Department of Medicine, University of Cincinnati College of Medicine, Cincinnati, Ohio.
Department of Medicine II, University Hospital, LMU Munich, Germany.
Am J Physiol Endocrinol Metab. 2020 Feb 1;318(2):E189-E197. doi: 10.1152/ajpendo.00298.2019. Epub 2019 Nov 19.
Glucagon-like peptide-1 (GLP-1) is an enteral peptide that contributes to the incretin effect. GLP-1 action is typically described as endocrine, but this mechanism has been questioned because rapid inactivation in the circulation by dipeptidylpeptidase 4 (DPP4) results in a short half-life, limiting the amount of the hormone that can reach the pancreatic islet. An alternative mechanism for GLP-1 to regulate insulin secretion through neuroendocrine signaling originating from sensors in the portal vein has been proposed. We hypothesized that portal infusion of GLP-1 would cause greater glucose-stimulated insulin secretion than equimolar administration into the jugular vein. To test this, hyperglycemic clamps with superimposed graded infusions of GLP-1 into the jugular or portal veins of male rats were performed. These experiments were repeated with pharmacologic DPP4 inhibition to determine the effect of GLP-1 metabolism in the jugular and portal venous beds. Contrary to our hypothesis, we found a higher insulinotropic effect with jugular compared with portal GLP-1, which was associated with higher plasma concentrations of intact GLP-1. The greater insulinotropic effect of jugular venous GLP-1 persisted even with pharmacological DPP4 inhibition. These findings do not support an important role of portal vein GLP-1 signaling for the incretin effect but highlight the hepatoportal bed as a major site of GLP-1 degradation that persists even with pharmacological inhibition. Together, these results support rapid inactivation of enterally released GLP-1 in the liver as limiting endocrine actions on the β-cell and raise questions about the conventional endocrine model of pharmacologic effects of DPP4 inhibitors.
胰高血糖素样肽 1(GLP-1)是一种肠肽,有助于肠促胰岛素效应。GLP-1 的作用通常被描述为内分泌,但这种机制受到质疑,因为二肽基肽酶 4(DPP4)在循环中快速失活导致半衰期短,限制了到达胰岛的激素量。已经提出了 GLP-1 通过源自门静脉传感器的神经内分泌信号调节胰岛素分泌的替代机制。我们假设门静脉输注 GLP-1 会引起比等摩尔静脉内输注到颈静脉更大的葡萄糖刺激胰岛素分泌。为了验证这一点,对雄性大鼠进行了颈静脉和门静脉内输注 GLP-1 的高血糖钳夹实验,并叠加分级输注。这些实验用药理学 DPP4 抑制重复进行,以确定 GLP-1 在颈静脉和门静脉床中的代谢作用。与我们的假设相反,我们发现颈静脉内 GLP-1 比门静脉内 GLP-1 具有更高的胰岛素促分泌作用,这与完整 GLP-1 的血浆浓度更高有关。即使在药理学 DPP4 抑制下,颈静脉 GLP-1 的胰岛素促分泌作用仍然存在。这些发现不支持门静脉 GLP-1 信号在肠促胰岛素效应中的重要作用,但强调了肝门静脉床作为 GLP-1 降解的主要部位,即使在药理学抑制下也仍然存在。总之,这些结果支持肠内释放的 GLP-1 在肝脏中快速失活,从而限制了对β细胞的内分泌作用,并对 DPP4 抑制剂的药理学作用的传统内分泌模型提出了质疑。