Endocrinology Vol. 141, No. 9 3287-3295
Copyright © 2000 by The Endocrine Society
A Link between Insulin Resistance and Hyperinsulinemia: Inhibitors of Phosphatidylinositol 3-Kinase Augment Glucose-Induced Insulin Secretion from Islets of Lean, But Not Obese, Rats1
Walter S. Zawalich and
Kathleen C. Zawalich
Yale University School of Nursing, New Haven, Connecticut
06536-0740
Address all correspondence and requests for reprints to: Dr. Walter S. Zawalich, Yale University School of Nursing, 100 Church Street South, New Haven, Connecticut 06536-0740. E-mail:
walter.zawalich{at}yale.edu
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Abstract
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Wortmannin (5100 nM), a specific phosphatidyinositol
3-kinase inhibitor, augmented 8 mM glucose-induced insulin
secretion from control Sprague Dawley rat islets in a dose-dependent
manner. This effect persisted after its removal from the perifusion
medium; however, this augmenting effect was reduced by the calcium
channel inhibitor nitrendipine or by lowering the glucose level to 3
mM. Wortmannin amplified insulin release induced by the
combination of 68 mM glucose plus 1 µM
carbachol; however, it had no effect on phorbol ester- or
-ketoisocaproate-induced insulin secretion. The potentiating action
of wortmannin on 8 mM glucose-induced release was
duplicated by LY294002. Wortmannin had no effect on glucose usage rates
or inositol phosphate accumulation in
[3H]inositol-prelabeled islets. Of particular
significance, although 50 nM wortmannin potentiated 8
mM glucose-induced secretion from islets of lean Zucker
control rats, the fungal metabolite had little effect on 8
mM glucose-induced release from islets of insulin-resistant
Zucker fatty rats. These findings support the concept that the same
biochemical process, inhibition of phosphatidyinositol 3-kinase, that
causes peripheral tissue insulin resistance enhances ß-cell
sensitivity to glucose and produces a compensatory increase in insulin
secretion from these cells. The efficacy of wortmannin depends on the
in vivo status of the donors insulin signaling
pathways. This elegant biochemical control mechanism in ß-cells
ensures the maintenance of glucose homeostasis despite a reduction in
insulin action on peripheral tissues.
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Introduction
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A SENSITIVE and dynamic balance between
tissue sensitivity to insulin and the prevailing insulin concentration
exists. In situations (prediabetes, obesity, and type 2 diabetes)
characterized by the development of insulin resistance (1, 2, 3), a
compensatory secretory response of the ß-cell occurs, and plasma
levels of insulin are increased. Although the development of insulin
resistance in peripheral tissues such as liver, muscle, and adipose
cells is thought to be the result of a reduction in insulin signaling
via phosphatidyinositol 3-kinase (PI3K) (4, 5), the nature of the
stimulus for the enhanced secretion of insulin has yet to be
established. Of particular significance, perhaps, are the observations
that insulin receptors (6), insulin receptor messenger RNA (7), insulin
receptor substrate-1 (7), and PI3K have been identified in ß-cells
(8). This raises the possibility that the same biochemical pathways
that determine insulin sensitivity in peripheral tissues may be
involved in ß-cell secretory activity and participate in the adaptive
response of these cells to insulin resistance.
In an attempt to address this issue, studies were conducted with
wortmannin, a fungal metabolite that specifically inhibits signaling
via the PI3K pathway (9, 10, 11), using islets isolated from control
Sprague Dawley rats. Additional experiments were conducted with
LY294002, a PI3K inhibitor structurally distinct from wortmannin.
Finally, we determined whether the in vivo status of the
donors insulin signaling pathways played any role in the in
vitro islet responses to wortmannin by performing parallel studies
using islets isolated from obese, insulin-resistant, hyperinsulinemic
Zucker fatty rats and their lean counterparts.
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Materials and Methods
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Islet isolation
The detailed methodologies employed to assess insulin output
from collagenase-isolated islets have been previously described (12).
Male Sprague Dawley rats (350475 g), lean control Zucker rats
(220240 g), and fa/fa Zucker fatty rats (260310 g) were
purchased from Charles River Laboratories, Inc.
(Wilmington, MA). All animals were treated in a manner that complied
with the NIH Guidelines for the Care and Use of Laboratory Animals (NIH
Publication 8523, revised 1985). The animals were fed ad
libitum. After ip Nembutal (pentobarbital sodium, 50 mg/kg; Abbott
Laboratories, North Chicago, IL)-induced anesthesia, islets were
isolated by collagenase digestion and handpicked, using a glass loop
pipette, under a stereo microscope. They were free of exocrine
contamination.
Perifusion studies
Groups of 1418 isolated islets were loaded onto nylon filters
(Tetko, Inc., Briarcliff Manor, NY) and perifused in a Krebs-Ringer
bicarbonate (KRB) buffer at a flow rate of 1 ml/min for 30 min, usually
with 3 mM glucose, to establish basal and stable insulin
secretory rates. In experiments with
-ketoisocaproate, glucose was
omitted during the first 30 min of the perifusion. After this 30-min
stabilization period they were then perifused with the appropriate
agonist or agonist combinations as indicated in the figure legends and
Results. Wortmannin or LY294002 were dissolved in
dimethylsulfoxide, and comparable amounts of this diluent were added to
control solutions. Perifusate solutions were gassed with 95%
O2-5% CO2 and maintained
at 37 C. Insulin released into the medium was measured by RIA (13).
Islet labeling for inositol phosphate (IP) studies
After isolation, groups of 1826 islets were loaded onto nylon
filters, placed in a small glass vial, and incubated for 3 h in a
myo-[2-3H]inositol-containing KRB solution made
up as follows. Myo-[2-3H]inositol (10 µCi;
SA, 1623 Ci/mM) was placed in a 10 x 75-mm culture
tube. To this aliquot of tracer 250 µl warmed (to 37 C) and
oxygenated (KRB) medium supplemented with 5.0 mM glucose
were added. After mixing, 240 µl of this solution were gently added
to the vial with islets. The vial was capped with a rubber stopper,
gassed for 10 sec with 95%
O2-5%CO2, and incubated at
37 C. The vials were again gently oxygenated after 90 min. After the
labeling period, the islets still on nylon filters were washed with 5
ml fresh KRB.
IP measurements
After washing, the islets on nylon filters were placed in small
glass vials. Added gently to the vial was 400 µl KRB supplemented
with 10 mM LiCl to prevent IP degradation and the
appropriate agonists as indicated. The vials were capped and gently
gassed for 5 sec with 95% O2-5%
CO2. After a 60-min incubation with the indicated
agonists, the generation of IPs was stopped by adding 400 µl 20%
perchloric acid. Total IPs formed were then measured using Dowex
(Bio Rad Laboratories, Hercules, CA) columns as described
previously (14, 15).
Glucose utilization rates
The usage of glucose was measured by determining the rate of
3H2O formation from
[5-3H]glucose using methods previously
described (16). These islets were incubated in 0.125 ml 8
mM glucose with or without 50 nM wortmannin
solution supplemented with tracer
[5-3H]glucose. The
3H2O formed during a 1-h
incubation was separated from the unused
[3H]glucose as described previously (16).
Reagents
Hanks solution was used for the islet isolation. The
perifusion medium consisted of 115 mM NaCl, 5
mM KCl, 2.2 mM CaCl2, 1
mM MgCl2, 24 mM
NaHCO3, and 0.17 g/dl BSA. The
125I-labeled insulin for the insulin assay,
[5-3H]glucose, and the
3H2O for the glucose usage
studies were purchased from New England Nuclear (Boston, MA).
[3H]Inositol was purchased from Amersham Pharmacia Biotech (Arlington Heights, IL). BSA (RIA grade),
glucose, wortmannin, carbachol, phorbol 12-myristate 13-acetate (PMA),
-ketoisocaproate, LY294002, and the salts used to make the Hanks
solution and perifusion medium were purchased from Sigma
(St. Louis, MO). Nitrendipine was the gift from A. Scriabine (Miles
Institute for Preclinical Pharmacology, Elkhart, IN). Rat insulin
standard (lot 615-ZS-157) was a gift from Dr. Gerald Gold (Eli Lilly & Co., Indianapolis, IN). Collagenase (type P) was
obtained from Roche Molecular Biochemicals (Indianapolis,
IN).
Statistics
Statistical significance was determined using Students
t test for unpaired data or ANOVA in conjunction with the
Newman-Keuls test for unpaired data. P < 0.05 was
taken as significant. Values presented in the figures and results
represent the mean ± SE of at least three
observations.
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Results
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Effects of wortmannin on glucose-induced secretion from control
Sprague Dawley rats
Rat islets were collagenase isolated and perifused. After a 30-min
perifusion in the presence of 3 mM (54 mg/100 ml)
glucose to establish stable basal rates of insulin secretion, the
response to 8 mM (144 mg/100 ml) glucose was
determined. When compared with prestimulatory secretory rate of 40
± 3 pg/islet·min (n = 14) in the presence of 3 mM
glucose alone, the insulin secretory rate increased slowly when the
perifusate glucose concentration was increased to 8 mM
(Fig. 1
, left). Forty minutes
after the onset of 8 mM glucose stimulation,
insulin release rates had increased to 184 ± 18 pg/islet·min
(n = 14). Extending the stimulatory period to 60 min resulted in a
response of 202 ± 19 pg/islet·min. Including wortmannin (50
nM) in the perifusate together with 8
mM glucose markedly augmented insulin release
from perifused rat islets (Fig. 1
, left). Most dramatic were
its effects during the final 3060 min of the perifusion period. For
example, although release rates from control islets perifused with 8
mM glucose alone averaged 160 ± 16,
184 ± 18, and 201 ± 15 pg/islet·min 30, 40, or 50 min
after the onset of stimulation with 8 mM glucose
alone, the addition of 50 nM wortmannin
significantly increased release rates to 325 ± 42, 504 ±
63, and 596 ± 92 pg/islet·min (n = 5) at these time
points, respectively. A level (50 nM) of
wortmannin that increased 8 mM glucose-induced
release 3-fold had no additional effect when release was stimulated by
a maximally effective 20-mM glucose stimulus
(Fig. 1
, right). Dose-response studies (Fig. 2
) revealed that 5
nM wortmannin was sufficient to significantly
amplify the modest insulin stimulatory action of 8
mM glucose. However, levels of wortmannin as high
as 50 nM had no effect on release in the presence
of 3 mM glucose (results not shown).

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Figure 1. Wortmannin potentiates 8 mM, but not
20 mM, glucose-induced insulin secretion. Groups of 1418
rat islets were isolated and perifused. For the initial 30 min all
islets were maintained with 3 mM glucose (G3) to establish
basal and stable insulin secretory rates. Left panel,
Islets were then perifused (indicated by the vertical
line) for 60 min with 8 mM glucose (G8) alone
(open circles; n = 14), 8 mM glucose
plus 50 nM wortmannin (closed
circles, solid line; n = 5) or 8
mM glucose, 50 nM wortmannin, plus 500
nM nitrendipine (closed circles,
dashed line; n = 4). Right panel,
Islets were then perifused (indicated by the vertical
line) for 60 min with 20 mM glucose (G20) alone
(n = 9) or 20 mM glucose plus 50 nM
wortmannin (n = 5). The mean ± SE are given in
this and subsequent figures. Note the change in insulin secretion scale
between left and right panels. The
asterisks indicate a significant (P
< 0.05) difference between release values at this time. This and
subsequent perifusion figures have not been corrected for the dead
space in the perifusion apparatus, 2.5 ml or 2.5 min with a flow rate
of 1 ml/min.
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Figure 2. Dose-response of wortmannin on 8 mM
glucose-induced insulin release. Groups of islets were perifused for 30
min with 3 mM glucose and for an additional 60 min with 8
mM glucose alone or in the additional presence of the
indicated wortmannin concentrations. The data presented here are the
mean ± SE insulin secretion rates measured during the
final 30 min of stimulation (6090 min) during the perifusion. The
asterisk indicates significance between release rates
measured in the presence and absence of wortmannin. At least four
separate experiments were conducted under each condition.
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Calcium influx and insulin secretion
The influx of calcium into the ß-cell is essential for
glucose-induced secretion and also for the amplifying effect of 50
nM wortmannin (Fig. 1
, left panel). For example,
30 or 60 min after the onset of stimulation with the combination of 8
mM glucose plus 50 nM
wortmannin, the release rate from islets averaged 325 ± 42 or
567 ± 51 pg/islet·min (n = 5). Inclusion of 500
nM of the calcium channel inhibitor nitrendipine
attenuated the stimulatory effect of 8 mM glucose
plus 50 nM wortmannin on secretion from isolated
islets, with the release rate averaging 88 ± 15 or 95 ± 4
pg/islet·min (n = 3) 30 or 60 min after the onset of
stimulation, respectively.
Pretreatment with wortmannin accelerates its potentiation of
glucose-induced secretion
When simultaneously perifused with 8 mM glucose plus
50 nM wortmannin, a potentiated insulin secretory response
was evident after a delay of 20 min (Fig. 1
, left
panel). In an attempt to accelerate the effects of
wortmannin, islets were pretreated with the fungal metabolite during
the 30-min perifusion with 3 mM glucose. As shown
in Fig. 3
, a significant potentiating
effect of wortmannin was observed within minutes after exposure to 8
mM glucose.

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Figure 3. Wortmannin pretreatment accelerates its
potentiating effect on 8 mM glucose-induced secretion. Two
groups of islets were studied. They were perifused for 30 min with 3
mM glucose alone (open circles) or 3
mM glucose plus 50 nM wortmannin
(closed circles). For an additional 40
min (indicated by the vertical line), the islets were
stimulated with 8 mM glucose alone (open
circles) or 8 mM glucose plus 50 nM
wortmannin (closed circles). Three
experiments were conducted under each condition, and the
asterisks indicate significance between release rates
measured in the presence and absence of wortmannin.
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Reversibility of wortmannin action on the ß-cell
Previous studies have demonstrated that in other tissues
wortmannin is a specific and irreversible inhibitor of PI3K (10, 17).
In the next series of studies we examined whether wortmannins
potentiating effect persisted after its removal from the perifusion
medium. Islets were stimulated for 40 min with 8 mM glucose
plus 50 nM wortmannin, during which time secretion was
dramatically amplified from these islets compared with that from islets
stimulated with 8 mM glucose alone (compare Fig. 1
, left, open circles, with Fig. 4
). For the final 20 min of the
perifusion, wortmannin was removed from the medium in one group
(closed circles, solid line), whereas the glucose
level was maintained at 8 mM. Before the removal
of wortmannin from the perifusion medium, release rates averaged
606 ± 127 pg/islet·min (n = 4). Release persisted at high
rates for the remainder of the perifusion. For example, 20 min after
removal of the fungal metabolite release rates still averaged 513
± 94 pg/islet·min. In additional studies, the glucose level was
decreased to 3 mM, whereas wortmannin was
maintained at 50 nM for the final 20 min. Under
this condition, and consistent with the inability of wortmannin to
augment release at substimulatory glucose levels, release rates fell
dramatically upon removal of 8 mM glucose (Fig. 4
).

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Figure 4. Examining the reversibility of wortmannins
effect on glucose-induced release. Two groups of islets were studied.
They were both perifused for 30 min with 3 mM glucose and
for an additional 40 min with 8 mM glucose plus 50
nM wortmannin (indicated by the vertical
line). For the final 20 min one group was perifused with 8
mM glucose alone (closed circles,
solid line), and the second group was perifused with 3
mM glucose plus 50 nM wortmannin (closed
circles, dashed line). Note the rapid decline in
secretion when the glucose level was lowered to 3 mM, but
not when wortmannin was omitted from the medium in the continued
presence of 8 mM glucose. The asterisks
indicate a significant (P < 0.05) difference
between release values at this time. Four experiments were conducted
under each condition.
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Effects of wortmannin on glucose- plus carbachol- induced
secretion
Postprandial increments in the prevailing insulin level are
thought to be a result of the interactions between both fuel and
neurohumoral signals, especially vagally derived acetylcholine, acting
in concert on the ß-cell (18, 19, 20, 21). We next explored the effect of 50
nM wortmannin on secretion evoked by glucose-carbachol
combinations. When stimulated with 6 mM glucose plus 1
µM carbachol, insulin secretory rates remained relatively
constant at about 4050 pg/islet·min (Fig. 5
, left panel). The inclusion
of 50 nM wortmannin during the stimulatory phase
together with 6 mM glucose plus 1
µM carbachol amplified release. This effect was
most prominent during the final 30 min of stimulation (Fig. 5
, left panel), and significance (P < 0.05)
was achieved during the final 20 min of the study.

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Figure 5. Wortmannin amplifies release in response to
glucose plus carbachol combinations. Groups of islets were perifused
for 30 min with 3 mM glucose. Left panel,
For the next 60 min (onset indicated by vertical line)
islets were stimulated with 6 mM glucose plus 1
µM carbachol (open circles; n = 6) or
6 mM glucose, 1 µM carbachol, plus 50
nM wortmannin (closed circles, n = 6). Right
panel, For the next 60 min islets were stimulated with 8
mM glucose plus 1 µM carbachol (open
circles; n = 11) or 8 mM glucose, 1
µM carbachol, plus 50 nM wortmannin
(closed circles; n = 10) The
asterisks indicate a significant (P
< 0.05) difference between release values at this time.
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Elevating the glucose level to 8 mM and maintaining
carbachol at 1 µM were accompanied by a more robust
insulin secretory response from control islets compared with the
response to 6 mM glucose plus 1 µM carbachol
(Fig. 5
, right panel). The addition of 50
nM wortmannin together with 8
mM glucose plus 1 µM
carbachol further amplified secretion (Fig. 5
, right panel).
For the final 45 min of the perifusion, the differences were
significant (P < 0.05) for each time point.
Effects of wortmannin on glucose usage and IP accumulation
There is little question that glucose metabolism is a primary
component of its insulin stimulatory action. To determine whether
the potentiating effect of wortmannin on glucose-induced release
is mediated by any impact on metabolism, glucose usage rates were
measured in the presence or absence of 50 nM wortmannin. At
8 mM, islets use glucose at rates of 108 ± 7
pmol/islet·h (n = 4). The additional presence of 50
nM wortmannin during the 1-h incubation was without
any significant effect; usage rates now averaged 114 ± 6
pmol/islet·h (n = 5).
An increase in the glucose level bathing them is accompanied by
significant dose-dependent increases in IP accumulation in
[3H]inositol-prelabeled rat islets (22, 23, 24). We
next determined whether the response to wortmannin could be accounted
for by enhanced glucose-induced activation of phospholipase C, using IP
accumulation as the biochemical marker of this event. IP accumulation
in response to 8 mM glucose stimulation was comparable
regardless of whether 50 nM wortmannin was included in the
incubation medium (Table 1
).
Specificity of wortmannins stimulatory effect on insulin
secretion
In addition to glucose, a variety of structurally distinct
compounds also possess the capacity to augment release independent of
an elevation in the glucose concentration. Studies were then conducted
with two such compounds to determine the specificity of wortmannin on
islet responses. As shown in Fig. 6
, a
level of wortmannin that amplifies 8 mM glucose-induced
release approximately 3-fold had no effect on release stimulated by 10
mM
-ketoisocaproate (left panel), an amino
acid derivative metabolized within the mitochondrion, or 500
nM PMA (right panel), a protein kinase
C (PKC) activator (25, 26).

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Figure 6. Wortmannin fails to potentiate secretion in
response to -ketoisocaproate (KIC) or PMA. Left
panel, Two groups of islets were perifused for 30 min in the
absence of any added fuel and for an additional 60 min (indicated by
vertical line) with 10 mM KIC alone (n
= 6) or 10 mM KIC plus 50 nM wortmannin (n
= 5). Right panel, Two groups of islets were perifused
for 30 min with 3 mM glucose. For the next 60 min both
groups were stimulated by the further addition of 500 nM
PMA alone (n = 8) or with 500 nM PMA plus 50
nM wortmannin (n = 5).
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Effects of LY294002, a PI3K inhibitor structurally distinct from
wortmannin, on 8 mM glucose-induced release
If wortmannins potentiating effect on glucose-induced release is
a result of PI3K inhibition, then it might be predicted that LY294002,
another commonly used PI3K inhibitor, should mimic the effect of the
fungal metabolite. At a level of 10 µM, LY294002 addition
to islets perifused with 8 mM glucose resulted in a
potentiated insulin secretory response (Fig. 7
).

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Figure 7. LY294002 potentiates 8 mM
glucose-induced insulin secretion. Groups of 1418 rat
islets were isolated and perifused. For the initial 30 min all islets
were maintained with 3 mM glucose (G3) to establish basal
and stable insulin secretory rates. Islets were then perifused
(indicated by the vertical line) for 60 min with 8
mM glucose (G8) alone (open
circles; n = 14; these are the same data as in Fig. 1 ) or 8 mM glucose plus 10 µM LY294002
(closed circles; n = 3). The
asterisks indicate a significant (P
< 0.05) difference between release values at this time.
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Effect of wortmannin on 8 mMglucose-induced release from islets of
insulin-resistant Zucker fatty rats or their lean counterparts
In vivo insulin resistance in a variety of animal
models is thought to be a result at least in part of a reduction in
insulin signaling via PI3K-dependent processes (4, 27, 28). It has been
demonstrated previously that significant reductions in the expression
of the regulatory subunits of PI3K occur in livers of Zucker fatty
rats, a commonly used model of insulin resistance and hyperinsulinemia
(29). We next examined the effects of wortmannin on islets isolated
from Zucker fatty rats.
As shown in Fig. 8
(top) and
consistent with the actions of wortmannin on islets isolated from
Sprague Dawley rats, the fungal metabolite significantly enhanced 8
mM glucose-induced release from lean control
Zucker rats. For the final 30 min of the perifusion, insulin release
rates were significantly greater in the simultaneous presence of 50
nM wortmannin. For example, 40, 50, or 60 min
after the onset of stimulation with 8 mM glucose
plus 50 nM wortmannin, insulin release rates
averaged 322 ± 65, 409 ± 39, or 463 ± 37
pg/islet·min, respectively. The release rates to 8 mM
glucose alone from lean Zucker rats averaged 163 ± 14, 216
± 16, or 252 ± 22 pg/islet·min at these times.

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Figure 8. Effect of wortmannin on 8 mM
glucose-induced insulin release from islets of lean Zucker rats or
Zucker fatty rats. Top panel, Two groups of 1418
islets were isolated from lean Zucker rats and perifused for 30 min
with 3 mM glucose. One group (open
circles; n = 9) was then stimulated with 8
mM glucose alone for 60 min. The second group
(closed circles; n = 9) was stimulated with 8
mM glucose plus 50 nM wortmannin. The
asterisks indicate a significant (P
< 0.05) difference between release values at this time. Bottom
panel, Two groups of 1418 islets were isolated from Zucker
fatty rats and perifused for 30 min with 3 mM glucose. One
group (open circles; n = 6) was then stimulated
with 8 mM glucose alone for 60 min. The second group
(closed circles; n = 5) was stimulated with 8
mM glucose plus 50 nM wortmannin. The
asterisks indicate a significant (P
< 0.05) difference between release values at this time.
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We then proceeded to explore the impact of 50 nM wortmannin
on 8 mM glucose-induced release from Zucker fatty rats.
Compared with islets isolated from lean Zucker rats and in accord with
the established hyperresponsiveness of Zucker fatty rat islets to
glucose stimulation (30), the responses to 8 mM glucose
alone were significantly greater in fatty Zucker rats islets than in
lean Zucker rat islets (compare open circles, Fig. 8
, top and bottom panels). The effects of wortmannin
on Zucker fatty rat islets were minimal. During the final 30 min of the
perifusion, time points when its impact on 8 mM
glucose-induced release from lean islets is maximal, there was no
significant enhancing effect of the fungal metabolite on rates of
insulin release from islets of Zucker fatty rats (Fig. 8
, bottom panel). At only one time point during the
entire 60-min stimulatory period was significance achieved. Finally, to
allay the criticism that islets isolated from Zucker fatty rats are
secreting insulin at their maximum capacity and are unresponsive to
wortmannin for this reason, these islets were stimulated for 20 min
with 5 µM forskolin in the presence of 8
mM glucose. Release rates increased significantly
in response to the addition of forskolin. For example, compared with
the release rate of 416 ± 89 pg/islet·min during the final 5
min of stimulation with 8 mM glucose plus 50
nM wortmannin, the addition of 5
µM forskolin to 8 mM
glucose increased the secretory rate from these islets to 766 ±
100 pg/islet·min after 10 min of stimulation.
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Discussion
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In the present series of experiments we used the fungal metabolite
wortmannin to inhibit PI3K, an enzyme normally activated by insulin in
several insulin-dependent tissues including muscle, liver, and fat
cells and whose impaired activation has been implicated in the
pathogenesis of type 2 diabetes (4, 31). The inactivation of PI3K by
wortmannin was not directly monitored. However, the levels used in our
islet studies are well within the range of concentrations employed by
many investigators to inhibit this enzyme in insulin-sensitive target
tissues (11, 32, 33, 34). Moreover, direct inhibition of PI3K in isolated
islets and MIN cells by wortmannin levels identical to those used in
our studies has been reported (8, 35). Furthermore, the salient
observation reported here for wortmannin and 8 mM
glucose-induced secretion was duplicated using a
structurally distinct PI3K inhibitor, LY294002. It seems reasonable to
conclude that a reduction in PI3K-dependent processes accounts at least
in part for these results.
Using perifused rat islets, islets whose secretory responsiveness is
comparable to that found in the perfused pancreas preparation (36, 37),
we observed that 50 nM wortmannin inclusion together with 8
mM glucose markedly and persistently amplified insulin
secretion during a dynamic perifusion. The potentiating effect was most
pronounced during the final 30 min of the perifusion. Dose-response
studies revealed that in the presence of 8 mM glucose, the
threshold for this action was around 5 nM, with a maximal
effect observed at about 100 nM. Secretion fell somewhat at
the highest level (1 µM) employed. A level (50
nM) of wortmannin that increased 8 mM
glucose-induced release about 3-fold had no additional effect when
islets were stimulated by a maximally effective 20 mM
glucose stimulus. Wortmannin had no effect on release in the presence
of 3 mM glucose, a finding suggesting that it
amplifies or prolongs in some manner a glucose-derived
stimulatory signal normally attenuated by insulin signaling.
Several other characteristics of wortmannins effects on islet cell
responses were also established. First, release in response to the
combination of 8 mM glucose plus 50 nM
wortmannin was largely abolished by reducing calcium influx into the
ß-cell with nitrendipine. This finding would seem to preclude
nonspecific damage to the ß-cell and the subsequent leakage of
insulin into the perifusion medium as a cause of its dramatic
potentiating action. Second, consistent with its largely irreversible
effect on PI3K documented in other tissues (17), insulin release
persisted at high rates despite the removal of wortmannin from 8
mM glucose-containing perifusion medium. In contrast,
lowering the glucose level to 3 mM even in the continued
presence of wortmannin abruptly curtailed secretion. Finally,
pretreatment with 50 nM wortmannin during the 30-min
prestimulatory phase of the perifusion with 3 mM glucose
markedly accelerated its potentiating effect on 8 mM
glucose-induced secretion.
As postprandial insulin release is regulated by both modest increments
in the prevailing glucose level and increases in cholinergic
stimulation (18), we examined how wortmannin influenced secretion
induced by glucose plus carbachol combinations. Even in the presence of
6 mM (108 mg/100 ml) glucose and a level of
cholinergic agonist similar to that used to study the effects of
cholinergic stimulation in islets and other tissues (20, 38), the
inclusion of 50 nM wortmannin enhanced insulin secretion.
When islets were stimulated with 8 mM glucose, 1
µM carbachol, and 50 nM wortmannin, an
increase in peak insulin release rates approaching that produced in
response to 20 mM glucose alone were noted.
We are aware of several other studies in which the effects of
wortmannin on glucose-induced insulin release from rat islets or mouse
insulinoma cells (MIN 6) were studied. In the report by Gao and
co-workers (8), levels of wortmannin overlapping those employed in the
present experiments had no stimulatory effect on release despite the
demonstrated inhibition of PI3K activity. Several major points of
departure between this study and ours deserve emphasis. First, in this
report (8) the effects of wortmannin were tested in islets stimulated
with 3 mM glucose alone or with the combination of 28
mM glucose plus 500 µM carbachol. As pointed
out above and in agreement with this report (8), we also found no
effect of wortmannin in the presence of 3 mM glucose. In
our studies no amplifying effect of 50 nM wortmannin was
observed if the glucose level was increased to 20 mM. We
have repeated studies using islets stimulated with 28 mM
glucose plus 500 µM carbachol and have confirmed, in
agreement with this report (8), that wortmannin has no positive impact
on release under this extreme stimulatory condition (unpublished
observations). Our findings suggest that under the conditions employed
in these studies wortmannin increases the sensitivity of islets to
modest glucose or glucose plus carbachol stimulation, but it is not
capable of enhancing release evoked by a maximally effective glucose
stimulus.
One additional difference between this (8) and our study merits further
consideration. We monitored secretion using a dynamic perifusion
system. Excessive amounts of insulin (39) are not allowed to accumulate
in the vicinity of the islet, but are washed away and replenished by
fresh medium. In the studies by Gao et al. (8),
batch-incubated conditions were employed. This type of methodology
allows large amounts of insulin to accumulate in the medium and may
influence ongoing ß-cell responses. Moreover, the failure of
batch-incubated islets to release insulin at rates comparable to those
observed from perifused islets (40) might be a consequence of a
negative feedback effect of insulin on its own release, as this and
other studies suggest (41, 42).
In a series of experiments using the mouse cell line MIN6, Hagiwara and
co-workers (35) found that levels of wortmannin identical to those
employed in our studies potentiated glucose-induced release and
directly inhibited PI3K activity. Our findings fully support these
observations made with this cell line and extend them.
We could not ascribe the potentiating effect of wortmannin on 8
mM glucose-induced insulin secretion to any enhancing
effect of the fungal metabolite on glucose usage rates by the islet.
Wortmannin was also without any effect on the activation of
phospholipase C, monitored by IP accumulation in islets. Furthermore,
of the independent stimulants employed to augment release, the effects
of wortmannin were confined to glucose. When used at concentrations
that are approximately equipotent to 8 mM glucose,
wortmannin had no potentiating effect on either
-ketoisocaproate- or
phorbol ester-induced insulin release in terms of their ability to
stimulate secretion. The inability of wortmannin to augment release in
response to
-ketoisocaproate or to the PKC activator PMA suggests
that biochemical events proximal to the entry of hexose metabolites
into the mitochondria and proximal to the activation of PKC are
responsible for potentiation. Taken in their entirety, these findings
indicate a high degree of specificity for wortmannin and localize its
action to early steps in glucose recognition by the ß-cell.
The most critical assessment of the potential significance of these
findings to the regulation of glucose homeostasis in vivo
comes from our studies using a well characterized model of obesity,
insulin resistance, and hyperinsulinemia: the Zucker fatty rat. Like
Sprague Dawley rats, lean Zucker rats were sensitive to the
potentiating effect of wortmannin on 8 mM
glucose-induced insulin release. We confirmed (30) that compared with
islets isolated from lean Zucker rats, islets isolated from fatty
Zucker rats are significantly more responsive to 8
mM glucose stimulation. Most importantly and a
result that would have been predicted based on the assumption that
reduced PI3K activity documented in peripheral tissues also occurs in
the ß-cell, wortmannin had no appreciable effect on sustained rates
of insulin release from islets of Zucker fatty rats. However, these
islets were still quite responsive to forskolin, a compound that
activates adenylate cyclase, increases cAMP, and potentiates secretion.
The simplest interpretation of these findings is that the reduction in
PI3K activation that has been established to exist in the peripheral
tissues of these animals (29) also exists in their islets, plays a role
in their in vivo hyperinsulinemia, persists after their
isolation, and also makes them immune in vitro to any
further potentiating effect of wortmannin.
Complex effects in mice with targeted disruption or with heterozygous
null mutations of the insulin receptor, insulin receptor substrate
(IRS-1), and/or IRS-2 have been reported (43, 44, 45, 46). Insulin resistance,
hyperinsulinemia, and ß-cell hyperplasia are characteristic of these
genetic alterations. Islet responses to glucose and arginine have been
studied in mice with tissue-specific knockout of the insulin receptor
(47) or from IRS-1 knockout mice (48). ß-Cell insensitivity to
glucose stimulation occurs in cultured islets isolated from these
animals (48). In our studies with freshly isolated rat islets,
disruption of insulin signaling via PI3K amplifies glucose-induced
secretion, differences that may be due to the acute nature of our
studies or to underlying species differences in glucose sensitivity
(49, 50, 51). Studies using cultured rat islets, insulinoma cells, or
clonal mouse ß-cells have also demonstrated that insulin stimulates
insulin gene transcription via a PI3K-dependent pathway (52, 53).
Insulin stimulates PDX-1 DNA binding, and insulin promoter activity,
also via a PI3K-dependent pathway (54). Although earlier reports
demonstrated that insulin suppresses its own secretion (42, 55, 56), it
has been reported that insulin stimulates its own secretion (57). These
and other studies (58) suggest that, similar to glucoses effects, the
observed actions of insulin on the ß-cell may be time dependent, cell
line dependent, and complex.
These results provide evidence that insulin exerts a negative autocrine
feedback effect on its own secretion and uses the same PI3K-dependent
pathways that have been characterized in insulin-dependent target
tissues such as liver, muscle, and adipose cells. The inhibition of
PI3K by wortmannin abolishes this negative feedback effect,
dramatically enhances the sensitivity of the ß-cell to glucose
concentrations in the postprandial range, and culminates in a markedly
amplified insulin secretory response. The results also suggest that as
insulin resistance and potential deterioration of fuel homeostasis
develop in peripheral tissues as a consequence of reduced PI3K
activation, the same biochemical process regulates a compensatory
increase in insulin secretion from the ß-cell. As the same signaling
pathway is altered in both ß-cells and peripheral tissues, the
release of insulin is titrated to the developing peripheral tissue
insulin resistance, and euglycemia is maintained. However, the
euglycemia is maintained at the expense of hyperinsulinemia. Our
findings using islets isolated from Zucker fatty rats demonstrate that
the in vivo status of the donors insulin signaling
pathways may be a key determinant of wortmannins effect on the
ß-cell; in this animal model of insulin resistance and
hyperinsulinemia in which PI3K activity is already reduced, wortmannin
has no further effect on ß-cell responses to glucose stimulation.
Finally, these findings may shed some light on the still unsettled
issue of which comes first, insulin resistance or hyperinsulinemia (1, 59, 60, 61, 62, 63, 64), in the pathogenesis of obesity or obesity culminating in type
2 diabetes. Insulin resistance at the level of the ß-cell may account
for the coupled and parallel emergence of hyperinsulinemia seen under a
variety of conditions (1, 2).
 |
Footnotes
|
|---|
1 This work was supported by NIH Grant 41230 and a grant from the
American Diabetes Association. 
Received February 22, 2000.
 |
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