What is Known Regarding β-Cell Intracellular Fatty Acid in Relation to Glucose-Stimulated
insulin Secretion?
Elevation of extracellular glucose causes fusion of the β granules and the plasma
membrane as a result of increased submembrane Ca2+ concentration. A raised adenosine
triphosphate (ATP)-to-adenosine diphosphate (ADP) ratio is pivotal to this process,
as it causes closure of the ATP-sensitive K+ (KATP) channel, membrane depolarization,
opening of voltage-dependent calcium channels and finally Ca2+ influx from the cell
exterior. Soon thereafter, glucose-stimulated insulin secretion (GSIS) is augmented
as the releasable pool of β granules is replenished. Although the molecular basis
of this augmentation has not been fully defined, free fatty acid (FFA) has been strongly
implicated as having an indispensable role in this process. Quantities of FFA in the
micromolar range, and therefore too minute to generate classic metabolic coupling
factor(s), such as ATP for insulin exocytosis, enhance GSIS when added to the incubation
in conjunction with a stimulatory concentration of glucose1. Furthermore, pre-exposure
of β-cells to a similarly low concentration of FFA in the absence of a stimulatory
concentration of glucose primes the cells so that the insulin release (IR) subsequently
provoked by any stimulation is enhanced compared with that in β-cells not treated
with FFA1. Continued exposure of β-cells to a high concentration of glucose causes
an anaplerotic output of citrate from the tricarboxylic acid (TCA) cycle, elevating
cytosolic malonyl-CoA, which causes suppression of carnitine palmitoyltransferase 1
leading to decreased FFA entry to mitochondria2. The subsequent accumulation of cytosolic
FFA might increase insulin secretion through fatty acylation of key protein(s) involved
in exocytosis3. In contrast, increased cellular fatty acyl-CoA (FA-CoA) could also
enhance IR through the glycerolipid/FFA cycle2. Knockdown of desnutrin/adipose triglyceride
lipase (ATGL) in β-cells by short hairpin ribonucleic acid suppressed GSIS4. All of
these data show that acute elevation and lowering of cellular FFA in β-cells, respectively,
enhanced and suppressed GSIS. However, the downstream effector or effectors of FFA
regulation of insulin secretion have remained elusive, especially under the conditions
of sustained β-cell specific lowering of intracellular FFA.
Newer Insights Obtained by β-Cell Specific Desnutrin/ATGL Knockout
In an elegant recent study, Tang et al.5 identified a novel downstream signaling pathway
for intracellular FFA in pan-creatic β-cells: activation of peroxis-ome proliferator-activated
receptor δ (PPARδ) followed by enhanced mitochondrial metabolism. This was accomplished
by using β-cell specific desnutrin/ATGL knockout (desnutrin βKO) mice (Figure1). The
desnutrin βKO mouse showed postprandial and postglucose hyperglycemia with blunted
nutrient- or glucose-induced insulin secretion. Interestingly, the islets were enlarged
and the insulin content increased by approximately 50%, while there was no evidence
of increased insulin synthesis, so that islet insulin appeared to have increased as
a result of decreased IR. Because desnutrin hydrolyzes triacylglycerol (TAG), TAG
accumulated and the FFA content and glycerol output were reduced in the islets of
the KO mouse. Extracellular application of oleate (concentration unspecified) in the
presence of a stimulatory concentration of glucose failed to acutely elevate insulin
exocytosis in the β-cells of the KO mouse. This indicated that a constitutive, normal
level of intracellular FFA by desnutrin is required to uphold the β-cell machinery
for IR competence in response not only to glucose, but also to fatty acid. IR directly
triggered by high K+-induced membrane depolarization in the presence or absence of
the KATP channel opener, diazoxide, remained unaffected in the KO mouse. In other
words, the FFA produced by desnutrin tonically maintains the nutrient-induced IR in
the β-cells. Using mitochondrial membrane potential markers, Tang et al.5 further
showed that the loss of desnutrin/reduced TAG hydrolysis was associated with impaired
mitochondrial metabolism, which was in this case as a result of defective activation
of PPARδ. Adenoviral transfection of desnutrin and pharmacological activation of PPARδ
mostly restored the altered phenotype of the desnutrin KO mouse, implying that the
absence of desnutrin was in fact causal for impaired PPARδ activation and the series
of phenotypic, cellular and subcellular abnormalities in the β-cell specific desnutrin
KO mouse/islets. Feeding a normal mouse on a high-fat diet for 8 weeks caused 50%
suppression of desnutrin protein and messenger ribonucleic acid in the islet cells.
Figure 1
A proposed newer view on the free fatty acid (FFA) signaling in (a) pancreatic β-cells,
on the basis of the findings in (b) the β-cell specific desnutrin knockout mouse.
The novel pathway shown by Tang et al.5 is shown in blue. Downward or upward arrows
indicate increase or decrease, respectively, in the substrate or signaling. (b) Faintness
in blue implies attenuated signaling. The scheme is focused on the topic of the work
of Tang et al.5, and is not intended to cover all aspects of β-cell metabolism-secretion
coupling. ADP, adenosine diphosphate; ATP, adenosine triphosphate; KATP channel, adenosine
triphosphate-sensitive K+ channel; LC-CoA, long-chain acyl-CoA; PPARδ, peroxisome
proliferator-activated receptor-δ; TAG, triacylglycerol; VDCC, voltage-dependent calcium
channel.
Critical Appraisal
The β-cell specific desnutrin KO mouse shows a very unique phenotype from the viewpoint
of islet physiology and pathophysiology. The desnutrin βKO mouse has large islets
with increased insulin content in the absence of attenuated insulin sensitivity in
vivo. Having large islets with increased insulin content is a typical phenotype for
animals fed a high-fat diet, and decreased whole-body insulin sensitivity with increased
insulin synthesis is the rule under this condition. Nevertheless, in the desnutrin
βKO mouse, there was no enhancement of insulin synthesis as indexed by expression
of the messenger ribonucleic acid. Despite increased insulin islet content, basal
insulin secretion was not at all elevated either in vivo or in vitro. Although GSIS
by the islets was depressed, the IR triggered by a depolarizing concentration of K+
was normal, with no increase. Taken together, these findings imply that, in the KO
mouse: (i) the islet insulin content increases mostly, if not entirely, as a consequence
of reduced insulin secretion; that is, the accumulation of insulin in the β-cells
caused by impaired secretion; and (ii) the distribution of β granules clearly shifts
to the reserve, or poorly releasable, pool. In other words, there is a diminution
in the size of the readily releasable pool of β granules.
It should be noted that TAG hydrolysis by desnutrin was not the only source of FFA
in the cells. In addition to TAG hydrolysis by desnutrin, an influx of FFA from outside
the cells, a de novo accumulation of FFA in part as a result of the inhibition of
carnitine palmitoyltransferase-1 (CPT-1) by malonyl-CoA and hydrolysis of diacyl glycerol
by hormone sensitive lipase all contributed to maintaining cellular FFA in the β-cells.
Accordingly, the level of islet free FFA in the desnutrin KO mouse was modestly (approximately
40%), but not radically, suppressed. Therefore, it can be inferred that the deranged
in vivo and in vitro phenotype of the KO mouse was a result of attenuation, not total
obliteration, of FFA signaling. Thus, it can be assumed that a certain level of intracellular
FFA is a required positive effector for the maintenance of the glucose competence
of the IR machinery. There is a similarity between the data for the β-cell specific
desnutrin KO mouse and the β-cells of fasted rats6. In the latter case, nutrient-induced,
but not depolarization-induced, IR is preferentially suppressed with selective impairment
of the mitochondrial metabolism. However, there is a crucial difference between the
two conditions in that islet insulin content increased in the former, but decreased
in the latter.
The data from the IR experiments was presented ‘per islet’; that is, it was not adjusted
for increased islet insulin content. The values for basal insulin output in the presence
of substimulatory concentrations of glucose, so called constitutive release, might
have been significantly lower if they had been expressed ‘per islet insulin content’.
Also, the degree of suppression in GSIS would have been much more pronounced if the
data had been expressed as ‘per islet insulin content’. Similarly, IR directly triggered
by high K+ could have been more appropriately interpreted as ‘decreased’ if the increased
insulin content of the islets had been taken into account. The authors concluded that
the treatment with PPARδ agonist of the KO mouse for 2 weeks caused ‘normalization’
of GSIS in the islets of the KO mouse. However, knowing that insulin content is grossly
increased in the islets of the KO mouse, we are afraid that this interpretation might
have been too simplistic. In other words, it appears that treatment with the PPARδ
agonist only partially restored the relative decrease of the releasable pool of β
granules. This finding strongly indicates the existence of PPARδ-independent, insulinotropic
signaling of FFA in the β-cells. If the imbalance in the distribution of β granules
had been completely corrected by the PPARδ agonist, GSIS in the agonist-treated islets
should have been significantly greater than in the control islets. Nevertheless, the
novel findings in the present study, especially the PPARδ mediation of the effects
of FFA, constitute a valuable addition to previously accumulated knowledge relating
to the role of FFA in β-cells. Because the effect of PPARδ would have been manifested
through changes in gene transcription and protein synthesis within a timeframe of
several hours, this mechanism provides an elegant explanation for the chronic, sustained
effects of FFA in β-cells. If the data from the heterozygous desnutrin KO mouse and
from those fed a high-fat diet with a halving of desnutrin had been somewhere in between
homozygotes and the control mice, desnutrin might have been appropriately described
as a ‘regulator’ of IR. Although activation of PPARδ and the mitochondrial metabolism,
especially raised ATP/ADP, were implicated as downstream effectors of FFA, pharmacological
activation of PPARδ in flox mouse did not cause upregulation of IR.
Conclusions
Free fatty acid signaling in islet β-cells is complicated. Tang et al.5 have identified
PPARδ-mediated activation of mitochondrial metabolism as a novel downstream effector
of FFA in a comprehensive study of the β-cell specific desnutrin KO mouse. Specific
pharmacological modulation of this signaling branch, if possible, would provide an
innovative treatment for type 2 diabetes.