Role of Lipid Peroxidation and PPAR-δ in Amplifying Glucose-Stimulated Insulin Secretion

Tissue culture reagents were from Biological Industries (Beit-Haemek, Israel). 4-HDDE and 4-hydroxynonenoic acid (4-HNA) were synthesized as described (24,25). Compounds and reagents included GW501516 and 4-HNE (Calbiochem, Darmstadt, Germany); GSK0660, troglitazone, WY14643, PPAR-δ primer sequences, scrambled RNA sequences, and anti-tubulin antibody (Sigma-Aldrich, Rehovot, Israel); carboxy-DCFDA [5-(and-6)-carboxy-2′,7′-dichlorofluorescein diacetate], OptiMEM, and lipofectamine 2000 (Invitrogen, Carlsbad, CA); collagenase-P (Roche Diagnostics, Mannheim, Germany); polyclonal antibodies against the various PPAR isotypes (Cayman Chemicals, Ann Arbor, MI); horseradish peroxidase–conjugated anti-rabbit- and anti-mouse IgG (Jackson ImmunoResearch, West Grove, PA); anti-cPLA₂ and anti-pSer⁵⁰⁵-cPLA₂ antibodies (Cell Signaling, Boston, MA); monoclonal anti-4-HNE histidine adduct antibody (Abcam, Cambridge, MA); TransIT-LT1 reagent (Mirus Bio-Corporation, Madison, WI); dual luciferase reporter assay (Promega, Madison, WI); real-time PCR reagents (Applied Biosystems, Carlsbad, CA); All-blue ROX PCR-mix (Thermo Scientific, Epsom, Surrey, U.K.); and PPAR-δ small interfering RNA (siRNA) sequences (Dharmacon, Chicago, IL). The pcDNA–hPPAR-δ expression vector was constructed as described (18).

Male Wistar rats (150–250 g) and diabetes-prone male Psammomys obesus (P. obesus) gerbils (150–200 g) were from Harlan laboratories (Jerusalem, Israel). The gerbils were fed a low-energy (LE) diet (9.96 kJ/g; Koffolk, Petach-Tikva, Israel) to maintain normoglycemia (random nonfasted blood glucose <5.6 mmol/L). Some animals were fed a high-energy (HE) diet (14.23 kJ/g; Teklad Global Diets, Boston, MA) for at least 7 days to induce postprandial hyperglycemia (nonfasted blood glucose >8.6 mmol/L). The joint ethics committee for animal welfare of the Hebrew University and Hadassah Medical Center approved the study protocol. The Hebrew University is an Association for Assessment and Accreditation of Laboratory Animal Care International–accredited institute. Pancreatic islets were isolated from rats after collagenase digestion, as previously described (26). Pooled islets from three to five animals were preincubated in RPMI-1640 medium (11 mmol/L glucose) for a 16-h recovery period and then divided into the experimental groups, each consisting of 15 islets of a similar size. INS-1E cells (passages 70–90) were grown and maintained as described (27).

INS-1E cells were collected in PBS from 100-mm tissue culture plates; 6 × 10⁶ cell pellets were suspended in 1-mL double-distilled water, vortexed, and centrifuged at 14,000g for 30 min at 4°C to separate membrane pellets from the mixture. Phospholipid extracts of these pellets were obtained after extraction with 2:1 chloroform-to-methanol according to Ferreri and Chatgilialoglu (28) and Bligh and Dyer (29). The purity of the obtained fraction was analyzed by thin layer chromatography, using the bidimensional method according to Mangold and Malins (30). Fatty acid methyl esters of membrane phospholipids were prepared as described (31) and were then extracted with n-hexane and analyzed by gas chromatography (GC). Saturated fatty acids (SFAs) and unsaturated fatty acids, including the cis and trans geometrical fatty acids, were identified by comparison with standard references either commercially available or obtained by synthesis, as already described (32). The quantitative determination of the fatty acids was also obtained using the calibration curves of reference compounds in the GC apparatus.

Isolated rat islets and INS-1E cells were preincubated for 30 min in Krebs-Ringer bicarbonate HEPES–BSA buffer containing 3.3 mmol/L glucose, followed by a 1-h incubation at 3.3 and an additional 1 h at 16.7 mmol/L glucose, as described (26). Aliquots from the incubation buffers were collected, cleared by centrifugation, and frozen until used for insulin radioimmunoassay. Total insulin content in β-cells was measured in aliquots of cell extracts (26).

Rat islets were treated for 48 h, followed by a dynamic assay, performed as previously described (33). Briefly, 40–50 islets per group were placed in a 25-mm Swinnex chamber (Millipore Corp., Billerica, MA) and perifused (0.5 mL/min) with Krebs-Ringer bicarbonate HEPES–BSA buffer containing 3.3 mmol/L glucose and saturated with 95% O₂/5% CO₂ at 37°C for a 1-h equilibration period. The islets were then perifused with 16.7 mmol/L glucose for 40 min, followed by 10 min at 3.3 mmol/L glucose. Samples were collected throughout the perifusion period for insulin determination. Suitable insulin radioimmunoassay kits for P. obesus insulin (26) and rat insulin (Linco Research, St. Charles, MO) were used according to manufacturers’ protocols.

Cell lysates were prepared and used for Western blot analyses of PPARs, tubulin, cPLA₂, pSer^505/515-cPLA₂, and 4-HNE–protein adducts according to the suppliers’ protocols.

The RNeasy kit (Qiagen, Valencia, CA) was used for RNA isolation. The RevertAid kit (Fermentas, Glen Burnie, MD) was used for cDNA synthesis, using oligo(dT) primers, according to the kit’s instructions. Real-time PCR was performed in Stratagene MX3000P system (Stratagene, Santa Clara, CA) according to the manufacturer’s guidelines. Oligonucleotide primers were designed using Primer Express program (Applied Biosystems) and were synthesized by Sigma-Aldrich. Primer sequences were PPAR-δ: FW-CCCTTCATCATCCACGACATT; RV-TGGACTGGCAGCGGTAGAAC; and glyceraldehyde-3-phosphate dehydrogenase (GAPDH): FW-GGCACAGTCAAGGCTGAGAAT; RV-GCCTTCTCCATGGTGGTGAA. PCR was performed in 20-μL volumes containing SyBr Green ROX Mix, 175 nmol/L of sense and anti-sense primers, and 62.5 pg cDNA. The thermal cycling program consisted of 15 min at 95°C activation, followed by 40 cycles of 15 s at 95°C, 30 s at 60°C, and 30 s at 72°C. The last cycle of 30 s at 95°C and 30 s at 60°C was used to detect nonspecific amplification products. A cycle threshold was calculated for each sample using MXpro software (Stratagene). Results were normalized against those obtained for GAPDH and the internal ROX control.

INS-1E cells were cotransfected with expression vectors for human (h)PPAR-α, hPPAR-γ₁, hPPAR-γ₂, or hPPAR-δ, along with the retinoid X receptor (hRXR), green fluorescent protein and Renilla luciferase expression vectors, and the 3XPPRE-TK-luciferase reporter, as previously described (18). The yield of the transfection, assessed by green fluorescent protein fluorescence, was >80%. Luciferase-induced luminescence was determined in cell lysates with the dual luciferase reporter assay using the Mithras LB-940 luminometer (Berthold Technologies, Bad Wildbad, Germany); results were normalized to the Renilla luciferase activity, used as an internal control, according to the kit’s instructions.

Polar lipids from INS-1E culture media or animal sera were extracted, and high-performance liquid chromatography (HPLC) analysis of 4-HDDE in the extracts was performed as described (18). The HPLC analysis of 4-HNE was as follows: elution was at a flow rate of 1 mL/min with a two-solvent gradient; the initial solvent mixture was 30:70 (A: acetonitrile, B: water) and a linear gradient progressed over 25 min to 100% of A. The elution peak (223 nm) was at 4.2 min. The recovery of the standards, added to fresh samples prior to extraction, was 85–90%. Peaks in the HPLC profiles were monitored and quantified by using Clarity-Lite software (DataApex Co., Prague, Czech Republic).

INS-1E cell cultures at 40% confluency were maintained in antibiotic-free RPMI-1640 medium for 24 h before transfection. The cells were then transfected with 15 pmol/L siRNA or scrambled RNA sequences using lipofectamine 2000 in OptiMEM according to the manufacturer’s instructions. Cells were harvested 72 h after transfection and processed for further analysis. Target sequences for PPAR-δ siRNA were ACGAGAAGUGCGAUCGGAU, CCUCAAGUACGGCGUGCAU, CCACAACGCUACCGCUUU, and CAUGAGUUCUUGCGCAGUA.

The trypan blue exclusion test was performed on dispersed rat islet cells and INS-1E cells, as described (34). Apoptosis was determined in INS-1E cells with the Poly Caspases FLICA Kit (ImmunoChemistry Technologies, Bloomington, MN) according to the manufacturer’s instructions.

The green fluorescence dye carboxy-H2DCFDA was used in INS-1E cell cultures, according to the manufacturer’s instructions.

Results are given as mean ± SEM. Statistical analyses were performed using single factor ANOVA. P < 0.05 is considered significant.

The fatty acid composition in membrane phospholipids of INS-1E cells exposed to 5, 11, or 25 mmol/L glucose for 16 h was determined by lipidomic analysis. The overall analysis (Supplementary Table 1) shows the relative abundance of major PUFAs, monounsaturated fatty acids (MUFAs), and SFAs in the phospholipid compartment of the cells under increasing glucose levels; while the relative content of SFAs was not significantly altered, MUFA content was elevated and PUFA content reduced.

These data were used to quantify the content of AA and LA. Figure 1A shows a marked decrease in their content in the phospholipid compartment of cells maintained at 11 and 25 mmol/L glucose in comparison with the 5 mmol/L glucose incubation; AA was reduced by 45 and 59% and LA by 64 and 88%, respectively. The high number of cells (>10⁶ cells per determination) required for the lipidomic analysis precluded its application to purified islet-derived β-cells.

The release of these fatty acids from membrane phospholipids is mediated by enzymes of the PLA₂ family. We found that incubation of INS-1E cells with 11 and 25 mmol/L glucose activated cPLA₂ (Ser⁵⁰⁵ phosphorylation) by 2.5 ± 0.4 and 3.9 ± 0.7 fold, respectively, compared with cells at 5 mmol/L glucose; total cPLA₂ content was not significantly altered. In a similar manner, Ser⁵¹⁵ phosphorylation, which is required for full cPLA₂ activation (35), was concomitantly increased 2.3 ± 0.5 and 3.3 ± 0.7 fold, respectively (Fig. 1B).

The major peroxidation products of AA and LA are 4-HNE and 4-HDDE (15). We measured their levels in culture media of INS-1E cells exposed to increasing glucose concentrations in a serum-free medium during the last 16 h of incubation. This procedure eliminates the formation of 4-HNE adducts with serum proteins. Figure 2A shows a clear glucose-dependent increase in 4-HNE generation, up to ninefold at 25 mmol/L glucose. In contrast, 4-HDDE was not detectable in INS-1E culture medium extracts at all glucose concentrations used (data not shown). The gerbil P. obesus is an established animal model of diet-induced diabetes (5). Figure 2B shows that hyperglycemia induced by HE diet was accompanied by a marked increase in serum 4-HNE. The plasma insulin levels in the normo- and hyperglycemic animal were 1.41 ± 0.16 and 6.38 ± 0.59 nmol/L, respectively. ROS mediate the initiation step in the peroxidation cascade of AA and LA (15). Figure 2C shows increased ROS production in INS-1E cells incubated at 11 and 25 mmol/L glucose.

The insulin secretory capacity of isolated rat islets and INS-1E cells after preexposure to increasing glucose concentrations was determined. The preexposure periods for rat islets (48 h) and INS-1E cells (24 h) were selected empirically to allow maximal glucose-stimulated insulin secretion (GSIS) with no apparent depletion of cellular insulin content. As expected, GSIS was significantly amplified in a glucose-dependent manner in both β-cell preparations (Fig. 3A). The marked reduction of the response in the presence of the selective PPAR-δ antagonist GSK0660 indicated that this nuclear receptor plays a role in the insulin secretion amplifying action of glucose preexposure.

The effect of exogenously added 4-HNE on GSIS was then investigated; isolated rat islets and INS-1E cells were maintained for 48 or 24 h, respectively, in standard RPMI-1640 medium (11 mmol/L glucose) without or with increasing 4-HNE concentrations, followed by a static GSIS assay (Fig. 3B). The addition of 4-HNE amplified GSIS in a concentration-dependent manner; maximal effects were observed with 25 and 1 μmol/L 4-HNE in rat islets and in INS-1E cells, respectively. Above these levels, GSIS was reduced, possibly as a result of cytotoxic effects of 4-HNE (see Fig. 7).

Next, we compared the effects of 4-HNE in β-cells exposed to 5, 11, and 25 mmol/L glucose (Fig. 3C). Treatment with 4-HNE amplified GSIS in both β-cell preparations preexposed to 5 and 11 mmol/L glucose. However, it did not increase further GSIS in cells preexposed to 25 mmol/L glucose.

The enzyme fatty aldehyde dehydrogenase (FALDH) converts 4-HNE to its acidic metabolite 4-HNA (25). We asked whether this metabolite mediates the effect on insulin secretion attributed to 4-HNE. To answer this question, we synthesized 4-HNA; studies at different doses and incubation times showed that it lacked insulin secretory activity in INS-1E cells (Supplementary Fig. 1A).

Recent reports show that 4-HNE is an endogenous ligand of PPAR-δ (21); therefore, we tested its ability to activate PPAR-δ in INS-1E cells. The cells were transfected with hPPAR-α, hPPAR-γ1, hPPAR-γ2, or hPPAR-δ expression vectors along with hRXR- and 3XPPRE (PPAR response element)-luciferase expression vectors, as described before (18). Each hPPAR isotype was successfully expressed in INS-1E cells (Supplementary Fig. 2). Furthermore, WY14643, troglitazone, and GW501516, the pharmacological agonists of PPAR-α, PPAR-γ, and PPAR-δ, respectively (18), transactivated luciferase expression in an hPPAR isotype–specific manner (Fig. 4A). Exogenously added 4-HNE mimicked GW501516 and induced luciferase activity only in cells ectopically expressing hPPAR-δ. The finding that 4-HNE activated PPAR-δ in β-cells was further confirmed by the use of the selective PPAR-δ antagonist GSK0660; it abolished 4-HNE–induced luciferase activity in hPPAR-δ–expressing cells (Fig. 4B). The corresponding analysis of GSK0660 inhibitory effects on GW501516-treated INS-1E cells is shown in Supplementary Fig. 3. Moreover, 4-HNA, the acidic metabolite of 4-HNE, lacked any PPAR-δ stimulating activity (Supplementary Fig. 1B). Figure 4C shows a similar transactivation assay with increasing glucose concentrations in the absence or presence of GSK0660. Glucose stimulated luciferase activity in a concentration-dependent manner, which was abolished by the PPAR-δ antagonist.

To establish the role of PPAR-δ in mediating high glucose-induced amplification of insulin secretion, we silenced its expression. Supplementary Fig. 4A and B shows that siRNA targeted to PPAR-δ mRNA reduced the mRNA and protein levels by 65–75 and 45–60%, respectively. Figure 5A shows that this treatment resulted in loss of the cells’ ability to amplify GSIS after preexposure to high glucose levels. Noteworthy, the activation of PPAR-δ by increasing glucose concentrations was not associated with increased expression of this nuclear receptor (Supplementary Fig. 4A and B).

To ascertain the role of PPAR-δ in insulin secretion, we tested the effect of GW501516. This PPAR-δ agonist mimicked the effect of high glucose preexposure; it increased GSIS dose-dependently by up to twofold in isolated rat islets and INS-1E cells, with maximal stimulatory effect at 50–100 nmol/L (Fig. 5B). This effect of GW501516 was abolished by GSK0660 (Fig. 5C). GSK0660 also fully antagonized the amplifying effect of 4-HNE on insulin secretion in both β-cell preparations (Fig. 5D).

Further support for the role of 4-HNE and PPAR-δ in regulating insulin secretion comes from dynamic insulin secretion studies. Isolated rat islets were preincubated for 48 h in the absence or presence of effective concentrations of 4-HNE or GW501516; both agents considerably augmented both first and second phases of insulin secretion, in comparison with the secretion profile of the vehicle-treated islets, as shown in the representative experiment depicted in Fig. 5E. The inset in Fig. 5E gives the values of the areas under the curve (AUC) of four independent experiments that are summarized in Supplementary Fig. 5.

The role of endogenous 4-HNE in regulating insulin secretion was further substantiated by measuring insulin secretion after the blocking of 4-HNE production in β-cells by the antioxidant N-acetylcysteine (NAC), as described previously (18). Figure 6A and B shows that glucose-induced generation of ROS and 4-HNE in INS-1E cells was nearly abolished in the presence of 1 mmol/L NAC. This treatment also prevented high glucose-induced expression of luciferase in the PPRE-dependent transactivation assay in cells overexpressing PPAR-δ. Finally, glucose-amplified insulin secretion was markedly reduced in NAC-treated rat islets and in INS-1E cells (Fig. 6D).

The data shown in Fig. 2B suggest that 4-HNE levels above the physiological effective range are deleterious to the cells, impairing insulin secretion. Therefore, the trypan blue exclusion test was used to determine the viability of rat islets and INS-1E cells exposed to increasing concentrations of 4-HNE (Fig. 7A). We observed that INS-1E cells were more susceptible to 4-HNE–induced death than rat islet cells; the former tolerated 4-HNE up to 20 μmol/L, while the latter sustained it well at 50 μmol/L. Figure 7B shows marked apoptosis of INS-1E cells exposed to 50 μmol/L 4-HNE. Representative images of apoptotic INS-1E cells treated with increasing 4-HNE concentrations are shown in Supplementary Fig. 6.

A key feature of 4-HNE–induced cell damage is the accumulation of 4-HNE–protein adducts. A Western blot analysis of histidine–4-HNE adducts in lysates of INS-1E cells incubated without or with increasing 4-HNE concentrations is depicted in Fig. 7C. A modest accumulation of adducts was observed up to 20 μmol/L, whereas a marked increase was apparent at 50 μmol/L 4-HNE, the same concentration that induced substantial apoptosis and cell death.

A role for PUFAs and their LO-derived metabolites in regulating insulin secretion has long been suggested (6–9). Our results link the glucose-induced activation of cPLA₂, the release of PUFAs from membrane phospholipids in β-cells, and their peroxidation to this phenomenon. In particular, PPAR-δ and its endogenous ligand 4-HNE amplify the adaptive insulin secretory response of β-cells upon exposure to increasing glucose concentrations.

The current lipidomic analysis shows that preexposure of β-cells to high glucose modifies the distribution of various fatty acids in membrane phospholipids. While the abundance of SFAs was not significantly altered, the relative content of MUFAs increased and that of PUFAs decreased. Within the latter group, the relative abundance of n-3 PUFAs increased, whereas that of n-6 PUFAs decreased. It is interesting that a reduced ratio of n-6–to–n-3 PUFAs in β-cells of the fat-1 mouse, genetically engineered to produce n-3 PUFAs, has recently been associated with an enhanced insulin secretion (36); however, the molecular mechanisms behind this phenomenon and its applicability to other metabolic conditions is not clear.

The abundance of palmitic acid in membrane phospholipids was moderately reduced under high glucose incubation, whereas that of oleic acid increased. The observed increase in the monounsaturated palmitoleic acid in β-cell phospholipids after exposure to high glucose could be mediated by stearoyl-CoA desaturase-1. Noteworthy, recent studies suggest that palmitoleic acid functions as a lipid mediator in organ cross talk and metabolic abnormalities (37). Whether these changes in the content of SFAs and MUFAs in phospholipids affect β-cell function under high glucose conditions remains to be investigated. It has been shown that insulin content and the abundance of secretory granule membranes are lower in INS-1E cells than in intact rat β-cells (27). In a similar manner, the lipidome of β-cells in rat islets may differ from that of INS-1E cells.

We suggest that AA-derived 4-HNE participates in the regulation of insulin secretion. Keane and Newsholme (6) have recently reported that AA has regulatory and protective effects that improve β-cell function and survival. Recent studies and our present work show that hyperglycemia in human and animal models of diabetes is associated with an increased generation of 4-hydroxyalkenals (17–19). The present findings on hyperglycemic P. obesus gerbils correlate the increased 4-HNE plasma levels to the increased compensatory plasma insulin level. The antioxidant NAC, which markedly reduced the generation of endogenous 4-HNE, also blocked PPAR-δ activation and abolished the amplifying effect of high glucose. These data suggest a key role for 4-HNE in glucose amplification of insulin secretion.

Various signaling and regulatory functions were attributed to 4-HNE, yet very few genuine pharmacological targets (e.g., receptors) have been identified (15). Both the study by Coleman et al. (21) and the current study demonstrate that 4-HNE is an endogenous activating ligand of PPAR-δ. In silico analysis suggests specific binding interactions between 4-HNE and certain amino acid moieties within the ligand-binding domain of PPAR-δ (21). The discovery of 4-HNE as a PPAR-δ ligand is important in view of the regulatory functions that this receptor mediates in β-cells; it potentiates GSIS by regulating the expression of enzymes involved in anaplerotic glucose metabolism and mitochondrial oxidative reactions, as well as increasing fatty acid transport and metabolism (23,38,39). In contrast to the stimulatory effects of PPAR-δ, both PPAR-α and PPAR-γ suppress insulin secretion from β-cells by either attenuating glucose-induced Ca⁺² signals (40) or inducing endoplasmic reticulum stress (41,42). However, the suppressive effects of PPAR-α and PPAR-γ may not be physiologically relevant because their expression level in β-cells is normally low (23).

Upon activation, PPAR-δ dimerizes with its cognate partner, the retinoic X receptor (RXR). The resulting complex interacts with PPREs in promoters of target genes and activates the transcription program that ultimately enhances GSIS. Recent studies point to pyruvate dehydrogenase kinase 4 (PDK4) and carnitine palmitoyltransferase 1 (CPT1) as targets for PPAR-δ in β-cells; Ravnskjaer et al. (23) and Wan et al. (43) have associated PPAR-δ activation in different β-cell lines to an increased expression of PDK4, which can be linked to increased mitochondrial activity and insulin secretion. The latter group has also shown that the activation of PPAR-δ significantly increased CPT1 mRNA levels. Of interest, Sol et al. (44) have demonstrated that overexpression of CPT1 counteracts glucolipotoxicity in INS-1E cells. Additional studies are needed to identify the gene network that mediates high glucose-primed insulin secretion in β-cells in a PPAR-δ–dependent manner. Also of interest, Xu et al. (45) have shown that PPAR-δ activation induces phosphorylation of cPLA₂ in cholangiocarcinoma cell lines. It remains to be investigated whether such a regulatory loop functions in β-cells.

We report that the amplifying effect of 4-HNE was more pronounced in INS-1E cells and isolated rat islets that were preexposed to 11 mmol/L compared with 5 mmol/L glucose. This disparity may result from high glucose-regulated expression of coactivators or corepressors of the PPAR-δ–RXR transcription complex, and/or factors involved in the intracellular trafficking of insulin granules. The lack of effect of exogenous 4-HNE in β-cells exposed to 25 mmol/L glucose most likely results from the endogenous 4-HNE production, which already amplifies insulin secretion.

The duality of 4-HNE function as an endogenous signaling molecule on one hand and a cytotoxic agent on the other hand has long been recognized (46). The cytotoxic effects result from an excessive accumulation of covalent 4-HNE adducts with proteins, phospholipids, and DNA (15). Our results indicate that the level of 4-HNE in INS-1E cultures exposed to increasing glucose levels remains below the cytotoxic threshold. The current study agrees with Miwa et al. (47) who reported that 100 μmol/L 4-HNE, which is above this threshold, impeded insulin secretion from isolated rat islets. The disparate susceptibility of primary islet cells and the immortalized β-cell line to 4-HNE, observed in our study, may result from differences in the expression and function of 4-hydroxyalkenal–neutralizing enzymes (FALDH and glutathione-S-transferase) (48,49) between these β-cell preparations. Nonetheless, 4-HNA, the FALDH metabolite of 4-HNE, does not activate PPAR-δ or augment insulin secretion.

Chronic high glucose-induced β-cell dysfunction may be associated with an excessive generation of 4-hydroxyalkenals, which are deleterious to cells. Of interest is the finding that increased LO activity induces β-cell dysfunction (50). Whether this results in an excessive production of hydroperoxy metabolites of AA and LA, which are subsequently peroxidized to cytotoxic levels of 4-HNE, remains to be investigated. Finally, our findings on glucose-mediated generation of 4-HNE and the subsequent activation of PPAR-δ that leads to an amplified insulin secretion from β-cells are summarized in the model shown in Fig. 8.

This work was supported by grants from the Israel Science Foundation (44/10) and the Yedidut Foundation, Mexico, at the Hebrew University. The support and sponsorship of COST Actions BM0602 on “Adipose Tissue: A Key Target for Prevention of the Metabolic Syndrome,” CM0603 on “Free Radicals in Chemical Biology (CHEMBIORADICAL),” and B35 on “Lipid Peroxidation Associated Disorders: LPO” are gratefully acknowledged. G.C., Y.R., and O.S. have received fellowships from the Hebrew University Center for Diabetes Research. S.S. is affiliated with the David R. Bloom Center for Pharmacy and the Dr. Adolf and Klara Brettler Center for Research of Molecular Pharmacology and Therapeutics.

No potential conflicts of interest relevant to this article were reported.

G.C. researched data, contributed to discussion, and wrote and edited the manuscript. Y.R. and O.S. researched data. M.G. contributed to discussion and reviewed the manuscript. C.C. and C.F. researched data, contributed to discussion, and reviewed the manuscript. N.K. contributed to discussion and reviewed the manuscript. S.S. wrote and edited the manuscript.

The authors are grateful to Mrs. Y. Ariav (Endocrinology and Metabolism Service of the Hebrew University–Hadassah Medical Center) for sharing her technical expertise in islet studies; Dr. B.M. Spiegelman (Dana Farber Cancer Institute, Boston, MA), Dr. R. Evans (Howard Hughes Medical Institute, La Jolla, CA), and Dr. B. Staels (Université Lille Nord de France, Lille, France) for kindly providing the pSVPORT1-hRXR vector and the 3XPPRE-TK-luciferase plasmid, the pCMX-hPPAR-γ1 and pCMX-hPPAR-γ2 plasmids, and the pSG5-hPPAR-α plasmid, respectively; Dr. K.U. Malik (University of Tennessee, Memphis, TN) for the generous gift of purified anti-phospho-Ser⁵¹⁵-cPLA₂ antibody; and Prof. E. Cerasi (Endocrinology and Metabolism Service of the Hebrew University–Hadassah Medical Center) for critically reading the manuscript and providing valuable comments.