The gastrointestinal tract is a major source of the acute metformin-stimulated rise in GDF15
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jats:titleAbstract</jats:title>jats:pThe hormone GDF15 is secreted in response to cellular stressors. Metformin elevates circulating levels of GDF15, an action important for the drug’s beneficial effects on body weight. Metformin can also inhibit mammalian respiratory complex I, leading to decreases in ATP:AMP ratio, activation of AMP Kinase (AMPK), and increased GDF15 production. We undertook studies using a range of mice with tissue-specific loss of jats:italicGdf15</jats:italic> (namely gut, liver and global deletion) to determine the relative contributions of two classical metformin target tissues, the gut and liver, to the elevation of GDF15 seen with metformin. In addition, we performed comparative studies with another pharmacological agent, the AMP kinase pan-activator, MK-8722. Deletion of jats:italicGdf15</jats:italic> from the intestinal epithelium significantly reduced the circulating GDF15 response to oral metformin, whereas deletion of jats:italicGdf15</jats:italic> from the liver had no effect. In contrast, deletion of jats:italicGdf15</jats:italic> from the liver, but not the gut, markedly reduced circulating GDF15 responses to MK-8722. Further, our data show that, while GDF15 restricts high-fat diet-induced weight gain, the intestinal production of GDF15 is not necessary for this effect. These findings add to the body of evidence implicating the intestinal epithelium in key aspects of the pharmacology of metformin action.</jats:p>
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Acknowledgements: The authors thank the Clinical Biochemistry Assay Lab, Disease Model Core (DMC), Histopathology Core and Imaging Core facilities at IMS-MRL, University of Cambridge, for experimental support for this study.
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MRC Metabolic Diseases Unit (MC_UU_00014/1)
NIHR Clinical Lectureship (CL-2019-14-504)