Targeting development of incretin-producing cells increases insulin secretion

J Clin Invest. 2015 Jan;125(1):379-85. doi: 10.1172/JCI75838. Epub 2014 Dec 15.

Abstract

Glucagon-like peptide-1-based (GLP-1-based) therapies improve glycemic control in patients with type 2 diabetes. While these agents augment insulin secretion, they do not mimic the physiological meal-related rise and fall of GLP-1 concentrations. Here, we tested the hypothesis that increasing the number of intestinal L cells, which produce GLP-1, is an alternative strategy to augment insulin responses and improve glucose tolerance. Blocking the NOTCH signaling pathway with the γ-secretase inhibitor dibenzazepine increased the number of L cells in intestinal organoid-based mouse and human culture systems and augmented glucose-stimulated GLP-1 secretion. In a high-fat diet-fed mouse model of impaired glucose tolerance and type 2 diabetes, dibenzazepine administration increased L cell numbers in the intestine, improved the early insulin response to glucose, and restored glucose tolerance. Dibenzazepine also increased K cell numbers, resulting in increased gastric inhibitory polypeptide (GIP) secretion. Using a GLP-1 receptor antagonist, we determined that the insulinotropic effect of dibenzazepine was mediated through an increase in GLP-1 signaling. Together, our data indicate that modulation of the development of incretin-producing cells in the intestine has potential as a therapeutic strategy to improve glycemic control.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Animals
  • Cells, Cultured
  • Diet, High-Fat
  • Enteroendocrine Cells / physiology*
  • Glucagon-Like Peptide 1 / metabolism
  • Glucose Intolerance
  • Humans
  • Ileum / cytology
  • Incretins / metabolism*
  • Insulin / metabolism*
  • Insulin Secretion
  • Male
  • Mice, Inbred C57BL
  • Receptors, Notch / antagonists & inhibitors
  • Receptors, Notch / metabolism

Substances

  • Incretins
  • Insulin
  • Receptors, Notch
  • Glucagon-Like Peptide 1