Beijing Key Laboratory of Diabetes Research and Care, Department of Endocrinology and Metabolism, Beijing Diabetes Institute, Beijing Tongren Hospital, Capital Medical University, Beijing, 100730, China.
Laboratory for Clinical Medicine, Capital Medical University, Beijing, 100069, China.
Signal Transduct Target Ther. 2024 Aug 12;9(1):207. doi: 10.1038/s41392-024-01923-z.
Derived from enteroendocrine cells (EECs), glucagon-like peptide-1 (GLP-1) and glucose-dependent insulinotropic peptide (GIP) are pivotal incretin hormones crucial for blood glucose regulation. Medications of GLP-1 analogs and GLP-1 receptor activators are extensively used in the treatment of type 2 diabetes (T2D) and obesity. However, there are currently no agents to stimulate endogenous incretin secretion. Here, we find the pivotal role of KCNH2 potassium channels in the regulation of incretin secretion. Co-localization of KCNH2 with incretin-secreting EECs in the intestinal epithelium of rodents highlights its significance. Gut epithelial cell-specific KCNH2 knockout in mice improves glucose tolerance and increases oral glucose-triggered GLP-1 and GIP secretion, particularly GIP. Furthermore, KCNH2-deficient primary intestinal epithelial cells exhibit heightened incretin, especially GIP secretion upon nutrient stimulation. Mechanistically, KCNH2 knockdown in EECs leads to reduced K currents, prolonged action potential duration, and elevated intracellular calcium levels. Finally, we found that dofetilide, a KCNH2-specific inhibitor, could promote incretin secretion in enteroendocrine STC-1 cells in vitro and in hyperglycemic mice in vivo. These findings elucidate, for the first time, the mechanism and application of KCNH2 in regulating incretin secretion by EECs. Given the therapeutic promise of GLP-1 and GIP in diabetes and obesity management, this study advances our understanding of incretin regulation, paving the way for potential incretin secretagogue therapies in the treatment of diabetes and obesity.
肠内分泌细胞(EECs)衍生的胰高血糖素样肽-1(GLP-1)和葡萄糖依赖性胰岛素释放肽(GIP)是调节血糖的重要肠促胰岛素激素。GLP-1 类似物和 GLP-1 受体激动剂的药物被广泛用于 2 型糖尿病(T2D)和肥胖症的治疗。然而,目前尚无刺激内源性肠促胰岛素分泌的药物。在这里,我们发现 KCNH2 钾通道在肠促胰岛素分泌的调节中起着关键作用。KCNH2 与啮齿动物肠道上皮中的肠促胰岛素分泌 EEC 共定位,突出了其重要性。在小鼠中,肠道上皮细胞特异性敲除 KCNH2 可改善葡萄糖耐量并增加口服葡萄糖触发的 GLP-1 和 GIP 分泌,特别是 GIP。此外,缺乏 KCNH2 的原代肠道上皮细胞在受到营养刺激时表现出更高的肠促胰岛素,特别是 GIP 分泌。从机制上讲,EECs 中的 KCNH2 敲低会导致 K 电流减少、动作电位持续时间延长和细胞内钙水平升高。最后,我们发现 KCNH2 特异性抑制剂多非利特可促进体外肠内分泌 STC-1 细胞和体内高血糖小鼠的肠促胰岛素分泌。这些发现首次阐明了 KCNH2 在调节 EEC 肠促胰岛素分泌中的作用机制和应用。鉴于 GLP-1 和 GIP 在糖尿病和肥胖症管理中的治疗潜力,本研究增进了我们对肠促胰岛素调节的理解,为糖尿病和肥胖症治疗中潜在的肠促胰岛素分泌剂治疗铺平了道路。