Mechanisms of action of VIP and PACAP in the stimulation of insulin release.

VIP and PACAP stimulate insulin release by interaction with the VIP-2/PACAP-3 receptor on the beta cell. Activation of the receptor results in Gs-mediated stimulation of adenylyl cyclase and increased cellular cyclic AMP levels. Increased cyclic AMP results in a small and transient increase in [Ca2+]i, which is likely to have only a small and transient effect on the secretion rate. Cyclic AMP also potentiates insulin secretion by an as yet unknown action at a distal site. A third action of VIP and PACAP is responsible for the continued stimulation of insulin secretion after the levels of cyclic AMP and [Ca2+]i have returned to basal values. This third pathway, which is identified at present only by its sensitivity to low concentrations of wortmannin, plays a major role in the prolonged stimulation of insulin release by VIP and PACAP.