Peptidic glucagon antagonists have been shown to lower blood glucose levels in diabetic models (1-3), but attempts to identify small molecular weight glucagon receptor-binding antagonists have met with little success. Skyrin, a fungal bisanthroquinone, exhibits functional glucagon antagonism by uncoupling the glucagon receptor from adenylate cyclase activation in rat liver membranes (1). We have examined the effects of skyrin on cells transfected with the human glucagon receptor and on isolated rat and human hepatocytes. The skyrin used was isolated from Talaromyces wortmanni American Type Culture Collection 10517. In rat hepatocytes, skyrin (30 µmol/l) inhibited glucagon-stimulated cAMP production (53%) and glucose output (IC 50 56 µmol/l). There was no detectable effect on epinephrine or glucagon-like peptide 1 (GLP-1) stimulation of these parameters, which demonstrates skyrin's selective activity. Skyrin was also evaluated in primary cultures of human hepatocytes. Unlike cell lines, which are largely unresponsive to glucagon, primary human hepatocytes exhibited glucagon-dependent cAMP production for 14 days in culture (EC 50 10 nmol/l). Skyrin (10 µmol/l) markedly reduced glucagon-stimulated cAMP production (55%) and glycogenolysis (27%) in human hepatocytes. The inhibition of glucagon stimulation was a specific property displayed by skyrin and oxyskyrin but not shared by other bisanthroquinones. Skyrin is the first small molecular weight nonpeptidic agent demonstrated to interfere with the coupling of glucagon to adenylate cyclase independent of binding to the glucagon receptor. The data presented in this study indicate that functional uncoupling of the human glucagon receptor from cAMP production results in metabolic effects that could reduce hepatocyte glucose production and hence alleviate diabetic hyperglycemia.
The normal increment of plasma ACTH in the IHT is greater than necessary for stimulating serum cortisol to levels > 500 nmol/l. Patients with a subnormal ACTH but normal cortisol response in the IHT have a decreased ACTH secretory reserve. It is unlikely that they are at increased risk of developing an adrenal crisis perioperatively or in other stressful situations unless pituitary function deteriorates. The ACTH-cortisol relationship in the IHT performed in patients with pituitary disease shows no sharp dividing line between normality and disease, and whether a patient needs permanent glucocorticoid substitution is a discretionary decision.
Bidirectional fluxes of Cl- across isolated and stripped goldfish intestinal epithelium mounted in Ussing-type chambers increased after addition of 8-bromoadenosine 3',5'-cyclic monophosphate (8-Br-cAMP), suggesting an increase of the paracellular permeability for Cl-. Confirming this, the addition of 8-Br-cAMP to the stripped intestine reduced the diffusion potential generated by isosmotic serosal or mucosal replacement of part of the NaCl by mannitol. The addition of the protein kinase C (PKC) activator 4 beta-phorbol 12,13-dibutyrate (PDB), 8-bromoguanosine 3',5'-cyclic monophosphate (8-Br-cGMP), or the Ca2+ ionophore A23187 was without effect on the Cl- permeability. The cAMP-specific reduction of the diffusion potential was used to screen the epithelium for the presence of receptors coupled to adenylyl cyclase. The results indicate the presence of a serotonin (5-HT) receptor, positively coupled to adenylyl cyclase but insensitive to 5-HT1-, 5-HT2-, 5-HT3-, and nonclassical 5-HT4-receptor antagonists. Addition of vasoactive intestinal polypeptide (VIP) also reduced the diffusion potential in a dose-dependent way. Epinephrine restored the diffusion potential after its reduction by 5-HT or VIP. This effect could be mimicked by the partial alpha 2-adrenergic receptor agonist clonidine and blocked by the alpha 2-antagonists yohimbine and idazoxan. The Rp diastereoisomer of cAMP, (Rp)adenosine 3',5'-cyclic phosphorothioate [(Rp)cAMPS], counteracted the effect of VIP. The results indicate that in goldfish enterocytes VIP and 5-HT reduce the ion selectivity of the tight junctions through elevation of cAMP and that activation of alpha 2-adrenergic receptors antagonize these effects.(ABSTRACT TRUNCATED AT 250 WORDS)
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