Endocrinology Vol. 138, No. 6 2359-2364
Copyright © 1997 by The Endocrine Society
Correlation of the Activation of Ca2+/Calmodulin-Dependent Protein Kinase II with the Initiation of Insulin Secretion from Perifused Pancreatic Islets1
Richard A. Easom,
Natalie R. Filler,
Emma M. Ings,
Jim Tarpley and
Michael Landt
Department of Biochemistry and Molecular Biology (R.A.E., N.R.F.,
E.M.I., J.T.), University of North Texas Health Science Center at Fort
Worth, Fort Worth, Texas 76107-2699; and Department of Pediatrics
(M.L.), Washington University School of Medicine, St. Louis, Missouri
63110
Address all correspondence and requests for reprints to: Richard A. Easom, Department of Biochemistry and Molecular Biology, University of North Texas Health Science Center at Fort Worth, 3500 Camp Bowie Boulevard, Fort Worth, Texas 76107-2699. E-mail:
reasom{at}hsc.unt.edu
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Abstract
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An experimental procedure has been designed to permit the simultaneous
assessment of the activation status of the multifunctional
Ca2+/calmodulin-dependent protein kinase II (CaM kinase II)
with insulin secretion in perifused islets. By this procedure, the
activation of CaM kinase II by glucose correlated closely with the
initial and sustained phases of insulin secretion within a 30-min test
period. By contrast, islets (160200/tube) in static incubations
neither supported second-phase insulin secretion nor CaM kinase II
activation beyond 1015 min. This was not the result of the
accumulation of insulin, because the introduction of insulin (40160
ng/ml) into the perifusion medium failed to mimic the suppression of
glucose-induced insulin secretion or CaM kinase II activation. A
similar addition of SRIF (0.011 µM) or epinephrine (1
µM) profoundly suppressed insulin secretion although
failing to significantly influence CaM kinase II activation. Finally,
on withdrawal of glucose from perifused islets, insulin secretion
rapidly returned to basal rates, but CaM kinase II deactivation was
significantly delayed. The correlation of kinase activation with the
initiation of insulin secretion suggests that CaM kinase II may be
important in the regulation of glucose-induced insulin secretion. The
observed dissociation of these parameters in the presence of inhibitory
hormones or after the withdrawal of a glucose stimulus, however,
suggests that the kinase is not directly involved in the final steps of
insulin exocytosis.
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Introduction
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A PRIMARY response of the ß-cell to
D-glucose is to increase the intracellular concentration of
Ca2+ (1, 2). This is achieved primarily by the promotion of
Ca2+ influx (3, 4), although there is also evidence that
the mobilization from intracellular stores may contribute to the
increase (5). Although intense investigation has established the roles
of glucose metabolism and various ion channels in this process (6, 7),
the mechanism by which Ca2+ stimulates exocytosis from the
ß-cell is largely unknown.
It has been hypothesized that the activation of
Ca2+/calmodulin-dependent protein kinases (CaM kinases)
function in the initiation of insulin release (8, 9, 10). Included in this
group is the multifunctional CaM kinase II, which has been shown to be
present (11, 12) and activated (13) by glucose in isolated rat islets.
Despite numerous attempts to link this enzyme with insulin secretion
via correlative studies or by the use of putative inhibitors of CaM
kinase II, current evidence of a role of this kinase is ambiguous.
Although glucose activation of CaM kinase II correlates with insulin
secretion, at least with respect to glucose concentration (13), other
experimental results suggest that these cellular events may be
independent of each other. For example, exposure of islets to the
muscarinic agonist, carbachol, in the presence of stimulatory
concentrations of glucose, suppresses the activation of CaM kinase II
while potentiating insulin secretion (14). Moreover, though several
reports have documented that the putative inhibitor of CaM kinase II,
KN-62 (15), inhibits glucose- and nutrient-induced insulin secretion
from isolated islets (16, 17) or cultured ß-cells (18), other studies
have shown that KN-62 does not inhibit Ca2+-induced insulin
secretion from permeabilized ß-cells (18). Studies using intact cells
are further complicated by the reported effect of KN-62 to inhibit
Ca2+ channel activity (18, 19).
The suggestion that CaM kinase II activation and insulin secretion may
be dissociated has major implications with respect to the role of this
enzyme in the exocytotic process. This has prompted a direct analysis
of the temporal correlation of glucose-induced kinase activation and
insulin secretion in conditions where both could be measured
simultaneously. Such conditions have been achieved using a perifusion
technique in which isolated rat islets are immobilized on a hydrophilic
membrane to allow their recovery at any given time. The analysis of the
insulin content of the perifusate has thus permitted the direct
measurement of the rate of insulin secretion at the moment of kinase
assay. This analysis has provided convincing data for the association
of CaM kinase II activation with the initiation of insulin secretion
but suggests that kinase deactivation lags the cessation of secretion
on the removal of stimulus.
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Materials and Methods
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Materials
Male Wistar rats were purchased from Harlan Sprague-Dawley
(Indianapolis, IN) and maintained on Tekland Rodent Diet (Indianapolis,
IN) ad libitum for 710 days before use. CMRL-1066,
glutamine, streptomycin, and FBS were purchased from Life Technologies
(Gaithersburg, MD), and HBSS was from Biowhittaker (Walkersville, MD).
Ficoll, ATP (disodium salt), SRIF, bovine insulin, and leupeptin were
purchased from Sigma Chemical Co. (St. Louis, MO). Collagenase P was
purchased from Boehringer Mannheim (Indianapolis, IN) and glucose
(Dextrose) was from the National Bureau of Standards (Gaithersburg,
MD). [
-32P]ATP was purchased from NEN Research
Chemicals (DuPont, Boston, MA). Autocamtide-2, sequence KKALRRQETVDAL
(20), was synthesized by Bio-Synthesis, Inc. (Lewisville, TX). All
other chemicals were of the finest reagent grade available.
Isolation of islets
Pancreatic islets were isolated from male rats (250350g) by
collagenase P digestion and subsequent enrichment by centrifugation on
a Ficoll gradient as described previously (14). After isolation, islets
were cultured for at least 1 h in CMRL-1066 containing 5.5
mM glucose and supplemented with 2 mM
L-glutamine, 10% heat-inactivated FBS at 24 C under an
atmosphere of 95% air/5% CO2. Animal maintenance and
surgical procedures were conducted in accordance with an Institutional
Animal Care and Use Committee-approved protocol (University of North
Texas Health Science Center at Fort Worth).
Insulin secretion models
Static secretion.
For static secretion experiments, islets
(160200 per tube) were counted into polypropylene microcentrifuge
tubes and preincubated for 15 min at 37 C in Krebs-Ringer-Bicarbonate
(KRB) basal medium (25 mM HEPES, pH 7.4, 115 mM
NaCl, 24 mM NaHCO3, 5 mM KCl, 2.5
mM CaCl2, 1 mM MgCl2)
containing 3 mM glucose and 0.1% BSA (500 µl) under an
atmosphere of oxygen/CO2 (95/5%). The medium was then
replaced with fresh KRB basal medium (3 mM glucose) or KRB
medium supplemented with 17 mM glucose, and the incubation
continued for the indicated times. Incubations were terminated by brief
centrifugation (7000 x g, 5 sec) and supernatants
recovered for the analysis of insulin content by double-antibody RIA
(21). The pelleted islets were washed once in 500 ml ice-cold
homogenization buffer (20 mM Tris-HCl, pH 7.5, 0.5
mM EGTA, 1.0 mM EDTA, 2.0 mM
dithiothreitol, 10 mM sodium pyrophosphate, 0.4
mM ammonium molybdate) and homogenized by sonication (10
pulses, setting 3, 30% duty cycle) in 50 ml homogenization buffer
supplemented with 100 µg/ml leupeptin. The resulting homogenate was
used for the assay of CaM kinase II activation.
Perifusion.
Islets (150200 per chamber) were placed on
hydrophilic 13-mm polycarbonate cyclopore filters (Whatman, Fairfield,
NJ) in Swinnex chambers (Whatman) and perifused with KRB basal medium
(3 mM glucose) at 1 ml/min for 30 min at 37 C. The
perifusion was then continued with either the same medium or KRB medium
containing 17 mM glucose. The perifusate was collected in
1- to 5-ml fractions and analyzed for insulin or C-peptide content by
RIA (21, 22). At the indicated time, the perifusion was terminated, and
the islets were recovered from the filter by washing twice with
ice-cold homogenization buffer containing 1 mg/ml BSA. The islets were
further harvested by centrifugation and homogenized as described
above.
Assay of CaM kinase II activity
CaM kinase II activity was assayed using the determination of
32P incorporation into an exogenously added selective
peptide substrate, autocamtide-2, by a method described previously
(14). CaM kinase II activity was assayed in a reaction mixture
containing 50 mM piperazine diethanesulfonic acid, pH 7.0,
10 mM MgCl2, 0.1 mg/ml BSA (fraction V), 10
µM autocamtide-2, 20 µM ATP (specific
activity, 40 Ci/mmol), and either 0.5 mM
CaCl2/5 µg/ml calmodulin for Ca2+-stimulated
activity or 0.9 mM EGTA for Ca2+-independent
activity. Total reaction vol was 50 µl. The assay was initiated by
the addition of 10 µl of islet homogenate and continued for 30 sec at
30 C before termination by the addition of ice-cold trichloroacetic
acid (25 µl, 15%). After centrifugation (12,000 x
g, 1 min), 35 µl of the resulting supernatant was spotted
onto 3 cm by 0.5-cm strips of phosphocellulose paper (Whatman P81),
washed 5 times in 500 ml distilled H2O, and dried at 110 C
for 15 min. 32Pi incorporation into
autocamtide-2 was determined by Cerenkov radiation (Beckman
Instruments, Inc., Fullerton, CA). In the described experiments,
32Pi incorporation into autocamtide-2 in the
absence of Ca2+/calmodulin (autonomous CaM kinase II
activity) is expressed as percentage of incorporation in the presence
of these cofactors (Ca2+-dependent CaM kinase II activity).
Because autonomous activity is a property of autophosphorylated,
activated CaM kinase II (23), this ratio was used as a measure of
enzyme activation.
Statistical treatment of data
Data are presented as mean ± SE determined
from at least three independent observations, unless otherwise stated.
Where indicated, statistical significance was assessed by a Students
t test.
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Results
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The perifusion of isolated rat islets with stimulatory
concentrations of glucose induced an initial burst of insulin secretion
that peaked at 3 min (first phase) followed by a transient nadir at
67 min and a steady increase in insulin secretion that was sustained
for the period of stimulation (30 min, second phase) (Fig. 1A
). This pattern of secretion was similar to that
reported previously (24, 25). To correlate CaM kinase II activation
with biphasic hormone release, islets were recovered from the
perifusion chambers at various time points subsequent to the
introduction of stimulatory glucose concentrations (17 mM)
and the amount of CaM kinase II in an autonomous, autophosphorylated
form determined. As demonstrated in Fig. 1B
, glucose (17
mM) induced the activation of CaM kinase II with a temporal
profile that was very similar to insulin secretion from the same
islets. Before stimulation, the ratio of autonomous to
Ca2+-dependent CaM kinase II activity was determined to be
16.14 ± 2.89% of CaM kinase II, and this ratio did not change
significantly throughout the period of incubation in the presence of
basal (3 mM) glucose. On exposure to stimulatory
concentrations of glucose (17 mM), the activation state of
CaM kinase II increased rapidly to 31.89 ± 2.86% by 3 min and
then onto 39.42 ± 4.52% at 30 min. A closer analysis suggested
that enzyme activation also was biphasic, although the observed nadir
in activation state was not statistically significant from the peak
activation at 3 min. Nevertheless, Fig. 1C
demonstrates that the
temporal profiles of insulin secretion and CaM kinase II activation
were, for the most part, superimposable, suggesting that the two
processes are closely related.

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Figure 1. Correlation of the activation of CaM kinase II by
glucose with the initiation of insulin secretion in perifused rat
islets. A and B, Islets (150200/chamber) were preperifused with basal
KRB containing 3 mM glucose for 30 min. At the indicated
arrow, islets were perifused with the same medium ( )
or KRB containing 17 mM glucose (). Perifusates (15
ml) were collected for the determination of insulin content (A). At the
indicated times, islets were recovered from selected chambers,
homogenized, and assayed for CaM kinase II activation (B). C, Panels A
and B have been superimposed to illustrate the correlation of the two
parameters.
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The sustained activation of CaM kinase II observed in this study was in
marked contrast to the monophasic activation profile observed
previously using static incubation of islets (13) and reproduced in the
current study (Fig. 2A
). Because of this disparity, it
was of interest to study the temporal profile of insulin secretion from
islets incubated in a static medium. As demonstrated in Fig. 2B
, under
these conditions the absolute amount of insulin secreted increased
rapidly on the introduction of stimulatory concentrations of glucose
(17 mM at time zero), such that approximately 15 µU was
released in the first 3 min. The amounts of insulin accumulated between
subsequent time points was not, however, consistent. For example, only
a net 2 µU of insulin was secreted as the incubation was extended
from 15 min to 20 min (Fig. 2B
). These differences are revealed in an
additional plot of the calculated rate of secretion between the time
increments (Fig. 2C
). A maximal secretion rate was achieved during the
first 3 min, followed by a transient return of secretion rates to the
basal level at 6 min. This initial burst of secretion likely
corresponded to the first phase of secretion observed in islet
perifusion (see Fig. 1
). This was followed by a second burst of
secretion that peaked at 10 min. However, unlike the steady incline of
secretion rates observed from perifused islets, this phase was
characterized by a marked decline of secretion such that by 20 min, the
rate of secretion was not significantly different from that observed
under basal glucose concentrations. This observation suggests that
insulin secretion from statically incubated islets was biphasic but
that the second phase of secretion was prohibited beyond 10 min, even
in the presence of stimulatory concentrations of glucose.
Interestingly, this prohibition of secretion correlated with the
observed decline in CaM kinase II activation under similar conditions
(Fig. 2A
), though the temporal pattern of kinase activation did not
include a clear second phase in these static secretion conditions.

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Figure 2. Correlation of glucose activation of CaM kinase II
(A) with insulin secretion (B and C) from static incubations of islets.
Islets (160200/tube) were incubated at 37 C with 3 mM
( ) or () 17 mM glucose KRB (0.5 ml) for the indicated
times. A, Islets were homogenized and assayed for CaM kinase II
activation; B, the insulin content of the incubation medium was
determined by RIA; C, the increment in insulin accumulation has been
divided by the time elapsed between the appropriate points and plotted
against time.
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Initially, it was reasoned that the accumulation of insulin within the
medium may feedback-inhibit both insulin secretion and CaM kinase II
activation in static incubations. To test this hypothesis in perifusion
experiments, insulin at concentrations of 40, 80, and 160 ng/ml was
introduced to the perifusion medium 15 min after glucose addition and
the effect on hormone release and CaM kinase II activation state
evaluated. As indicated in Fig. 3
, this treatment caused
no inhibition of the second phase of insulin secretion, indirectly
determined by the measurement of secreted C-peptide, despite being
added at concentrations likely to be representative of hormone
accumulation in static incubations. The introduction of insulin tended
to potentiate C-peptide accumulation, although this was likely the
result of an observed incremental affect to slow the perifusion rate.
The activation of CaM kinase II by glucose was not influenced in these
conditions in perifused islets (Fig. 3B
), suggesting that insulin
accumulation did not account for the observed suppression of kinase
activation in static islet incubations.

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Figure 3. Effect of insulin on glucose-induced C-peptide
release and activation of CaM kinase II. Islets (160200/chamber) were
perifused with basal KRB for 30 min and then with 17 mM
glucose for the remaining time. At 40 min (indicated by the
arrow), bovine insulin at the indicated concentrations
(or control) was added. A, The collected perifusate (15 ml) was
analyzed for C-peptide content by RIA; B, islets were recovered from
chambers at 70 min and assayed for CaM kinase II activity.
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Because SRIF also is secreted from
-cells of the pancreatic islet
and is known to inhibit insulin secretion (26, 27), similar experiments
were performed to test the hypothesis that the accumulation of this
hormone accounted for the decline in insulin secretion and CaM kinase
II activation. As shown in Fig. 4A
, the introduction of
1 µM SRIF, 15 min subsequent to the exposure of islets to
17 mM glucose, rapidly decreased insulin secretion,
reaching a maximal inhibition of approximately 70%. By contrast, SRIF
had no significant effect on glucose activation of CaM kinase II (Fig. 4B
). In additional experiments, SRIF (01 µM)
dose-dependently inhibited the onset of insulin secretion but had no
significant effect on glucose activation of CaM kinase II determined at
3 min after the addition of glucose (data not shown). These results
suggest that neither insulin nor SRIF account, in toto, for
the observed suppression of insulin secretion or CaM kinase II
activation, although it is possible that SRIF contributed to the
suppression of insulin secretion.

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Figure 4. Effect of SRIF on glucose-induced insulin release
and activation of CaM kinase II. Islets (160200/chamber) were
perifused with basal KRB for 30 min and then with 17 mM
glucose for the remaining period. At 45 min, SRIF at concentrations of
01 µM was added to the medium. A, The collected
perifusate (15 ml) was analyzed for insulin content by RIA. Only the
effect of 1 µM SRIF is illustrated. B, Islets were
recovered from chambers at 75 min and assayed for CaM kinase II
activity.
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The sites of action of SRIF in the ß-cell are not fully known but
likely include: 1) the modulation of membrane polarization resulting in
decreases in cytoplasmic Ca2+ concentration in the presence
of a stimulus (26); and/or 2) an unidentified exocytotic regulation
point, possibly an exocytotic G-protein (Ge) (27, 28). The
inhibitory effects elicited by SRIF are similarly induced by the
2-adrenergic agonist, epinephrine (Epi) (28), and so the
ability of this hormone to alter CaM kinase II activation also was
studied. As demonstrated in Fig. 5A
, Epi totally
reversed glucose-induced insulin secretion, when added 10 min
subsequent to the initiation of secretion, by the addition of
stimulatory concentrations of glucose. As observed for SRIF, this
concentration of Epi only modestly decreased the activation status of
CaM kinase II (Fig. 5B
, P > 0.05). These observations
suggest that insulin secretion and CaM kinase II, though showing
similarities with respect to the initiation of insulin secretion, can
be dissociated and that this dissociation may occur with respect to the
exocytotic site.

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Figure 5. Effect of Epi on glucose-induced insulin release
and activation of CaM kinase II. Islets (160200/chamber) were
perifused with basal KRB for 30 min and then with 17 mM
glucose for the remaining period. At 40 min, 1 µM was
added to the medium. A, The collected perifusate (15 ml) was analyzed
for insulin content by RIA. Only the effect of 1 µM SRIF
is illustrated. B, Islets were recovered from chambers at 70 min and
assayed for CaM kinase II activity.
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In a final series of experiments, the relationship between CaM kinase
II activation and insulin secretion was evaluated after the withdrawal
of a glucose stimulus. As demonstrated in Fig. 6
, insulin secretion declined rapidly after the withdrawal of stimulatory
concentrations of glucose from the perifusion medium. By 3 min, a 50%
reversal of secretion was observed, and basal secretion rates were
achieved by 15 min. In contrast, a maximal level of CaM kinase II
activation (i.e. 50% autonomous) was maintained for at
least 5 min subsequent to the withdrawal of glucose. Only then was
enzyme deactivation observed such that greater than 90% reversal was
achieved by 30 min, a time significantly longer than that required for
the reversal of insulin secretion. These observations again suggest
that although insulin secretion and CaM kinase II may be similar in
activation profile, these parameters may be dissociated at the point of
exocytosis.
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Discussion
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Classically, insulin secretion from isolated islets in
vitro has been assessed using one of two experimental models, the
determination of the insulin content of 1) a volume of medium in which
islets have been statically incubated for a given test period; or 2) a
medium that has been passed over islets immobilized on some matrix
support. This latter procedure is technically more challenging but
provides a dynamic view of secretion in which first and second phases
of insulin secretion are observed and, as such, resemble physiological
secretion from the intact pancreas in vivo (29). The current
study demonstrates that distinct temporal profiles of insulin secretion
are supported by the different techniques. Most importantly, these data
demonstrate that insulin secretion, at least with numbers of islets
greater than 150 islets/tube, is not supported for longer that a few
minutes in static incubations, despite the continued incubation in
stimulatory concentrations of glucose. The observed profound
suppression of second-phase secretion in the static model was
suggestive of the accumulation of a feedback inhibitory factor.
However, these data suggest that it was not the result of the
accumulation of insulin, because the introduction of insulin to the
medium failed to suppress glucose-induced insulin in the perifusion
model. The partial suppression of secretion observed on the
introduction of a high concentration of SRIF suggests that
glucose-induced accumulation of this hormone in static incubations may
have contributed to (though not be totally responsible for) this
phenomenon. It is considered likely that additional factors, such as
localized regions of anoxia or glucose depletion, contributed to the
observed suppression of secretion. Independent of the mechanism, it is
important to note that a static incubation of islets may not produce a
true quantitation of hormone release, particularly when a relatively
large number of islets are employed.
In a general sense, the activation of CaM kinase II was found to
correlate closely with insulin secretion. By perifusion, the activation
of CaM kinase II coincided with the onset of hormone release, and for
the most part, the two time profiles were superimposable, even to the
extent that kinase activation seemed biphasic, although not in a manner
that could be statistically established. This close temporal
correlation suggests that these cellular events are associated and
constitutes evidence in support of a function of CaM kinase II in the
insulin secretion process. Furthermore, this temporal profile,
particularly with respect to sustained kinase activation that
correlated with the second phase of insulin secretion, was distinct
from the monophasic-like profile observed from static incubation of
islets, in which kinase activation was steadily repressed after 5 min
of stimulation (see Fig. 2
and 13 . It is interesting to note,
therefore, that both kinase activation and insulin secretion were
suppressed in static incubations after a 5- to 10-min period of
stimulation. Although there is no direct evidence for a cause-effect
relationship between these two parameters, it is tempting to speculate
that the activation of CaM kinase II is required for insulin secretion
and that the observed suppression of secretion is the result of
inhibition of this enzyme.
Interpretation of the observed dissociation of CaM kinase II activation
and insulin secretion in the presence of SRIF or Epi, or after glucose
withdrawal, are less straightforward. At a cursory level, the observed
ability of Epi and SRIF to profoundly suppress glucose-induced insulin
secretion by more than 95% and more than 70%, respectively, without
any significant effect on kinase activation, could be taken as evidence
that CaM kinase II has no functional role in the insulin secretory
process. Indeed, it should be recognized that insulin secretion can be
elicited by mechanisms independent of the elevation of intracellular
Ca2+ (30). An alternative explanation, however, could be
that the targets of these secretory antagonists are cellular components
distal to the activation of CaM kinase II by Ca2+. This
explanation is supported by a substantial amount of evidence to suggest
that these hormones directly interfere with exocytosis through the
modulation of G-proteins (Gi or possibly Go)
(26, 30, 31). Other reported effects of these hormones to promote
membrane repolarization and ultimately decrease cytosolic
Ca2+ concentrations (32) may not be of sufficient magnitude
to affect the activation state of CaM kinase II.
The rapid return of insulin secretion to baseline rates after the
withdrawal of a glucose stimulus, indicates that this nutrient tightly
controls the final stages of exocytosis (i.e. secretory
granule fusion and content release into the extracellular medium). The
observed delay in CaM kinase II deactivation (by 510 min) eliminates
the involvement of autonomous kinase activity in these events but is
consistent with a potential involvement of this enzyme to regulate
upstream events that represent the ATP-dependent steps of insulin
exocytosis (30), as previously proposed by Ammala et al.
(19). The movement of secretory granules to preexocytotic sites is
thought to involve both microtubule and microfilament components of the
cytoskeleton (33, 34, 35, 36). It is of interest, therefore, that
calmodulin-dependent kinases have been reported to be associated with
this cellular structure (9) and mediate Ca2+-induced
phosphorylation of cytoskeletal or vesicle-associated components, such
as microtubule-associated protein-2 (37) and synapsin I (38, 39), in
intact or permeabilized ß-cells. It is conceivable, therefore, that
the activation of CaM kinase II regulates movement of nascent secretory
granules to the exocytosis site via the modulation of microtubule
dynamics. This process would be envisaged to be activated immediately
on stimulation of the cell but, ideally, would be required further to
continue past the termination of the stimulus to permit the restocking
of pools of granules strategically stored in close proximity to the
plasma membrane for immediate release on cell stimulation. The property
of CaM kinase II to convert, on activation, to a
Ca2+-independent, autonomous form that will continue to
phosphorylate and modulate the function of substrates, despite the
elimination of stimulatory second messengers (40, 41, 42), perfectly equips
this enzyme for such a role.
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Footnotes
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1 This work was supported by NIH Grant DK-47925 (to R.A.E.). 
Received January 9, 1997.
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