To directly examine whether insulin signaling modulates glucagon secretion in vivo, we created and characterized mice with a conditional knockout of the insulin receptor in pancreatic α-cells (αIRKO mice). Adult male αIRKO mice exhibited hyperglucagonemia, glucose intolerance, and fed hyperglycemia, and an elevated glucagon response to L-arginine stimulation. Hyperinsulinemic-hypoglycemic clamp studies revealed an enhanced glucagon secretory response in αIRKO mice. These in vivo findings were complemented by enhanced glucagon secretion in siRNA-mediated knockdown of the insulin receptor in InR1G cells. Together, these data provide direct genetic evidence for a significant role for the insulin receptor in the modulation of pancreatic α-cell function.
The regulation of glucagon secretion involves a complex interplay of signals including glucose, intra-islet paracrine factors, and the central and autonomic nervous systems (
Gromada et al., 2007). Insulin, secreted from β-cells has been proposed as one of the intra-islet paracrine factors that can modulate the secretion of glucagon by neighboring α-cells (
Asplin et al., 1981;
Maruyama et al., 1984;
Weir et al., 1976). Although several
ex vivo (e.g. isolated islets) and/or
in vitro (e.g. dispersed islet cells) approaches (reviewed in (
Cryer, 1994;
Gromada et al., 2007)) have been used to address the role of intra-islet insulin, these studies do not mimic the
in vivo situation where the direction of blood flow from β-cells can potentially influence the function of α-cells located downstream (
Bonner-Weir and Orci, 1982;
Samols and Stagner, 1988). The αIRKO mouse model circumvents these limitations and provides direct
in vivo evidence that disrupting insulin signaling in α-cells leads to hyperglucagonemia and glucose intolerance. The relatively mild hyperglucagonemia in the αIRKOs did not translate to major defects in hepatic gene expression patterns in the non-stressed mouse. However, subjecting the αIRKOs to fasting stress led to a significant attenuation of the decrease in expression of hepatic glucokinase, while after refeeding, the decrease in hepatic G6Pase expression was also significantly lower compared to the response in controls. It is possible that a lack of appropriate suppression of glucokinase and G6Pase, that are both important for hepatic glucose metabolism (
Barthel and Schmoll, 2003) contributed, in part, to the glycemic perturbations in the αIRKOs.
Intra-islet insulin has been implicated in the glucagon counterregulatory response that is necessary to prevent hypoglycemia (
Ahren, 2000;
Gromada et al., 2007). To directly assess the role of intra-islet insulin in the αIRKO model we used two paradigms of hypoglycemia. Subjecting the mice to hyperinsulinemic hypoglycemia revealed significantly reduced glucagon release in controls compared to αIRKOs suggesting that the concomitant elevation in insulin suppresses the α-cell secretory response to hypoglycemia in the controls but not in αIRKOs. The lack of suppression in the αIRKOs is likely due to absent insulin signaling in α-cells that in turn allows a greater glucagon secretory response to hypoglycemia despite lower sympathetic (i.e. norepinephrine) tone. The similar rise in epinephrine levels in the two groups indicates the effects of the experimental hypoglycemia on α-cell secretion are independent of circulating epinephrine (
Gromada et al., 2007). It is also possible that the additional deficiency in epinephrine-induced counter-regulatory defense against hypoglycemia, that is observed in many patients with type 1 diabetes (
Heller and Cryer, 1991;
Mokan et al., 1994;
Powell et al., 1993), is due to chronic hypoglycemia and is not fully manifest in the αIRKO mice. The lower norepinephrine (basal and hypoglycemic) response in the αIRKOs suggests that insulin signaling in α-cells potentially signals to the brain to recruit the sympathetic nervous system to participate in the hypoglycemic response (
Gromada et al., 2007). However, it is worth noting that changes in systemic levels of norepinephrine have been reported to be the result of ‘spill-over’ and are considered non-discriminatory in clamp studies (
Evans et al., 2004;
McCrimmon et al., 2005). The αIRKO mouse provides a useful model to evaluate if additional neuronal signals can contribute to counter-regulatory glucagon responses in the absence of the effects of intra-islet insulin. Glucose infusion rates (GIR) are typically expected to be low during hypoglycemic clamps when compared to euglycemic clamps (
Jacobson et al., 2006), due to the combined effects of the decrease in the mass action of glucose (suppress the liver glucose production and augment muscle glucose uptake), and of the increased counteregulatory hormones opposing insulin action. The lower GIR in the αIRKO mice during the hypoglycemic clamp may be due, in part, to hepatic insulin resistance induced by higher glucagon responses. It is conceivable that insulin sensitivity is lower as well and studies with euglycemic clamps may shed further light on this phenomenon.
In a second paradigm, when hypoglycemia was induced by fasting but without a substantial decrease in insulin levels, the circulating glucagon levels did not drop in controls. These data suggest that a “switch-off” mechanism (
Hope et al., 2004;
Zhou et al., 2004) may not operate
in vivo, and the recognition of a significant decrease in circulating insulin, by insulin receptors in α-cells, is necessary for an appropriate glucagon secretory response to hypoglycemia. The αIRKO mouse would be a useful tool to further distinguish the significance of glucose versus somatostatin in the intra-islet control of α-cell secretion (
Greenbaum et al., 1991).
The alterations in glucagon gene expression in the αIRKO islets exposed to different concentrations of glucose indicates a regulatory role for insulin signaling in α-cells at the level of transcription consistent with previous studies (
Gonzalez et al., 2008;
Philippe, 1989). Since glucose is an important physiological suppressor of glucagon secretion
in vivo (
Gromada et al., 2007) the paradoxical stimulation of glucagon secretion by high glucose (
Salehi et al., 2006) has led to the suggestion that additional modulator(s) exist for glucagon suppression
in vivo. Our observations of enhanced glucagon secretion in InR1G cells with a knockdown of insulin receptors complements our
in vivo findings and indicates that the additional modulator is insulin itself or that the putative modulator requires a functional insulin receptor for its effects on α-cells. Although InR1G cells do not secrete insulin (
Drucker et al., 1988), it is possible that the insulin present in growth media used to routinely culture and maintain the cells has a suppressive effect on glucagon secretion that is unmasked in the controls but not in the knockdown cells. Further support for a direct role for insulin in the regulation of α-cell function is provided by the observation that glucagon secretion is abolished in response to low glucose in isolated islets and in αTC6 cells expressing nsulin receptor siRNA (
Diao et al., 2005).
Surprisingly, we observed an increase in β-cell mass and a decrease in α-cell mass in the αIRKO mice. Given the potential role for glucagon in the development of β-cells (
Prasadan et al., 2002;
Vuguin et al., 2006), it is conceivable that altered α-cell function in the αIRKO mice directly or indirectly influences β-cell proliferation in the mutants. On the other hand, the reduced α-cells in older αIRKO mice may be secondary to attenuation of insulin signaling-mediated anti-apoptosis leading to increased α-cell death, an observation that is similar to the reduced β-cell mass in β-cell specific insulin receptor knockout mice (
Kulkarni et al., 1999a). Alternatively, α- to β-cell trans-differentiation, that has been suggested to involve the transcription factor aristaless-related homeobox (Arx) (
Collombat et al., 2003), may induce an increase in β-cells at the expense of α-cells. PancChip analyses of islets (
Scearce et al., 2002) (Supplemental Table 1) revealed no significant differences between groups in the expression of transcription factors, including PDX-1 and MafB, that are important for proliferation and/or development of islets cells except for a marginal increase in Pax-4 in the αIRKOs. Further investigation during early development and post-natal periods is necessary to examine the potential role of Pax4 in islet cell fate specification in the αIRKO mice. Alternatively, lineage trace analyses could be useful to explore whether the new β-cells in the αIRKOs emerge from irreversibly marked α-cells lacking growth factor signaling. Finally, it will be worth exploring the individual contributions of insulin versus IGF-I receptors and proteins in their signaling pathways to the α-cell hyperplasia that is observed in glucagon resistant models (
Chen et al., 2005;
Gelling et al., 2003).
In summary, we provide direct genetic evidence for a role for insulin signaling in the regulation of α-cell function in vivo. We propose that insulin resistance in the α-cell contributes to dysregulation of glucagon secretion in altered glycemic states. These data provide a basis for developing therapeutic approaches aimed at modulating α-cell growth and function with the long-term goal of improving glucose homeostasis in patients with T1DM and T2DM.