Baggio Laurie L, Kim Jung-Guk, Drucker Daniel J
Banting and Best Diabetes Centre, University of Toronto, Toronto General Hospital, 200 Elizabeth St., MBRW 4R-402, Toronto, Ontario Canada M5G 2C4.
Diabetes. 2004 Dec;53 Suppl 3:S205-14. doi: 10.2337/diabetes.53.suppl_3.s205.
Glucagon-like peptide-1 (GLP-1) stimulates glucose-dependent insulin secretion and inhibits food intake, gastric emptying, and glucagon secretion, actions that promote reduction of fasting and postprandial glycemia in subjects with type 2 diabetes. The rapid degradation of native GLP-1 has engendered interest in more stable longer-acting GLP-1 receptor agonists such as exendin-4 (Ex-4); however, the potential consequences of sustained GLP-1 receptor activation leading to receptor desensitization has not been extensively studied. We have now examined a range of GLP-1 receptor-dependent responses following treatment with Ex-4 using INS-1 cells in vitro and both wild-type control and MT-Ex-4 transgenic mice in vivo. Although both GLP-1 and Ex-4 acutely desensitized GLP-1 receptor-dependent cAMP accumulation in INS-1 cells, Ex-4 produced more sustained receptor desensitization, relative to GLP-1, in both acute (5-120 min) and chronic (24-72 h) experiments. PMA (4-phorbol 12-myristate 13-acetate) but not glucagon, glucose-dependent insulinotropic polypeptide (GIP), or epinephrine produced heterologous desensitization in vitro. MT-Ex-4 transgenic mice exhibited a reduced glycemic response to oral but not intraperitoneal glucose challenge following acute Ex-4 administration. In contrast, no differences in glycemic excursion or plasma insulin were observed after 1 week of twice-daily Ex-4 administration to wild-type versus MT-Ex-4 mice. Similarly, the levels of insulin, pdx-1, and GLP-1 receptor mRNA transcripts were comparable in wild-type and MT-Ex-4 transgenic mice after 1 week of Ex-4 administration. However, repeated Ex-4 administration significantly reduced food intake in MT-Ex-4 but not in wild-type mice. These findings illustrate that although Ex-4 is more potent than native GLP-1 in producing GLP-1 receptor desensitization in vitro, chronic exposure to Ex-4 in normal or transgenic mice is not associated with significant downregulation of GLP-1 receptor-dependent responses coupled to glucose homeostasis in vivo.
胰高血糖素样肽-1(GLP-1)刺激葡萄糖依赖性胰岛素分泌,并抑制食物摄入、胃排空和胰高血糖素分泌,这些作用可促进2型糖尿病患者空腹和餐后血糖的降低。天然GLP-1的快速降解引发了人们对更稳定的长效GLP-1受体激动剂(如艾塞那肽-4(Ex-4))的兴趣;然而,持续的GLP-1受体激活导致受体脱敏的潜在后果尚未得到广泛研究。我们现在使用体外INS-1细胞以及野生型对照和MT-Ex-4转基因小鼠体内研究了Ex-4处理后一系列GLP-1受体依赖性反应。尽管GLP-1和Ex-4均可使INS-1细胞中GLP-1受体依赖性cAMP积累急性脱敏,但在急性(5 - 120分钟)和慢性(24 - 72小时)实验中,相对于GLP-1,Ex-4产生了更持久的受体脱敏作用。佛波酯(4-佛波醇12-肉豆蔻酸酯13-乙酸酯)而非胰高血糖素、葡萄糖依赖性促胰岛素多肽(GIP)或肾上腺素在体外产生异源脱敏。急性给予Ex-4后,MT-Ex-4转基因小鼠对口服葡萄糖挑战的血糖反应降低,但对腹腔注射葡萄糖挑战的血糖反应无差异。相比之下,在野生型和MT-Ex-4小鼠中,每天两次给予Ex-� 1周后,血糖波动或血浆胰岛素水平未观察到差异。同样,给予Ex-4 1周后,野生型和MT-Ex-4转基因小鼠中胰岛素、pdx-1和GLP-1受体mRNA转录本水平相当。然而,重复给予Ex-4可显著降低MT-Ex-4小鼠的食物摄入量,但对野生型小鼠无此作用。这些发现表明,尽管Ex-4在体外产生GLP-1受体脱敏方面比天然GLP-1更有效,但在正常或转基因小鼠中,长期暴露于Ex-4与体内与葡萄糖稳态相关的GLP-1受体依赖性反应的显著下调无关。