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© 2002 The American Society for Nutritional Sciences J. Nutr. 132:3030-3035, October 2002


Nutrient-Gene Interactions

Expression of PDX-1 Is Reduced in Pancreatic Islets from Pups of Rat Dams Fed a Low Protein Diet during Gestation and Lactation1

Vanessa C. Arantes, Vicente P. A. Teixeira{dagger}, Marise A. B. Reis, Márcia Q. Latorraca**, Adriana R. Leite, Everardo M. Carneiro, Áureo T. Yamada* and Antonio C. Boschero2

Departamento de Fisiologia e Biofísica e * Departamento de Histologia e Embriologia, Instituto de Biologia, Universidade Estadual de Campinas, Campinas, SP, Brasil; {dagger} Departamento de Patologia Geral, Faculdade de Medicina do Triângulo Mineiro, Uberaba, MG, Brasil; e ** Departamento de Nutrição e Dietética, Faculdade de Enfermagem e Nutrição, Universidade Federal de Mato Grosso, Cuiabá, Brasil

2To whom correspondence should be addressed. E-mail: boschero{at}unicamp.br.


    ABSTRACT
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 LITERATURE CITED
 
Intrauterine and early postnatal malnutrition has profound consequences on fetal and postnatal development in both humans and animals. In addition, low birth weight has been reported to be associated with impaired insulin secretion, insulin resistance and diminished area of pancreatic islets. Because the transcription factor pancreatic and duodenal homeobox 1 (PDX-1) is important for the maintenance of B-cell physiology, PDX-1 expression and islet area were assessed in neonatal rats of dams fed low (6%) or normal (17%) protein diets during pregnancy. PDX-1 protein and mRNA levels, as well as insulin secretion and islet area, were measured after 28 d of life in normal, low protein and recovered rats whose dams consumed a normal protein diet after delivery. Insulin secretion by isolated islets in response to 2.8 and 16.7 mmol glucose/L was reduced in 28-d-old low protein rats compared with the control (P < 0.05). At birth and after 28 d of life, the islet area and PDX-1 protein expression were also reduced (P < 0.05). In contrast, PDX-1 mRNA levels in islets from 28-d-old low protein rats were not different from control rats. PDX-1 protein expression in pancreatic islets, the area of islets and insulin secretion were restored in recovered rats, whereas PDX-1 mRNA levels were higher than in normal rats (P < 0.05). These results suggest a link among diminished PDX-1 protein expression, a reduction in islet area and impaired insulin secretion in low protein rats. The reintroduction of a normal diet early in life restored islet area and cell physiology.


KEY WORDS: • pancreatic islets • low protein diet • insulin secretion • islet size • rats


    INTRODUCTION
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 LITERATURE CITED
 
The appropriate maternal metabolic environment is essential for development of the fetus, including its endocrine pancreas (1Citation ). In rapidly growing organisms, malnutrition in early life is a serious challenge to which the system tries to adjust. The quantity and/or quality of nutrition in this critical period has permanent consequences for later life. One of the mechanisms of adaptation to an inadequate supply of nutrients is to slow down the rate of cell division in tissues and organs, which may lead to altered "programming" of the structure and function of the system (2Citation –4Citation ).

Based on epidemiologic evidence, malnutrition has been envisaged as an etiological and/or a precipitating factor for diabetes in malnourished individuals in developing countries (5Citation ,6Citation ). The prevalence of type 2 diabetes is much higher in adults with a low weight at birth (7Citation ), and malnutrition is associated with impaired insulin secretion (8Citation ). Alteration in the maternal metabolic milieu during pregnancy influences the development and functional maturation of B cells (9Citation ). Fetal malnutrition in rat pups results in a reduced number of B cells, a diminution in the proliferation of islet cells, reduced islet size and a marked decrease in islet vascularization (10Citation ).

Glucose homeostasis in mammals requires the proper regulation of insulin secretion from pancreatic B cells. The primary signal for secretion is an elevation in blood glucose concentrations that induces the release of stored insulin. Glucose also regulates the transcription (11Citation –14Citation ) and translation (15Citation –18Citation ) of preproinsulin (PPI)3 and stabilizes PPI mRNA (19Citation ). However, the mechanisms by which glucose influences the expression of the PPI gene are less well understood than those that control insulin secretion acutely.

The 5' flanking region of the PPI gene has been studied extensively and a number of important regulatory elements and trans-acting factors have been identified (20Citation ). One of these factors is the homeodomain transcription factor pancreatic duodenal homeobox-1 (PDX-1), which plays an important role in lineage determination in the developing endocrine pancreas (20Citation ,21Citation ). In addition, PDX-1 transactivates insulin, glucose transporter isoform 2 (GLUT-2), glucokinase and somatostatin genes (22Citation ). There is strong evidence supporting a role for PDX-1 in the mechanism by which glucose stimulates insulin gene transcription (23Citation –25Citation ). Glucose stimulates the conversion of PDX-1 from a 31-kDa unphosphorylated to a 46-kDa phosphorylated form in human isolated islets. In B cells, this event appears to be dependent on insulin signaling via the phosphatidylinositol 3-kinase pathway (26Citation ).

In this study, we evaluated the insulin secretion, islet size and PDX-1 expression in islets from rats fed a protein-deficient diet during gestation and lactation, and examined the influence of nutritional recovery on these variables.


    MATERIALS AND METHODS
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 LITERATURE CITED
 
Animals.

The animal experiments were approved by the institutional (UNICAMP) Committee for Ethics in Animal Experimentation. Virgin female Wistar rats (80–90 d old) were obtained from the breeding colony at UNICAMP. Mating was done by housing females with males overnight, and pregnancy was confirmed by examining vaginal smears for the presence of sperm. Pregnant females were separated at random and fed from d 1 of pregnancy until the end of lactation an isoenergetic diet containing 6% protein (low protein diet, LP) or 17% protein (control diet). The protein in the LP diet was replaced by the same amount of carbohydrate as described previously (27Citation ). Some of the control and LP diet rats were killed at birth to determine immunohistochemistry. The remaining rats were assigned to three groups: 1) a control group (C) consisting of rats born to and suckled by dams fed a control diet during pregnancy and lactation; 2) an LP group consisting of the offspring of dams fed a LP diet during both pregnancy and lactation; and 3) a recovered group (R) consisting of the offspring of dams fed the LP diet during pregnancy but fed the control diet during lactation. During the experimental period, the dams consumed their respective diets ad libitum and had free access to water. The rats were housed under standard lighting (12-h light:dark cycle) at a temperature of 24°C. At the end of the experimental period (28 d of life), the rats were killed by decapitation. Serum glucose (glucose enzymatique kit, Biotrol Diagnostic, Chennevières, France) and free fatty acids (Nonesterified Fatty Acid C kit, Wako Chemicals GmbH, Neuss, Germany) were measured immediately. Part of the serum was stored at -20°C for the subsequent measurement of insulin by RIA (28Citation ).

Insulin secretion.

Islets were isolated by collagenase digestion. Briefly, the pancreas was inflated with Hanks solution containing 0.7–0.9 g collagenase/L, excised and then maintained at 37°C for 20 min. The digested tissue was harvested and the islets were handpicked. Groups of five islets were first incubated for 45 min at 37°C in 0.5 mL of Krebs-bicarbonate buffer of the following composition (mmol/L): NaCl, 115; KCl, 5; CaCl2, 2.56; MgCl2, 1; NaHCO3, 24; and glucose, 5.6, supplemented with 3 g/L bovine serum albumin and equilibrated with a mixture of 95%O2/5%CO2, pH 7.4. This medium was then replaced with fresh buffer and the islets incubated for 90 min in the presence of 2.8 or 16.7 mmol/L glucose. The insulin in the medium at the end of the incubation period was measured by RIA (28Citation ).

Morphometry and immunohistochemistry.

The pancreata were excised and dissected free of surrounding tissues, weighed and fixed by immersion in 10% formaldehyde-PBS solution. The fixed tissue was embedded in paraffin using a standardized protocol, then cut in 6-µm thick sections and mounted on glass slides. The sections were counterstained with hematoxylin-eosin for morphometric analysis. The islet area was measured by planimetry using a MOP-Videoplan image analysis software (Kontron Eletronik, Munich, Germany). The sectional area of islets was measured at a magnification of 40X.

Every 10th section from each pancreas was deparaffinized, rehydrated and heated in 10 mmol/L citrate buffer (pH 6.0) at 92°C for 10 min in a microwave oven for antigen retrieval. After cooling at room temperature, the sections were washed three times with PBS, and endogenous peroxidase was blocked by a 30-min incubation with 3% H2O2 at room temperature. For PDX-1 immunohistochemistry, sections were incubated overnight at 4°C with polyclonal rabbit anti-PDX-1 antibody diluted 1:1000. Detection was with a streptavidin-biotin-peroxidase complex developed with aminoethylcarbazol (Zymed, San Francisco, CA). As a negative control, liver slices underwent similar treatment, and no positive reactions to the antibody against PDX-1 were observed (not shown).

Western blot.

After isolation by collagenase digestion of pancreata and subsequent separation on discontinuous lyophilized Ficoll DL-400 gradients, a pool of at least 1000 clean islets from each experimental group was homogenized by sonication (15 s) in an anti-protease cocktail (10 mmol/L imidazole, pH 8.0, 4 mmol/L EDTA, 1 mmol/L EGTA, 0.5 mg/L pepstatin A, 2 mg/L aprotinin, 2.5 mg/L leupeptin, 30 mg/L trypsin inhibitor, 200 µmol/L DL-dithiothreitol and 200 µmol/L phenylmethylsulfonyl fluoride. After sonication, an aliquot of extract was collected and the total protein content was determined by the dye-binding protein assay kit (Bio-Rad Laboratories, Hercules, CA). Samples of crude membrane preparations from each experimental group containing 70 µg of protein were incubated for 5 min at 80°C with 5X concentrated Laemmli sample buffer (1 mmol/L sodium phosphate, pH 7.8, 0.1% bromophenol blue, 50% glycerol, 10% SDS, 2% mercaptoethanol) (4:1, v/v). The samples were then run on 10% polyacrylamide gels. Electrotransfer of proteins to nitrocellulose membranes (Bio-Rad) was done for 1 h at 120 V (constant) in buffer containing methanol and SDS. After checking the efficiency of transfer by Ponceau S staining, the membranes were blocked with 50 g/L dry skimmed milk in TTBS (10 mmol/L Tris, 150 mmol/L NaCl, 0.5% Tween 20) overnight at 4°C. PDX-1 was detected in the membrane after a 2-h incubation at room temperature with a rabbit polyclonal antibody against PDX-1 (diluted 1:2500 in TTBS plus 30 g/L dry skimmed milk). The membrane was then incubated with a rabbit anti-mouse immunoglobulin G (diluted 1:1500 in TTBS plus 30 g/L dry skimmed milk) followed by a further 2-h incubation at room temperature with I125-labeled protein A (diluted 1:1000 in TTBS plus 10 g/L dry skimmed milk). Radiolabeled protein bound to the antibody was detected by autoradiography. Band intensities were quantified by optical densitometry (Scion Image, Frederick, MD) of the developed autoradiogram.

mRNA expression.

Total RNA from 400 islets, isolated and separated as described for Western blot analysis, was extracted using TriZol reagent (Life Technologies, Auckland, New Zealand). For polymerase chain reaction (PCR) analysis, RNA (2 µg) was reverse-transcribed using oligo(DT) primers. The resulting cDNA were amplified by PCR using oligonucleotides complementary to sequences in the PDX-1 gene (5'-CCGAATGGAACCGAGACTGG-3' and 5'-AGGTGGTGGCTTTGGCAATG-3') and phospholipase A2 gene (5'-CTGCTGGCTGCTTTGCTCAC-3'and 5'-ACGGCATAGACAGGAAGTGGG-3'), with the latter as the internal control. The PCR was done in a 25-µL reaction volume containing 1 µL cDNA, 0.05 mmol/L each cold dNTP (dATP, dCTP, dGTP, dTTP), 0.37 mmol/L MgCl2, 0.25X PCR buffer, 0.1 µmol/L of appropriate oligonucleotides primers, and 1 U Taq polymerase (Life Technologies). The PCR amplification conditions for PDX-1 were as follows: 3 min at 94°C followed by 29 cycles (30 s each) at 94, 59 and 72°C, and for phospholipase A2 (internal control), 2 min at 94°C followed by 25 cycles (30 s each) at 94, 58 and 72°C. Because actin was altered in LP islets, it was not used as an internal control. The PCR products were separated on a 1.5% agarose gel in Tris borate EDTA buffer 1X (TBE 1X) and stained with ethidium bromide. All PCR included a negative control. The absence of genome contamination in the RNA samples was confirmed by the reverse transcription–negative RNA samples. The relative band intensities were determined by densitometry and the ratio of PDX-1 to phospholipase A2 was calculated for each sample.

Statistical analysis.

The results were expressed as means ± SEM. Student’s two-tailed unpaired t test was used to compare the normal (C) and LP groups at birth. Levene’s test for homogeneity of variances was initially used to check the normality of the data before testing with parametric ANOVA. One-way ANOVA was used to compare the body and pancreas weights, serum glucose, insulin and FFA levels, islet areas and aggregates positive for PDX-1 in the C, LP and R groups at 28 d of life. Two-way ANOVA followed by the Bonferroni’s test was used to evaluate differences in insulin secretion. A two-way frequency table (29Citation ) was used to verify whether the distribution of islet size was affected by protein deprivation and by nutritional recovery. A P-value < 0.05 indicated a significant difference. All statistical analyses were done using the Statistica software package (Statsoft, Tulsa, OK).


    RESULTS
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 LITERATURE CITED
 
Characteristics of the rats.

At birth, pups from dams fed the LP diet during pregnancy had lower body and pancreas weights than control pups. The serum glucose but not insulin level was reduced, whereas serum FFA were higher than in control pups. After 28 d, LP rats had lower body and pancreas weights, reduced serum glucose and insulin levels, and greater serum FFA concentrations than C and R rats (P < 0.001). Except for body and pancreas weights, which were higher than in C rats (P < 0.001), all variables were normalized in the R pups (Table 1Citation ).


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TABLE 1 Body and pancreas weights and serum glucose, insulin and free fatty acids (FFA) of control (C), low protein (LP) and recovered (R) rats 1 and 28 d after birth1

 
Insulin secretion.

Insulin secretion in the presence of 2.8 and 16.7 mmol glucose/L was lower in islets from LP pups than in those from controls (P < 0.05). In islets from R pups, secretion was restored to values not different from those in controls (Fig. 1Citation ).



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FIGURE 1 Glucose stimulation of insulin secretion in islets from control (C), low protein (LP) and recovered (R) rats. Groups of five islets were incubated for 45 min in Krebs-bicarbonate medium containing 5.6 mmol glucose/L, after which the medium was replaced with Krebs solution containing 2.8 mmol (A) or 16.7 mmol glucose/L (B) The columns represent the cumulative 90-min insulin secretion and are the means ± SEM, n = 4–6 independent experiments. Means without a common letter differ, P < 0.05.

 
Islet area.

At birth, the area of islets from LP rats was significantly lower than C rats (P < 0.0001). After weaning, the area of islets from C and R rats did not differ but was still reduced in LP rats (P < 0.001 LP vs. C and R) (Table 2Citation ). Newborn LP rats had 71% of islets with the lowest size class (<4000 µm2), whereas C rats had 31% islets of intermediate size (4000–8000 µm2) and 21% of the highest (>8000 µm2) size class (G = 32.04; df = 2; P < 0.001). In weaned rats (C vs. R groups: G = 1.75, df = 2, P = 0.42; C vs. LP groups: G = 28.2, df = 2, P < 0.001; R vs. LP groups: G = 34.17, df = 2, P < 0.001), the frequency of the lowest size class (<5000 µm2) was not different in R (44%) and C (49%) groups, and was lower than in the LP pups (74%). The frequency of both intermediate (5000–10,000 µm2) and highest (>10,000 µm2) size classes in R rats (36 and 21%, respectively) did not differ from that of C rats (35% and 16%, respectively). In both cases, these were higher than in the LP group (18 and 8%, respectively).


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TABLE 2 Number of positive pancreatic duodenal homeobox 1 (PDX-1) aggregates and area of islets of control (C), low protein (LP) and recovered (R) rats 1 and 28 d after birth1

 
PDX-1 mRNA and protein expression.

PDX-1 expression in islets from 28-d-old C, LP and R rats was analyzed by immunoblotting using a polyclonal anti-PDX-1 antibody (Fig. 2Citation ). A 46-kDa protein representing PDX-1 was detected in all three tissue extracts. Densitometry of the bands showed that the amount of PDX-1 in the extract from LP islets was ~50% lower than in extracts from C and R islets (P < 0.01). The presence of PDX-1 in B cells was confirmed by immunocytochemistry. PDX-1 labeling was located in the nucleus of the islet cells and showed a bright, interspersed pattern within the nucleus (Fig. 3Citation , upper panels). The number of positive cells for PDX-1 was higher in islets from control than LP diet pups on d 1 (Fig. 3Citation A, B). PDX-1 labeling was also detected in pancreatic duct cells (Fig. 3Citation A). Figure 3Citation (CE) shows that PDX-1 expression in islets from 28-d-old LP rats (D) was lower than in islets from C rats (C) and was normalized in islets from R rats (E). The number of aggregates positive for PDX-1 (Table 2)Citation in islets from LP pups was ~20% of that in islets from controls at birth and after weaning (P < 0.05). The number of positive aggregates in R islets was not different from that in C islets. The positive aggregates represent, in fact, the number of PDX-1 immunopositive cells per islet area.



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FIGURE 2 Pancreatic duodenal homeobox 1 (PDX-1) protein content in islets from control (C), low protein (LP) and recovered (R) rats. Each lane contained 70 µg of protein extracted from isolated islets from 28-d-old rats. PDX-1 was detected by immunoblotting with polyclonal anti-PDX-1 antibody. Values are the means ± SEM, n = 3 independent experiments. Means without a common letter differ, P < 0.05.

 


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FIGURE 3 Immunolocalization of pancreatic duodenal homeobox 1 (PDX-1) in islets from control (C) (A) and low protein (LP) pups (B) at birth and in C (C), LP (D) and recovered (R) (E) rats after weaning. Note the greater amount of PDX-1 positive granules in islets from C and R rats, and the preferential location of PDX-1 in the nucleus. PDX-1 positive granules were also detected (arrow) in cells from pancreatic ducts (A). Magnification, 40 x.

 
In contrast, the PDX-1 mRNA concentrations in islets from 28-d-old LP and C rats did not differ and were less than in islets from recovered rats (P < 0.05) (Fig. 4Citation ). These results suggest that the reduced expression of PDX-1 protein in LP rats was because of alterations in the translational process.



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FIGURE 4 Pancreatic duodenal homeobox 1 (PDX-1) mRNA levels in pancreatic islets from control (C), low protein (LP) and recovered (R) 28-d-old rats. Total RNA was extracted from ~ 400 islets for each group and reverse-transcribed. Equal amounts of cDNA were subjected to polymerase chain reaction using primers complementary to the 5' and 3' ends of the PDX-1 and phospholipase A2 genes. The mRNA concentrations of PDX-1 was expressed relative to phospholipase A2 mRNA. The columns are the means ± SEM, n = 4 independent experiments. Means without a common letter differ, P < 0.05.

 

    DISCUSSION
 TOP
 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
 LITERATURE CITED
 
In this study, we investigated the effect of a low protein diet during fetal life and lactation on insulin secretion, islet area and PDX-1 expression. Newborn and weaned LP rats showed typical features of protein malnutrition, including a low body weight and high FFA. A reduction in body weight was associated with low serum glucose levels in pups from LP dams compared with those from C dams (8Citation ). As previously reported, low maternal glycemia caused by malnutrition accounted for the reduced liver glycogen concentration and consequent low serum glucose levels of the offspring (30Citation ). The reduced body weight of LP rats may also have been related to the reduced serum insulin levels. Insulin exerts a profound effect on the growth of organs and on fetal metabolism, as judged by the hyperinsulinemia and macrosomia of neonates from noncompensated diabetic mothers (31Citation ). In weaned LP rats, the postprandial serum glucose levels were lower than in C and R rats. These results were consistent with an increased sensitivity to insulin in the target tissues of these animals (32Citation ). In R rats, all features were normalized, except for the body and pancreas weights which were still higher than in C rats. These findings confirmed and extended previous observations that no obvious alterations persisted at weaning when the protein deficiency was restricted to fetal life (33Citation –35Citation ).

Protein deficiency impairs insulin secretion (8Citation ), and this was confirmed by our experiments with isolated islets. LP islets showed reduced glucose-induced insulin secretion in the presence of a high concentration of glucose (16.7 mmol/L) compared with the C and R groups. It is conceivable that different steps in the mechanism of insulin secretion may be altered, such as a reduction in Ca2+ uptake by the islets (36Citation ).

A reduction in islet size, a decrease in B-cell proliferation and a reduction in the size of the islet vascular bed have been related to protein restriction during pregnancy (10Citation ). At birth, pups from LP dams had a much lower pancreas weight and islet size compared with the controls. After weaning (28 d old), these alterations were still present in LP rats, but the islet size was fully normalized in R rats, showing that the endocrine pancreas has considerable plasticity and is able to adapt to environmental changes during development, but only when the protein deficiency is restricted to fetal life (35Citation ). Thus, independent of the increased sensitivity to insulin in target tissues, the reduced insulin secretion in islets from LP pups may result from intrinsic alterations in islets such as a smaller size and/or a reduced volume of B cells (37Citation ).

One explanation for the reduced size of islets in LP rats could be the decrease in serum glucose, which could signal to the B cells that less insulin is required, so that the latter would not have to replicate or increase in size (38Citation ). In addition, amino acids, particularly branched-chain amino acids, may promote B-cell proliferation by stimulating the phosphorylation of PHAS-1 (a regulator of translation initiation during mitogenesis) and by facilitating the proliferative effects mediated by growth factors (39Citation ). Because branched-chain amino acids are most depleted in the plasma of fetuses from LP dams (40Citation ), this could explain the lower rate of B-cell proliferation in the pancreas of LP pups. A reduced expression of insulin growth factor II may also contribute to the lower B-cell proliferation rate and increased apoptosis observed in the fetus and neonate after exposure to a LP diet (41Citation ).

Alterations such as a reduced insulin secretion and a smaller size or reduced cell volume for B cells may also result from a decrease in insulin synthesis (10Citation ). PDX-1 is an important B cell–specific transcription factor (42Citation ) that links glucose metabolism to the regulation of insulin gene transcription (43Citation ). Glucose activates PDX-1 through an insulin-dependent cell signaling pathway involving phosphatidylinositol 3-kinase. The stimulation of this pathway leads to phosphorylation and the activation of a cytoplasmic form of PDX-1 that translocates to the nucleus (26Citation ). Thus, lower levels of circulating glucose in LP rats could contribute to the reduced PDX-1 expression.

The exposure of isolated islets to high concentrations of palmitic acid reduced PDX-1 mRNA and protein expression as well as PDX-1 binding activity for its cis regulatory elements in the insulin and GLUT-2 genes (22Citation ). However, in islets from LP and C rats, PDX-1 mRNA levels were similar, indicating that the change in FFA levels in vivo can not account for the altered PDX-1 mRNA expression. The reduced PDX-1 protein expression in islets from LP rats was probably related to alterations in the translation process, as recently proposed (44Citation ).

Taken together, these results indicate that a low protein diet during the fetal and lactation periods leads to alterations in islet size and functionality. These effects are linked to a reduction in PDX-1 protein, but not PDX-1 mRNA expression. The reintroduction of a normal diet immediately after birth normalizes the expression of PDX-1 protein and restores the islets cell mass and B-cell secretory capacity.


    ACKNOWLEDGMENTS
 
The authors thank L. D. Teixeira and V. Pereira for technical assistance, O. D. Madsen (Hagerdorn Research Institute-Denmark) for the antibody anti-PDX-1, S. Hyslop for language editing and C. H. Fregadolli for statistical analysis.


    FOOTNOTES
 
1 Supported by the Brazilian foundations CNPq, FAPESP, and CNPq/PRONEX. Back

3 Abbreviations used: C, control; FFA, free fatty acid; GLUT-2, glucose transporter isoform 2; LP, low protein; PCR, polymerase chain reaction; PDX-1, pancreatic duodenal homeobox 1; PPI, preproinsulin; R, recovered; TTBS, Tris Tween-20 buffered saline. Back

Manuscript received 19 April 2002. Initial review completed 30 May 2002. Revision accepted 19 July 2002.


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 ABSTRACT
 INTRODUCTION
 MATERIALS AND METHODS
 RESULTS
 DISCUSSION
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