Arginine-vasopressin mediates counter-regulatory glucagon release and is diminished in type 1 diabetes

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  • Angela Kim
  • Joseph C. Madara
  • Anna Benrick
  • Thomas G. Hill
  • Lina Abdul Kadir
  • Joely A. Kellard
  • Lisa Mellander
  • Caroline Miranda
  • Haopeng Lin
  • Timothy James
  • Kinga Suba
  • Aliya F. Spigelman
  • Yanling Wu
  • Patrick E. Macdonald
  • Ingrid Wernstedt Asterholm
  • Tore Magnussen
  • Mikkel Christensen
  • Victoria Salem
  • Patrik Rorsman
  • Bradford B. Lowell
  • Linford J. B. Briant

Insulin-induced hypoglycemia is a major barrier to the treatment of type-1 diabetes (T1D). Accordingly, it is important that we understand the mechanisms regulating the circulating levels of glucagon – the body’s principal blood glucose-elevating hormone which is secreted from alpha-cells of the pancreatic islets. Varying glucose over the range of concentrations that occur physiologically between the fed and fuel-deprived states (from 8 to 4 mM) has no significant effect on glucagon secretion in the perfused mouse pancreas or in isolated mouse islets (in vitro) and yet associates with dramatic changes in plasma glucagon in vivo. The identity of the systemic factor(s) that stimulates glucagon secretion remains unknown. Here, we show that arginine-vasopressin (AVP), secreted from the posterior pituitary, stimulates glucagon secretion. Glucagon-secreting alpha-cells express high levels of the vasopressin 1b receptor gene (Avpr1b). Activation of AVP neurons in vivo increased circulating copeptin (the C-terminal segment of the AVP precursor peptide, a stable surrogate marker of AVP) and increased blood glucose; effects blocked by pharmacological antagonism of either the glucagon receptor or vasopressin 1b receptor. AVP also mediates the stimulatory effects of hypoglycemia produced by exogenous insulin and 2-deoxy-D-glucose on glucagon secretion. We show that the A1/C1 neurons of the medulla oblongata drive AVP neuron activation in response to insulin-induced hypoglycemia. Exogenous injection of AVP in vivo increased cytoplasmic Ca2+ in alpha-cells (implanted into the anterior chamber of the eye) and glucagon release. Hypoglycemia also increases circulating levels of AVP in humans and this hormone stimulates glucagon secretion from isolated human islets. In patients with T1D, hypoglycemia failed to increase both plasma copeptin and glucagon levels. These findings suggest that AVP is a physiological systemic regulator of glucagon secretion and that this mechanism becomes impaired in T1D.

OriginalsprogEngelsk
Artikelnummere72919
TidsskrifteLife
Vol/bind10
Antal sider29
ISSN2050-084X
DOI
StatusUdgivet - 2021

Bibliografisk note

Funding Information:
This study was funded by the following: Wellcome Senior Investigator Award (095531),

Funding Information:
providing human islets, the isolation of which was supported in part by the Alberta Diabetes

Funding Information:
Wallenberg’s Stiftelse. J.G.K. and C.G. are supported by a Novo Nordisk postdoctoral

Funding Information:
DK057521). A.K. holds an NIH grant (F31 DK109575). V.S. is a Diabetes UK Harry Keen

Funding Information:
of Health Research (CIHR: 148451). B.B.L. is the recipient of grants from the NIH (R01

Funding Information:
from the OXION Programme (Wellcome). P.E.M. holds a grant from the Canadian Institutes

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© 2021, eLife Sciences Publications Ltd. All rights reserved.

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