Direct deleterious effects of FFAs on β cells are collectively termed "lipotoxicity"(
17). PA elicited INS-1 cells death mainly through apoptosis. Results in our study showed decreased proliferation and increased apoptosis in INS-1 cells induced by PA coincidence with previous study of Sung-E Choi's (
16). An improved INS-1 cells survival was observed following treatment with Liraglutide in FFA environment, suggesting that Liraglutide protected β cells from death. In addition, the ultrastructure analysis of PA-treated INS-1 cells clearly demonstrated the formation of double-membrane autophagosomes and single membrane autolysosomes with the treatment of Liraglutide. Conversion of LC3-Ⅰto LC3-Ⅱin FFA-induced INS-1 cells was significantly increased following the addition of Liraglutide. Such conversion was increased in presence of FFA alone with relatively weak efficiency (
16). Our results demonstrated that Liraglutide was able to elicit autophagosome formation. Some debris in autolysosomes suggested that cytoplasmic organelles were functionally degraded by autophagy. All the data presented in this report suggested that FFA-induced INS-1 cells death was improved in the presence of Liraglutide by stimulated autophagy.
It was previously proposed that β cells lipotoxicity was directly induced by PA at least in part via pathways involving ERs and reactive oxygen species (ROS)(
17,
18). Lipotoxic ERs-mediated β cell dysfunction and apoptosis may be relevant in the development of T2D. Saturated and, to a lesser extent, unsaturated FFA trigger β cell ER stress. Physical ER stress occurs when high demand for protein load occurs, which is readily mitigated by UPR and is actually favorable to the β cells (
19). But persistent ER stress results in rapid accumulation of unfolded proteins, which triggers β cell apoptosis (
20). It is suggested that β cell survival in FFA was the consequence of the enhanced capacity to handle the UPR and thereby prevented INS-1 cell apoptosis from Lipotoxic ERs. In addition to ERs, pancreatic β cells were prone to oxidative stress, due to the fact that antioxidants such as superoxide dismutase (SOD), glutathione peroxidase and catalase were present at low levels in β cells (
21). Oxidative stress can also lead to the accumulation of misfolded proteins. According to these published results, the protective role of Liraglutide observed in our study might be due to the degradation of misfolded proteins accumulation.
Liraglutide, a long-acting GLP-1 analogue, is more efficient in protection of β cells than native GLP-1. Liraglutide inhibited cytokine-induced and FFA-induced apoptosis in islet cells in a dose-dependent manner, which has been concluded that liraglutidemight be useful for retaining β cell mass in both type 1 and type 2 diabetic patients (
3). Liraglutide mediates its anti-apoptotic effects through GLP-1 receptor and its associated signaling cascade (
3). Shimoda‘s results supported that liraglutide affected pancreatic β cell mass in diabetic conditions by directly stimulating cellular proliferation and could reduce triacylglycerol content in db/db mice (
22). Several studies provided evidences of Liraglutide of ameliorating ERs. Liraglutideexerts its effects by inducing mitochondrial fusion, which prevented the onset of ERs induced by high-glucose (
23). In addition, Liraglutide reduced and suppressed oxidative and ER stress by downregulating pro-apoptosis genes and those involved in lipid synthesis (
22). The ultrastructure analysis of PA-treated INS-1 cells in our study clearly indicated the presence of induced autophagy. Not only did these results suggestedLiraglutide stimulated autophagy, but it also provided evidences as to why Liraglutide could improve INS-1 cell survival.
To investigate the role of autophagy in PA-induced INS-1 cell death, 3-MA, a specific inhibitor of class III PI3K was used in our research. An augment of PA-induced INS-1 cell death was shown following treatment of 3-MA, indicating a protective role of autophagy in PA environment. As an adaptive process responding to the metabolic stress, the activated autophagy finally results in degradation of intracellular protein and organelles (
24). Some debris in autolysosomes suggested that cytoplasmic organelles were functionally degraded by autophagy (
16). Thus, autophagy was responsible for removing the overload of unfolded and misfolded protein that exceeded the ER capacity (
25). On the other hand, autophagy could also be implicated in cell death via apoptosis. It was possible that autophagy determined cell fate depending upon the kind and severity of stress (
26,
27). In recent research, macro-autophagy has been identified as a mechanism for removal of fatty acid loads from hepatocytes (
7). Studies by Singh et al. (
9) considered autophagy targeting lipids inside the celllipoautpphagy. Sharma concluded that GLP-1 reduced the fat load in hepatocytes by inducing autophagy. Exendin-4 significantly increased the rate of autophagosome and autophagolysosome formation or autophagic flux (
7). All the published results indicated that Liraglutide induced the level of autophagy to ameliorate FFA-induced cell death from different perspectives. Firstly, Liraglutide exerts its effect through controlling lipid synthesis, and the other mechanism was to remove already accumulated fat load in cells. These provided data consistently supported our observations that Autophagy has been involved in Liraglutide's protective effect.
In conclusion, our data showed that Liraglutide stimulated autophagy in PA-treated INS-1 cells, and induced autophagy played a protective role in PA-induced cell death. Autophagy exerts its effect in ameliorating ERs and removing fat load. Therapies that increase β cell resistance to FFA by Liraglutide, may have clinical application, as they prevent T2D or attenuate the progression of the disease.