Extracellular ATP has been proposed as a paracrine signal in rodent islets, but it is unclear what role ATP plays in human islets. We now show the presence of an ATP signaling pathway that enhances the human β cell's sensitivity and responsiveness to glucose fluctuations. By using in situ hybridization, RT-PCR, immunohistochemistry, and Western blotting as well as recordings of cytoplasmic-free Ca 2+ concentration, [Ca 2+ ] i , and hormone release in vitro, we show that human β cells express ionotropic ATP receptors of the P2X 3 type and that activation of these receptors by ATP coreleased with insulin amplifies glucose-induced insulin secretion. Released ATP activates P2X 3 receptors in the β-cell plasma membrane, resulting in increased [Ca 2+ ] i and enhanced insulin secretion. Therefore, in human islets, released ATP forms a positive autocrine feedback loop that sensitizes the β cell's secretory machinery. This may explain how the human pancreatic β cell can respond so effectively to relatively modest changes in glucose concentration under physiological conditions in vivo.extracellular ATP | human pancreatic β cell | insulin secretion | P2X receptor | positive autocrine feedback G lucose homeostasis is tightly controlled by hormone secretion from the endocrine pancreas, the islets of Langerhans. Even small physiological deviations (e.g., 10%) in plasma glucose are effectively counteracted by sharp (e.g., 3-fold) increases in the secretion of the islet hormones insulin and glucagon (1). Intraislet autocrine and paracrine signaling are pivotal mechanisms for proper function of the islet, making islet cells extremely sensitive and responsive to plasma glucose fluctuations. The roles of different compounds such as GABA, glutamate, Zn 2+ , insulin, and ATP as autocrine and paracrine regulators of islet hormone release have been examined extensively (2-8). Extracellular ATP seems important because it is present in insulin-containing secretory granules and is released during glucose stimulation in sufficient amounts to stimulate ATP receptors (9-12).Extracellular ATP is an important neurotransmitter signal in the brain as well as in vascular, immune, and endocrine cells (13-15). The purinergic system comprises receptors for extracellular ATP and adenosine, the P2 and P1 receptors, respectively. P2 purinergic receptors can be divided into metabotropic P2Y receptors (G protein coupled) and ionotropic P2X receptors (ligand-gated ion channels) (16). The ionotropic P2X family comprises seven subtypes named P2X 1 -P2X 7 that regulate cell function by opening cation channels permeable to Na + , K + , and Ca 2+ (15,17). Activation of these channels regulates the release of neurotransmitters and hormones, either through direct Ca 2+ influx or by promoting membrane depolarization and thereby inducing action potentials (18-21).The role of ATP signaling in the physiology of pancreatic islets has been studied in rodent models, but the results in the literature are conflicting (22-28). In rat islets, purinergic agonists...