André Herchuelz

Initiation and execution of lipotoxic ER stress in pancreatic beta-cells.

Free fatty acids (FFA) cause apoptosis of pancreatic β-cells and might contribute to β-cell loss in type 2 diabetes via the induction of endoplasmic reticulum (ER) stress. We studied here the molecular mechanisms implicated in FFA-induced ER stress initiation and apoptosis in INS-1E cells, FACS-purified primary β-cells and human islets exposed to oleate and/or palmitate. Treatment with saturated and/or unsaturated FFA led to differential ER stress signaling. Palmitate induced more apoptosis and markedly activated the IRE1, PERK and ATF6 pathways, owing to a sustained depletion of ER Ca2+ stores, whereas the unsaturated FFA oleate led to milder PERK and IRE1 activation and comparable ATF6 signaling. Non-metabolizable methyl-FFA analogs induced neither ER stress nor β-cell apoptosis. The FFA-induced ER stress response was not modified by high glucose concentrations, suggesting that ER stress in primary β-cells is primarily lipotoxic, and not glucolipotoxic. Palmitate, but not oleate, activated JNK. JNK inhibitors reduced palmitate-mediated AP-1 activation and apoptosis. Blocking the transcription factor CHOP delayed palmitate-induced β-cell apoptosis. In conclusion, saturated FFA induce ER stress via ER Ca2+ depletion. The IRE1 and resulting JNK activation contribute to β-cell apoptosis. PERK activation by palmitate also contributes to β-cell apoptosis via CHOP.

The stimulus-secretion coupling of glucose-induced insulin release. XXXV. The links between metabolic and cationic events.

SummaryWhen isolated rat islets were exposed to glucose, the concentrations of NADH and NADPH, and the NADH/NAD+ and NADPH/NADP+ ratios were increased. The dose-response curve resembled that characterising the glucose-induced secondary rise in45Ca efflux, displaying a sigmoidal pattern with a half-maximal value at glucose 7.5 mmol/l. The glucose-induced increase in NAD(P)H was detectable within 1 min of exposure to the sugar. Except for the fall in ATP concentration and ATP/ADP ratio found at very low glucose concentrations (zero to 1.7 mmol/l) no effect of glucose (2.8–27.8 mmol/l) upon the steady-state concentration of adenine nucleotides was observed. However, a stepwise increase in glucose concentration provoked a dramatic and transient fall in the ATP concentration, followed by a sustained increase in both O2 consumption and oxidation of exogenous + endogenous nutrients. This may be essential to meet the energy requirements in the stimulated B-cell. Although no significant effect of glucose upon intracellular pH was detected by the 5,5-dimethyloxazolidine-2,4-dione method, the net release of H+ was markedly increased by glucose, with a hyperbolic dose-response curve (half-maximal response at glucose 2.9 mmol/l) similar to that characterising the glucose-induced initial fall in45Ca efflux. It is proposed that the generation of both NAD(P)H and H+ participates in the coupling of glucose metabolism to distal events in the secretory sequence, especially the ionophoretic process of Ca2+ inward and outward transport, and that changes in these parameters occur in concert with an increased turn-over rate of high-energy phosphate intermediates.L-Glutamine enhances insulin release evoked by L-leucine in isolated rat pancreatic islets. The enhancing action of L-glutamine, which is a rapid but steadily increasing and not rapidly reversible phenomenon is not attributable to any major change in either K+ or Ca2+ outflow from the islet cells. It coincides with an apparent increase in Ca2+ inflow rate and, hence, with Ca accumulation in the islets. The initial ionic response to L-leucine is not qualitatively altered by the presence of L-glutamine. In their combined capacity to stimulate 45Ca net uptake in the islets, L-glutamine can be replaced by L-asparagine but not by L-glutamate, whereas L-leucine can be replaced by L-norvaline or L-isoleucine, but not by L-valine, glycine or L-lysine. Such a specificity is identical to that characterizing the effect of these various amino acids upon insulin release. It is postulated that the release of insulin evoked by the combination of L-leucine and L-glutamine involves essentially the same remodelling of ionic fluxes as that evoked by other nutrient secretagogues with, however, an unusual time course for the functional response to L-glutamine.

The pharmacokinetics of oxybutynin in man

SummaryWe have studied the pharmacokinetics of oxybutynin (Ditropan) after single oral (5 mg) and intravenous administration (1 and 5 mg), and after repeated oral administration in healthy volunteers.Oxybutynin was rapidly absorbed, maximum plasma concentrations (8 ng·ml−1) being reached in less than 1 h. The absolute systemic availability averaged 6% and the tablet and solution forms displayed similar relative systemic availability.Plasma concentrations of oxybutynin fell biexponentially, the elimination half-life being about 2 h. There was a large interindividual variation in oxybutynin plasma concentrations. Almost no intact drug could be recovered in the urine. During repeated oral administration steady-state was reached after eight days of treatment.The low absolute systemic availability of oxybutynin, the large interindividual variability in its plasma concentrations, and the apparent absence of intact oxybutynin in the urine suggest that its major pathway of elimination is hepatic metabolism.

Regulation of calcium fluxes in rat pancreatic islets: calcium extrusion by sodium-calcium countertransport.

SummaryThe mechanisms by which glucose regulates calcium fluxes in pancreatic endocrine cells were investigated by monitoring the efflux of45Ca from prelabeled and perifused rat pancreatic islets. In the absence of both extracellular calcium and glucose, partial or total removal of extracellular sodium decreases the efflux of45Ca from prelabeled islets. Glucose also reduces the efflux of45Ca from islets perifused in the absence of extracellular calcium. This inhibitory effect of glucose on45Ca efflux is decreased by half when the extracellular concentration of sodium is lowered to 24mm. In the absence of extracellular calcium but presence of glucose, partial or even total removal of extracellular sodium fails to decrease the efflux of45Ca. At normal extracellular calcium concentration (1mm) partial removal of extracellular sodium dramatically increases45Ca efflux from pancreatic islets. This increase in45Ca efflux is partially but not totally suppressed by either 16.7mm glucose or cobalt. It is totally suppressed by 4.4mm glucose or by the combination of 16.7mm glucose and cobalt. At normal extracellular calcium concentration, glucose initially reduces and subsequently increases45Ca efflux. The initial fall is unaffected by tetrodotoxin but decreased by 50% at low extracellular sodium concentration (24mm). The present results suggest the existence in pancreatic endocrine cells of a glucose-sensitive process of sodium-calcium counter-transport. By inhibiting such a process, glucose may decrease the efflux of calcium from islet cells. The effect of glucose is not mediated by an increase in intracellular sodium concentration. It could contribute to the intracellular accumulation of calcium which is thought to trigger insulin release.

REGULATION OF CALCIUM FLUXES AND THEIR REGULATORY ROLES IN PANCREATIC ISLETS

It is today considered as crystal clear that calcium plays an essential role in the regulation of insulin release by the pancreatic B-cell. Some of the major issues concerning such a role are as follows: ( i ) what is the detailed mechanism by which secretagogues are susceptible to influence the handling of calcium in the B-cell; (ii) what is the nature and location of the critical pool of calcium that controls insulin release; (iii) what is the relative and respective contribution of calcium influx, efflux, and subcellar distribution in the regulation of such a pool; and (iv) how does calcium influence the process by which secretory granules migrate to the cell boundary and are extruded via exocytosis in the interstitial fluid.’ In the present report, for the sake of clarity, we will restrict the discussion of these questions to the process of glucose-induced insulin release, with the main emphasis on the possible significance of passive ionophoretic movements. The process by which glucose provokes insulin release can be viewed as a sequence of three major events, namely: ( i ) the recognition or identification of glucose by the B-cell; (ii) the subsequent remodelling of cationic fluxes; and (iii) the activation by calcium of an effector system controlling the migration and exocytosis of secretory granules.2 The role of calcium in insulin release is here considered within the framework of such a sequential view.

Regulation of calcium fluxes in pancreatic islets: dissociation between calcium and insulin release.

1. The release of 45calcium from prelabelled pancreatic islets is rapidly and almost totally inhibited by lanthanum. 2. Glucose provokes an intitial fall followed by a secondary rise in 45calcium efflux. The latter rise occurs concomitantly with insulin release. Its magnitude is reduced whenever the secretory response to glucose is inhibited, e.g. in the absence of extracellular calcium, presence of Verapamil, or at high magnesium concentration. 3. However, under suitable conditions, the glucose‐induced secondary rise in 45calcium efflux is not totally suppressed whilst insulin release is totally abolished. 4. Inversely, when calcium is replaced by barium in the perifusate, glucose increases insulin output without causing any obvious secondary rise in 45calcium efflux. 5. It is concluded that this secondary rise, which originates from a lanthanum‐nondisplaceable calcium pool, does not correspond solely to an exocytotic release of 45calcium. It could represent, in part at least, a displacement of 45calcium from cellular sites and reflect a glucose‐induced increase in the rate of calcium entry in islet cells.

The stimulus-secretion coupling of glucose-induced insulin release XLVI. Physiological role of l-glutamine as a fuel for pancreatic islets

Exogenous L-glutamine is actively metabolized in rat pancreatic islets. The rate of L-glutamine deamidation largely exceeds the rate of glutamate conversion to gamma-aminobutyrate and alpha-ketoglutarate. The latter conversion occurs in part by oxidative deamination, and in part by transamination reactions coupled with the conversion of 2-keto acids (pyruvate, oxaloacetate), themselves derived from the metabolism of glutamine, to their corresponding amino acids (alanine, aspartate). An important fraction of malate formed from alpha-ketoglutarate leaves the Krebs cycle and is converted to pyruvate, the process being apparently associated with the induction of a more reduced state in cytosolic redox couples. L-Glutamine abolishes the oxidation of endogenous nutrients is documented by the fact that the glutamine-induced increase in O2 consumption is much lower than expected from the rate of 14CO2 output from islets exposed to L-[U-14C]glutamine, L-Glutamine, although decreasing K+ conductance, fails to stimulate insulin release both in the absence and presence of D-glucose. It is proposed that L-glutamine represents a major fuel for pancreatic islets under physiological conditions.

The Stimulus-secretion Coupling of Amino Acid-induced Insulin Release: Metabolism and Cationic Effects of Leucine

When isolated rat pancreatic islets are exposed to L-leucine (20 mM), the rate of NH4 production is close to the summed rates of L-[1-14 C] leucine decarboxylation and α-ketoisocaproate production, whereas the rates of acetoacetate production and L-[U-14 C]-leucine oxidation are compatible with the conversion of each mole of the amino acid to one mole of acetoacetate and three moles of CO2. ATP content, ATP/ADP ratio, and adenylate charge are maintained at normal values by L-leucine, whereas the NADH/NAD+ ratio (but not the NADPH/NADP+ ratio) is significantly increased. The release of insulin evoked by L-leucine is potentiated by 2-ketoisovalerate, unaffected by L-valine, and inhibited by menadione. L-leucine mimicks the effect of D-glucose on 86Rb+ and 45Ca2+ handling by the islets. However, relative to its rate of oxidation, the insulinotropic effect of L-leucine is less marked than that of D-glucose. This may be due, in part at least, to a decrease in the oxidation of endogenous nutrients. It is concluded that the metabolic, cationic, and secretory effects of L-leucine in isolated islets are not incompatible with the fuel hypothesis for insulin release.

Targeted Disruption of Na+/Ca2+ Exchanger 3 (NCX3) Gene Leads to a Worsening of Ischemic Brain Damage

Na+/Ca2+ exchanger 3 (NCX3), one of the three isoforms of the NCX family, is highly expressed in the brain and is involved in the maintenance of intracellular Na+ and Ca2+ homeostasis. Interestingly, whereas the function of NCX3 under physiological conditions has been determined, its role under anoxia is still unknown. To assess NCX3 role in cerebral ischemia, we exposed ncx3−/− mice to transient middle cerebral artery occlusion followed by reperfusion. In addition, to evaluate the effect of ncx3 ablation on neuronal survival, organotypic hippocampal cultures and primary cortical neurons from ncx3−/− mice were subjected to oxygen glucose deprivation (OGD) plus reoxygenation. Here we report that ncx3 gene suppression leads to a worsening of brain damage after focal ischemia and to a massive neuronal death in all the hippocampal fields of organotypic cultures as well as in cortical neurons from ncx3−/− mice exposed to OGD plus reoxygenation. In addition, in ncx3−/− cortical neurons exposed to hypoxia, NCX currents, recorded in the reverse mode of operation, were significantly lower than those detected in ncx3+/+. From these results, NCX3 protein emerges as a new molecular target that may have a potential therapeutic value in modulating cerebral ischemia.

Stimulus-Secretion Coupling of Glucose-Induced Insulin Release. Effect of Intracellular Acidification Upon Calcium Efflux From Islet Cells

When pancreatic islets were exposed to a medium of normal pH (7.4) equilibrated with a gaz mixture containing 30% (instead of 5%) CO2, the intracellular pH of the islet cells, as judged by the apparent space of distribution of 14C-DMO, was decreased. The intracellular acidification was associated with a delayed decrease of [U-14C] glucose oxidation, but no major change in glucose-stimulated proinsulin biosynthesis, 45 calcium net uptake, or insulin release. The increase in PCO2 provoked an immediate and sustained decrease in the fractional outflow rate of 45Ca from prelabeled and perfused islets. The latter decrease was most marked under conditions associated with stimulated 40Ca-45Ca exchange (i.e., at glucose 16.7 mM and normal Ca2+ concentration), but was also present when a process of Na+-Ca2+ countertransport accounted for the major part of 45Ca efflux (e.g., in the absence of both glucose and extracellular Ca2+). These findings are compatible with the view that the generation of H+ derived from the metabolism of glucose in islet cells plays a role in the sugar-induced decrease in 45Ca fractional outflow rate.