Publication Date:
2013-01-08
Description:
Glucose production by the liver is essential for providing a substrate for the brain during fasting. The inability of insulin to suppress hepatic glucose output is a major aetiological factor in the hyperglycaemia of type-2 diabetes mellitus and other diseases of insulin resistance. For fifty years, one of the few classes of therapeutics effective in reducing glucose production has been the biguanides, which include phenformin and metformin, the latter the most frequently prescribed drug for type-2 diabetes. Nonetheless, the mechanism of action of biguanides remains imperfectly understood. The suggestion a decade ago that metformin reduces glucose synthesis through activation of the enzyme AMP-activated protein kinase (AMPK) has recently been challenged by genetic loss-of-function experiments. Here we provide a novel mechanism by which metformin antagonizes the action of glucagon, thus reducing fasting glucose levels. In mouse hepatocytes, metformin leads to the accumulation of AMP and related nucleotides, which inhibit adenylate cyclase, reduce levels of cyclic AMP and protein kinase A (PKA) activity, abrogate phosphorylation of critical protein targets of PKA, and block glucagon-dependent glucose output from hepatocytes. These data support a mechanism of action for metformin involving antagonism of glucagon, and suggest an approach for the development of antidiabetic drugs.〈br /〉〈br /〉〈a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573218/" target="_blank"〉〈img src="https://static.pubmed.gov/portal/portal3rc.fcgi/4089621/img/3977009" border="0"〉〈/a〉 〈a href="https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3573218/" target="_blank"〉This paper as free author manuscript - peer-reviewed and accepted for publication〈/a〉〈br /〉〈br /〉〈span class="detail_caption"〉Notes: 〈/span〉Miller, Russell A -- Chu, Qingwei -- Xie, Jianxin -- Foretz, Marc -- Viollet, Benoit -- Birnbaum, Morris J -- F32 DK079572/DK/NIDDK NIH HHS/ -- P01 DK049210/DK/NIDDK NIH HHS/ -- P01 DK49210/DK/NIDDK NIH HHS/ -- P30 DK19525/DK/NIDDK NIH HHS/ -- R01 DK056886/DK/NIDDK NIH HHS/ -- R01 DK56886/DK/NIDDK NIH HHS/ -- England -- Nature. 2013 Feb 14;494(7436):256-60. doi: 10.1038/nature11808. Epub 2013 Jan 6.〈br /〉〈span class="detail_caption"〉Author address: 〈/span〉Institute for Diabetes, Obesity, and Metabolism, Perelman School of Medicine, University of Pennsylvania, Philadelphia, Pennsylvania 19104, USA.〈br /〉〈span class="detail_caption"〉Record origin:〈/span〉 〈a href="http://www.ncbi.nlm.nih.gov/pubmed/23292513" target="_blank"〉PubMed〈/a〉
Keywords:
AMP-Activated Protein Kinases/metabolism
;
Adenylyl Cyclases/metabolism
;
Animals
;
Biguanides/*pharmacology
;
Cells, Cultured
;
Cyclic AMP/biosynthesis/*metabolism
;
Cyclic AMP-Dependent Protein Kinases/metabolism
;
Diabetes Mellitus, Type 2/drug therapy
;
Enzyme Activation/drug effects
;
Glucagon/*antagonists & inhibitors/*metabolism
;
Glucose/metabolism
;
Hepatocytes/*drug effects/*metabolism
;
Hypoglycemic Agents
;
Liver/cytology/drug effects/metabolism
;
Metformin/pharmacology/therapeutic use
;
Mice
;
Phenformin/pharmacology
;
Phosphorylation
;
Signal Transduction/*drug effects
Print ISSN:
0028-0836
Electronic ISSN:
1476-4687
Topics:
Biology
,
Chemistry and Pharmacology
,
Medicine
,
Natural Sciences in General
,
Physics
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