezug auf C-Peptid und dessen Wirkmechanismus ist weiterhin groß. Dennoch zeichnen die verfügbaren Daten das Bild eines bioaktiven Peptids mit therapeutischem Potenzial.

Abstract

Much information on C-peptide physiology has been published during the past 20 years. It has been shown that C-peptide binds specifically to cell membranes and elicits intracellular signaling via G-protein and Ca2+-dependent pathways, resulting in activation and increased expression of endothelial nitric oxide synthase, Na+/K+-ATPase, and several transcription factors of importance for anti-inflammatory and cell protective mechanisms. Studies in animal models of diabetes and early clinical trials in patients with type 1 diabetes demonstrate that C-peptide in replacement doses has beneficial effects on early stages of diabetes-induced functional and structural abnormalities of the peripheral nerves, autonomic nervous system, and kidneys. Although there is still much to be learned about C-peptide and its mechanism of action, the available evidence presents the picture of a bioactive peptide with therapeutic potential.

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Interessenkonflikt

Der korrespondierende Autor weist für sich und seinen Koautor auf folgende Beziehung hin: J. Wahren und Å. Kallas sind Angestellte von Cebix AB, Stockholm, Schweden.

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  1. Department of Molecular Medicine and Surgery, Karolinska Institutet, Fogdevreten 2, 17165, Solna, Schweden

    J. Wahren & Å. Kallas

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Correspondence to J. Wahren.

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Wahren, J., Kallas, Å. C-Peptid. Diabetologe 9, 319–332 (2013). https://doi.org/10.1007/s11428-013-1044-0

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