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1 Glucagon

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3 To my mother Ana Marília and my beloved Pablo

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5 List of papers This thesis is based on the following papers, which will be referred to in the text by their roman numerals. I II III IV Liu Y.J., Vieira E., Gylfe E. A store-operated mechanism determines the activity of the electrically excitable glucagon-secreting pancreatic -cell. Cell Calcium, 35: (2004) Vieira E., Liu Y.J., Gylfe E. Involvement of 1 and adrenoceptors in adrenaline stimulation of glucagon-secreting mouse -cell. Naunyn Schmiedebergs Arch Pharmacol, 369: (2004) Vieira E., Salehi A., Gylfe E. Glucose inhibits glucagon secretion from mouse pancreatic -cells independent of K ATP channels and paracrine -cell influence (submitted article). Salehi A., Vieira E., Gylfe E. Paradoxical stimulation of glucagon secretion by high glucose concentrations (submitted article) Reprints were made with the permission of the publishers.

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7 Contents Introduction...9 Diabetes mellitus, a bihormonal disease...9 Adrenergic control of glucagon secretion...10 Signal Transduction of Glucagon Secretion...10 Store-operated Ca 2+ entry...13 Aims...15 Materials and Methods...16 Preparation of pancreatic islets and cells...16 Loading with indicators...17 Parallel measurements of [Ca 2+ ] i and membrane potential by digital imaging fluorometry...17 Paracrine influence...19 Identification of -cells...20 Measurements of glucagon and insulin secretion...20 Results and Discussion...21 Adrenaline stimulates glucagon secretion via 1 and adrenoceptors...21 Adrenaline stimulation and glucose inhibition of the -cell involve a store-operated current...22 K ATP channels are functionally active in mouse -cells...25 The elevation of [Ca 2+ ] i underlying glucagon secretion from mouse -cells is due to opening of L-type Ca 2+ channels...28 Glucose inhibition of glucagon secretion in mouse islets occurs independently of K ATP channels and products secreted from pancreatic -cells...28 High glucose concentrations paradoxically stimulate glucagon release from mouse islets and clonal -cells...30 Conclusions...32 Svensk sammanfattning...33 Acknowledgements...35 References...37

8 Abbreviations [Ca 2+ ] i camp EN ER GABA IP 3 K ATP channel PLC PTX SERCA SOCs Cytoplasmic Ca 2+ concentration Cyclic adenosine monophosphate Endoplasmatiskt nätverk Endoplasmic reticulum -aminobutyric acid Inositol 1,4,5-trisphosphate ATP-sensitive K + channel Phospholipase C Pertussis toxin Sarco(endo)plasmic reticulum Ca 2+ ATPase Store-operated channels

9 Introduction Diabetes mellitus, a bihormonal disease The plasma glucose concentration is normally maintained within a relatively narrow range (3-8 mmol/l) by hormonal and neural mechanisms. The hormonal mechanisms for glucose homeostasis involve the glucose-lowering action of insulin and the glucose-elevating effects of glucagon and adrenaline. Insulin secreted by pancreatic -cells reduces blood glucose by inhibiting glycogenolysis and gluconeogenesis in the liver and by stimulating glucose uptake, storage, and utilization in muscle and fat. Glucagon is secreted by pancreatic -cells and is primarily acting on the liver. It is a potent activator of glycogenolysis and gluconeogenesis and increases blood glucose levels within minutes. The hyperglycaemic effect of the adrenomedullary hormone adrenaline is more complex. Adrenaline has a glucagon-like action on the liver increasing glycogenolysis and gluconeogenesis and the hormone also stimulates the secretion of glucagon and inhibits that of insulin. A change in the balance between these hormones may consequently impair glucose homeostasis. Diabetes mellitus is primarily a disease with hyperglycemia due to lack or inappropriate secretion of insulin. However, diabetes has long been viewed as a bihormonal disorder, since hypersecretion of glucagon contributes to the hyperglycemia. Both types 1 and 2 diabetes are associated with abnormalities of glucagon secretion. In diabetic subjects, hyperglycemia is aggravated because glucose fails to suppress the secretion of glucagon (Gerich et al., 1976) and a glucose challenge has been found to paradoxically stimulate glucagon release (Ohneda et al., 1978; Mitrakou et al., 1990). Moreover, a defective glucose counter-regulation with failing stimulation of glucagon release when the blood glucose concentration falls below the normal fasting level makes diabetic patients treated with insulin or sulphonylureas susceptible to dangerous hypoglycemia. This is a potentially life-threatening condition and hypoglycemia is a significant cause of deaths in insulin-treated diabetes (Cryer, 2002). To improve the treatment of diabetic subjects it is therefore important to clarify the signal transduction underlying both insulin and glucagon secretion. 9

10 Adrenergic control of glucagon secretion Like the secretion of most other hormones, exocytosis of glucagon from the -cells is triggered by an increase of the cytoplasmic Ca 2+ concentration ( Ca 2+ i ) (Barg et al., 2000). It is well established that adrenaline stimulation of glucagon secretion involves a -adrenergic mechanism with rise of cyclic adenosine monophosphate (camp) (Lacey et al., 1991). Studies in dispersed islet cells from the guinea pig indicated that this effect is exerted at the level of the -cell (Johansson et al., 1987; Johansson et al., 1989). Adrenaline was thus found to elevate Ca 2+ i by activation of a -adrenergic mechanism involving rise of camp. Later studies on rat -cells have clarified that the stimulatory effect of adrenaline on exocytosis of glucagon is partly explained by a protein kinase A-dependent increase of Ca 2+ influx through voltage-dependent L-type channels (Gromada et al., 1997). Whereas it is generally accepted that adrenaline inhibition of insulin secretion involves an 2 -adrenergic mechanism (Nakaki et al., 1980; Schuit and Pipeleers, 1986), there are different opinions about the involvement of -adrenergic mechanisms in adrenaline stimulation of glucagon secretion. Studies of the perfused rat pancreas did not indicate an essential role of -adrenoceptors (Filipponi et al., 1986). On the other hand, in vivo experiments on rat and mouse have favoured the involvement of both 1 and 2 adrenoceptors (Skoglund et al., 1987; Saito et al., 1992). Signal Transduction of Glucagon Secretion Nutrients and hormones are the most important regulators of glucagon secretion. Whereas, amino acids and adrenaline stimulate glucagon release, glucose is inhibitory (Pipeleers et al., 1985). Consistent with the roles of glucagon and insulin to maintain normoglycemia, glucagon secretion is inhibited when the glucose concentrations is raised to 4-6 mm and insulin secretion is stimulated at higher glucose concentrations of the sugar. Studies in the mouse have shown that stimulation of -cells results in depolarizationdependent large amplitude Ca 2+ i oscillations similar to those in -cells providing an explanation for pulsatile release of glucagon (Berts et al., 1995; Berts et al., 1996b; Berts et al., 1997). It is well established that -cells are electrically excitable and generate action potentials in the absence of glucose (Rorsman and Hellman, 1988; Gromada et al., 1997; Göpel et al., 2000a). The membrane conductances involved in action potential generation have been characterized in guinea pig (Rorsman, 1988; Rorsman and Hellman, 1988), mouse (Göpel et al., 2000b), and rat (Gromada et al., 1997) -cells. These studies indicate that -cells are equipped with voltage dependent T-, N-, and L-type Ca 2+ currents. They also contain a prominent voltage-gated and tetrodotoxin-sensitive Na + current that is activated during action poten- 10

11 tials (Bokvist et al., 1999; Göpel et al., 2000b). However, the mechanisms for stimulus-secretion coupling of glucagon release are unclear. In the insulin releasing -cell, ATP-sensitive K + (K ATP ) channels have a central role in stimulus-secretion coupling. During glucose stimulation it is the closure of these channels, which causes depolarisation leading to influx of Ca 2+ through voltage-dependent channels, rise of Ca 2+ i and exocytosis of insulin (Ashcroft and Rorsman, 1989). In pancreatic -cells, the role of K ATP channels is controversial and their closure has been suggested to result in both stimulation and inhibition of glucagon secretion. Evidence for a stimulatory role of K ATP channels in glucagon secretion has been obtained in rat -cells, which have much higher channel density (Bokvist et al., 1999) than mouse -cells (Quesada et al., 1999; Göpel et al., 2000b), even exceeding the density in rat -cells (Bokvist et al., 1999). Accordingly, tolbutamide-induced closure of the K ATP channels, stimulates the electrical activity (Bokvist et al., 1999) and exocytosis of glucagon (Høy et al., 2000) in isolated rat -cells, and glucose was recently found to paradoxically stimulate glucagon release from purified rat -cells by closing the K ATP channels (Olsen et al., 2005). Studies of the clonal hamster -cell line R1G9 have shown that closure of the K ATP channels by tolbutamide tends to elevate Ca 2+ i whereas the K ATP channel opener diazoxide has a pronounced lowering effect (Bode et al., 1999). Ablation of K ATP channels by knockout of the regulatory sulphonylurea receptor 1 subunit provided support for a stimulatory role of these channels in the -cells by showing that glucagon secretion is diminished (Muñoz et al., 2005) or absent (Shiota et al., 2005) during exposure to low glucose concentrations. Apart from the role in the pancreatic -cells, the K ATP channels in the hypothalamus may be important for stimulation of glucagon release from the pancreas. Due to the presence of K ATP channels, low blood glucose concentrations are sensed by hypothalamic neurons, resulting in increased autonomic stimulation of the -cells (Miki et al., 2001; Evans et al., 2004). Despite the above-mentioned evidence for a stimulatory role of K ATP channel closure in -cells and -cells, the K ATP channel closure in mouse cells has been suggested to lead to inhibition of glucagon release (Göpel et al., 2000b; Gromada et al., 2004). In this model, depolarization by glucoseinduced closure of K ATP channels inhibits glucagon release by inactivating voltage-dependent ion channels involved in the action potential firing (Göpel et al., 2000b). However, such a role is difficult to reconcile with observations that glucose inhibits glucagon secretion from mice lacking K ATP channels after knockout of the channel forming inward rectifier K + channel Kir6.2 (Miki et al., 2001) and inhibits the blunted glucagon secretion from SUR1 knockout mice (Muñoz et al., 2005). Glucose has also been proposed to inhibit glucagon secretion by a K ATP channel independent mechanism. Based on early studies of guinea-pig -cells it was suggested that glucose inhibits glucagon release by lowering [Ca 2+ ] i after promoting intracellular 11

12 sequestration and outward transport of the ion (Johansson et al., 1987; Johansson et al., 1989). However, this mechanism cannot account for the inactivation of voltage-dependent Ca 2+ entry associated with inhibition of glucagon secretion (Gromada et al., 1997; Barg et al., 2000). In another study of clonal hamster R1G9 -cells, the inhibitory effect of glucose is attributed to hyperpolarization by activation of the electrogenic Na/K-ATPase (Bode et al., 1999). Apart from a direct effect of glucose on -cells, inhibition of glucagon release may be due to stimulated secretion of paracrine factors from the other cells types within the pancreatic islet. It has been proposed that insulin (Östenson, 1979; Berts et al., 1996b; Diao et al., 2005; Ravier and Rutter, 2005), -aminobutyric acid (GABA) (Rorsman et al., 1989) and Zn 2+ (Ishihara et al., 2003; Franklin et al., 2005) from the -cells or somatostatin from the -cells (Cejvan et al., 2003) are important inhibitors of glucagon release. The situation is complicated by observations indicating that different mechanisms may be involved depending on species. Recently, it was proposed that glucose inhibits glucagon secretion from rat islets but stimulates secretion in purified rat -cells (Franklin et al., 2005), indicating that inhibition is accounted for paracrine factors in this species. However, in another study, glucose was found to inhibit glucagon secretion from purified rat cells (Pipeleers et al., 1985). Studies of rat islets and -cells have provided evidence that secretion of GABA from the -cells is involved in glucose inhibition of glucagon release (Rorsman et al., 1989; Wendt et al., 2004). Insulin and Zn 2+, which is co-secreted with insulin, independently inhibit glucagon secretion from rat -cells/islets, perhaps by activating K ATP channels in -cells (Ishihara et al., 2003; Franklin et al., 2005). However, in another study, insulin had no effect on glucagon secretion from purified rat cells (Pipeleers et al., 1985). Also somatostatin released from cells has been proposed to mediate glucose inhibition of glucagon release by acting on somatostain receptor subtype 2 (Cejvan et al., 2003). In another study, somatostatin was found to inhibit exocytosis in isolated rat -cells by activating the serine/threonine protein phosphatase calcineurin (Gromada et al., 2001). The situation is different in the mouse. GABA has no effect on Ca 2+ i in isolated mouse -cells (Berts et al., 1996b). Although GABA slightly reduces glucagon secretion from mouse islets, this effect is too small to explain the inhibitory effect of glucose (Gilon et al., 1991). In contrast to the inhibitory effect of Zn 2+ on rat -cells, this cation has been found to activate mouse -cells (Ravier and Rutter, 2005). However, there is evidence for an inhibitory role of insulin in both primary (Berts et al., 1996b; Ravier and Rutter, 2005) and clonal (Ravier and Rutter, 2005) mouse -cells. Confusingly, studies of primary mouse and clonal TC-6 cells have indicated that insulin receptors are critical for stimulation of glucagon secretion at low glucose concentrations (Diao et al., 2005). The role of somatostatin to inhibit glucagon secretion may be similar in the mouse and rat. Somatostatin was 12

13 thus found to hyperpolarize mouse -cells by activating G-protein-gated K + channels (Yoshimoto et al., 1999). Although GABA is released from -cells vesicles other than the insulinzinc complex, secretion is regulated in similar manner (Braun et al., 2004). A major objection against the involvement of paracrine -cells factors in the regulation of glucagon secretion is that the physiologically important inhibition occurs at lower glucose concentrations than those stimulating insulin secretion (Gerich et al., 1976; Gylfe, 1990). Store-operated Ca 2+ entry The [Ca 2+ ] i signals regulating a variety of cellular functions often result from a combination of Ca 2+ influx through the plasma membrane and release from intracellular stores. In excitable cells like the -cell, voltage-dependent Ca 2+ influx is most important for providing the elevation of [Ca 2+ ] i, which triggers exocytosis (Barg et al., 2000). The store-operated or capacitative pathway for Ca 2+ entry was first discovered in non-excitable cells lacking voltagedependent Ca 2+ channels (Putney, 1986; Putney, 1990). Activation of G-protein-coupled receptors linked to phospholipase C (PLC), results in generation of inositol 1,4,5-trisphosphate (IP 3 ), which mobilizes Ca 2+ from the endoplasmic reticulum (ER). The resulting calcium depletion of the ER activates a store-operated influx of Ca 2+ required for store refilling and repetitive release. It is the depletion rather than IP 3 or an IP 3 metabolite that triggers influx, since the store-operated channels (SOCs) can also be activated by exposing the cells to Ca 2+ -deficient medium or to inhibitors of the sarco(endo)plasmatic reticulum Ca 2+ ATPase (SERCA) (Putney, 1990). Despite intense research the Ca 2+ sensor in the ER and the signal activating SOCs remain elusive. According to the conformational coupling model emptying of Ca 2+ from the ER leads to a conformation change in the IP 3 receptors, which is transmitted to SOCs in the plasma membrane by direct protein-protein interaction (Berridge, 1990; Irvine, 1990). Another model involves a diffusible calcium influx factor, which is released from the ER and is acting on the SOCs (Randriamampita and Tsien, 1993). Recently, a novel ER protein STIM1 was found to have a central role in the activation of SOCs (Draber and Draberova, 2005; Liou et al., 2005; Roos et al., 2005; Zhang et al., 2005). The exact function of STIM1 is unclear. It was suggested to act as Ca 2+ sensor in the ER (Liou et al., 2005; Roos et al., 2005; Zhang et al., 2005), induce calcium influx factor production (Draber and Draberova, 2005) and even take part in the formation of SOCs (Zhang et al., 2005). However, other data indicate that SOCs belong to a family of transient receptor potential channels (Hardie and Minke, 1993). The transient receptor potential channels can be classified into three major subfamilies: classical, vanilloid and melastatin. Expression of the classical and vanilloid type 6 13

14 channels has thus been found to induce Ca 2+ entry in response to depletion of intracellular Ca 2+ stores in different cell types (Parekh and Putney, 2005). The store-operated Ca 2+ influx plays a role also in excitable cells (Moffatt and Cocks, 2004; Parekh and Putney, 2005), where it has a depolarizing effect. The first evidence for a store-operated mechanism in islets was obtained in mouse pancreatic -cells with the observation that carbachol induces influx-dependent sustained elevation of [Ca 2+ ] i even when the voltagedependent Ca 2+ channels are blocked (Gylfe, 1991). Later studies clarified that the emptying of the ER activates a voltage-independent influx pathway (Liu and Gylfe, 1997) and that the rate of influx is inversely proportional to the filling state of the ER (Dyachok and Gylfe, 2001). The Ca 2+ sequestration in the ER is stimulated by glucose (Gylfe, 1991; Tengholm et al., 1999; Tengholm et al., 2001), which consequently shuts off the store-operated pathway (Liu and Gylfe, 1997). Even when maximally activated, the current through the store-operated pathway is not sufficiently pronounced to depolarize the -cell from the resting -70 mm to the -40 to -50 mv required for opening of the voltage-dependent L-type Ca 2+ channels (Worley et al., 1994; Chow et al., 1995). Nevertheless it has been suggested that a store-operated current carried by Na + or Ca 2+ may be important for generating fast [Ca 2+ ] i oscillations when the -cells are somewhat depolarized (Worley et al., 1994; Bertram et al., 1995; Gilon et al., 1999). Also influx of Ca 2+ through the store-operated pathway may be of physiological significance for maintained PLC activity during exposure of -cells to G-protein coupled receptor agonists (Thore et al., 2005). Due to a high input resistance the membrane potential of -cells is more sensitive to small currents than in -cells (Barg et al., 2000). Since the action potentials of -cells start at voltages as negative as -60 mv (Rorsman and Hellman, 1988; Bokvist et al., 1999; Göpel et al., 2000b), a small storeoperated current can be expected to have much more dramatic effects in cells than in -cells. Because adrenaline mobilizes intracellular Ca 2+ in cells (Johansson et al., 1989) activation of a store-operated current may underlie the depolarization, which activates voltage-dependent Ca 2+ influx. 14

15 Aims The aims of the present study were to clarify: 1. The possible involvement of K ATP channels in signal transduction of glucagon secretion in mouse -cells 2. Whether a calcium store-operated mechanism can explain adrenaline stimulation and glucose inhibition of glucagon secretion in mouse -cells 3. Receptors and signalling pathways involved in adrenaline stimulation of glucagon secretion from mouse -cells 4. The possible involvement of K ATP channels and paracrine release from pancreatic -cells in glucose inhibition of glucagon secretion from mouse -cells 5. The involvement of [Ca 2+ ] i in the paradoxical glucose stimulation of glucagon release 15

16 Materials and Methods Preparation of pancreatic islets and cells Islets of Langerhans were isolated with collagenase (Boehringer Mannheim GmbH, Mannheim, Germany) from NMRI and C57/BL6 mice. The Uppsala Ethics Committee approved the experimental procedures. The animals were killed by decapitation under anesthesia with CO 2. The lower duodenal part of the pancreas was rejected to avoid cells producing pancreatic polypeptide (Liu et al., 1999). The freshly isolated islets were either used for studies of glucagon secretion or preparation of free cells. Free cells were obtained by incubating the islets for 4 min at 37 C in Ca 2+ -deficient medium containing 0.5 mm EDTA and 0.05% trypsin (Invitrogen, Carlsbad, CA) followed by brief shaking. The cells were suspended in RPMI 1640 medium (Gibco Ltd., Paisley, Scotland) supplemented with 10% fetal calf serum (Gibco), 100 IU/ml penicillin, 100 µg/ml streptomycin and 30 µg/ml gentamicin. Small samples of this suspension (15 l) were applied to the centers of poly-l-lysine-coated (Sigma Chemical Co., St. Louis, MO) circular 25 mm cover slips. The cover slips were then kept for 60 min in an incubator at 37 C with a humidified atmosphere of 5% CO 2 to allow cells to settle and begin attachment. More medium was then cautiously added and the cells were cultured for 1-3 days. In some experiments 100 ng/ml pertussis toxin (PTX, Sigma) was present during the last h. Rat basophilic leukemia cells (kindly provided by Professor Tobias Meyer, Stanford University, Stanford, USA) used in control experiments were cultured in Dulbecco s modified essential medium (Gibco) supplemented with 10% fetal calf serum. These cells were allowed to grow close to confluence on 25 mm cover slips. R1G9 hamster glucagonoma cells were kindly provided by Dr. Björn Olde, Lund University, Sweden with permission from Dr Jacques Philippe, University of Geneva, Switzerland. The cells were cultured in plastic dishes or culture bottles in GlutaMAX TM -containing RPMI 1640 medium (Gibco) supplemented with 10% fetal calf serum, 100 U/ml penicillin, and 100 µg/ml streptomycin. For secretion studies the R1G9 cells were seeded at a density of cells/well in 48-well plates and cultured for 3 days as described above. 16

17 Loading with indicators Loading of cells with the Ca 2+ indicator fura-2 was performed during 40 min incubation at 37 C in a buffer containing 0.5 mg/ml bovine serum albumin (Sigma), 125 mm NaCl, 4.8 mm KCl, 1.2 mm MgCl 2, 1.28 mm CaCl 2, 3 mm glucose, 1 µm fura-2 acetoxymethyl ester (Molecular Probes Inc., Eugene, OR; 0.1% dimethylsulphoxide, Sigma) and 25 mm HEPES (Sigma) with ph adjusted to 7.4 with 13 mm NaOH. The cells were then equilibrated for 10 min at room temperature with 450 nm of the potential-sensitive probe bis-oxonol (Molecular Probes) in the same medium but lacking fura-2 acetoxymethyl ester. When the effects of higher concentrations of KCl were tested osmotic compensation was made by reduction of NaCl. The cover slips with the attached cells were used as exchangeable bottoms of an open chamber. The chamber volume was 0.16 ml and the cells were superfused at a rate of 1 ml/min with a medium containing 450 nm bis-oxonol. Thapsigargin (Sigma), which sticks to plastic, was added directly to the superfusion chamber with a pipette. The superfusion flow was then interrupted for 2-3 min to ascertain an effect of the drug. Parallel measurements of [Ca 2+ ] i and membrane potential by digital imaging fluorometry The superfusion chamber was placed on the stage of an inverted Nikon Diaphot microscope equipped with an epifluorescence illuminator and a 40x oil immersion fluorescence objective. The chamber holder and the objective were maintained at 37 C by custom-built thermostats. The epifluorescence illuminator was connected through a 5 mm diameter liquid light guide to an Optoscan monochromator (Cairn Research Ltd., Faversham, UK) with rapid grating and slit width adjustment and a 150W xenon arc lamp. The monochromator provided excitation light at 340 nm (2.8 nm half-bandwidth), 380 nm (2.5 nm half-bandwidth) and 485 nm (2.5 nm half-bandwidth) and emission was measured at >515 nm by an intensified CCD camera. The Metafluor software (Universal Imaging Corp., Downingtown, PA) controlled the monochromator acquiring fluorescence images of 30 accumulated frames at 340, 380 and 485 nm every 4 s. [Ca 2+ ] i images were calculated from 340/380 nm ratio images as previously described (Liu et al., 2004). Increases in bisoxonol fluorescence indicated depolarization and decreases hyperpolarization (Epps et al., 1994). Tolbutamide (Hoechst Marion Roussel AB, Stockholm, Sweden) increased the bis-oxonol fluorescence more than expected when comparing with K + depolarization. Even the hyperglycaemic and hyperpolarizing sulphonamide diazoxide increased bis-oxonol fluorescence in - and -cells, indicating that this class of drugs interacts with the indicator fluorescence 17

18 independently of membrane potential. Control experiments were therefore performed on non-excitable rat basophilic leukaemia cells in which sulphonamides are not expected to affect the membrane potential. Fig. 1 indicates that 500 M tolbutamide, which was used in most experiments, increased the bis-oxonol fluorescence equivalent to a depolarization with about 50 mm K +. When comparing 500 M tolbutamide with of 50 M glipizide (Figs. 1-2) and 100 M glibenclamide (Fig. 2) it became apparent that the magnitude of the effect on bis-oxonol fluorescence was dependent on sulphonamide concentration. Fig. 2 shows that none of the drugs affected [Ca 2+ ] i in these non-excitable cells. Ideally the membrane potential recordings should be performed with a more potent sulphonamide than tolbutamide. This was not done because the interference was discovered at a relatively late stage of the studies. Bis-oxonol is a slow indicator and depolarization in response to K + or adrenaline seemingly lagged the [Ca 2+ ] i responses by sec. Fig 1. Effect of 50 M glipizide (G), 500 M tolbutamide (T) and different concentrations of K + on the bis-oxonol fluorescence from rat basophilic leukemia (RBL) cells. The fluorescence change induced by tolbutamide corresponded to depolarization by about 50 mm K +. 18

19 Fig 2. Effect of 500 M tolbutamide (T), 100 M glibenclamide (Glib) and 50 M glipizide (G) on bis-oxonol fluorescence and [Ca 2+ ] i of rat basophilic leukemia (RBL) cells. Paracrine influence The procedures for concentrating cells to the central area of the cover slips resulted in an average of 13 cells per measured image field of 0,085 mm 2. Since image fields with high cell density were selected to obtain measurements from more than one -cell, this density is probably an overestimate for the central region. Few cells were found in the periphery and the average cell density in the entire chamber with 64 mm 2 bottom area was considerably smaller. The chamber volume (0.16 ml) was exchanged 6 times per min by the superfusion medium. It is apparent that the concentrations of paracrine factors released from -cell and -cells are much smaller than those obtained in the narrow extracellular space of islets when measuring insulin secretion in batch incubations. The concentration of insulin in the superfusion medium was determined by ultra sensitive ELISA (Bergsten et al., 1994) in 10 experiments. Under conditions, which stimulate insulin secretion maximally 19

20 (20 mm glucose), the effluent from the superfusion chamber contained <1 pm insulin. Pretreatment with PTX, which blocks the inhibitory effect of somatostatin on glucagon secretion (Göpel et al., 2004), and exposure to 0.1 M of the phosphatidylinositol 3 kinase inhibitor wortmannin (Sigma), which prevents insulin inhibition of the -cell (Ravier and Rutter, 2005), were used to clarify whether the effects of glucose on membrane potential and [Ca 2+ ] i could be explained by paracrine influence from neighboring and -cells. Identification of -cells The -cells were initially selected by their small size and [Ca 2+ ] i response to adrenaline (Sigma) (Johansson et al., 1989; I), which is not shared by - (I) and -cells (Berts et al., 1996a). Moreover, each experiment was terminated by immunostaining the cells in the experimental chamber. The cells were superfused with albumin-free medium and fixed with 95% ethanol. After rinsing with distilled water and Tris buffer (0.5 M, ph 7.6), normal goat serum (diluted 1:10; DAKO Corp.) was added to reduce background staining. After 10 min, rabbit anti-glucagon (1:200; Zymed Laboratories INC) was added for min followed by rinsing with Tris buffer. Biotinylated goat anti-rabbit immunoglobulin (1:500; DAKO) was then introduced for 10 min, followed by rinsing and addition of alkaline phosphatase-conjugated streptavidine (1:200; DAKO Corp.) for a further 10 min. The BCIP/NBT color reagent (DAKO) was then added for 2-5 min. Measurements of glucagon and insulin secretion Batches of 8 12 islets and 3-day cultured R1G9 cells were pre-incubated for 30 min at 37 C in 1 ml of Krebs-Ringer buffer (ph 7.4) supplemented with 10 mm HEPES, 0.1% bovine serum albumin and 1 mm glucose. Each incubation vial was gassed with 95% O 2 and 5% CO 2 to obtain constant ph and oxygenation. The islets were then incubated for 1 h at 37 C in a Krebs- Ringer buffer supplemented with different glucose concentrations, 500 M tolbutamide, 4.8 or 8 mm K + and 50 M cyclopiazonic acid (Calbiochem, La Jolla, CA). At the end of the incubation, aliquots of the medium were removed and frozen pending the radioimmunoassays (Panagiotidis et al., 1992). 20

21 Results and Discussion Adrenaline stimulates glucagon secretion via 1 and adrenoceptors Among blood glucose elevating hormones adrenaline is important both by mobilizing hepatic glycogen directly and by stimulating glucagon secretion. It is clear from the present study that the adrenaline effect on the -cell consisted of initial mobilization of intracellular Ca 2+, accompanied by voltagedependent influx of the ion (I). The presence of early and late effects of adrenaline raised the question whether different types of receptors are involved. Using guinea pig -cells it was previously demonstrated that -adrenergic activation with elevation of camp is involved in adrenalineinduced increase of Ca 2+ i required for glucagon secretion (Johansson et al., 1989). The existence of such a mechanism has been confirmed in rat -cells (Gromada et al., 1997). In the present study, the -adrenergic antagonist propanolol inhibited the late Ca 2+ i response to adrenaline and had a much smaller effect on the early adrenaline response in isolated -cells (II). In support for a -adrenergic mechanism with elevation of camp, the late Ca 2+ i response to adrenaline was partially or completely inhibited by the protein kinase A inhibitor Rp-cAMPS. The role of camp was evident also from the observation that the adenylate cyclase activator forskolin mimicked the effect of adrenaline by inducing slow Ca 2+ i oscillations (II). Our data consequently indicated that camp is preferentially involved in the late Ca 2+ i response to adrenaline, which can be attributed to voltage-dependent influx of Ca 2+ in being inhibited by hyperpolarizing diazoxide (II). This conclusion is consistent with the observation in rat (Gromada et al., 1997) and mouse (Ma et al., 2005) -cells that camp amplifies Ca 2+ i signaling by increasing the voltage-dependent Ca 2+ current. Apart from the involvement in the late Ca 2+ i response to adrenaline, camp may contribute to the initial mobilization of intracellular Ca 2+. Studies of pancreatic -cells have indicated that sensitization of the IP 3 receptors by protein kinase A-mediated phosphorylation promotes Ca 2+ mobilization (Liu et al., 1996; Dyachok and Gylfe, 2004). Based on in vivo experiments in rats it was suggested that 2 receptor activation leads to stimulation of glucagon secretion (Saito et al., 1992). Since 2 receptors couple to inhibitory G-proteins and lower camp, such stimulations may be due to reduced release of inhibitory paracrine factors rather 21

22 than to a direct effect on -cells. In the present study the 2 -agonist clonidine lacked effect on the -cell, and the 2 -antagonist yohimbine marginally inhibited of the Ca 2+ i response to adrenaline (II). Therefore, it seems unlikely that 2 -adrenoceptors on the -cells are important for stimulation of glucagon secretion. 1 -Adrenergic activation involves the classical PLC pathway resulting in formation of Ca 2+ -mobilizing IP 3 (García-Sáinz et al., 1999). The participation of 1 adrenoceptors in the action of adrenaline on Ca 2+ i was evident from complete inhibition of the initial as well as the late Ca 2+ i response by the 1 receptor antagonists phentolamine and prazosin (II). The complete inhibition of the late adrenaline response is intriguing considering the involvement of a -adrenergic component in this phase. Interestingly, in vivo experiments in mice have shown that -blockage with phentolamine inhibits -adrenergic activation of glucagon secretion (Ahrén and Lundquist, ). Our data indicate that such an inhibition does not necessarily involve paracrine or endocrine mediators, since it is present also in isolated -cells. Adrenaline stimulation and glucose inhibition of the -cell involve a store-operated current As discussed above, the adrenaline effect on -cells consisted of an initial mobilization of Ca 2+ from intracellular stores attributed to formation of both IP 3 and camp. The subsequent late Ca 2+ i response to adrenaline depended on depolarization, since it was usually prevented by diazoxide and always inhibited by the voltage-dependent Ca 2+ channel blocker methoxyverapamil (I). Although camp has been found to enhance the Ca 2+ current through L- type channels in depolarized rat (Gromada et al., 1997) and mouse (Ma et al., 2005) -cells, such a mechanism cannot account for the depolarization, which opens the channels. The present results indicated that emptying of the Ca 2+ stores in the ER is the mechanism causing the depolarization by activating a store-operated depolarizing current. In support for the involvement of a store-operated mechanism leading to depolarization and voltage-dependent Ca 2+ influx, the late effect of carbachol, which mobilizes intracellular Ca 2+ via muscarinic receptors (Berts et al., 1997), was inhibited by diazoxide (I). Moreover, depletion of the ER by SERCA inhibition depolarized the -cells and caused Ca 2+ i oscillations, which were inhibited by diazoxide and methoxyverapamil (I). In mouse pancreatic -cells Ca 2+ -mobilizing agonists activate a store-operated influx of Ca 2+, which is blocked by the inhibitor 2-aminoethoxydiphenyl borate (Dyachok and Gylfe, 2001). In accordance with such actions we found that 2-aminoethoxydiphenyl borate had little effect on the initial -cell response to adrenaline but blocked the small sustained elevation, which remains when preventing Ca 2+ influx through the voltage-dependent channels (I). 22

23 It is well established that glucose stimulates Ca 2+ sequestration in the ER of -cells (Gylfe, 1991; Chow et al., 1995; Tengholm et al., 1999), and that such filling turns off the store-operated entry of Ca 2+ (Liu and Gylfe, 1997; Dyachok and Gylfe, 2001). The present study extends previous observation in guinea-pig -cells, that Ca 2+ incorporated in response to glucose is mobilized with adrenaline (Johansson et al., 1989), by showing that glucoseinduced Ca 2+ sequestration results in hyperpolarization after shutting off a store-operated current (I). This current is, at least in part, mediated by Ca 2+, since omission of the sugar resulted in depolarization and increase of basal Ca 2+ i under conditions preventing Ca 2+ influx through the L-type channels. Glucose-induced Ca 2+ sequestration in the -cell is associated with lowering of [Ca 2+ ] i below the basal level and both the sequestering and lowering effects are maximal at 20 mm of the sugar (Gylfe, 1988; Gylfe, 1991; Tengholm et al., 1999). Such a glucose dependence was confirmed in the present study, showing modest lowering of basal [Ca 2+ ] i in hyperpolarized -cells when the glucose concentration was raised from 0 to 7 mm and a more pronounced effect after further rise of glucose to 30 mm (IV). The glucose dependence of -cells studied in parallel was different with maximal lowering of [Ca 2+ ] i at 7 mm. Indeed, experiments performed with 0, 3 and 20 mm glucose indicated that both the [Ca 2+ ] i lowering and Ca 2+ sequestering effects of glucose were close to maximal at 3 mm of the sugar (I). Consistent with a role for the store-operated mechanism in glucose inhibition of glucagon secretion, glucose regulation of Ca 2+ sequestration in the -cells was much left-shifted as compared to the -cell and coincided with 0-7 mm range inhibiting secretion (III). Measurements of glucagon provided additional evidence for a role of a store-operated pathway in glucose inhibition of secretion. SERCA inhibition consequently stimulated glucagon release in the 0-20 mm glucose range and eliminated the inhibitory effect of the sugar (III). These actions were paralleled by abolishment of the hyperpolarizing and [Ca 2+ ] i lowering effect of glucose on individual -cells. The pronounced effect of SERCA inhibition on glucagon release contrasted dramatically to a modest amplification of glucose-stimulated insulin secretion without significant effect at subthreshold concentration of the sugar. The insulin data are consistent with little effect of SERCA inhibition on [Ca 2+ ] i and membrane potential in unstimulated -cells (Chow et al., 1995; Dyachok and Gylfe, 2001). It is only when the -cell is somewhat depolarized that additional depolarization by the store-operated pathway is sufficient to trigger a voltage-dependent rise of [Ca 2+ ] i (Worley et al., 1994) and insulin release (Cruz-Cruz et al., 2005). Apparently the -cells show an exceptional sensitivity to variation in the store-operated current. Due to the presence of a depolarizing cascade with activation of low threshold T-type Ca 2+, voltage-dependent Na + as well as L- type Ca 2+ channels the -cells respond to injection of small currents with electrical activity (Göpel et al., 2000b). The present data indicated that mobi- 23

24 lization of intracellular Ca 2+ by adrenaline induces a store-operated current sufficient for -cell activation. A model for adrenaline stimulation and glucose inhibition of glucagon secretion is presented in Fig.3. Adrenaline binds to both 1 and -adrenergic receptors in the -cells. The resulting formation of IP 3 and camp are involved in the release of Ca 2+ from the ER that activates a depolarizing store-operated influx of cations, which eventually triggers voltage-dependent Ca 2+ influx and glucagon secretion. The role of glucose is to activate Ca 2+ sequestration in the ER and shut off the stimulatory cascade. Fig. 3. Model for adrenaline stimulation and glucose inhibition of glucagon secretion. Adrenaline (Adr) endoplasmic reticulum (ER), store-operated (SOC) voltagedependent (VOC) and sarco(endo)plasmic reticulum Ca 2+ ATPase (SERCA) 24

25 K ATP channels are functionally active in mouse -cells Studying mouse -cells exposed to 3 mm glucose we found that only 6 % of previously silent cells responded to tolbutamide-induced closure of K ATP channels with elevation of [Ca 2+ ] i (I). However, the K ATP channel activator diazoxide inhibited adrenaline-stimulated [Ca 2+ ] i signalling and this effect was readily reversed by tolbutamide (I). These data were taken to indicate that the K ATP channels are functionally inactive in most mouse -cells. Subsequent studies in 1 mm glucose showed that 21% of the previously silent -cells responded with [Ca 2+ ] i elevation to tolbutamide and 8 % to slight depolarization by raising the K + concentration from 4.8 to 8 mm (III). However, all -cells responded when combining 8 mm K + with tolbutamide. It therefore seems that the K ATP channels are functionally active in -cells but that their closure alone is insufficient to trigger voltage-dependent Ca 2+ influx. This was an unexpected finding considering the high input resistance of -cells making the membrane potential sensitive to small current variations (Barg et al., 2000). As mentioned above depolarization by closure of K ATP channels in the -cells has been proposed to result both in inhibition (Göpel et al., 2000b; Gromada et al., 2004) and stimulation (Bode et al., 1999; Bokvist et al., 1999; Høy et al., 2000; Muñoz et al., 2005; Olsen et al., 2005; Shiota et al., 2005) of glucagon secretion. The most compelling arguments for an inhibitory effect was obtained with the observation that depolarization by mm K + or by tolbutamide inhibit glucagon secretion from mouse islets (Gromada et al., 2004). We found inhibitory effects of either 8 mm K + or 0.5 mm tolbutamide on glucagon secretion from mouse islets (Fig. 4). However, 8 mm K + or tolbutamide stimulated only isolated mouse -cells as evident from a tendency to depolarise and raise [Ca 2+ ] i (III). Moreover, the elevation of [Ca 2+ ] i, which was always observed in response to 8 mm K + plus tolbutamide (III), was associated with stimulation of glucagon secretion as compared to 8 mm K + or tolbutamide alone (Fig.4). We therefore think that the inhibitory effects of depolarization with tolbutamide or 8 mm K + are mediated by paracrine factors released from the non- -cells within the islets. A stimulatory role of K ATP channel closure in mouse -cells was supported from most results (I, III, IV) including the observation that activation of the K ATP channels was associated with lowering of [Ca 2+ ] i in isolated -cells and inhibition of glucagon secretion at low glucose concentrations (IV). Evidence for a stimulatory role of K ATP channel closure is provided also from studies of [Ca 2+ ] i (Olsen et al., 2005), electrical activity (Bokvist et al., 1999), exocytosis (Høy et al., 2000) and secretion (Olsen et al., 2005) of glucagon from the K ATP channel-rich rat -cells, and by the observation that tolbutamide raises [Ca 2+ ] i in clonal hamster glucagonoma cell line R1G9 (Bode et al., 1999). Moreover, the most salient feature in mice lacking functional K ATP channels after knockout of the regulatory sulphonylurea receptor 25

26 1 subunit is a low glucagon secretion with lacking (Shiota et al., 2005) or diminished (Muñoz et al., 2005) stimulation at low glucose concentrations. Glucagon secretion pg/(islet h) *** *** *** *** 0 Glucose (mm) Tolbutamide ( M) K + (mm) Fig.4 Effects of glucose, tolbutamide and 8 mm K + on glucagon secretion from isolated mouse pancreatic islets. Glucagon secretion was measured after 60 min incubation. Glucose (1 mm), tolbutamide (0 or 500 M) and K + (4.8 or 8 mm) were present as indicated. Data are presented as mean values ± SEM of 8 experiments. **P=0.002, ***P<0.001 by paired t-test. Data obtained in collaboration with Albert Salehi from Lund University. The majority of the isolated mouse -cells did not show any spontaneous activity in 1 mm glucose (III), which is consistent with poor glucagon secretion from purified rat -cells exposed to similar concentrations of the sugar (Pipeleers et al., 1985; Olsen et al., 2005). These observations contrast to the stimulated glucagon secretion from mouse (III, IV) and rat (Franklin et al., 2005) islets exposed to 0-1 mm glucose. We therefore speculate that apart from the inhibitory influence from the neighbouring cells in the islets, there is also a stimulatory component. This component may be depolarizing amino acids originating from the islet cells. It is likely that the interstitial space 26

27 within the islets contains amino acids during static incubation. Considerable amounts of free amino acids are lost from islets during perfusion with nutrient-free medium but not during static incubation (Gylfe, 1974). Under physiological conditions the -cells are exposed to a depolarizing mixture of amino acids. We have found that isolated -cells exposed to RPMI 1640 medium containing 1 mm glucose show spontaneous [Ca 2+ ] i oscillations, which are inhibited by glucose elevation (Vieira and Gylfe, 2004). Consistent with these observations RPMI 1640 medium containing 1 mm glucose doubled glucagon secretion from mouse islets as compared to amino acid-free medium with the same sugar concentration (Fig. 5). Moreover, 20 mm glucose readily inhibited glucagon secretion in the RPMI 1640 medium. Instead of using a depolarizing mixture of amino acids to activate [Ca 2+ ] i signalling in single -cells, the -cells were depolarized in a more controlled manner by exposure to 8 mm K + plus 500 M tolbutamide (III). With presence of tolbutamide it became possible to study K ATP channelindependent effects of glucose on individual -cells. *** *** *** Glucagon Secretion pg/islets/h 50 0 RPMI Glucose (mm) Conotoxin ( M) Nifedipine ( M) Fig. 5 Effects of RPMI 1640 medium, glucose concentration, -conotoxin and nifedipine on glucagon secretion from isolated mouse islets. Glucagon secretion was measured in a balanced salt solution containing 1mM glucose or in RPMI medium with 1 mm or 20 mm glucose. The effects of -conotoxin (0.1 M) and nifedipine (10 M) were tested in the RPMI medium containing 1mM glucose. Data are presented as mean values ± S.E.M. of 12 experiments. *P 0,001. Data obtained in collaboration with Dr. Albert Salehi, Lund University, Sweden 27

28 The elevation of [Ca 2+ ] i underlying glucagon secretion from mouse -cells is due to opening of L-type Ca 2+ channels The elevation of [Ca 2+ ] i causing glucagon secretion from the depolarized -cell has generally been attributed to opening of L-type Ca 2+ channels (Rorsman and Hellman, 1988; Berts et al., 1996b; Barg et al., 2000; Göpel et al., 2000b; Muñoz et al., 2005). However, it was recently proposed that stimulation of glucagon release in 1 mm glucose is due to activation of N- rather than L-type Ca 2+ channels but that the L-type channels become dominating after increase of camp (Gromada et al., 1997; Gromada et al., 2004). In mouse -cells the N-type Ca 2+ channels have been proposed to mediate tonic glucagon release and the L-type channels camp-dependent secretion (Ma et al., 2005). We found that [Ca 2+ ] i signalling induced by 8 mm K + plus tolbutamide was always inhibited by the L-type Ca 2+ channel blocker nifedipine but never by the N-type channel blocker -conotoxin (III). Likewise [Ca 2+ ] i signalling in -cells exposed to RPMI 1640 medium containing 1 mm glucose was always inhibited by nifedipine but rarely by -conotoxin (Vieira and Gylfe, 2004). Fig. 4 shows that glucagon secretion in RPMI 1640 medium with 1 mm glucose was unaffected by -conotoxin but abolished by nifedipine. Our data indicate that L-type Ca 2+ channels are most important for stimulated glucagon secretion under physiological conditions. Glucose inhibition of glucagon secretion in mouse islets occurs independently of K ATP channels and products secreted from pancreatic -cells It is well established that inhibition of glucagon secretion is more sensitive to the glucose concentration than is stimulation of insulin release (Gerich et al., 1974). Our data indicated that maximal inhibition of glucagon secretion from mouse islets occurs at the glucose threshold for stimulation of insulin release (III, IV). Although this finding does not support a role of inhibitory -cell factors (Gylfe, 1990), it cannot be excluded that such factors contribute to glucose inhibition of glucagon release, when -cell secretion is stimulated (Östenson, 1979; Rorsman et al., 1989). It is also possible that inhibition of glucagon secretion results from stimulated release of somatostatin (Cejvan et al., 2003) or from a direct effect of glucose on the pancreatic -cell (Pipeleers et al., 1985; Unger, 1985; Johansson et al., 1987; Bode et al., 1999). However, wortmannin, which prevents the inhibitory effect of insulin (Ravier and Rutter, 2005), and PTX pretreatment, which blocks the inhibitory action of somatostatin (Göpel et al., 2004) did not prevent glucose reduction of [Ca 2+ ] i in the individual -cells (III). GABA, which may act as a 28

29 paracrine inhibitor of glucagon secretion in the guinea-pig (Rorsman et al., 1989) and rat (Wendt et al., 2004), but has little effect on glucagon secretion from mouse islets (Gilon et al., 1991), failed to affect [Ca 2+ ] i and membrane potential in the mouse -cells (III). Zn 2+, which is co-secreted with insulin and inhibits glucagon secretion from rat islets (Ishihara et al., 2003; Franklin et al., 2005), was recently found to stimulate mouse -cells (Ravier and Rutter, 2005). In accordance with the latter observation we found that Zn 2+ depolarized all -cells and activated Ca 2+ signaling (III). Against this background it seems unlikely that the actions of glucose on [Ca 2+ ] i and membrane potential in individual -cells should be mediated by paracrine factors released from non- -cells attached to the cover slip. Closure of K ATP channels in -cells have been proposed to couple and increase of glucose concentration to inhibit glucagon secretion (Göpel et al., 2000b; Gromada et al., 2004). This scenario predicts that closure of the K ATP channels depolarizes the -cells and lowers [Ca 2+ ] i. We instead determined that depolarization obtained with tolbutamide was associated with increase of [Ca 2+ ] i in about 21% of previously silent mouse -cells exposed to 1 mm glucose and 80 % of the -cells with spontaneous [Ca 2+ ] i oscillations. Moreover tolbutamide always activated -cells exposed to 8 mm K +. The depolarization and [Ca 2+ ] i signalling in -cells exposed to 8 mm K + plus tolbutamide were counteracted by glucose concentrations ranging from 1-20 mm, indicating that these actions of the sugar occurred independently of K ATP channel closure (III). Contrary to a glucose-induced depolarization predicted by the K ATP channel dependent model for inhibition of glucagon release (Göpel et al., 2000b; Gromada et al., 2004), the sugar always hyperpolarized mouse -cells (I, III). The dose-response relationship for glucose-inhibited glucagon secretion from mouse islets showed maximal effect at 7-8 mm glucose both under control conditions and in the presence of 8 mm K + plus tolbutamide, further supporting a K ATP channel-independent mechanism (III). Aditional evidence that glucose inhibits glucagon secretion independently of K ATP channels and products secreted from -cells was obtained with the observation that some inhibition of glucagon secretion from mouse islets remained in the presence of the K ATP channel opener diazoxide. Under these conditions all types of islets cells are hyperpolarized, which should minimize the release of paracrine factors (IV). Consistent with a direct inhibitory effect of glucose on -cells, glucose inhibited glucagon secretion from hamster R1G9 glucagonoma cells (IV). 29