Exendin-4 reduces glycemia by increasing liver glucokinase activity: an insulin independent effect

Pharmacol Rep. 2012;64(1):140-9. doi: 10.1016/s1734-1140(12)70740-5.

Abstract

Exendin-4 is a stable peptide agonist of GLP-1 receptor that exhibits insulinotropic actions. Some in vivo studies indicated insulin-independent glucoregulatory actions of exendin-4. That finding prompted us to evaluate effects of exendin-4 on liver glucose metabolism. Acute and chronic treatment of exendin-4 resulted in increased hepatic glucokinase activity in db/db mice but not in lean C57 mice. The stimulatory effect of exendin-4 on glucokinase activity was abrogated by exendin 9-39, a GLP-1 antagonist. Exposure of hepatocytes isolated from db/db mice to exendin-4 elicited a rapid increase in cAMP, which was synergized by IBMX, an inhibitor of cAMP degradation. The GLP-1 antagonist, exendin 9-39, has abolished the cAMP generating effects of exendin-4 as well. Furthermore, chronic treatment of exendin-4 in streptozotocin-treated C57 mice resulted in restoration of hepatic glycogen, an indicator of improved glucose metabolism, without apparent changes in serum insulin levels. In conclusion, exendin-4 increased glucokinase enzyme protein and activity in liver via a mechanism parallel to and independent of insulin. Exendin-4-induced increase in hepatic glucokinase activity is more pronounced in the presence of hepatic insulin resistance. This beneficial effect of exendin-4 on liver glucokinase activity may be mediated by GLP-1 receptor.

MeSH terms

  • Animals
  • Cyclic AMP / metabolism
  • Diabetes Mellitus, Experimental / blood
  • Diabetes Mellitus, Experimental / drug therapy
  • Diabetes Mellitus, Experimental / enzymology
  • Diabetes Mellitus, Experimental / metabolism
  • Exenatide
  • Glucagon-Like Peptide 1 / antagonists & inhibitors
  • Glucagon-Like Peptide-1 Receptor
  • Glucokinase / metabolism*
  • Glucose / metabolism
  • Glycogen / metabolism
  • Hepatocytes / drug effects
  • Hepatocytes / metabolism
  • Hyperglycemia / blood
  • Hyperglycemia / drug therapy*
  • Hyperglycemia / enzymology
  • Hyperglycemia / metabolism
  • Insulin / blood*
  • Insulin Resistance / physiology
  • Liver / drug effects*
  • Liver / enzymology*
  • Liver / metabolism
  • Male
  • Mice
  • Mice, Inbred C57BL
  • Mice, Obese
  • Peptides / pharmacology*
  • Receptors, Glucagon / antagonists & inhibitors
  • Venoms / pharmacology*

Substances

  • Glp1r protein, mouse
  • Glucagon-Like Peptide-1 Receptor
  • Insulin
  • Peptides
  • Receptors, Glucagon
  • Venoms
  • Glucagon-Like Peptide 1
  • Glycogen
  • Exenatide
  • Cyclic AMP
  • Glucokinase
  • Glucose