Autoimmune activation of the GnRH receptor induces insulin resistance in
a rat model of polycystic ovary syndrome Short Title: GnRHR
autoantibody-induced insulin resistance in rats
Abstract
Polycystic ovary syndrome (PCOS), a metabolic and reproductive disease,
is frequently associated with type 2 diabetes. We previously
demonstrated that autoantibodies (AAb) directed toward the second
extracellular loop (ECL2) of the gonadotropin-releasing hormone receptor
(GnRHR) are present in a high percentage of PCOS patients. It is unclear
whether GnRHR-AAb can induce peripheral tissue insulin resistance (IR)
in animal models. In the present study, we examined the impact of
GnRHR-AAb on glucose metabolism, inflammation, and insulin signaling in
a recently established autoimmune rat model of PCOS. Sixteen rats were
divided into two groups: a GnRHR ECL2 peptide-immunized group, and a
control group. Sera GnRHR-AAb, luteinizing hormone (LH), and
testosterone were measured by ELISA. All immunized rats produced
elevated anti-GnRHR ECL2 antibody titers and higher concentration of
testosterone and LH. Intraperitoneal glucose tolerance tests
demonstrated higher blood glucose levels in immunized rats at 30 minutes
and 60 minutes. A homeostatic model assessment of insulin resistance
index was also higher. Furthermore, the mRNA expression levels of
insulin signaling genes in peripheral tissue were decreased. The
concentration of sera TNF-α, IL-1α, and IL-18 were increased, while IL-4
and IL-10 were inhibited in the immunized group. These data support the
likelihood of GnRHR-ECL2 AAbs inducing IR in peripheral tissue.
GnRHR-ECL2 AAb may alter the synthesis and pulsatile secretion of LH
thus leading to hyperandrogenemia, inflammation, and IR. Our studies
provide the realistic expectation of new knowledge regarding the
etiology of IR in PCOS as well as a pathway for development of novel
effective treatment.