Dextromethorphan, an over-the-counter cough suppressant, and its metabolites may improve diabetic complications in mice and humans, according to research published in Nature Medicine. These results suggest a potential adjunct treatment for type 2 diabetes.
Dextromethorphan is an active ingredient, with only a few minor adverse side effects, found in many over-the-counter cough medications and it acts by inhibiting N-Methyl-D-Aspartate (NMDA) receptors. These receptors are expressed in tiny clusters of insulin-producing beta cells in the pancreas, but their physiological role has not been clear.
DZD scientist Eckhard Lammert and colleagues found that genetic deletion of a key part of this class of receptors, or their pharmacological inhibition by drugs such as dextromethorphan, results in more potent glucose-stimulated insulin secretion in a sample of normal mouse and human pancreatic tissue. In addition, the researchers found that dextromethorphan protects pancreatic islets from cell death under certain experimental conditions, which could be of interest to patients with type 1 diabetes.
These results, as well as improved glucose control, were - observed in a mouse model of type 2 diabetes on administration of dextromethorphan. In a small, phase 2a, clinical trial involving 20 volunteers with type 2 diabetes, the authors confirmed that dextromethorphan increases serum insulin concentrations and lowers blood glucose. Long-term clinical studies are now needed to study the benefits of dextromethorphan for patients with diabetes in more depth.
Marquard J., Otter S., Welters A., Stirban A., Fischer A., Eglinger J., Herebian D., Kletke O., Klemen M.S., Stožer A., Wnendt S., Piemonti L., Köhler M., Ferrer J., Thorens B., Schliess F., Rupnik M.S., Heise T., Berggren PO., Klöcker N., Meissner T., Mayatepek E., Eberhard D., Kragl M., Lammert E. Characterization of pancreatic NMDA receptors as possible drug targets for diabetes treatment. doi: 10.1038/nm.3822
Nature Medicine March 16, 2015
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