Hyperglucagonaemia in diabetes: altered amino acid metabolism triggers mTORC1 activation, which drives glucagon production

• Published in: Diabetologia 2023-10, Vol.66 (10), p.1925-1942
• Main Authors: Riahi, Yael, Kogot-Levin, Aviram, Kadosh, Liat, Agranovich, Bella, Malka, Assaf, Assa, Michael, Piran, Ron, Avrahami, Dana, Glaser, Benjamin, Gottlieb, Eyal, Jackson, Fields, Cerasi, Erol, Bernal-Mizrachi, Ernesto, Helman, Aharon, Leibowitz, Gil
• Format: Article
• Language: English
• Subjects: Adult; Amino acids; Animals; Chronic exposure; Confocal microscopy; Diabetes; Diabetes mellitus (insulin dependent); Diabetes mellitus (non-insulin dependent); Diabetes Mellitus, Experimental; Diabetes Mellitus, Type 2; Extended Article; Flow cytometry; Gene expression; Glucagon; Glucose; Glucose tolerance; Glycolysis; Human Physiology; Humans; Hyperglycemia; Internal Medicine; Labeling; Mammals; Mechanistic Target of Rapamycin Complex 1; Medicine; Medicine & Public Health; Metabolic Diseases; Metabolic flux; Metabolism; Metabolites; Metabolomics; Methionine; Phosphorylation; Rapamycin; Ribosomal protein S6; TOR protein
• ISSN: 0012-186X; 1432-0428; 1432-0428
• DOI: 10.1007/s00125-023-05967-8

Aim/hypothesis Hyperglycaemia is associated with alpha cell dysfunction, leading to dysregulated glucagon secretion in type 1 and type 2 diabetes; however, the mechanisms involved are still elusive. The nutrient sensor mammalian target of rapamycin complex 1 (mTORC1) plays a major role in the maintenance of alpha cell mass and function. We studied the regulation of alpha cell mTORC1 by nutrients and its role in the development of hyperglucagonaemia in diabetes. Methods Alpha cell mTORC1 activity was assessed by immunostaining for phosphorylation of its downstream target, the ribosomal protein S6, and glucagon, followed by confocal microscopy on pancreatic sections and flow cytometry on dispersed human and mouse islets and the alpha cell line, αTC1-6. Metabolomics and metabolic flux were studied by 13 C glucose labelling in 2.8 or 16.7 mmol/l glucose followed by LC-MS analysis. To study the role of mTORC1 in mediating hyperglucagonaemia in diabetes, we generated an inducible alpha cell-specific Rptor knockout in the Akita mouse model of diabetes and tested the effects on glucose tolerance by IPGTT and on glucagon secretion. Results mTORC1 activity was increased in alpha cells from diabetic Akita mice in parallel to the development of hyperglycaemia and hyperglucagonaemia (two- to eightfold increase). Acute exposure of mouse and human islets to amino acids stimulated alpha cell mTORC1 (3.5-fold increase), whereas high glucose concentrations inhibited mTORC1 (1.4-fold decrease). The mTORC1 response to glucose was abolished in human and mouse diabetic alpha cells following prolonged islet exposure to high glucose levels, resulting in sustained activation of mTORC1, along with increased glucagon secretion. Metabolomics and metabolic flux analysis showed that exposure to high glucose levels enhanced glycolysis, glucose oxidation and the synthesis of glucose-derived amino acids. In addition, chronic exposure to high glucose levels increased the expression of Slc7a2 and Slc38a4 , which encode amino acid transporters, as well as the levels of branched-chain amino acids and methionine cycle metabolites (~1.3-fold increase for both). Finally, conditional Rptor knockout in alpha cells from adult diabetic mice inhibited mTORC1, thereby inhibiting glucagon secretion (~sixfold decrease) and improving diabetes, despite persistent insulin deficiency. Conclusions/interpretation Alpha cell exposure to hyperglycaemia enhances amino acid synthesis and transport, resulting in s