Several common genetic variations have been associated with type 2 diabetes, but the exact disease mechanisms are still poorly elucidated. Using congenic strains from the diabetic Goto-Kakizaki rat, we identified a 1.4-megabase genomic locus that was linked to impaired insulin granule docking at the plasma membrane and reduced beta cell exocytosis. In this locus, Adra2a, encoding the alpha2A-adrenergic receptor [alpha(2A)AR], was significantly overexpressed. Alpha(2A)AR mediates adrenergic suppression of insulin secretion. Pharmacological receptor antagonism, silencing of receptor expression, or blockade of downstream effectors rescued insulin secretion in congenic islets. Furthermore, we identified a single-nucleotide polymorphism in the human ADRA2A gene for which risk allele carriers exhibited overexpression of alpha(2A)AR, reduced insulin secretion, and increased type 2 diabetes risk. Human pancreatic islets from risk allele carriers exhibited reduced granule docking and secreted less insulin in response to glucose; both effects were counteracted by pharmacological alpha(2A)AR antagonists.

Concerted activation of different voltage-gated Ca 2+ channel isoforms may determine the kinetics of insulin release from pancreatic islets. Here we have elucidated the role of R-type Ca V 2.3 channels in that process. A 20% reduction in glucose-evoked insulin secretion was observed in Ca V 2.3-knockout (Ca V 2.3 -/-) islets, close to the 17% inhibition by the R-type blocker SNX482 but much less than the 77% inhibition produced by the L-type Ca 2+ channel antagonist isradipine. Dynamic insulin-release measurements revealed that genetic or pharmacological Ca V 2.3 ablation strongly suppressed second-phase secretion, whereas first-phase secretion was unaffected, a result also observed in vivo. Suppression of the second phase coincided with an 18% reduction in oscillatory Ca 2+ signaling and a 25% reduction in granule recruitment after completion of the initial exocytotic burst in single Ca V 2.3 -/-β cells. Ca V 2.3 ablation also impaired glucose-mediated suppression of glucagon secretion in isolated islets (27% versus 58% in WT), an effect associated with coexpression of insulin and glucagon in a fraction of the islet cells in the Ca V 2.3 -/-mouse. We propose a specific role for Ca V 2.3 Ca 2+ channels in second-phase insulin release, that of mediating the Ca 2+ entry needed for replenishment of the releasable pool of granules as well as islet cell differentiation. IntroductionSystemic glucose tolerance is orchestrated by the regulated release of insulin and glucagon from the β and α cells of the pancreatic islets of Langerhans. The α and β cells are electrically excitable and use electrical signals to couple changes in blood glucose concentration to stimulation or inhibition of hormone release. In both cell types, influx of extracellular Ca 2+ through voltage-gated Ca 2+ channels with resultant elevation of intracellular Ca 2+ concentration ([Ca 2+ ] i ) triggers exocytosis of the hormone-containing secretory granules. Like other electrically excitable cells, both α and β cells contain several types of voltage-gated Ca 2+ channel (1, 2). Assigning physiological functions to the respective Ca 2+ channels is central to the understanding of electrical and secretory activities in these cells.Voltage-gated Ca 2+ channels are divided into 3 subfamilies: (a) L-type high voltage-activated (HVA) Ca 2+ channel family that comprises the Ca V 1.1, 1.2, 1.3, and 1.4 channels and is inhibited by dihydropyridines (DHPs) (1, 3, 4); (b) non-L-type HVA channels Ca V 2.1 (P/Q-type), 2.2 (N-type), and 2.3 (R-type) that are sensitive to ω-agatoxin IVA and ω-conotoxin GVIA and SNX482, respectively (1, 4, 5); and (c) the low voltage-activated (LVA) T-type Ca 2+ channel family (Ca V 3.1, 3.2, and 3.3). The latter subtype differs electrophysiologically from the HVA Ca 2+ channels in opening transiently already upon modest depolarization (6, 7) and fulfilling important roles in pacemaker cells (8).

Concerted activation of different voltage-gated Ca 2+ channel isoforms may determine the kinetics of insulin release from pancreatic islets. Here we have elucidated the role of R-type Ca V 2.3 channels in that process. A 20% reduction in glucose-evoked insulin secretion was observed in Ca V 2.3-knockout (Ca V 2.3 -/-) islets, close to the 17% inhibition by the R-type blocker SNX482 but much less than the 77% inhibition produced by the L-type Ca 2+ channel antagonist isradipine. Dynamic insulin-release measurements revealed that genetic or pharmacological Ca V 2.3 ablation strongly suppressed second-phase secretion, whereas first-phase secretion was unaffected, a result also observed in vivo. Suppression of the second phase coincided with an 18% reduction in oscillatory Ca 2+ signaling and a 25% reduction in granule recruitment after completion of the initial exocytotic burst in single Ca V 2.3 -/-β cells. Ca V 2.3 ablation also impaired glucose-mediated suppression of glucagon secretion in isolated islets (27% versus 58% in WT), an effect associated with coexpression of insulin and glucagon in a fraction of the islet cells in the Ca V 2.3 -/-mouse. We propose a specific role for Ca V 2.3 Ca 2+ channels in second-phase insulin release, that of mediating the Ca 2+ entry needed for replenishment of the releasable pool of granules as well as islet cell differentiation. IntroductionSystemic glucose tolerance is orchestrated by the regulated release of insulin and glucagon from the β and α cells of the pancreatic islets of Langerhans. The α and β cells are electrically excitable and use electrical signals to couple changes in blood glucose concentration to stimulation or inhibition of hormone release. In both cell types, influx of extracellular Ca 2+ through voltage-gated Ca 2+ channels with resultant elevation of intracellular Ca 2+ concentration ([Ca 2+ ] i ) triggers exocytosis of the hormone-containing secretory granules. Like other electrically excitable cells, both α and β cells contain several types of voltage-gated Ca 2+ channel (1, 2). Assigning physiological functions to the respective Ca 2+ channels is central to the understanding of electrical and secretory activities in these cells.Voltage-gated Ca 2+ channels are divided into 3 subfamilies: (a) L-type high voltage-activated (HVA) Ca 2+ channel family that comprises the Ca V 1.1, 1.2, 1.3, and 1.4 channels and is inhibited by dihydropyridines (DHPs) (1, 3, 4); (b) non-L-type HVA channels Ca V 2.1 (P/Q-type), 2.2 (N-type), and 2.3 (R-type) that are sensitive to ω-agatoxin IVA and ω-conotoxin GVIA and SNX482, respectively (1, 4, 5); and (c) the low voltage-activated (LVA) T-type Ca 2+ channel family (Ca V 3.1, 3.2, and 3.3). The latter subtype differs electrophysiologically from the HVA Ca 2+ channels in opening transiently already upon modest depolarization (6, 7) and fulfilling important roles in pacemaker cells (8).

Nicotinamide adenine dinucleotide phosphate (NADPH) enhances Ca(2+)-induced exocytosis in pancreatic beta-cells, an effect suggested to involve the cytosolic redox protein glutaredoxin-1 (GRX-1). We here detail the role of GRX-1 in NADPH-stimulated beta-cell exocytosis and glucose-stimulated insulin secretion. Silencing of GRX-1 by RNA interference reduced glucose-stimulated insulin secretion in both clonal INS-1 832/13 cells and primary rat islets. GRX-1 silencing did not affect cell viability or the intracellular redox environment, suggesting that GRX-1 regulates the exocytotic machinery by a local action. By contrast, knockdown of the related protein thioredoxin-1 (TRX-1) was ineffective. Confocal immunocytochemistry revealed that GRX-1 locates to the cell periphery, whereas TRX-1 expression is uniform. These data suggest that the distinct subcellular localizations of TRX-1 and GRX-1 result in differences in substrate specificities and actions on insulin secretion. Single-cell exocytosis was likewise suppressed by GRX-1 knockdown in both rat beta-cells and clonal 832/13 cells, whereas after overexpression exocytosis increased by approximately 40%. Intracellular addition of NADPH (0.1 mm) stimulated Ca(2+)-evoked exocytosis in both cell types. Interestingly, the stimulatory action of NADPH on the exocytotic machinery coincided with an approximately 30% inhibition in whole-cell Ca(2+) currents. After GRX-1 silencing, NADPH failed to amplify insulin release but still inhibited Ca(2+) currents in 832/13 cells. In conclusion, NADPH stimulates the exocytotic machinery in pancreatic beta-cells. This effect is mediated by the NADPH acceptor protein GRX-1 by a local redox reaction that accelerates beta-cell exocytosis and, in turn, insulin secretion.