Transthyretin (TTR) is a transport protein for thyroxine and, in association with retinol-binding protein, for retinol, mainly existing as a tetramer in vivo. We now demonstrate that TTR tetramer has a positive role in pancreatic -cell stimulus-secretion coupling. TTR promoted glucose-induced increases in cytoplasmic free Ca 2؉ concentration ([Ca 2؉ ]i) and insulin release. This resulted from a direct effect on glucose-induced electrical activity and voltagegated Ca 2؉ channels. TTR also protected against -cell apoptosis. The concentration of TTR tetramer was decreased, whereas that of a monomeric form was increased in sera from patients with type 1 diabetes. The monomer was without effect on glucose-induced insulin release and apoptosis. Thus, TTR tetramer constitutes a component in normal -cell function. Conversion of TTR tetramer to monomer may be involved in the development of -cell failure͞ destruction in type 1 diabetes.type 1 diabetes ͉ Ca 2ϩ channels ͉ insulin release ͉ -cell signal transduction ͉ apoptosis T ransthyretin (TTR) is a protein that is synthesized in the liver, the choroid plexus of the brain, and the endocrine pancreas (1, 2). It is a transport protein for thyroxine and, in association with retinol-binding protein, for retinol. It has been reported that 1-2% of plasma TTR circulates bound to highdensity lipoprotein (HDL) and that the association to the HDL vesicle occurs through binding to apolipoprotein A1 (3). TTR has a complex equilibrium between different quaternary structures in serum (4),but exists mainly as a tetrameric protein of 14-kDa subunits (160-380 mg͞liter) with only a small amount of TTR monomer present in vivo in normal individuals (5, 6). Consequently, measurements of TTR in serum by conventional methods mainly reflect the tetrameric form. The TTR amyloidoses are human diseases in which misfolded TTR protein aggregates in different tissues. Several point mutations in TTR have been related to familial amyloidotic polyneuropathy (FAP) (7). The fact that TTR is also produced within the pancreatic islet made us interested in evaluating a possible role of this protein in -cell stimulus-secretion coupling.
MethodsIdentification of TTR in Human Sera. Sera from type 1 diabetes (T1D) patients and control subjects were collected, identically sterile-processed, heat-inactivated by incubation at 56°C for 30 min, and stored frozen at Ϫ20°C until used. Changes in cytoplasmic free Ca 2ϩ concentration ([Ca 2ϩ ] i ) were tested in -cells when they were depolarized with 25 mM KCl. Those diabetic sera that induced a higher increase in [Ca 2ϩ ] i than sera from controls were centrifuged, and the supernatant was passed through a 0.45-mm sterile filter. Samples were loaded on SepPak C 18 preconditioned with 0.1% trifluoroacetic acid. After application, the sample proteins were eluted with 60% acetonitrile in 0.1% trifluoroacetic acid. This procedure was repeated twice. The two fractions were pooled, and the volume was reduced by lyophilization.The lyophilized material was submitted to...