Insulin release from pancreatic β-cells is required to maintain normal glucose homoeostasis in man and many other animals. Defective insulin secretion underlies all forms of diabetes mellitus, a disease currently reaching epidemic proportions worldwide. Although the destruction of β-cells is responsible for Type 1 diabetes (T1D), both lowered β-cell mass and loss of secretory function are implicated in Type 2 diabetes (T2D). Emerging results suggest that a functional deficiency, involving de-differentiation of the mature β-cell towards a more progenitor-like state, may be an important driver for impaired secretion in T2D. Conversely, at least in rodents, reprogramming of islet non-β to β-cells appears to occur spontaneously in models of T1D, and may occur in man. In the present paper, we summarize the biochemical properties which define the 'identity' of the mature β-cell as a glucose sensor par excellence. In particular, we discuss the importance of suppressing a group of 11 'disallowed' housekeeping genes, including Ldha and the monocarboxylate transporter Mct1 (Slc16a1), for normal nutrient sensing. We then survey the changes in the expression and/or activity of β-cell-enriched transcription factors, including FOXO1, PDX1, NKX6.1, MAFA and RFX6, as well as non-coding RNAs, which may contribute to β-cell de-differentiation and functional impairment in T2D. The relevance of these observations for the development of new approaches to treat T1D and T2D is considered.

No abstract

Glucose induces insulin release from pancreatic β-cells by stimulating ATP synthesis, membrane depolarisation and Ca2+ influx. As well as activating ATP-consuming processes, cytosolic Ca2+ increases may also potentiate mitochondrial ATP synthesis. Until recently, the ability to study the role of mitochondrial Ca2+ transport in glucose-stimulated insulin secretion has been hindered by the absence of suitable approaches either to suppress Ca2+ uptake into these organelles, or to examine the impact on β-cell excitability. Here, we have combined patch-clamp electrophysiology with simultaneous real-time imaging of compartmentalised changes in Ca2+ and ATP/ADP ratio in single primary mouse β-cells, using recombinant targeted (Pericam or Perceval, respectively) as well as entrapped intracellular (Fura-Red), probes. Through shRNA-mediated silencing we show that the recently-identified mitochondrial Ca2+ uniporter, MCU, is required for depolarisation-induced mitochondrial Ca2+ increases, and for a sustained increase in cytosolic ATP/ADP ratio. By contrast, silencing of the mitochondrial Na+-Ca2+ exchanger NCLX affected the kinetics of glucose-induced changes in, but not steady state values of, cytosolic ATP/ADP. Exposure to gluco-lipotoxic conditions delayed both mitochondrial Ca2+ uptake and cytosolic ATP/ADP ratio increases without affecting the expression of either gene. Mitochondrial Ca2+ accumulation, mediated by MCU and modulated by NCLX, is thus required for normal glucose sensing by pancreatic β-cells, and becomes defective in conditions mimicking the diabetic milieu.

In pancreatic ␤ cells, elevated glucose concentrations stimulate mitochondrial oxidative metabolism to raise intracellular ATP/ADP levels, prompting insulin secretion. Unusually low levels of expression of genes encoding the plasma membrane monocarboxylate transporter, MCT1 (SLC16A1), as well as lactate dehydrogenase A (LDHA) ensure that glucose-derived pyruvate is efficiently metabolized by mitochondria, while exogenous lactate or pyruvate is unable to stimulate metabolism and hence insulin secretion inappropriately. We show here that whereas DNA methylation at the Mct1 promoter is unlikely to be involved in cell-type-specific transcriptional repression, three microRNAs (miRNAs), miR-29a, miR-29b, and miR-124, selectively target both human and mouse MCT1 3 untranslated regions. Mutation of the cognate miR-29 or miR-124 binding sites abolishes the effects of the corresponding miRNAs, demonstrating a direct action of these miRNAs on the MCT1 message. However, despite reports of its expression in the mouse ␤-cell line MIN6, miR-124 was not detectably expressed in mature mouse islets. In contrast, the three isoforms of miR-29 are highly expressed and enriched in mouse islets. We show that inhibition of miR-29a in primary mouse islets increases Mct1 mRNA levels, demonstrating that miR-29 isoforms contribute to the ␤-cell-specific silencing of the MCT1 transporter and may thus affect insulin release.Glucose metabolism in pancreatic ␤ cells is specialized to efficiently couple glucose oxidation to an increase in ATP/ADP ratio, critical for stimulating insulin secretion (37). Alternative metabolic pathways that could interfere with glucose sensing are suppressed by specifically "disallowing" expression of certain genes in ␤ cells. These disallowed genes include those encoding lactate dehydrogenase A (LDHA), which converts pyruvate to lactate (25,39,40), and MCT1 (SLC16A1) (14,15,17,40,45,46), a plasma membrane monocarboxylate transporter. Both of these genes are widely expressed in other tissues but display very low expression levels in ␤ cells (32,40). This modification seems likely to serve a 2-fold role: first, to avoid inappropriate stimulation of oxidative metabolism, and hence insulin release, in response to circulating pyruvate or lactate; and second, to prevent the loss of glucose-derived pyruvate from ␤ cells.The effects of inappropriate overexpression of MCT1 are observed in the rare genetic disorder physical exercise-induced hypoglycemia (32). In this condition, autosomal dominant mutations in the MCT1 (SLC16A1) promoter lead to increased transcription of the MCT1 gene sufficient to overcome the ␤-cell-specific block on expression (31). During strenuous physical exercise, pyruvate and lactate produced by anaerobic metabolism in skeletal muscle are released into the bloodstream. The presence of MCT1 then appears to allow the circulating pyruvate/lactate to enter ␤ cells, where it acts as a substrate for mitochondrial oxidation leading to an increased cytosolic ATP/ADP ratio. This triggers insulin release desp...

(2010) Identification of genes selectively disallowed in the pancreatic islet, Islets, 2:2, 89-95,