Pulsatility of insulin release--a clinically important phenomenon.
Pulsatility of insulin release--a clinically important phenomenon.
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DOI：
10.3109/03009730903366075
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发表时间：
2009
影响因子：
3.4
通讯作者：
Hellman B
中科院分区：
文献类型：
--
作者：
Hellman B
本文以半个多世纪以来与朗格汉斯岛相伴的背景为背景，介绍了脉冲式胰岛素释放的机制和临床重要性。胰岛素分泌β细胞是振荡细胞，具有细胞质ATP和Ca2+的内在变化。在胰岛内，β细胞通过间隙连接和扩散因子（ATP）相互夹带成共同的节律。胰腺中不同胰岛的同步化被认为是由于通过乙酰胆碱和ATP的神经输出将振荡调整到相同的相位。对大鼠和小鼠灌注胰腺激素分泌的研究表明，葡萄糖诱导胰高血糖素脉冲与胰岛素和生长抑素脉冲反同步。这种反同步性可能是生长抑素对胰高血糖素α细胞的旁分泌作用所致。嘌呤受体在胰岛激素的脉冲式释放中起着关键作用。有可能去除胰高血糖素和生长抑素脉冲，同时用P2Y1受体抑制剂维持胰岛素脉冲。腺苷A1受体的敲除延长了胰高血糖素和生长抑素的脉冲，而不影响胰岛素脉冲的持续时间。对离体人胰岛的研究表明，胰岛素、胰高血糖素和生长抑素脉冲之间的关系与啮齿动物胰腺灌注期间发现的相似。观察胰岛素和胰高血糖素的逆转循环有助于了解胰岛如何调节肝脏葡萄糖的产生。脉冲静脉输注治疗（PIVIT）的现行方案应进行修改，以模拟门静脉血中常见的胰岛素和胰高血糖素之间的反同步。
The mechanisms and clinical importance of pulsatile insulin release are presented against the background of more than half a century of companionship with the islets of Langerhans. The insulin-secreting β-cells are oscillators with intrinsic variations of cytoplasmic ATP and Ca2+. Within the islets the β-cells are mutually entrained into a common rhythm by gap junctions and diffusible factors (ATP). Synchronization of the different islets in the pancreas is supposed to be due to adjustment of the oscillations to the same phase by neural output of acetylcholine and ATP. Studies of hormone secretion from the perfused pancreas of rats and mice revealed that glucose induces pulses of glucagon anti-synchronous with pulses of insulin and somatostatin. The anti-synchrony may result from a paracrine action of somatostatin on the glucagon-producing α-cells. Purinoceptors have a key function for pulsatile release of islet hormones. It was possible to remove the glucagon and somatostatin pulses with maintenance of those of insulin with an inhibitor of the P2Y1 receptors. Knock-out of the adenosine A1 receptor prolonged the pulses of glucagon and somatostatin without affecting the duration of the insulin pulses. Studies of isolated human islets indicate similar relations between pulses of insulin, glucagon, and somatostatin as found during perfusion of the rodent pancreas. The observation of reversed cycles of insulin and glucagon adds to the understanding how the islets regulate hepatic glucose production. Current protocols for pulsatile intravenous infusion therapy (PIVIT) should be modified to mimic the anti-synchrony between insulin and glucagon normally seen in the portal blood.
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DOI：
10.1006/bbrc.1995.1387
发表时间：
1995-03-17
影响因子：
3.1
作者：
BERTS, A;GYLFE, E;HELLMAN, B
通讯作者：
HELLMAN, B
影响因子：
64.8
作者：
Dyachok, O;Isakov, Y;Tengholm, A
通讯作者：
Tengholm, A
影响因子：
3.7
作者：
Ahmed, M;Grapengiesser, E
通讯作者：
Grapengiesser, E
影响因子：
5.4
作者：
Aoki, T T;Grecu, E O;Ahn, J H
通讯作者：
Ahn, J H
DOI：
10.1006/bbrc.1994.2746
发表时间：
1994-11-30
影响因子：
3.1
作者：
DRYSELIUS, S;LUND, PE;HELLMAN, B
通讯作者：
HELLMAN, B