MedicalResearch.com Interview with:
Silvia Conde, PhD
CEDOC, NOVA Medical School
Faculdade de Ciências Médicas
Universidade Nova de Lisboa
MedicalResearch.com: What is the background for this study? What are the main findings?
Response: In 2013, Silvia Vilares Conde and her research group described that the carotid body, a paired organ that is located in the bifurcation of the common carotid artery and that is classically defined as an oxygen sensor, regulates peripheral insulin sensitivity and that its dysfunction is involved in the development of metabolic diseases.
This first study (Ribeiro et al. 2013, Diabetes, 62:2905-16) and others afterwards performed by her group in diabetic rats (Sacramento et al. 2017, Diabetologia 60(1):158-168) showed that the bilateral resection of the carotid sinus nerve, and therefore the abolishment of the connection between the carotid body and the brain, restore insulin sensitivity and glucose tolerance. Although efficient this surgical irreversible approach has disadvantages, since the carotid body possesses other physiological functions as the response to the lack of oxygen (hypoxia) or the adaptation to exercise. Silvia Conde’s team also described that the carotid body is over-activated in animal models of type 2 diabetes, suggesting that decreasing the activity of the organ could be a good therapeutic strategy.
In this new work (Sacramento et al. 2018, doi: 10.1007/s00125-017-4533-7), her group in collaboration with Galvani Bioelectronics (former Glaxo Smith Kline Bioelectronics) demonstrated that is possible to electrically modulate the carotid sinus nerve to maintain glucose homeostasis in diabetic animals without significant adverse effects.
MedicalResearch.com: What should readers take away from your report?
Response: That type 2 diabetes rats in which electrodes have been implanted in the carotid sinus nerve and submitted to electrical modulation recover insulin sensitivity and glucose tolerance. This effect was reversible since when the electrical modulation stopped the animals become diabetic again.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: A lot of work needs to be done before this kind of therapeutic gets to the market, especially in terms of technology. With this paper we have described the first steps for this kind of therapy, that still needs to be tested in another animal species, but developments in terms of rechargeable and wireless electrodes are needed to move forward to the implantation of electrodes and neuromodulation of the carotid sinus nerve in type 2 diabetes patients.
MedicalResearch.com: Is there anything else you would like to add?
Response: Silvia Vilares Conde has received funding for research support from GlaxoSmithKline Bioelectronics R&D to perform this study.
Joana F. Sacramento, Daniel J. Chew, Bernardete F. Melo, Matteo Donegá, Wesley Dopson, Maria P. Guarino, Alison Robinson, Jesus Prieto-Lloret, Sonal Patel, Bradley J. Holinski, Nishan Ramnarain, Victor Pikov, Kristoffer Famm, Silvia V. Conde. Bioelectronic modulation of carotid sinus nerve activity in the rat: a potential therapeutic approach for type 2 diabetes. Diabetologia, 2018; DOI: 10.1007/s00125-017-4533-7
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