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The bile acid receptors, farnesoid X receptor (FXR) and Takeda G-protein-coupled receptor 5 (TGR5), regulate multiple pathways, including glucose and lipid metabolism. In a rabbit model of high-fat diet (HFD)-induced metabolic syndrome, long-term treatment with the dual FXR/TGR5 agonist INT-767 reduces visceral adipose tissue accumulation, hypercholesterolemia and nonalcoholic steatohepatitis. INT-767 significantly improves the hallmarks of insulin resistance in visceral adipose tissue (VAT) and induces mitochondrial and brown fat-specific markers. VAT preadipocytes isolated from INT-767-treated rabbits, compared to preadipocytes from HFD, show increased mRNA expression of brown adipogenesis markers. In addition, INT-767 induces improved mitochondrial ultrastructure and dynamic, reduced superoxide production and improved insulin signaling and lipid handling in preadipocytes. Both in vivo and in vitro treatments with INT-767 counteract, in preadipocytes, the HFD-induced alterations by upregulating genes related to mitochondrial biogenesis and function. In preadipocytes, INT-767 behaves mainly as a TGR5 agonist, directly activating dose dependently the cAMP/PKA pathway. However, in vitro experiments also suggest that FXR activation by INT-767 contributes to the insulin signaling improvement. INT-767 treatment counteracts HFD-induced liver histological alterations and normalizes the increased pro-inflammatory genes. INT-767 also induces a significant reduction of fatty acid synthesis and fibrosis markers, while increasing lipid handling, insulin signaling and mitochondrial markers. In conclusion, INT-767 significantly counteracts HFD-induced liver and fat alterations, restoring insulin sensitivity and prompting preadipocytes differentiation toward a metabolically healthy phenotype. [ABSTRACT FROM AUTHOR]

Introduction In subjects with erectile dysfunction responding poorly to sildenafil, metformin was reported to improve erections. Aims The aim of this study is to investigate metformin's mechanism of action on erectile function, particularly focusing on adenosine ( ADO) and nitric oxide ( NO) signaling in an animal model of high-fat diet ( HFD)-induced metabolic syndrome. Methods In vitro contractility studies of penile strips. Penile expression of genes related to ADO or NO signaling was also evaluated. Main Outcome Measure In vitro contractility studies were used to investigate the effect of in vivo and ex vivo metformin administration on ADO- or acetylcholine ( Ach)-induced relaxation of penile strips from HFD as compared with animals fed a regular diet ( RD). Results Expression of ADO receptor type 3 ( A3R), ADO deaminase ( ADA), AMP deaminase type 1 ( AMPD1), and 2 ( AMPD2) was decreased in HFD as compared with RD. Accordingly, in HFD the ADO relaxant effect was potentiated as compared with RD ( P < 0.02). In vivo metformin treatment in both RD and HFD significantly increased the ADO relaxing effect ( P < 0.0001 and P < 0.01, respectively, vs. relative untreated groups) although to a different extent. In fact, the half-maximal inhibitory concentration ( IC50)/ IC50 ratio in RD increased fourfold vs. HFD ( RD IC50 ratio = 13.75 ± 2.96; HFD IC50 ratio = 2.85 ± 0.52). In corpora cavernosa ( CC) from HFD, in vivo metformin (i) normalized A3R, ADA, and AMPD1; (ii) further decreased AMPD2; (iii) increased dimethylarginine dimethylamino-hydrolase; and (iv) partially restored impaired Ach-induced relaxation. Ex vivo metformin time and dose dependently increased the relaxant effect of ADO in RD. The potentiating effect of metformin on ADO-induced relaxation was significantly reduced by preincubation with NO synthase inhibitor Nω-Nitro-L-arginine methyl ester hydrochloride ( L-NAME). Interestingly, in vivo testosterone supplementation in HFD rabbits (i) increased penile expression of endothelial NO synthase and AMPD2 and (ii) restored metformin's potentiating effect on ADO-induced relaxation up to RD level. Conclusion Metformin in vivo and ex vivo increases ADO signaling in CC, most probably interfering with NO formation and ADO breakdown. Vignozzi L, Filippi S, Comeglio P, Cellai I, Morelli A, Rastrelli G, Maneschi E, Mannucci E, and Maggi M. Metformin in vitro and in vivo increases adenosine signaling in rabbit corpora cavernosa. J Sex Med 2014;11:1694-1708. [ABSTRACT FROM AUTHOR]

Introduction Metabolic syndrome ( MetS) and lower urinary tract symptoms ( LUTS) are often associated. Bladder detrusor hyper-contractility-a major LUTS determinant-is characterized by increased Ras homolog gene family, member A/Rho-associated protein kinase ( RhoA/ ROCK) signaling, which is often upregulated in MetS. Aim This study investigated the effects of tadalafil dosing on RhoA/ ROCK signaling in bladder, in a rabbit model of high-fat diet ( HFD)-induced MetS. Methods Adult male rabbits feeding a HFD for 12 weeks. A subset of HFD animals was treated with tadalafil (2 mg/kg/day, 1 week: the last of the 12 weeks) and compared with HFD and control (feeding a regular diet) rabbits. Main Outcome Measures In vitro contractility studies to evaluate the relaxant effect of the selective ROCK inhibitor, Y-27632, in carbachol precontracted bladder strips. Evaluation of RhoA activation by its membrane translocation. Immunohistochemistry for ROCK expression has been performed to evaluate ROCK expression in bladder from the different experimental groups. mRNA expression of inflammation, pro-fibrotic markers by quantitative RT-PCR has been performed to evaluate the effect of tadalafil on MetS-induced inflammation and fibrosis within the bladder. The in vitro effect of tadalafil on RhoA/ ROCK signaling in bladder smooth muscle cells was evaluated by using chemotaxis assay. Results Bladder strips from HFD rabbits showed hyper-responsiveness to Y-27632, indicating RhoA/ ROCK overactivity in HFD bladder compared with matched controls. Accordingly, the fraction of activated (translocated to the membrane) RhoA as well as ROCK expression are increased in HFD bladder. Tadalafil dosing normalized HFD-induced bladder hypersensitivity to Y-27632, by reducing RhoA membrane translocation and ROCK overexpression. Tadalafil dosing reduced mRNA expression of inflammatory, pro-fibrotic, and hypoxia markers. A direct inhibitory effect of tadalafil on RhoA/ROCK signaling in bladder smooth muscle cell was demonstrated by using chemotaxis assay. Pre-treatment with tadalafil inhibited both basal and PDGF-induced migration of bladder smooth muscle cells. Conclusions Tadalafil dosing reduced RhoA/ ROCK signaling and smooth muscle overactivity in an animal model of MetS-associated bladder alterations. Our findings suggest a novel mechanism of action of tadalafil in alleviating LUTS in MetS patients. Vignozzi L, Filippi S, Comeglio P, Cellai I, Morelli A, Maneschi E, Sarchielli E, Gacci M, Carini M, Vannelli GB, and Maggi M. Tadalafil effect on metabolic syndrome-associated bladder alterations: An experimental study in a rabbit model. J Sex Med 2014;11:1159-1172. [ABSTRACT FROM AUTHOR]

Highlights: [•] Steatohepatitis (NASH) develops in a rabbit model of metabolic syndrome (MetS). [•] NASH is tightly associated to increased blood TNFα and erectile dysfunction (ED). [•] Liver TNFα is the major determinant of erectile dysfunction. [•] Testosterone or OCA dosing reduce liver and blood TNFα levels and normalize ED. [•] We propose NASH as an active player in MetS-induced erectile dysfunction. [ABSTRACT FROM AUTHOR]

We recently demonstrated that testosterone dosing ameliorated the metabolic profile and reduced visceral adipose tissue (VAT) in a high-fat diet (HFD)-induced rabbit model of metabolic syndrome (MetS). We studied the effects of HFD and in vivo testosterone dosing on VAT function and the adipogenic capacity of rabbit preadipocytes isolated from VAT of regular diet (RD), HFD, and testosterone-treated HFD rabbits. VAT was studied by immunohistochemistry, western blot, andRT-PCR. Isolated rPADswere exposed to adipocyte differentiating mixture (DIM) to evaluate adipogenic potential. Adipocyte size was significantly increased in HFD VAT compared with RD, indicating adipocyte dysfunction, which was normalized by testosterone dosing. Accordingly, perilipin, an anti-lipolytic protein, was significantly increased in HFD VAT, when compared with other groups. HFD VAT was hypoxic, while testosterone dosing normalized VAT oxygenation. In VAT, androgen receptor expression was positively associated with mRNA expression of GLUT4 (SLC2A4) (insulin-regulated glucose transporter) and STAMP2 (STEAP4) (androgen-dependent gene required for insulin signaling). In testosterone-treated HFDVAT, STAMP2 mRNA was significantly increased when compared with the other groups. Moreover, GLUT4 membrane translocationwas significantly reduced in HFD VAT, compared with RD, and increased by testosterone. In DIM-exposed preadipocytes from HFD, triglyceride accumulation, adipocyte-specific genes, insulin-stimulated triglyceride synthesis, glucose uptake, and GLUT4 membrane translocation were reduced compared with preadipocytes from RD and normalized by in vivo testosterone dosing. In conclusion, testosterone dosing in a MetS animal model positively affects VAT functions. This could reflect the ability of testosterone in restoring insulin sensitivity in VAT, thus counteracting metabolic alterations. [ABSTRACT FROM AUTHOR]

Metabolic syndrome (MetS) and benign prostatic hyperplasia (BPH)/lower urinary tract symptoms (LUTS) are often associated. One of their common denominators is hypogonadism. However, testosterone supplementation is limited by concerns for potential prostatic side effects. The objective was to determine whether MetS-associated prostate alterations are prevented by testosterone supplementation. We used a previously described animal model of MetS, obtained by feeding male rabbits a high-fat diet (HFD) for 12 weeks. Subsets of HFD rabbits were treated with testosterone or with the farnesoid X receptor agonist INT-747. Rabbits fed a standard diet were used as controls. HFD-animals develop hypogonadism and all the MetS features: hyperglycemia, glucose intolerance, dyslipidemia, hypertension, and visceral obesity. In addition, HFD-animals show a prostate inflammation. Immunohistochemical analysis demonstrated that HFD-induced prostate fibrosis, hypoxia, and inflammation. The mRNA expression of several proinflammatory (IL8, IL6, IL1b, and TNFa), T lymphocyte (CD4, CD8, Tbet, Gata3, and ROR gt), macrophage (TLR2, TLR4, and STAMP2), neutrophil (lactoferrin), inflammation (COX2 and RAGE), and fibrosis/myofibroblast activation (TGFb, SM22a, aSMA, RhoA, and ROCK1/ROCK2) markers was significantly increased in HFD prostate. Testosterone, as well as INT-747, treatment prevented some MetS features, although only testosterone normalized all the HFD-induced prostate alterations. Interestingly, the ratio between testosterone and estradiol plasma level retains a significant, negative, association with all the fibrosis and the majority of inflammatory markers analyzed. These data highlight that testosterone protects rabbit prostate from MetS-induced prostatic hypoxia, fibrosis, and inflammation, which can play a role toward the development/progression of BPH/LUTS. [ABSTRACT FROM AUTHOR]

Metabolic Syndrome (MetS) is a cluster of clinical conditions, associated to an increased cardiovascular (CV) and metabolic risk along with hypogonadism (HG). Lifestyle modifications (including physical exercise, PhyEx) are well-known treatments for this condition [1]. We previously established a rabbit model of MetS that recapitulates the human phenotype, including HG [2]. We now report studies on the effects of PhyEx on hypothalamus-pituitary-testis (HPT) axis. MetS was induced in adult male rabbits fed a high-fat diet (HFD). Rabbits fed a regular diet were used as controls (RD). RD and HFD rabbits were exercise-trained to run on a treadmill for 12 weeks (RD + PhyEx and HFD+ PhyEx). HFD rabbits showed typical metabolic and CV features of MetS along with hypogonadotropic HG (reduced testosterone and LH plasma levels). Within the hypothalamus (preoptic region) a significant reduction of GnRH- and KISS1R-positive neurons, along with the increase of genes related to inflammation (COX2, IL6, CD68), glucose metabolism (GLUT1, GLUT4, IRS-1) and estrogen action (ERb, GPR30) was detected in HFD rabbit, as compared to RD group. Immunohistochemistry analysis confirmed the HFD-induced hypothalamic inflammation. Interestingly, genes encoding for inhibitory factors for GnRH, such as NPY, were also increased in HFD hypothalamus. Within the testis, HFD down-regulated LH receptor and all the steroidogenic enzymes leading to T synthesis. PhyEx completely restored T and LH plasma levels and GnRH/KISS1R immunostaining. All the aforementioned HDF-induced increase of inflammatory markers were significantly reduced in HFD+ PhyEx, with the exception of IL6. Moreover, at hypothalamic level, PhyEx decreased orexigenic and GnRH-inhibiting factors (dinorphin and its receptors OPRD1 and OPRK1), whereas increased anorexigenic ones (POMC). Within the testis, genes related to T formation (17ßHSD3) and metabolism (5a-reductase 1) were increased by PhyEx. In conclusion, in this experimental model, endurance training (PhyEx) completely reverted MetS-induced hypogonadotropic hypogonadism, exerting beneficial effects on the HPT axis. Particularly, in the hypothalamus PhysEX reduced HFD-induced inflammation. Hence, aerobic exercise training can be regarded an interesting strategy to combat MetS-associated alterations of the HPT axis. [ABSTRACT FROM AUTHOR]

The influence of metabolic syndrome (MetS) on sperm quality and function is debated. Using a well-established high fat diet (HFD) rabbit model resembling human MetS, including development of hypogonadism, we demonstrate that HFD decreased sperm motility, morphology and acrosome reaction in response to progesterone and increased sperm cholesterol content. All the above parameters were associated with most MetS features, its severity and plasma testosterone (T) at univariate analysis. After T adjustment, sperm morphology and motility retained a significant association, respectively, with mean arterial pressure and circulating cholesterol levels. MetS modified the expression of inflammatory and tissue remodelling genes in the testis and of aquaporins in the epididymis. In a multivariate analysis, sperm morphology resulted associated with testis expression of fibronectin and collagen type 1 genes, whereas motility with epididymis aquaporin 1 gene. Administration of tamoxifen, used in the treatment of idiopathic male infertility, to HFD rabbits partially restored motility, but further decreased morphology and increased spontaneous acrosome reaction, without restoring responsiveness to progesterone. Overall our results indicate that development of MetS produces detrimental effects on sperm quality and functionality by inducing metabolic disorders leading to alterations in testis and epididymis functions and evidence a role of hypertension as a new determinant of abnormal sperm morphology, in line with a previous human study from our group. [ABSTRACT FROM AUTHOR]

Abstract: In the male, metabolic syndrome (MetS) is associated to an increased risk of benign prostatic hyperplasia (BPH) and lower urinary tract symptoms (LUTS). A recently established rabbit model of high fat diet (HFD)-induced MetS showed hypogonadism and the presence of prostate gland alterations, including inflammation, hypoxia and fibrosis. The present study investigated whether HFD-induced MetS might also alter bladder structure and function. Testosterone and the farnesoid X receptor (FXR) agonist INT-747, were evaluated for possible effects on HFD bladder. MetS rabbits develop bladder alterations, including fibrosis (reduced muscle/fiber ratio), hypoxia [2-fold increase as compared to regular diet (RD) group], low-grade inflammation (increased leukocyte infiltration and inflammatory markers) and RhoA/ROCK hyperactivity. Bladder strips from HFD rabbits, pre-contracted with carbachol, showed an overactive response to the selective ROCK inhibitor Y-27632. All these HFD-induced bladder alterations were partially blunted by testosterone and almost completely reverted by INT-747. Both treatments prevented some MetS features (glucose intolerance and visceral fat increase), thus suggesting that their effects on bladder could be ascribed to an improvement of the metabolic and/or hypogonadal state. However, a pathogenetic role for hypogonadism has been ruled out as GnRH analog-induced hypogonadal rabbits, fed a regular diet, did not show any detectable bladder alterations. In addition, INT-747 did not revert the MetS-induced hypogonadal state. FXR mRNA was highly expressed in rabbit bladder and positively associated with visceral fat increase. A direct effect of INT-747 on bladder smooth muscle was further suggested by inhibition of RhoA/ROCK-mediated activity by in vitro experiments on isolated cells. In conclusion, HFD-related MetS features are associated to bladder derangements, which are ameliorated by testosterone or INT-747 administration. INT-747 showed the most marked effects in counteracting MetS-related RhoA/ROCK overactivity, thus opening novel therapeutic opportunities for this drug. [Copyright &y& Elsevier]

Highlights: [•] Feeding rabbits with HFD induces MetS and hypogonadotropic hypogonadism (HH). [•] MetS-related HH is associated with hypothalamic inflammation and reduced KISS1R. [•] Overexpression of IL-6 and GLUT4 negatively correlated to gonadotropin deficiency. [•] Correcting glucose intolerance improves hypothalamic inflammation and GnRH expression. [ABSTRACT FROM AUTHOR]