Pacific Northwest Diabetes Research Institute and Division of Endocrinology and Metabolism, Department of Medicine and Pharmacology, University of Washington, Seattle, WA 98122, USA.
Diabetes Obes Metab. 2011 Oct;13 Suppl 1:106-11. doi: 10.1111/j.1463-1326.2011.01448.x.
Signalling by intraislet β-cells to neighbouring α-cells was recognized almost 40 years ago, leading to the hypothesis that this is an essential mechanism to regulate the glucagon counterregulatory response to hypoglycaemia. The thesis was that during normoglycaemia or hyperglycaemia insulin secretion from β-cells would enter the islet periportal circulation and travel downstream to α-cells to dampen glucagon secretion. As a corollary, during hypoglycaemia β-cells would stop secreting insulin, which would permit α-cells to release glucagon into the hepatic portal circulation so it could travel to the liver to increase glucose production and thereby correct hypoglycaemia. This mini-review briefly mentions the early work that established this hypothesis and more extensively examines more recent work that has provided direct evidence supporting the hypothesis. A new twist has been introduced based on the fact that zinc is bound to insulin within β-cells and co-secreted with insulin. Zinc is released from insulin when it reaches the higher pH of blood, and zinc has recently been shown to negatively regulate α-cell secretion. It is now suggested that a switch-off signal provided by a sudden cessation of zinc secretion from β-cells during hypoglycaemia may play a critical role in stimulating glucagon secretion that is independent of the effect of insulin.
胰岛内 β 细胞向邻近的 α 细胞发出信号的现象早在 40 年前就已被发现,这促使人们提出了这样一种假说,即这是调节低血糖时胰高血糖素反调节反应的一个基本机制。该假说认为,在正常血糖或高血糖期间,β 细胞分泌的胰岛素将进入胰岛门静脉循环,并向下游移动到 α 细胞,从而抑制胰高血糖素的分泌。相应地,在低血糖期间,β 细胞将停止分泌胰岛素,这将允许 α 细胞将胰高血糖素释放到肝门静脉循环中,从而使其能够进入肝脏以增加葡萄糖的产生,从而纠正低血糖。这篇简要综述简要提到了确立这一假说的早期工作,并更广泛地考察了最近提供直接证据支持该假说的工作。根据锌在β细胞内与胰岛素结合并与胰岛素一起被分泌的事实,引入了一个新的观点。当胰岛素到达血液的更高 pH 值时,锌会从胰岛素中释放出来,最近已经表明锌会负调节α细胞的分泌。现在有人提出,低血糖时β细胞突然停止分泌锌所提供的关闭信号,可能在刺激胰高血糖素分泌方面发挥关键作用,而这种分泌作用独立于胰岛素的作用。