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      Glucagon stimulates gluconeogenesis by InsP 3R-I mediated hepatic lipolysis

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          Abstract

          While it is well-established that alterations in the portal vein insulin/glucagon ratio play a major role in causing dysregulated hepatic glucose metabolism in type 2 diabetes (T2D) 13 , the mechanisms by which glucagon alters hepatic glucose production and mitochondrial oxidation remain poorly understood. Here we show that glucagon stimulates hepatic gluconeogenesis by increasing hepatic adipose triglyceride lipase activity, intrahepatic lipolysis, hepatic acetyl-CoA content, and pyruvate carboxylase flux, while also increasing mitochondrial fat oxidation, mediated by stimulation of the inositol triphosphate receptor-1 (InsP 3R-I). Chronic physiological increases in plasma glucagon concentrations increased mitochondrial hepatic fat oxidation and reversed diet-induced hepatic steatosis and insulin resistance in rats and mice; however, the effect of chronic glucagon treatment to reverse hepatic steatosis and glucose intolerance was abrogated in InsP 3R-I knockout mice. These results provide new insights into glucagon biology and suggest that InsP 3R-I may be a novel therapeutic target to reverse nonalcoholic fatty liver disease and T2D.

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          Most cited references22

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          The New Biology and Pharmacology of Glucagon.

          In the last two decades we have witnessed sizable progress in defining the role of gastrointestinal signals in the control of glucose and energy homeostasis. Specifically, the molecular basis of the huge metabolic benefits in bariatric surgery is emerging while novel incretin-based medicines based on endogenous hormones such as glucagon-like peptide 1 and pancreas-derived amylin are improving diabetes management. These and related developments have fostered the discovery of novel insights into endocrine control of systemic metabolism, and in particular a deeper understanding of the importance of communication across vital organs, and specifically the gut-brain-pancreas-liver network. Paradoxically, the pancreatic peptide glucagon has reemerged in this period among a plethora of newly identified metabolic macromolecules, and new data complement and challenge its historical position as a gut hormone involved in metabolic control. The synthesis of glucagon analogs that are biophysically stable and soluble in aqueous solutions has promoted biological study that has enriched our understanding of glucagon biology and ironically recruited glucagon agonism as a central element to lower body weight in the treatment of metabolic disease. This review summarizes the extensive historical record and the more recent provocative direction that integrates the prominent role of glucagon in glucose elevation with its under-acknowledged effects on lipids, body weight, and vascular health that have implications for the pathophysiology of metabolic diseases, and the emergence of precision medicines to treat metabolic diseases.
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            Malonyl-CoA: the regulator of fatty acid synthesis and oxidation.

            In the catabolic state with no food intake, the liver generates ketones by breaking down fatty acids. During the nocturnal fast or longer starvation periods, this protects the brain, which cannot oxidize fatty acids. In 1977, we published a study in the JCI noting the surprising realization that malonyl-CoA, the substrate of fatty acid synthesis, was also an inhibitor of fatty acid oxidation. Subsequent experiments have borne out this finding and furthered our understanding of molecular metabolism.
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              Calcium signaling through CaMKII regulates hepatic glucose production in fasting and obesity.

              Hepatic glucose production (HGP) is crucial for glucose homeostasis, but the underlying mechanisms have not been fully elucidated. Here, we show that a calcium-sensing enzyme, CaMKII, is activated in a calcium- and IP3R-dependent manner by cAMP and glucagon in primary hepatocytes and by glucagon and fasting in vivo. Genetic deficiency or inhibition of CaMKII blocks nuclear translocation of FoxO1 by affecting its phosphorylation, impairs fasting- and glucagon/cAMP-induced glycogenolysis and gluconeogenesis, and lowers blood glucose levels, while constitutively active CaMKII has the opposite effects. Importantly, the suppressive effect of CaMKII deficiency on glucose metabolism is abrogated by transduction with constitutively nuclear FoxO1, indicating that the effect of CaMKII deficiency requires nuclear exclusion of FoxO1. This same pathway is also involved in excessive HGP in the setting of obesity. These results reveal a calcium-mediated signaling pathway involved in FoxO1 nuclear localization and hepatic glucose homeostasis. Copyright © 2012 Elsevier Inc. All rights reserved.
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                Author and article information

                Journal
                0410462
                6011
                Nature
                Nature
                Nature
                0028-0836
                1476-4687
                22 January 2020
                04 March 2020
                March 2020
                04 September 2020
                : 579
                : 7798
                : 279-283
                Affiliations
                [1 ]Department of Internal Medicine, Yale University School of Medicine, New Haven, CT 06520-8020 USA
                [2 ]Department of Cellular & Molecular Physiology, Yale University School of Medicine, New Haven, CT 06520-8020 USA
                [3 ]Department of Pharmacology, Yale University School of Medicine, New Haven, CT 06520-8020 USA
                Author notes

                Author contributions

                The study was designed by R.J.P. and G.I.S. Data were collected and analyzed by R.J.P, D.Z., M.T.G., A.L.B., L.G., A.R.N., A.R.-C., Y.W., L.P., S.D., Y.Z., X.-M.Z., G.M.B., K.T., Y.N., K.F.P., G.W.C., B.E.E., and M.H.N. The manuscript was written by R.J.P. and G.I.S. with contributions and approval from all authors.

                [* ]Correspondence and requests for materials should be addressed to gerald.shulman@ 123456yale.edu .
                Article
                NIHMS1549977
                10.1038/s41586-020-2074-6
                7101062
                32132708
                3db52fbe-7232-4d82-b940-6dd942f9d82c

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