Name: hyperinsulinemic-euglycemic clamps in conscious, unrestrained mice
Uploaded: 2011-11-16T12:00:00
Duration: 11 min 10 s
Description: Watch this Scientific Journal Video about Hyperinsulinemic-euglycemic Clamps in Conscious, Unrestrained Mice at JoVE.com

This work was supported by Grant 5-U24-DK059637-10 to the Vanderbilt Mouse Metabolic Phenotyping Center.

<ol>
	<li>Ayala, J. E., Bracy, D. P., McGuinness, O. P., Wasserman, D. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Considerations+in+the+design+of+hyperinsulinemic-euglycemic+clamps+in+the+conscious+mouse.">Considerations in the design of hyperinsulinemic-euglycemic clamps in the conscious mouse.</a> Diabetes. 55, 390-397 (2006).</li><li>Berglund, E. D., Li, C. Y., Poffenberger, G., Ayala, J. E., Fueger, P. T., Willis, S. E., Jewell, M. M., Powers, A. C., Wasserman, D. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Glucose+metabolism+in+vivo+in+four+commonly+used+inbred+mouse+strains.">Glucose metabolism in vivo in four commonly used inbred mouse strains.</a> Diabetes. 57, 1790-1799 (2008).</li><li>Niswender, K. D., Shiota, M., Postic, C., Cherrington, A. D., Magnuson, M. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Effects+of+increased+glucokinase+gene+copy+number+on+glucose+homeostasis+and+hepatic+glucose+metabolism.">Effects of increased glucokinase gene copy number on glucose homeostasis and hepatic glucose metabolism.</a> J. Biol. Chem. 272, 22570-22575 (1997).</li><li>Kim, H. J., Higashimori, T., Park, S. Y., Choi, H., Dong, J., Kim, Y. J., Noh, H. L., Cho, Y. R., Cline, G., Kim, Y. B., Kim, J. K. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Differential+effects+of+interleukin-6+and+-10+on+skeletal+muscle+and+liver+insulin+action+in+vivo.">Differential effects of interleukin-6 and -10 on skeletal muscle and liver insulin action in vivo.</a> Diabetes. 53, 1060-1067 (2004).</li><li>Kim, J. K., Fillmore, J. J., Chen, Y., Yu, C., Moore, I. K., Pypaert, M., Lutz, E. P., Kako, Y., Velez-Carrasco, W., Goldberg, I. J., Breslow, J. L., Shulman, G. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Tissue-specific+overexpression+of+lipoprotein+lipase+causes+tissue-specific+insulin+resistance.">Tissue-specific overexpression of lipoprotein lipase causes tissue-specific insulin resistance.</a> Proc. Natl. Acad. Sci. U. S. A. 98, 7522-7527 (2001).</li><li>Kim, J. K., Fillmore, J. J., Gavrilova, O., Chao, L., Higashimori, T., Choi, H., Kim, H. J., Yu, C., Chen, Y., Qu, X., Haluzik, M., Reitman, M. L., Shulman, G. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Differential+effects+of+rosiglitazone+on+skeletal+muscle+and+liver+insulin+resistance+in+A-ZIP/F-1+fatless+mice.">Differential effects of rosiglitazone on skeletal muscle and liver insulin resistance in A-ZIP/F-1 fatless mice.</a> Diabetes. 52, 1311-1318 (2003).</li><li>Kim, J. K., Fillmore, J. J., Sunshine, M. J., Albrecht, B., Higashimori, T., Kim, D. W., Liu, Z. X., Soos, T. J., Cline, G. W., O'Brien, W. R., Littman, D. R., Shulman, G. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=PKC-theta+knockout+mice+are+protected+from+fat-induced+insulin+resistance.">PKC-theta knockout mice are protected from fat-induced insulin resistance.</a> J. Clin. Invest. 114, 823-827 (2004).</li><li>Kim, J. K., Gavrilova, O., Chen, Y., Reitman, M. L., Shulman, G. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Mechanism+of+insulin+resistance+in+A-ZIP/F-1+fatless+mice.">Mechanism of insulin resistance in A-ZIP/F-1 fatless mice.</a> J. Biol. Chem. 275, 8456-8460 (2000).</li><li>Kim, J. K., Gimeno, R. E., Higashimori, T., Kim, H. J., Choi, H., Punreddy, S., Mozell, R. L., Tan, G., Stricker-Krongrad, A., Hirsch, . <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Inactivation+of+fatty+acid+transport+protein+1+prevents+fat-induced+insulin+resistance+in+skeletal+muscle.">Inactivation of fatty acid transport protein 1 prevents fat-induced insulin resistance in skeletal muscle.</a> J. Clin. Invest. 113, 756-763 (2004).</li><li>Kim, J. K., Kim, H. J., Park, S. Y., Cederberg, A., Westergren, R., Nilsson, D., Higashimori, T., Cho, Y. R., Liu, Z. X., Dong, J., Cline, G. W., Enerback, S., Shulman, G. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adipocyte-specific+overexpression+of+FOXC2+prevents+diet-induced+increases+in+intramuscular+fatty+acyl+CoA+and+insulin+resistance.">Adipocyte-specific overexpression of FOXC2 prevents diet-induced increases in intramuscular fatty acyl CoA and insulin resistance.</a> Diabetes. 54, 1657-1663 (2005).</li><li>Kim, J. K., Kim, Y. J., Fillmore, J. J., Chen, Y., Moore, I., Lee, J., Yuan, M., Li, Z. W., Karin, M., Perret, P., Shoelson, S. E., Shulman, G. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Prevention+of+fat-induced+insulin+resistance+by+salicylate.">Prevention of fat-induced insulin resistance by salicylate.</a> J. Clin. Invest. 108, 437-446 (2001).</li><li>Kim, J. K., Michael, P. r. e. v. i. s., Peroni, S. F., Mauvais-Jarvis, O. D., Neschen, F., Kahn, S., Kahn, B. B., R, C., Shulman, G. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Redistribution+of+substrates+to+adipose+tissue+promotes+obesity+in+mice+with+selective+insulin+resistance+in+muscle.">Redistribution of substrates to adipose tissue promotes obesity in mice with selective insulin resistance in muscle.</a> J. Clin. Invest. 105, 1791-1797 (2000).</li><li>Kim, J. K., Zisman, A., Fillmore, J. J., Peroni, O. D., Kotani, K., Perret, P., Zong, H., Dong, J., Kahn, C. R., Kahn, B. B., Shulman, G. I. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Glucose+toxicity+and+the+development+of+diabetes+in+mice+with+muscle-specific+inactivation+of+GLUT4.">Glucose toxicity and the development of diabetes in mice with muscle-specific inactivation of GLUT4.</a> J. Clin. Invest. 108, 153-160 (2001).</li><li>Haluzik, M., Gavrilova, O., LeRoith, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Peroxisome+proliferator-activated+receptor-alpha+deficiency+does+not+alter+insulin+sensitivity+in+mice+maintained+on+regular+or+high-fat+diet:+hyperinsulinemic-euglycemic+clamp+studies.">Peroxisome proliferator-activated receptor-alpha deficiency does not alter insulin sensitivity in mice maintained on regular or high-fat diet: hyperinsulinemic-euglycemic clamp studies.</a> Endocrinology. 145, 1662-1667 (2004).</li><li>Haluzik, M., Yakar, S., Gavrilova, O., Setser, J., Boisclair, Y., LeRoith, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Insulin+resistance+in+the+liver-specific+IGF-1+gene-deleted+mouse+is+abrogated+by+deletion+of+the+acid-labile+subunit+of+the+IGF-binding+protein-3+complex:+relative+roles+of+growth+hormone+and+IGF-1+in+insulin+resistance.">Insulin resistance in the liver-specific IGF-1 gene-deleted mouse is abrogated by deletion of the acid-labile subunit of the IGF-binding protein-3 complex: relative roles of growth hormone and IGF-1 in insulin resistance.</a> Diabetes. 52, 2483-2489 (2003).</li><li>Haluzik, M. M., Lacinova, Z., Dolinkova, M., Haluzikova, D., Housa, D., Horinek, A., Vernerova, Z., Kumstyrova, T., Haluzik, M. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Improvement+of+insulin+sensitivity+after+peroxisome+proliferator-activated+receptor-alpha+agonist+treatment+is+accompanied+by+paradoxical+increase+of+circulating+resistin+levels.">Improvement of insulin sensitivity after peroxisome proliferator-activated receptor-alpha agonist treatment is accompanied by paradoxical increase of circulating resistin levels.</a> Endocrinology. 147, 4517-4524 (2006).</li><li>Kim, H., Haluzik, M., Asghar, Z., Yau, D., Joseph, J. W., Fernandez, A. M., Reitman, M. L., Yakar, S., Stannard, B., Heron-Milhavet, L., Wheeler, M. B., LeRoith, D. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Peroxisome+proliferator-activated+receptor-alpha+agonist+treatment+in+a+transgenic+model+of+type+2+diabetes+reverses+the+lipotoxic+state+and+improves+glucose+homeostasis.">Peroxisome proliferator-activated receptor-alpha agonist treatment in a transgenic model of type 2 diabetes reverses the lipotoxic state and improves glucose homeostasis.</a> Diabetes. 52, 1770-1778 (2003).</li><li>Deibert, D. C., DeFronzo, R. A. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Epinephrine-induced+insulin+resistance+in+man.">Epinephrine-induced insulin resistance in man.</a> J. Clin. Invest. 65, 717-721 (1980).</li><li>Rizza, R. A., Cryer, P. E., Haymond, M. W., Gerich, J. E. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Adrenergic+mechanisms+for+the+effects+of+epinephrine+on+glucose+production+and+clearance+in+man.">Adrenergic mechanisms for the effects of epinephrine on glucose production and clearance in man.</a> J. Clin. Invest. 65, 682-689 (1980).</li><li>Nunemaker, C. S., Wasserman, D. H., McGuinness, O. P., Sweet, I. R., Teague, J. C., Satin, L. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Insulin+secretion+in+the+conscious+mouse+is+biphasic+and+pulsatile.">Insulin secretion in the conscious mouse is biphasic and pulsatile.</a> Am. J. Physiol. Endocrinol. Metab. 290, 523-529 (2006).</li><li>Nunemaker, C. S., Zhang, M., Wasserman, D. H., McGuinness, O. P., Powers, A. C., Bertram, R., Sherman, A., Satin, L. S. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Individual+mice+can+be+distinguished+by+the+period+of+their+islet+calcium+oscillations:+is+there+an+intrinsic+islet+period+that+is+imprinted+in+vivo.">Individual mice can be distinguished by the period of their islet calcium oscillations: is there an intrinsic islet period that is imprinted in vivo.</a> Diabetes. 54, 3517-3522 (2005).</li><li>Halter, J. B., Beard, J. C., Jr, P. o. r. t. e., D, . <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Islet+function+and+stress+hyperglycemia:+plasma+glucose+and+epinephrine+interaction.">Islet function and stress hyperglycemia: plasma glucose and epinephrine interaction.</a> Am. J. Physiol. 247, 47-52 (1984).</li><li>Jacobson, L., Ansari, T., McGuinness, O. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Counterregulatory+deficits+occur+within+24+h+of+a+single+hypoglycemic+episode+in+conscious,+unrestrained,+chronically+cannulated+mice.">Counterregulatory deficits occur within 24 h of a single hypoglycemic episode in conscious, unrestrained, chronically cannulated mice.</a> Am. J. Physiol. Endocrinol. Metab. 290, 678-684 (2006).</li><li>Jacobson, L., Ansari, T., Potts, J., McGuinness, O. P. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Glucocorticoid-deficient+corticotropin-releasing+hormone+knockout+mice+maintain+glucose+requirements+but+not+autonomic+responses+during+repeated+hypoglycemia.">Glucocorticoid-deficient corticotropin-releasing hormone knockout mice maintain glucose requirements but not autonomic responses during repeated hypoglycemia.</a> Am. J. Physiol. Endocrinol. Metab. 291, 15-22 (2006).</li><li>Ayala, J. E., Bracy, D. P., James, F. D., Julien, B. M., Wasserman, D. H., Drucker, D. J. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=The+glucagon-like+peptide-1+receptor+regulates+endogenous+glucose+production+and+muscle+glucose+uptake+independent+of+its+incretin+action.">The glucagon-like peptide-1 receptor regulates endogenous glucose production and muscle glucose uptake independent of its incretin action.</a> Endocrinology. 150, 1155-1164 (2009).</li><li>Fueger, P. T., Bracy, D. P., Malabanan, C. M., Pencek, R. R., Granner, D. K., Wasserman, D. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hexokinase+II+overexpression+improves+exercise-stimulated+but+not+insulin-stimulated+muscle+glucose+uptake+in+high-fat-fed+C57BL/6J+mice.">Hexokinase II overexpression improves exercise-stimulated but not insulin-stimulated muscle glucose uptake in high-fat-fed C57BL/6J mice.</a> Diabetes. 53, 306-314 (2004).</li><li>Fueger, P. T., Bracy, D. P., Malabanan, C. M., Pencek, R. R., Wasserman, D. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Distributed+control+of+glucose+uptake+by+working+muscles+of+conscious+mice:+roles+of+transport+and+phosphorylation.">Distributed control of glucose uptake by working muscles of conscious mice: roles of transport and phosphorylation.</a> Am. J. Physiol. Endocrinol. Metab. 286, 77-84 (2004).</li><li>Fueger, P. T., Heikkinen, S., Bracy, D. P., Malabanan, C. M., Pencek, R. R., Laakso, M., Wasserman, D. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Hexokinase+II+partial+knockout+impairs+exercise-stimulated+glucose+uptake+in+oxidative+muscles+of+mice.">Hexokinase II partial knockout impairs exercise-stimulated glucose uptake in oxidative muscles of mice.</a> Am. J. Physiol. Endocrinol. Metab. 285, 958-963 (2003).</li><li>Fueger, P. T., Hess, H. S., Posey, K. A., Bracy, D. P., Pencek, R. R., Charron, M. J., Wasserman, D. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Control+of+exercise-stimulated+muscle+glucose+uptake+by+GLUT4+is+dependent+on+glucose+phosphorylation+capacity+in+the+conscious+mouse.">Control of exercise-stimulated muscle glucose uptake by GLUT4 is dependent on glucose phosphorylation capacity in the conscious mouse.</a> J. Biol. Chem. , (2004).</li><li>Fueger, P. T., Li, C. Y., Ayala, J. E., Shearer, J., Bracy, D. P., Charron, M. J., Rottman, J. N., Wasserman, D. H. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Glucose+kinetics+and+exercise+tolerance+in+mice+lacking+the+GLUT4+glucose+transporter.">Glucose kinetics and exercise tolerance in mice lacking the GLUT4 glucose transporter.</a> J. Physiol. 582, 801-812 (2007).</li><li>Shearer, J., Coenen, K. R., Pencek, R. R., Swift, L. L., Wasserman, D. H., Rottman, J. N. <a target="_blank" href="http://www.ncbi.nlm.nih.gov/entrez/query.fcgi?db=PubMed&cmd=Search&doptcmdl=Citation&defaultField=Title+Word&term=Long+chain+fatty+acid+uptake+in+vivo:+comparison+of+[125I]-BMIPP+and+[3H]-bromopalmitate.">Long chain fatty acid uptake in vivo: comparison of [125I]-BMIPP and [3H]-bromopalmitate.</a> Lipids. 43, 703-711 (2008).</li></ol>

No conflicts of interest declared.

The hyperinsulinemic-euglycemic clamp, or insulin clamp, is widely considered the "gold standard" method for assessing insulin action in vivo. This technique has been applied to several species including humans, dogs, rats and mice. Given the growing number of transgenic mouse models for metabolic disorders, the miniaturization of the technique for use in the mouse has provided significant advances to metabolic research.
While the concepts behind the insulin clamp are straightforward, in practice there are different approaches for performing insulin clamp experiments. This is not a trivial point, since the manner in which the experiment is performed affects results obtained1. Here we present the protocol used by the Vanderbilt MMPC. The key distinction between our protocol and that of others is that we use an arterial catheter for obtaining blood samples. This is in contrast to the more widely used approach of obtaining blood samples by severing the tip of the tail4, 7, 11, 12, 14-17. The advantage of sampling from an arterial catheter is that the experiment is conducted in a conscious and unrestrained mouse. Sampling from the tail often requires restraint and increases indices of stress when large blood samples are acquired1. Stress hormones stimulate endogenous glucose production and impair glucose disposal18, 19, potentially giving the appearance of an insulin resistant phenotype. Sampling from the severed tail may require special Institutional Animal Care and Use Committee approval because of its stressful nature. The arterial catheterization procedure was developed to avoid the stress to the mouse of severing the tail.
A key aspect of performing insulin clamps is the ability to maintain euglycemia. There are no algorithms that can correctly predict how the GIR should be adjusted based on blood glucose readings. Like the surgery, personnel conducting insulin clamp experiments will become proficient in maintaining reasonable euglycemia only through experience. It is important to note that because of their higher metabolic rate the data obtained from mouse studies will be inherently noisy. This makes the complete presentation of data, including time courses of glucose and GIR and absolute values for plasma insulin, endoRa, Rd and Rg crucial for the ability of any reader to interpret results. The high glucose flux rates in the mouse (approximately 5 times higher than the rate in humans) warrant a high frequency of glucose sampling. While the blood volume of the mouse is limited, a minimum sampling frequency of once every 10 minutes is necessary to be certain that an adequate clamp has been achieved.
As shown in Figure 4, clamp insulin levels can be different between groups. Factors such as diet interventions, transgenic manipulations or differences in background strains can affect fasting insulin levels, which can subsequently affect clamp insulin levels. Interpreting results when clamp insulin levels are different can be problematic. This can be experimentally addressed by performing pilot experiments to select insulin infusion rates that achieve equivalent clamp insulin levels between groups. Alternatively, somatostatin can be used to inhibit pancreatic hormone secretion, and insulin and glucagon can be replaced at experimentally controlled rates. This latter approach is more commonly done in insulin clamps on rats than mice. If these experimental approaches are not taken, the steady-state GIR can be normalized to the clamp insulin level, or an insulin sensitivity index (SI) can be derived from clamp data as SI=GIR/(G&bull;&Delta;I), where G is the steady-state glucose concentration and &Delta;I is the difference between fasting and clamp insulin concentrations. One assumption with either approach is that the clamp insulin level achieved is within the range where insulin sensitivity is linearly related to the insulin level according to the group being studied. This latter assumption may not apply when comparing insulin resistant and insulin sensitive groups. Ideally, an insulin dose response curve should be generated to select the appropriate insulin infusion. However, because of the requirement for additional experiments, this is rarely done.
The versatility provided by arterial catheterization extends to experimental approaches beyond euglycemic clamps. For example, hyperglycemic clamps, in which glucose is infused at a variable rate to maintain hyperglycemia relative to fasting glucose, can be used to assess endogenous pancreatic function in vivo2, 20, 21. The measurement of first phase insulin secretion during this test requires frequent acquisition of blood samples (i.e every 2-5 min), which is not feasible when obtaining samples from the tip of the tail. Furthermore, elevated catecholamines resulting from tail sampling can impair insulin secretion and enhance glucagon secretion22. The insulin clamp protocol can also be modified to allow for glucose levels to fall to relative hypoglycemia to assess counter-regulatory response2, 23, 24. Arterial catheterization can also be used to assess the dynamics of glucose metabolism during exercise25-30. This is significantly advantageous over conventional approaches conducted at single time points pre- and post-exercise or in isolated muscles ex vivo. The techniques presented here can also be used to assess not just glucose, but also fatty acid metabolism31.

hyperinsulinemic-euglycemic clamps in conscious, unrestrained mice

Type 2 diabetes is characterized by a defect in insulin action. The hyperinsulinemic-euglycemic clamp, or insulin clamp, is widely considered the "gold standard" method for assessing insulin action in vivo. During an insulin clamp, hyperinsulinemia is achieved by a constant insulin infusion. Euglycemia is maintained via a concomitant glucose infusion at a variable rate. This variable glucose infusion rate (GIR) is determined by measuring blood glucose at brief intervals throughout the experiment and adjusting the GIR accordingly. The GIR is indicative of whole-body insulin action, as mice with enhanced insulin action require a greater GIR. The insulin clamp can incorporate administration of isotopic 2[14C]deoxyglucose to assess tissue-specific glucose uptake and [3-3H]glucose to assess the ability of insulin to suppress the rate of endogenous glucose appearance (endoRa), a marker of hepatic glucose production, and to stimulate the rate of whole-body glucose disappearance (Rd).
The miniaturization of the insulin clamp for use in genetic mouse models of metabolic disease has led to significant advances in diabetes research. Methods for performing insulin clamps vary between laboratories. It is important to note that the manner in which an insulin clamp is performed can significantly affect the results obtained. We have published a comprehensive assessment of different approaches to performing insulin clamps in conscious mice1 as well as an evaluation of the metabolic response of four commonly used inbred mouse strains using various clamp techniques2. Here we present a protocol for performing insulin clamps on conscious, unrestrained mice developed by the Vanderbilt Mouse Metabolic Phenotyping Center (MMPC; URL: www.mc.vanderbilt.edu/mmpc). This includes a description of the method for implanting catheters used during the insulin clamp. The protocol employed by the Vanderbilt MMPC utilizes a unique two-catheter system3. One catheter is inserted into the jugular vein for infusions. A second catheter is inserted into the carotid artery, which allows for blood sampling without the need to restrain or handle the mouse. This technique provides a significant advantage to the most common method for obtaining blood samples during insulin clamps which is to sample from the severed tip of the tail. Unlike this latter method, sampling from an arterial catheter is not stressful to the mouse1. We also describe methods for using isotopic tracer infusions to assess tissue-specific insulin action. We also provide guidelines for the appropriate presentation of results obtained from insulin clamps.

Watch this Scientific Journal Video about Hyperinsulinemic-euglycemic Clamps in Conscious, Unrestrained Mice at JoVE.com

Hyperinsulinemic-euglycemic Clamps in Conscious, Unrestrained Mice

The hyperinsulinemic-euglycemic clamp, or insulin clamp, is the gold standard for assessing insulin action in vivo. A method for performing insulin clamps in mice is described. This includes a method for arterial catheterization that permits experiments to be performed in conscious, unrestrained mice with minimal stress.

Type 2 diabetes is characterized by a defect in insulin action. The hyperinsulinemic-euglycemic clamp, or insulin clamp, is widely considered the "gold ...

hyperinsulinemic-euglycemic-clamps-in-conscious-unrestrained-mice

Research

JoVE Journal

Medicine

Transthoracic Echocardiography in Mice

In recent years, murine models have become the primary avenue for studying the molecular mechanisms of cardiac dysfunction resulting from changes in gene expression. Transgenic and gene targeting methods can be used to generate mice with altered cardiac size and function,1-3 and as a result, in vivo techniques are needed to evaluate their cardiac phenotype. Transthoracic echocardiography, pulse wave Doppler (PWD), and tissue Doppler imaging (TDI) can be used to provide dimensional measurements of the mouse heart and to quantify the degree of cardiac systolic and diastolic performance. Two-dimensional imaging is used to detect abnormal anatomy or movements of the left ventricle, whereas M-mode echo is used for quantification of cardiac dimensions and contractility.4,5 In addition, PWD is used to quantify localized velocity of turbulent flow,6 whereas TDI is used to measure the velocity of myocardial motion.7 Thus, transthoracic echocardiography offers a comprehensive method for the noninvasive evaluation of cardiac function in mice.

Transthoracic echocardiography offers a noninvasive method for the evaluation of cardiac function in mice. A combination of ultrasound and Doppler imaging modalities can be used to obtain dimensional measurements of the heart and intracardiac blood flow, which together provide an assessment of cardiac systolic and diastolic performance.

In recent years, murine models have become the primary avenue for studying the molecular mechanisms of cardiac dysfunction resulting from changes in gene ...

Hyperinsulinemic-Euglycemic Clamp in the Conscious Rat

Type 2 diabetes (T2D) is rapidly rising in prevalence. Characterized by either inadequate insulin production or the inability to utilize insulin produced, T2D results in elevated blood glucose levels. The "gold-standard" in assessing insulin sensitivity is a hyperinsulinemic-euglycemic clamp or insulin clamp. In this procedure, insulin is infused at a constant rate resulting in a drop in blood glucose. To maintain blood glucose at a constant level, exogenous glucose (D50) is infused into the venous circulation. The amount of glucose infused to maintain homeostasis is indicative of insulin sensitivity. Here, we show the basic clamp procedure in the chronically catheterized, unrestrained, conscious rat. This model allows blood to be collected with minimal stress to the animal. Following the induction of anesthesia, a midline incision is made and the left common carotid artery and right jugular vein are catheterized. Inserted catheters are flushed with heparinized saline, then exteriorized and secured. Animals are allowed to recover for 4-5 days prior to experiments, with weight gain monitored daily. Only those animals who regain weight to pre-surgery levels are used for experiments. On the day of the experiment, rats are fasted and connected to pumps containing insulin and D50. Baseline glucose is assessed from the arterial line and used a benchmark throughout the experiment (euglycemia). Following this, insulin is infused at a constant rate into the venous circulation. To match the drop in blood glucose, D50 is infused. If the rate of D50 infusion is greater than the rate of uptake, a rise in glucose will occur. Similarly, if the rate is insufficient to match whole body glucose uptake, a drop will occur. Titration of glucose continues until stable glucose readings are achieved. Glucose levels and glucose infusion rates during this stable period are recorded and reported. Results provide an index of whole body insulin sensitivity. The technique can be refined to meet specific experimental requirements. It is further enhanced by the use of radioactive tracers that can determine tissue specific insulin-stimulated glucose uptake as well as whole body glucose turnover.

The hyperinsulinemic-euglycemic clamp is the "gold standard" for the assessment of insulin action. Insulin is infused at a constant rate stimulating glucose uptake. The amount of exogenous glucose infused to counter this drop is indicative of insulin sensitivity. Here the procedure is performed on a conscious, unrestrained rat.

Type 2 diabetes (T2D) is rapidly rising in prevalence. Characterized by either inadequate insulin production or the inability to utilize insulin produced, ...

Femoral Arterial and Venous Catheterization for Blood Sampling, Drug Administration and Conscious Blood Pressure and Heart Rate Measurements

In multiple fields of study, access to the circulatory system in laboratory studies is necessary. Pharmacological studies in rats using chronically implanted catheters permit a researcher to effectively and humanely administer substances, perform repeated blood sampling and assists in conscious direct measurements of blood pressure and heart rate. Once the catheter is implanted long-term sampling is possible. Patency and catheter life depends on multiple factors including the lock solution used, flushing regimen and catheter material. This video will demonstrate the methodology of femoral artery and venous catheterization of the rat. In addition the video will demonstrate the use of the femoral venous and arterial catheters for blood sampling, drug administration and use of the arterial catheter in taking measurements of blood pressure and heart rate in a conscious freely-moving rat. A tether and harness attached to a swivel system will allow the animal to be housed and have samples taken by the researcher with minimal disruption to the animal. To maintain patency of the catheter, careful daily maintenance of the catheter is required using lock solution (100 U/ml heparinized saline), machine-ground blunt tip syringe needles and the use of syringe filters to minimize potential contamination. With careful aseptic surgical techniques, proper catheter materials and careful catheter maintenance techniques, it is possible to sustain patent catheters and healthy animals for long periods of time (several weeks).

Chronic catheterization of blood vessels in the rat is often required for administration of substances, obtain blood sample over a period of time or for direct conscious blood pressure measurements. Femoral arterial catheterization of the rat and corresponding measurements of blood pressure in the conscious animal will be demonstrated.

In multiple fields of study, access to the circulatory system in laboratory studies is necessary. Pharmacological studies in rats using chronically ...

Catheterization of the Carotid Artery and Jugular Vein to Perform Hemodynamic Measures, Infusions and Blood Sampling in a Conscious Rat Model

The success of a small animal model to study critical illness is, in part, dependent on the ability of the model to simulate the human condition. Intra-tracheal inoculation of a known amount of bacteria has been successfully used to reproduce the pathogenesis of pneumonia which then develops into sepsis. Monitoring hemodynamic parameters and providing standard clinical treatment including infusion of antibiotics, fluids and drugs to maintain blood pressure is critical to simulate routine supportive care in this model but to do so requires both arterial and venous vascular access. The video details the surgical technique for implanting carotid artery and common jugular vein catheters in an anesthetized rat. Following a 72 hr recovery period, the animals will be re-anesthetized and connected to a tether and swivel setup attached to the rodent housing which connects the implanted catheters to the hemodynamic monitoring system. This setup allows free movement of the rat during the study while continuously monitoring pressures, infusing fluids and drugs (antibiotics, vasopressors) and performing blood sampling.

Vascular accesses to measure hemodynamics, provide fluids and perform blood sampling are important to any small animal model study. We present a technique for implanting catheters into the carotid artery and the common jugular vein in an anesthetized rat for connecting to a system to perform monitoring, infusions and sampling.

The success of a small animal model to study critical illness is, in part, dependent on the ability of the model to simulate the human condition. ...

Carotid Artery Infusions for Pharmacokinetic and Pharmacodynamic Analysis of Taxanes in Mice

When proposing the use of a drug, drug combination, or drug delivery into a novel system, one must assess the pharmacokinetics of the drug in the study model. As the use of mouse models are often a vital step in preclinical drug discovery and drug development1-8, it is necessary to design a system to introduce drugs into mice in a uniform, reproducible manner. Ideally, the system should permit the collection of blood samples at regular intervals over a set time course. The ability to measure drug concentrations by mass-spectrometry, has allowed investigators to follow the changes in plasma drug levels over time in individual mice1, 9, 10. In this study, paclitaxel was introduced into transgenic mice as a continuous arterial infusion over three hours, while blood samples were simultaneously taken by retro-orbital bleeds at set time points. Carotid artery infusions are a potential alternative to jugular vein infusions, when factors such as mammary tumors or other obstructions make jugular infusions impractical. Using this technique, paclitaxel concentrations in plasma and tissue achieved similar levels as compared to jugular infusion. In this tutorial, we will demonstrate how to successfully catheterize the carotid artery by preparing an optimized catheter for the individual mouse model, then show how to insert and secure the catheter into the mouse carotid artery, thread the end of the catheter out through the back of the mouse&#8217;s neck, and hook the mouse to a pump to deliver a controlled rate of drug influx. Multiple low volume retro-orbital bleeds allow for analysis of plasma drug concentrations over time.

This method was developed with the goal of delivering a steady drug solution via the carotid artery, to assess the pharmacokinetics of novel drugs in mouse models.

When proposing the use of a drug, drug combination, or drug delivery into a novel system, one must assess the pharmacokinetics of the drug in the study ...

Transcutaneous Assessment of Renal Function in Conscious Rodents

Glomerular filtration rate (GFR) is the gold standard to assess overall kidney function. However, traditional methods to evaluate GFR are cumbersome and time-consuming. In addition, serial blood or urine samples are required, with the associated stress for the experimental animals. A recent technique significantly reduces the investment in time and resources, minimizing the invasiveness and the animal stress, but being equally valid as the traditional approaches. The method measures transcutaneously renal function. Using an optical device and the exogenous renal marker fluorescein isothiocyanate (FITC)-sinistrin, this technique is capable of measuring the elimination kinetics of the marker through the skin. With neither blood nor urine samples nor the associated laboratory assays needed, the results of the transcutaneous measurement are almost instantaneously available. The method has been already validated in different species and successfully applied in several models of renal pathology. Moreover, due to its minimally invasive characteristics, it is suitable for sequential measurements within the same animal. Here is provided a detailed protocol to carry out the transcutaneous assessment of renal function in rodents.

Determination of glomerular filtration rate (GFR) is the gold standard to assess overall kidney function. However, traditional procedures to measure this parameter are cumbersome and require a large investment of time. Here we describe a faster and minimally invasive method to determinate GFR transcutaneously.

Glomerular filtration rate (GFR) is the gold standard to assess overall kidney function. However, traditional methods to evaluate GFR are cumbersome and ...

Novel Approach for Simultaneous Recording of Renal Sympathetic Nerve Activity and Blood Pressure with Intravenous Infusion in Conscious, Unrestrained Mice.

Renal sympathetic nerves contribute significantly to both physiological and pathophysiological phenomena. Evaluating renal sympathetic nerve activity (RSNA) is of great interest in many areas of research such as chronic kidney disease, hypertension, heart failure, diabetes and obesity. Unequivocal assessment of the role of the sympathetic nervous system is thus imperative for proper interpretation of experimental results and understanding of disease processes. RSNA has been traditionally measured in anesthetized rodents, including mice. However, mice usually exhibit very low systemic blood pressure and hemodynamic instability for several hours during anesthesia and surgery. Meaningful interpretation of RSNA is confounded by this non-physiological state, given the intimate relationship between sympathetic nervous tone and cardiovascular status. To address this limitation of traditional approaches, we developed a new method for measuring RSNA in conscious, freely-moving mice. Mice were chronically instrumented with radio-telemeters for continuous monitoring of blood pressure as well as a jugular venous infusion catheter and custom-designed bipolar electrode for direct recording of RSNA. Following a 48-72 hour recovery period, survival rate was 100% and all mice behaved normally. At this time-point, RSNA was successfully recorded in 80% of mice, with viable signals acquired up to 4 and 5 days post-surgery in 70% and 50% of mice, respectively. Physiological blood pressures were recorded in all mice (116&plusmn;2 mmHg; n=10). Recorded RSNA increased with eating and grooming, as well-established in the literature. Furthermore, RSNA was validated by ganglionic blockade and modulation of blood pressure with pharmacological agents. Herein, an effective and manageable method for clear recording of RSNA in conscious, freely-moving mice is described.

Anesthetized mice exhibit non-physiological systemic blood pressure, which precludes meaningful assessment of autonomic tone given the intimate relationship between blood pressure and the autonomic nervous system. Thus, a novel method to simultaneously record renal sympathetic nerve activity and blood pressure with intravenous infusion in conscious mice is outlined.

Renal sympathetic nerves contribute significantly to both physiological and pathophysiological phenomena. Evaluating renal sympathetic nerve activity ...

Assessment of Respiratory Function in Conscious Mice by Double-chamber Plethysmography

Air volume changes created by a conscious subject breathing spontaneously within a body box are at the basis of plethysmography, a technique used to non-invasively assess some features of the respiratory function in humans as well as in laboratory animals. The present article focuses on the application of the double-chamber plethysmography (DCP) in small animals. It provides background information on the methodology as well as a detailed step-by-step procedure to successfully assess respiratory function in conscious, spontaneously breathing animals in a non-invasive manner. The DCP can be used to monitor the respiratory function of multiple animals in parallel, as well as to identify changes induced by aerosolized substances over a chosen time period and in a repeated manner. Experiments on control and allergic mice are used herein to demonstrate the utility of the technique, explain the associated outcome parameters, as well as to discuss the related advantages and shortcomings. Overall, the DCP provides valid and theoretically sound readouts that can be trusted to evaluate the respiratory function of conscious small animals both at baseline and after challenges with aerosolized substances.

The objective of the present article is to provide a detailed description of the recommended procedures to evaluate respiratory function in conscious mice by double-chamber plethysmography.

Air volume changes created by a conscious subject breathing spontaneously within a body box are at the basis of plethysmography, a technique used to ...

Implantation of Combined Telemetric ECG and Blood Pressure Transmitters to Determine Spontaneous Baroreflex Sensitivity in Conscious Mice

Blood pressure (BP) and heart rate (HR) are both controlled by the autonomic nervous system (ANS) and are closely intertwined due to reflex mechanisms. The baroreflex is a key homeostatic mechanism to counteract acute, short-term changes in arterial BP and to maintain BP in a relatively narrow physiological range. BP is sensed by baroreceptors located in the aortic arch and carotid sinus. When BP changes, signals are transmitted to the central nervous system and are then communicated to the parasympathetic and sympathetic branches of the autonomic nervous system to adjust HR. A rise in BP causes a reflex decrease in HR, a drop in BP causes a reflex increase in HR.
Baroreflex sensitivity (BRS) is the quantitative relationship between changes in arterial BP and corresponding changes in HR. Cardiovascular diseases are often associated with impaired baroreflex function. In various studies reduced BRS has been reported in e.g., heart failure, myocardial infarction, or coronary artery disease. 
Determination of BRS requires information from both BP and HR, which can be recorded simultaneously using telemetric devices. The surgical procedure is described beginning with the insertion of the pressure sensor into the left carotid artery and positioning of its tip in the aortic arch to monitor arterial pressure followed by the subcutaneous placement of the transmitter and ECG electrodes. We also describe postoperative intensive care and analgesic management. After a two-week period of post-surgery recovery long-term ECG and BP recordings are performed in conscious and unrestrained mice. Finally, we include examples of high-quality recordings and the analysis of spontaneous baroreceptor sensitivity using the sequence method.

The baroreflex is a heart-rate regulation mechanism by the autonomic nervous system in response to blood-pressure changes. We describe a surgical technique to implant telemetry transmitters for continuous and simultaneous measurement of electrocardiogram and blood pressure in mice. This can determine spontaneous baroreflex sensitivity, an important prognostic marker for cardiovascular disease.

Blood pressure (BP) and heart rate (HR) are both controlled by the autonomic nervous system (ANS) and are closely intertwined due to reflex mechanisms. ...

Multi-system Monitoring for Identification of Seizures, Arrhythmias and Apnea in Conscious Restrained Rabbits

Patients with ion channelopathies are at a high risk of developing seizures and fatal cardiac arrhythmias. There is a higher prevalence of heart disease and arrhythmias in people with epilepsy (i.e., epileptic heart.) Additionally, cardiac and autonomic disturbances have been reported surrounding seizures. 1:1,000 epilepsy patients/year die of sudden unexpected death in epilepsy (SUDEP). The mechanisms for SUDEP remain incompletely understood. Electroencephalograms (EEG) and electrocardiograms (ECG) are two techniques routinely used in the clinical setting to detect and study the substrates/triggers for seizures and arrhythmias. While many studies and descriptions of this methodology are in rodents, their cardiac electrical activity differs significantly from humans. This article provides a description of a non-invasive method for recording simultaneous video-EEG-ECG-oximetry-capnography in conscious rabbits. As cardiac electrical function is similar in rabbits and humans, rabbits provide an excellent model of translational diagnostic and therapeutic studies. In addition to outlining the methodology for data acquisition, we discuss the analytical approaches for examining neuro-cardiac electrical function and pathology in rabbits. This includes arrhythmia detection, spectral analysis of EEG and a seizure scale developed for restrained rabbits.

Using simultaneous video-EEG-ECG-oximetry-capnography, we developed a methodology to evaluate the susceptibility of rabbit models to develop provoked arrhythmias and seizures. This novel recording system establishes a platform to test the efficacy and safety of therapeutics and can capture the complex cascade of multi-system events that culminate in sudden death.

Patients with ion channelopathies are at a high risk of developing seizures and fatal cardiac arrhythmias. There is a higher prevalence of heart disease ...