Skip to main content
Top
Published in: Diabetologia 5/2012

01-05-2012 | Article

Arctigenin, a natural compound, activates AMP-activated protein kinase via inhibition of mitochondria complex I and ameliorates metabolic disorders in ob/ob mice

Authors: S.-L. Huang, R.-T. Yu, J. Gong, Y. Feng, Y.-L. Dai, F. Hu, Y.-H. Hu, Y.-D. Tao, Y. Leng

Published in: Diabetologia | Issue 5/2012

Login to get access

Abstract

Aims/hypothesis

Arctigenin is a natural compound that had never been previously demonstrated to have a glucose-lowering effect. Here it was found to activate AMP-activated protein kinase (AMPK), and the mechanism by which this occurred, as well as the effects on glucose and lipid metabolism were investigated.

Methods

2-Deoxyglucose uptake and AMPK phosphorylation were examined in L6 myotubes and isolated skeletal muscle. Gluconeogenesis and lipid synthesis were evaluated in rat primary hepatocytes. The acute and chronic effects of arctigenin on metabolic abnormalities were observed in C57BL/6J and ob/ob mice. Changes in mitochondrial membrane potential were measured using the J-aggregate-forming dye, JC-1. Analysis of respiration of L6 myotubes or isolated mitochondria was conducted in a channel oxygen system.

Results

Arctigenin increased AMPK phosphorylation and stimulated glucose uptake in L6 myotubes and isolated skeletal muscles. In primary hepatocytes, it decreased gluconeogenesis and lipid synthesis. The enhancement of glucose uptake and suppression of hepatic gluconeogenesis and lipid synthesis by arctigenin were prevented by blockade of AMPK activation. The respiration of L6 myotubes or isolated mitochondria was inhibited by arctigenin with a specific effect on respiratory complex I. A single oral dose of arctigenin reduced gluconeogenesis in C57BL/6J mice. Chronic oral administration of arctigenin lowered blood glucose and improved lipid metabolism in ob/ob mice.

Conclusions/interpretation

This study demonstrates a new role for arctigenin as a potent indirect activator of AMPK via inhibition of respiratory complex I, with beneficial effects on metabolic disorders in ob/ob mice. This highlights the potential value of arctigenin as a possible treatment of type 2 diabetes.
Appendix
Available only for authorised users
Literature
1.
go back to reference DeFronzo RA, Jacot E, Jequier E, Maeder E, Wahren J, Felber JP (1981) The effect of insulin on the disposal of intravenous glucose. Results from indirect calorimetry and hepatic and femoral venous catheterization. Diabetes 30:1000–1007PubMed DeFronzo RA, Jacot E, Jequier E, Maeder E, Wahren J, Felber JP (1981) The effect of insulin on the disposal of intravenous glucose. Results from indirect calorimetry and hepatic and femoral venous catheterization. Diabetes 30:1000–1007PubMed
2.
go back to reference Ren JM, Marshall BA, Gulve EA et al (1993) Evidence from transgenic mice that glucose transport is rate-limiting for glycogen deposition and glycolysis in skeletal muscle. J Biol Chem 268:16113–16115PubMed Ren JM, Marshall BA, Gulve EA et al (1993) Evidence from transgenic mice that glucose transport is rate-limiting for glycogen deposition and glycolysis in skeletal muscle. J Biol Chem 268:16113–16115PubMed
3.
go back to reference Hansell CA, Schiering C, Kinstrie R et al (2011) Universal expression and dual function of the atypical chemokine receptor D6 on innate-like B cells in mice. Blood 117:5413–5424PubMedCrossRef Hansell CA, Schiering C, Kinstrie R et al (2011) Universal expression and dual function of the atypical chemokine receptor D6 on innate-like B cells in mice. Blood 117:5413–5424PubMedCrossRef
4.
go back to reference Kelley DE, Goodpaster B, Wing RR, Simoneau JA (1999) Skeletal muscle fatty acid metabolism in association with insulin resistance, obesity, and weight loss. Am J Physiol 277:E1130–E1141PubMed Kelley DE, Goodpaster B, Wing RR, Simoneau JA (1999) Skeletal muscle fatty acid metabolism in association with insulin resistance, obesity, and weight loss. Am J Physiol 277:E1130–E1141PubMed
5.
go back to reference Leng Y, Steiler TL, Zierath JR (2004) Effects of insulin, contraction, and phorbol esters on mitogen-activated protein kinase signaling in skeletal muscle from lean and ob/ob mice. Diabetes 53:1436–1444PubMedCrossRef Leng Y, Steiler TL, Zierath JR (2004) Effects of insulin, contraction, and phorbol esters on mitogen-activated protein kinase signaling in skeletal muscle from lean and ob/ob mice. Diabetes 53:1436–1444PubMedCrossRef
6.
go back to reference Zierath JR, Krook A, Wallberg-Henriksson H (2000) Insulin action and insulin resistance in human skeletal muscle. Diabetologia 43:821–835PubMedCrossRef Zierath JR, Krook A, Wallberg-Henriksson H (2000) Insulin action and insulin resistance in human skeletal muscle. Diabetologia 43:821–835PubMedCrossRef
7.
go back to reference Long YC, Zierath JR (2006) AMP-activated protein kinase signaling in metabolic regulation. J Clin Invest 116:1776–1783PubMedCrossRef Long YC, Zierath JR (2006) AMP-activated protein kinase signaling in metabolic regulation. J Clin Invest 116:1776–1783PubMedCrossRef
8.
go back to reference Winder WW (2001) Energy-sensing and signaling by AMP-activated protein kinase in skeletal muscle. J Appl Physiol 91:1017–1028PubMed Winder WW (2001) Energy-sensing and signaling by AMP-activated protein kinase in skeletal muscle. J Appl Physiol 91:1017–1028PubMed
9.
go back to reference Koistinen HA, Galuska D, Chibalin AV et al (2003) 5-amino-imidazole carboxamide riboside increases glucose transport and cell-surface GLUT4 content in skeletal muscle from subjects with type 2 diabetes. Diabetes 52:1066–1072PubMedCrossRef Koistinen HA, Galuska D, Chibalin AV et al (2003) 5-amino-imidazole carboxamide riboside increases glucose transport and cell-surface GLUT4 content in skeletal muscle from subjects with type 2 diabetes. Diabetes 52:1066–1072PubMedCrossRef
10.
go back to reference Shaw RJ, Kosmatka M, Bardeesy N et al (2004) The tumor suppressor LKB1 kinase directly activates AMP-activated kinase and regulates apoptosis in response to energy stress. Proc Natl Acad Sci U S A 101:3329–3335PubMedCrossRef Shaw RJ, Kosmatka M, Bardeesy N et al (2004) The tumor suppressor LKB1 kinase directly activates AMP-activated kinase and regulates apoptosis in response to energy stress. Proc Natl Acad Sci U S A 101:3329–3335PubMedCrossRef
11.
go back to reference Woods A, Dickerson K, Heath R et al (2005) Ca2+/calmodulin-dependent protein kinase kinase-beta acts upstream of AMP-activated protein kinase in mammalian cells. Cell Metab 2:21–33PubMedCrossRef Woods A, Dickerson K, Heath R et al (2005) Ca2+/calmodulin-dependent protein kinase kinase-beta acts upstream of AMP-activated protein kinase in mammalian cells. Cell Metab 2:21–33PubMedCrossRef
12.
go back to reference Towler MC, Hardie DG (2007) AMP-activated protein kinase in metabolic control and insulin signaling. Circ Res 100:328–341PubMedCrossRef Towler MC, Hardie DG (2007) AMP-activated protein kinase in metabolic control and insulin signaling. Circ Res 100:328–341PubMedCrossRef
13.
go back to reference Viollet B, Lantier L, Devin-Leclerc J et al (2009) Targeting the AMPK pathway for the treatment of type 2 diabetes. Front Biosci 14:3380–3400PubMedCrossRef Viollet B, Lantier L, Devin-Leclerc J et al (2009) Targeting the AMPK pathway for the treatment of type 2 diabetes. Front Biosci 14:3380–3400PubMedCrossRef
14.
go back to reference Musi N, Hirshman MF, Nygren J et al (2002) Metformin increases AMP-activated protein kinase activity in skeletal muscle of subjects with type 2 diabetes. Diabetes 51:2074–2081PubMedCrossRef Musi N, Hirshman MF, Nygren J et al (2002) Metformin increases AMP-activated protein kinase activity in skeletal muscle of subjects with type 2 diabetes. Diabetes 51:2074–2081PubMedCrossRef
15.
go back to reference Cool B, Zinker B, Chiou W et al (2006) Identification and characterization of a small molecule AMPK activator that treats key components of type 2 diabetes and the metabolic syndrome. Cell Metab 3:403–416PubMedCrossRef Cool B, Zinker B, Chiou W et al (2006) Identification and characterization of a small molecule AMPK activator that treats key components of type 2 diabetes and the metabolic syndrome. Cell Metab 3:403–416PubMedCrossRef
16.
go back to reference Newman DJ, Cragg GM (2007) Natural products as sources of new drugs over the last 25 years. J Nat Prod 70:461–477PubMedCrossRef Newman DJ, Cragg GM (2007) Natural products as sources of new drugs over the last 25 years. J Nat Prod 70:461–477PubMedCrossRef
17.
go back to reference Lee YS, Kim WS, Kim KH et al (2006) Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Diabetes 55:2256–2264PubMedCrossRef Lee YS, Kim WS, Kim KH et al (2006) Berberine, a natural plant product, activates AMP-activated protein kinase with beneficial metabolic effects in diabetic and insulin-resistant states. Diabetes 55:2256–2264PubMedCrossRef
18.
go back to reference Baur JA, Pearson KJ, Price NL et al (2006) Resveratrol improves health and survival of mice on a high-calorie diet. Nature 444:337–342PubMedCrossRef Baur JA, Pearson KJ, Price NL et al (2006) Resveratrol improves health and survival of mice on a high-calorie diet. Nature 444:337–342PubMedCrossRef
19.
go back to reference Collins QF, Liu HY, Pi J, Liu Z, Quon MJ, Cao W (2007) Epigallocatechin-3-gallate (EGCG), a green tea polyphenol, suppresses hepatic gluconeogenesis through 5′-AMP-activated protein kinase. J Biol Chem 282:30143–30149PubMedCrossRef Collins QF, Liu HY, Pi J, Liu Z, Quon MJ, Cao W (2007) Epigallocatechin-3-gallate (EGCG), a green tea polyphenol, suppresses hepatic gluconeogenesis through 5′-AMP-activated protein kinase. J Biol Chem 282:30143–30149PubMedCrossRef
20.
go back to reference Wagner BK, Kitami T, Gilbert TJ et al (2008) Large-scale chemical dissection of mitochondrial function. Nat Biotechnol 26:343–351PubMedCrossRef Wagner BK, Kitami T, Gilbert TJ et al (2008) Large-scale chemical dissection of mitochondrial function. Nat Biotechnol 26:343–351PubMedCrossRef
21.
go back to reference Turner N, Li JY, Gosby A et al (2008) Berberine and its more biologically available derivative, dihydroberberine, inhibit mitochondrial respiratory complex I: a mechanism for the action of berberine to activate AMP-activated protein kinase and improve insulin action. Diabetes 57:1414–1418PubMedCrossRef Turner N, Li JY, Gosby A et al (2008) Berberine and its more biologically available derivative, dihydroberberine, inhibit mitochondrial respiratory complex I: a mechanism for the action of berberine to activate AMP-activated protein kinase and improve insulin action. Diabetes 57:1414–1418PubMedCrossRef
22.
go back to reference Zou MH, Kirkpatrick SS, Davis BJ et al (2004) Activation of the AMP-activated protein kinase by the anti-diabetic drug metformin in vivo. Role of mitochondrial reactive nitrogen species. J Biol Chem 279:43940–43951PubMedCrossRef Zou MH, Kirkpatrick SS, Davis BJ et al (2004) Activation of the AMP-activated protein kinase by the anti-diabetic drug metformin in vivo. Role of mitochondrial reactive nitrogen species. J Biol Chem 279:43940–43951PubMedCrossRef
23.
go back to reference Fryer LG, Parbu-Patel A, Carling D (2002) The anti-diabetic drugs rosiglitazone and metformin stimulate AMP-activated protein kinase through distinct signaling pathways. J Biol Chem 277:25226–25232PubMedCrossRef Fryer LG, Parbu-Patel A, Carling D (2002) The anti-diabetic drugs rosiglitazone and metformin stimulate AMP-activated protein kinase through distinct signaling pathways. J Biol Chem 277:25226–25232PubMedCrossRef
24.
go back to reference Zhao F, Wang L, Liu K (2009) In vitro anti-inflammatory effects of arctigenin, a lignan from Arctium lappa L., through inhibition on iNOS pathway. J Ethnopharmacol 122:457–462PubMedCrossRef Zhao F, Wang L, Liu K (2009) In vitro anti-inflammatory effects of arctigenin, a lignan from Arctium lappa L., through inhibition on iNOS pathway. J Ethnopharmacol 122:457–462PubMedCrossRef
25.
go back to reference Sun S, Wang X, Wang C et al (2011) Arctigenin suppresses unfolded protein response and sensitizes glucose deprivation-mediated cytotoxicity of cancer cells. Planta Med 77:141–145PubMedCrossRef Sun S, Wang X, Wang C et al (2011) Arctigenin suppresses unfolded protein response and sensitizes glucose deprivation-mediated cytotoxicity of cancer cells. Planta Med 77:141–145PubMedCrossRef
26.
go back to reference Hotamisligil GS (2010) Endoplasmic reticulum stress and the inflammatory basis of metabolic disease. Cell 140:900–917PubMedCrossRef Hotamisligil GS (2010) Endoplasmic reticulum stress and the inflammatory basis of metabolic disease. Cell 140:900–917PubMedCrossRef
27.
go back to reference Deldicque L, Cani PD, Philp A et al (2010) The unfolded protein response is activated in skeletal muscle by high-fat feeding: potential role in the downregulation of protein synthesis. Am J Physiol Endocrinol Metab 299:E695–E705PubMedCrossRef Deldicque L, Cani PD, Philp A et al (2010) The unfolded protein response is activated in skeletal muscle by high-fat feeding: potential role in the downregulation of protein synthesis. Am J Physiol Endocrinol Metab 299:E695–E705PubMedCrossRef
28.
go back to reference Ye R, Jung DY, Jun JY et al (2010) Grp78 heterozygosity promotes adaptive unfolded protein response and attenuates diet-induced obesity and insulin resistance. Diabetes 59:6–16PubMedCrossRef Ye R, Jung DY, Jun JY et al (2010) Grp78 heterozygosity promotes adaptive unfolded protein response and attenuates diet-induced obesity and insulin resistance. Diabetes 59:6–16PubMedCrossRef
29.
go back to reference Bergeron R, Russell RR 3rd, Young LH et al (1999) Effect of AMPK activation on muscle glucose metabolism in conscious rats. Am J Physiol 276:E938–E944PubMed Bergeron R, Russell RR 3rd, Young LH et al (1999) Effect of AMPK activation on muscle glucose metabolism in conscious rats. Am J Physiol 276:E938–E944PubMed
30.
go back to reference Hardie DG (2003) Minireview: the AMP-activated protein kinase cascade: the key sensor of cellular energy status. Endocrinology 144:5179–5183PubMedCrossRef Hardie DG (2003) Minireview: the AMP-activated protein kinase cascade: the key sensor of cellular energy status. Endocrinology 144:5179–5183PubMedCrossRef
31.
go back to reference DeFronzo RA, Ferrannini E, Simonson DC (1989) Fasting hyperglycemia in non-insulin-dependent diabetes mellitus: contributions of excessive hepatic glucose production and impaired tissue glucose uptake. Metabolism 38:387–395PubMedCrossRef DeFronzo RA, Ferrannini E, Simonson DC (1989) Fasting hyperglycemia in non-insulin-dependent diabetes mellitus: contributions of excessive hepatic glucose production and impaired tissue glucose uptake. Metabolism 38:387–395PubMedCrossRef
32.
go back to reference Wolfrum C, Asilmaz E, Luca E, Friedman JM, Stoffel M (2004) Foxa2 regulates lipid metabolism and ketogenesis in the liver during fasting and in diabetes. Nature 432:1027–1032PubMedCrossRef Wolfrum C, Asilmaz E, Luca E, Friedman JM, Stoffel M (2004) Foxa2 regulates lipid metabolism and ketogenesis in the liver during fasting and in diabetes. Nature 432:1027–1032PubMedCrossRef
33.
go back to reference Zhou G, Myers R, Li Y et al (2001) Role of AMP-activated protein kinase in mechanism of metformin action. J Clin Invest 108:1167–1174PubMed Zhou G, Myers R, Li Y et al (2001) Role of AMP-activated protein kinase in mechanism of metformin action. J Clin Invest 108:1167–1174PubMed
34.
go back to reference Sanders MJ, Grondin PO, Hegarty BD, Snowden MA, Carling D (2007) Investigating the mechanism for AMP activation of the AMP-activated protein kinase cascade. Biochem J 403:139–148PubMedCrossRef Sanders MJ, Grondin PO, Hegarty BD, Snowden MA, Carling D (2007) Investigating the mechanism for AMP activation of the AMP-activated protein kinase cascade. Biochem J 403:139–148PubMedCrossRef
35.
go back to reference Fujita Y, Hosokawa M, Fujimoto S et al (2010) Metformin suppresses hepatic gluconeogenesis and lowers fasting blood glucose levels through reactive nitrogen species in mice. Diabetologia 53:1472–1481PubMedCrossRef Fujita Y, Hosokawa M, Fujimoto S et al (2010) Metformin suppresses hepatic gluconeogenesis and lowers fasting blood glucose levels through reactive nitrogen species in mice. Diabetologia 53:1472–1481PubMedCrossRef
36.
go back to reference Hayashi T, Hirshman MF, Fujii N, Habinowski SA, Witters LA, Goodyear LJ (2000) Metabolic stress and altered glucose transport: activation of AMP-activated protein kinase as a unifying coupling mechanism. Diabetes 49:527–531PubMedCrossRef Hayashi T, Hirshman MF, Fujii N, Habinowski SA, Witters LA, Goodyear LJ (2000) Metabolic stress and altered glucose transport: activation of AMP-activated protein kinase as a unifying coupling mechanism. Diabetes 49:527–531PubMedCrossRef
37.
go back to reference Kosaka T, Okuyama R, Sun W et al (2005) Identification of molecular target of AMP-activated protein kinase activator by affinity purification and mass spectrometry. Anal Chem 77:2050–2055PubMedCrossRef Kosaka T, Okuyama R, Sun W et al (2005) Identification of molecular target of AMP-activated protein kinase activator by affinity purification and mass spectrometry. Anal Chem 77:2050–2055PubMedCrossRef
38.
go back to reference Konrad D, Rudich A, Bilan PJ et al (2005) Troglitazone causes acute mitochondrial membrane depolarisation and an AMPK-mediated increase in glucose phosphorylation in muscle cells. Diabetologia 48:954–966PubMedCrossRef Konrad D, Rudich A, Bilan PJ et al (2005) Troglitazone causes acute mitochondrial membrane depolarisation and an AMPK-mediated increase in glucose phosphorylation in muscle cells. Diabetologia 48:954–966PubMedCrossRef
39.
go back to reference Hutchinson DS, Csikasz RI, Yamamoto DL et al (2007) Diphenylene iodonium stimulates glucose uptake in skeletal muscle cells through mitochondrial complex I inhibition and activation of AMP-activated protein kinase. Cell Signal 19:1610–1620PubMedCrossRef Hutchinson DS, Csikasz RI, Yamamoto DL et al (2007) Diphenylene iodonium stimulates glucose uptake in skeletal muscle cells through mitochondrial complex I inhibition and activation of AMP-activated protein kinase. Cell Signal 19:1610–1620PubMedCrossRef
40.
go back to reference Narita M, Shimizu S, Ito T et al (1998) Bax interacts with the permeability transition pore to induce permeability transition and cytochrome c release in isolated mitochondria. Proc Natl Acad Sci U S A 95:14681–14686PubMedCrossRef Narita M, Shimizu S, Ito T et al (1998) Bax interacts with the permeability transition pore to induce permeability transition and cytochrome c release in isolated mitochondria. Proc Natl Acad Sci U S A 95:14681–14686PubMedCrossRef
41.
go back to reference Harper JA, Dickinson K, Brand MD (2001) Mitochondrial uncoupling as a target for drug development for the treatment of obesity. Obes Rev 2:255–265PubMedCrossRef Harper JA, Dickinson K, Brand MD (2001) Mitochondrial uncoupling as a target for drug development for the treatment of obesity. Obes Rev 2:255–265PubMedCrossRef
42.
go back to reference Brunmair B, Staniek K, Gras F et al (2004) Thiazolidinediones, like metformin, inhibit respiratory complex I: a common mechanism contributing to their antidiabetic actions? Diabetes 53:1052–1059PubMedCrossRef Brunmair B, Staniek K, Gras F et al (2004) Thiazolidinediones, like metformin, inhibit respiratory complex I: a common mechanism contributing to their antidiabetic actions? Diabetes 53:1052–1059PubMedCrossRef
43.
go back to reference Owen MR, Doran E, Halestrap AP (2000) Evidence that metformin exerts its anti-diabetic effects through inhibition of complex 1 of the mitochondrial respiratory chain. Biochem J 348:607–614PubMedCrossRef Owen MR, Doran E, Halestrap AP (2000) Evidence that metformin exerts its anti-diabetic effects through inhibition of complex 1 of the mitochondrial respiratory chain. Biochem J 348:607–614PubMedCrossRef
44.
go back to reference Narkar VA, Downes M, Yu RT et al (2008) AMPK and PPARdelta agonists are exercise mimetics. Cell 134:405–415PubMedCrossRef Narkar VA, Downes M, Yu RT et al (2008) AMPK and PPARdelta agonists are exercise mimetics. Cell 134:405–415PubMedCrossRef
45.
go back to reference Viollet B, Guigas B, Leclerc J et al (2009) AMP-activated protein kinase in the regulation of hepatic energy metabolism: from physiology to therapeutic perspectives. Acta Physiol (Oxf) 196:81–98CrossRef Viollet B, Guigas B, Leclerc J et al (2009) AMP-activated protein kinase in the regulation of hepatic energy metabolism: from physiology to therapeutic perspectives. Acta Physiol (Oxf) 196:81–98CrossRef
46.
go back to reference Winder WW, Hardie DG (1996) Inactivation of acetyl-CoA carboxylase and activation of AMP-activated protein kinase in muscle during exercise. Am J Physiol 270:E299–E304PubMed Winder WW, Hardie DG (1996) Inactivation of acetyl-CoA carboxylase and activation of AMP-activated protein kinase in muscle during exercise. Am J Physiol 270:E299–E304PubMed
47.
go back to reference Pan DA, Lillioja S, Kriketos AD et al (1997) Skeletal muscle triglyceride levels are inversely related to insulin action. Diabetes 46:983–988PubMedCrossRef Pan DA, Lillioja S, Kriketos AD et al (1997) Skeletal muscle triglyceride levels are inversely related to insulin action. Diabetes 46:983–988PubMedCrossRef
48.
go back to reference Oakes ND, Bell KS, Furler SM et al (1997) Diet-induced muscle insulin resistance in rats is ameliorated by acute dietary lipid withdrawal or a single bout of exercise: parallel relationship between insulin stimulation of glucose uptake and suppression of long-chain fatty acyl-CoA. Diabetes 46:2022–2028PubMedCrossRef Oakes ND, Bell KS, Furler SM et al (1997) Diet-induced muscle insulin resistance in rats is ameliorated by acute dietary lipid withdrawal or a single bout of exercise: parallel relationship between insulin stimulation of glucose uptake and suppression of long-chain fatty acyl-CoA. Diabetes 46:2022–2028PubMedCrossRef
Metadata
Title
Arctigenin, a natural compound, activates AMP-activated protein kinase via inhibition of mitochondria complex I and ameliorates metabolic disorders in ob/ob mice
Authors
S.-L. Huang
R.-T. Yu
J. Gong
Y. Feng
Y.-L. Dai
F. Hu
Y.-H. Hu
Y.-D. Tao
Y. Leng
Publication date
01-05-2012
Publisher
Springer-Verlag
Published in
Diabetologia / Issue 5/2012
Print ISSN: 0012-186X
Electronic ISSN: 1432-0428
DOI
https://doi.org/10.1007/s00125-011-2366-3

Other articles of this Issue 5/2012

Diabetologia 5/2012 Go to the issue
Live Webinar | 27-06-2024 | 18:00 (CEST)

Keynote webinar | Spotlight on medication adherence

Live: Thursday 27th June 2024, 18:00-19:30 (CEST)

WHO estimates that half of all patients worldwide are non-adherent to their prescribed medication. The consequences of poor adherence can be catastrophic, on both the individual and population level.

Join our expert panel to discover why you need to understand the drivers of non-adherence in your patients, and how you can optimize medication adherence in your clinics to drastically improve patient outcomes.

Prof. Kevin Dolgin
Prof. Florian Limbourg
Prof. Anoop Chauhan
Developed by: Springer Medicine
Obesity Clinical Trial Summary

At a glance: The STEP trials

A round-up of the STEP phase 3 clinical trials evaluating semaglutide for weight loss in people with overweight or obesity.

Developed by: Springer Medicine

Highlights from the ACC 2024 Congress

Year in Review: Pediatric cardiology

Watch Dr. Anne Marie Valente present the last year's highlights in pediatric and congenital heart disease in the official ACC.24 Year in Review session.

Year in Review: Pulmonary vascular disease

The last year's highlights in pulmonary vascular disease are presented by Dr. Jane Leopold in this official video from ACC.24.

Year in Review: Valvular heart disease

Watch Prof. William Zoghbi present the last year's highlights in valvular heart disease from the official ACC.24 Year in Review session.

Year in Review: Heart failure and cardiomyopathies

Watch this official video from ACC.24. Dr. Biykem Bozkurt discusses last year's major advances in heart failure and cardiomyopathies.