No abstract

ObjectiveMetformin, an oral medication used for type 2 diabetes mellitus, is the most commonly prescribed drug with less economic burden of patients. Although metformin’s efficacy and safety have long been recognized, approximately 5% of the patients treated with this drug develop severe diarrhea as an adverse effect and have to abandon treatment. Because there is no animal model to study metformin-induced diarrhea, it is hard to develop methods to maintain quality of life of patients prescribed with metformin.Research design and methodsUsing mouse models, we tried to develop an evaluation system for metformin-induced diarrhea to improve diarrheal symptoms in patients with diabetes. Healthy (C57BL/6J) and diabetic obese (db/db) mice were subjected to a stepwise dose escalation of metformin (250 mg/kg/day (125 mg/kg twice daily oral dose)—1000 mg/kg/day (500 mg/kg twice daily oral dose)), and fecal moisture contents and their score were monitored. To evaluate anti-diarrheal medications, wood creosote (a traditional medicine) was tested. Several groups of enterobacteria in fresh feces were examined by using PCR.Results1000 mg/kg/day (four times maximal effective dose) of metformin significantly increased fecal moisture content. Although no symptoms of diarrhea were observed in healthy C57BL/6J mice, the same dose of metformin induced severe diarrhea in diabetic obese db/db mice. A reduction in PCR signals for the Firmicutes group was associated with metformin-induced diarrhea. Wood creosote reduced diarrhea (high water-content) without affecting metformin’s efficacy or enterobacterial flora levels.ConclusionsWe have created the first animal model of metformin-induced diarrhea using db/db mice, which will provide better quality of life for patients suffering from diarrhea caused by metformin.

Tyrosinase catalyzes the rate‐limiting step in melanin synthesis. Melanin is synthesized from l‐tyrosin in the melanosomes, where tyrosinase and other melanogenic factors are recruited via the vesicle transport system. Genetic and biochemical approaches have revealed a correlation between impairments in the vesicle transport system and albinism. However, the specificity of the individual transport systems for the corresponding melanogenic factors has not been well elucidated yet. Here, we report that the thioxothiazolidin derivative, 4‐OST (4‐[(5E)‐5‐[(4‐fluorophenyl)methylidene]‐4‐oxo‐2‐sulfanylidene‐1,3‐thiazolidin‐3‐yl]‐4‐azatricyclo [5.2.1.02,6]dec‐8‐ene‐3,5‐dione: CAS RN. 477766‐87‐3) strongly inhibited melanogenesis in mouse melanoma B16F10 cells. 4‐OST reduces tyrosinase protein levels without affecting its messenger RNA levels or enzymatic activity. Although a reduction in tyrosinase protein level was observed in the presence of a protein synthesis inhibitor, the reduction may be coupled with protein synthesis. Similarly, GIF‐2202 (a derivative of 4‐OST) lowers tyrosinase protein levels without affecting the levels of another melanogenic enzyme, tyrosinase‐related protein 1 (TYRP1) level. The reduction in tyrosinase protein level is associated with an increase in the levels of the lysosomal proteinase cathepsin S. Chloroquine, a lysosome inhibitor, restored the tyrosinase protein level downregulated by GIF‐2202, although no effects of other inhibitors (against proteasome, autophagy, or exocytosis) were observed. In addition, GIF‐2202 segregated the immunofluorescence signals of tyrosinase from those of TYRP1. Chloroquine treatment resulted in co‐localization of tyrosinase and cathepsin S signals near the perinuclear region, suggesting that 4‐OST and GIF‐2202 may alter the destination of the tyrosinase vesicle from the melanosome to the lysosome. 4‐OST and GIF‐2202 can be new tools for studying the tyrosinase‐specific vesicle transport system.