Elevated O-GlcNAc has been associated with diabetes.
Pancreatic β cells synthesize and secrete insulin to regulate blood glucose levels. One study found that inhibition of OGA with streptozotocin followed by glucosamine treatment resulted in O-GlcNAc accumulation and apoptosis in β cells; a subsequent study showed that a galactose-based analogue of streptozotocin was unable to inhibit OGA but still resulted in apoptosis, suggesting that the apoptotic effects of streptozotocin are not directly due to OGA inhibition.
O-GlcNAc has been suggested to attenuate insulin signaling. In 3T3-L1 adipocytes, OGA inhibition with PUGNAc inhibited insulin-mediated glucose uptake. PUGNAc treatment also inhibited insulin-stimulated Akt T308 phosphorylation and downstream GSK3β S9 phosphorylation. In a later study, insulin stimulation of COS-7 cells caused OGT to localize to the plasma membrane. Inhibition of PI3K with wortmannin reversed this effect, suggesting dependence on phosphatidylinositol(3,4,5)-triphosphate. Increasing O-GlcNAc levels by subjecting cells to high glucose conditions or PUGNAc treatment inhibited insulin-stimulated phosphorylation of Akt T308 and Akt activity. IRS1 phosphorylation at S307 and S632/S635, which is associated with attenuated insulin signaling, was enhanced. Subsequent experiments in mice with adenoviral delivery of OGT showed that OGT overexpression negatively regulated insulin signaling in vivo. Many components of the insulin signaling pathway, including β-catenin, IR-β, IRS1, Akt, PDK1, and the p110α subunit of PI3K were found to be directly modified by O-GlcNAc. Insulin signaling has also been reported to lead to OGT tyrosine phosphorylation and OGT activation, resulting in increased O-GlcNAc levels.
As PUGNAc also inhibits lysosomal β-hexosaminidases, the OGA-selective inhibitor NButGT was developed to further probe the relationship between O-GlcNAc and insulin signaling in 3T3-L1 adipocytes. This study also found that PUGNAc resulted in impaired insulin signaling, but NButGT did not, as measured by changes in phosphorylation of Akt T308, suggesting that the effects observed with PUGNAc may be due to off-target effects besides OGA inhibition.