Enhanced agonist residence time, internalization rate and signalling of the GIP receptor variant [E354Q] facilitate receptor desensitization and long‐term impairment of the GIP system

• Published in: Basic & clinical pharmacology & toxicology 2020-06, Vol.126 (S6), p.122-132
• Main Authors: Gabe, Maria Buur Nordskov, van der Velden, Wijnand J. C., Gadgaard, Sarina, Smit, Florent Xavier, Hartmann, Bolette, Bräuner‐Osborne, Hans, Rosenkilde, Mette Marie
• Format: Article
• Language: English
• Subjects: Agonists; Animals; Antagonists; Arrestin; beta-Arrestins; Binding; Blood; Bone mineral density; Bone turnover; Chlorocebus aethiops; COS Cells; Desensitization; Diabetes mellitus; Diabetes mellitus (non-insulin dependent); Gastric Inhibitory Polypeptide - agonists; Gastric Inhibitory Polypeptide - chemistry; Gastric Inhibitory Polypeptide - metabolism; GIP receptor; GIPR‐[E354Q]; HEK293 Cells; Homology; Humans; Impairment; Internalization; Metabolism; Molecular Structure; Original; ORIGINAL ARTICLES; Phenotyping; Protein turnover; Receptors; Residence time distribution; Signal Transduction; Signaling; signalling
• ISSN: 1742-7835; 1742-7843
• DOI: 10.1111/bcpt.13289

In patients with type 2 diabetes mellitus (T2DM), the insulinotropic action of the GIP system is desensitized, whereas this is not the case for the GLP‐1 system. This has raised an interesting discussion of whether GIP agonists or antagonists are most suitable for future treatment of T2DM together with GLP‐1‐based therapies. Homozygous carriers of the GIP receptor (GIPR) variant, [E354Q], display lower bone mineral density, increased bone fracture risk and slightly increased blood glucose. Here, we present an in‐depth molecular pharmacological phenotyping of GIPR‐[E354Q]. In silico modelling suggested similar interaction of the endogenous agonist GIP(1‐42) to [E354Q] as to GIPR wt. This was supported by homologous competition binding in COS‐7 cells revealing GIPR wt‐like affinities of GIP(1‐42) with Kd values of ~2 nmol/L and wt‐like agonist association rates (Kon). In contrast, the dissociation rates (Koff) were slower, resulting in 25% higher agonist residence time for GIPR‐[E354Q]. Moreover, in Gαs signalling (cAMP production) GIP(1‐42) was ~2‐fold more potent and more efficacious on GIPR‐[E354Q] compared to wt with 17.5% higher basal activity. No difference from GIPR wt was found in the recruitment of β‐arrestin 2, whereas the agonist‐induced internalization rate was 2.1‐ to 2.3‐fold faster for [E354Q]. Together with the previously described impaired recycling of [E354Q], our findings with enhanced signalling and internalization rate possibly explained by an altered ligand‐binding kinetics will lead to receptor desensitization and down‐regulation. This could explain the long‐term functional impairment of the GIP system in bone metabolism and blood sugar maintenance for [E354Q] carriers and may shed light on the desensitization of the insulinotropic action of GIP in patients with T2DM.