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

eLife | 2021

Insulin-induced hypoglycemia is a major treatment barrier in type-1 diabetes (T1D). Accordingly, it is important that we understand the mechanisms regulating the circulating levels of glucagon. Varying glucose over the range of concentrations that occur physiologically between the fed and fuel-deprived states (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 increases in plasma glucagon. The identity of the systemic factor(s) that elevates circulating glucagon remains unknown. Here, we show that arginine-vasopressin (AVP), secreted from the posterior pituitary, stimulates glucagon secretion. Alpha-cells express high levels of the vasopressin 1b receptor (V1bR) gene (Avpr1b). Activation of AVP neurons in vivo increased circulating copeptin (the C-terminal segment of the AVP precursor peptide) and increased blood glucose; effects blocked by pharmacological antagonism of either the glucagon receptor or V1bR. 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. AVP injection increased cytoplasmic Ca2+ in alpha-cells (implanted into the anterior chamber of the eye) and glucagon release. Hypoglycemia also increases circulating levels of AVP/copeptin in humans and this hormone stimulates glucagon secretion from human islets. In patients with T1D, hypoglycemia failed to increase both copeptin and glucagon. These findings suggest that AVP is a physiological systemic regulator of glucagon secretion and that this mechanism becomes impaired in T1D.

Pubmed ID: 34787082 RIS Download

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Associated grants

  • Agency: CIHR, Canada
    Id: 148451
  • Agency: Medical Research Council, United Kingdom
    Id: MR/V011979/1
  • Agency: NIDDK NIH HHS, United States
    Id: R01 DK089044
  • Agency: Wellcome Trust, United Kingdom
    Id: 884655
  • Agency: NIDDK NIH HHS, United States
    Id: R01 DK096010
  • Agency: NIH HHS, United States
    Id: F31 DK109575
  • Agency: NIH HHS, United States
    Id: P30 DK046200
  • Agency: NIH HHS, United States
    Id: R01 DK075632
  • Agency: NIDDK NIH HHS, United States
    Id: P30 DK046200
  • Agency: NIH HHS, United States
    Id: P30 DK057521
  • Agency: Wellcome Trust, United Kingdom
    Id: 095531
  • Agency: NIH HHS, United States
    Id: R01 DK089044
  • Agency: Medical Research Council, United Kingdom
    Id: G0801995
  • Agency: NIH HHS, United States
    Id: R01 DK111401
  • Agency: Wellcome Trust, United Kingdom
    Id: 201325/Z/16/Z
  • Agency: NIDDK NIH HHS, United States
    Id: P30 DK057521
  • Agency: NIDDK NIH HHS, United States
    Id: F31 DK109575
  • Agency: NIDDK NIH HHS, United States
    Id: R01 DK075632
  • Agency: Wellcome Trust, United Kingdom
  • Agency: NIDDK NIH HHS, United States
    Id: R01 DK111401

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