Division of Endocrinology, Metabolism and Lipid Research, Department of Internal Medicine, Washington University School of Medicine, St. Louis, Missouri;
Am J Physiol Gastrointest Liver Physiol. 2014 Feb 15;306(4):G301-9. doi: 10.1152/ajpgi.00383.2013. Epub 2013 Dec 19.
Xenin-25 (Xen) is a neurotensin-related peptide secreted by a subset of glucose-dependent insulinotropic polypeptide (GIP)-producing enteroendocrine cells. In animals, Xen regulates gastrointestinal function and glucose homeostasis, typically by initiating neural relays. However, little is known about Xen action in humans. This study determines whether exogenously administered Xen modulates gastric emptying and/or insulin secretion rates (ISRs) following meal ingestion. Fasted subjects with normal (NGT) or impaired (IGT) glucose tolerance and Type 2 diabetes mellitus (T2DM; n = 10-14 per group) ingested a liquid mixed meal plus acetaminophen (ACM; to assess gastric emptying) at time zero. On separate occasions, a primed-constant intravenous infusion of vehicle or Xen at 4 (Lo-Xen) or 12 (Hi-Xen) pmol · kg(-1) · min(-1) was administered from zero until 300 min. Some subjects with NGT received 30- and 90-min Hi-Xen infusions. Plasma ACM, glucose, insulin, C-peptide, glucagon, Xen, GIP, and glucagon-like peptide-1 (GLP-1) levels were measured and ISRs calculated. Areas under the curves were compared for treatment effects. Infusion with Hi-Xen, but not Lo-Xen, similarly delayed gastric emptying and reduced postprandial glucose levels in all groups. Infusions for 90 or 300 min, but not 30 min, were equally effective. Hi-Xen reduced plasma GLP-1, but not GIP, levels without altering the insulin secretory response to glucose. Intense staining for Xen receptors was detected on PGP9.5-positive nerve fibers in the longitudinal muscle of the human stomach. Thus Xen reduces gastric emptying in humans with and without T2DM, probably via a neural relay. Moreover, endogenous GLP-1 may not be a major enhancer of insulin secretion in healthy humans under physiological conditions.
神经降压素-25(Xen)是一种神经降压素相关肽,由一部分葡萄糖依赖性胰岛素分泌多肽(GIP)产生的肠内分泌细胞分泌。在动物中,Xen 调节胃肠道功能和葡萄糖稳态,通常通过启动神经传递。然而,人们对 Xen 在人类中的作用知之甚少。本研究旨在确定外源性给予 Xen 是否会在摄入餐后调节胃排空和/或胰岛素分泌率(ISR)。糖耐量正常(NGT)或受损(IGT)和 2 型糖尿病(T2DM;每组 10-14 人)的空腹受试者在零时刻摄入混合液体餐加醋氨酚(用于评估胃排空)。在不同的时间,从零时开始至 300 分钟,以 4(低 Xen)或 12(高 Xen)pmol·kg(-1)·min(-1)的速度对受试者进行 Xen 或载体的预输注-恒速静脉输注。一些 NGT 受试者接受了 30 和 90 分钟的高 Xen 输注。测量血浆醋氨酚、葡萄糖、胰岛素、C 肽、胰高血糖素、Xen、GIP 和胰高血糖素样肽-1(GLP-1)水平,并计算 ISR。比较了治疗效果的曲线下面积。高 Xen 输注,而不是低 Xen 输注,同样延迟了所有组的胃排空并降低了餐后血糖水平。90 或 300 分钟的输注,而不是 30 分钟的输注,同样有效。高 Xen 降低了血浆 GLP-1,但不降低 GIP 水平,而不改变对葡萄糖的胰岛素分泌反应。在人类胃的纵行肌中,PGP9.5 阳性神经纤维上检测到 Xen 受体的强烈染色。因此,Xen 减少了 T2DM 患者和非 T2DM 患者的胃排空,可能通过神经传递。此外,在生理条件下,内源性 GLP-1 可能不是健康人类胰岛素分泌的主要增强剂。