Glucagon blockade restores functional β-cell mass in type 1 diabetic mice and enhances function of human islets

Proc Natl Acad Sci U S A. 2021 Mar 2;118(9):e2022142118. doi: 10.1073/pnas.2022142118.

Abstract

We evaluated the potential for a monoclonal antibody antagonist of the glucagon receptor (Ab-4) to maintain glucose homeostasis in type 1 diabetic rodents. We noted durable and sustained improvements in glycemia which persist long after treatment withdrawal. Ab-4 promoted β-cell survival and enhanced the recovery of insulin+ islet mass with concomitant increases in circulating insulin and C peptide. In PANIC-ATTAC mice, an inducible model of β-cell apoptosis which allows for robust assessment of β-cell regeneration following caspase-8-induced diabetes, Ab-4 drove a 6.7-fold increase in β-cell mass. Lineage tracing suggests that this restoration of functional insulin-producing cells was at least partially driven by α-cell-to-β-cell conversion. Following hyperglycemic onset in nonobese diabetic (NOD) mice, Ab-4 treatment promoted improvements in C-peptide levels and insulin+ islet mass was dramatically increased. Lastly, diabetic mice receiving human islet xenografts showed stable improvements in glycemic control and increased human insulin secretion.

Keywords: diabetes; glucagon; insulin; islet; regeneration.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't
  • Research Support, U.S. Gov't, Non-P.H.S.

MeSH terms

  • Animals
  • Antibodies, Monoclonal / pharmacology*
  • Blood Glucose / metabolism
  • C-Peptide / metabolism
  • Cell Lineage / drug effects
  • Cell Transdifferentiation / drug effects
  • Diabetes Mellitus, Experimental / genetics
  • Diabetes Mellitus, Experimental / immunology
  • Diabetes Mellitus, Experimental / pathology
  • Diabetes Mellitus, Experimental / therapy*
  • Diabetes Mellitus, Type 1 / genetics
  • Diabetes Mellitus, Type 1 / immunology
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 1 / therapy
  • Gene Expression
  • Glucagon / antagonists & inhibitors
  • Glucagon / metabolism
  • Glucagon-Secreting Cells / drug effects*
  • Glucagon-Secreting Cells / metabolism
  • Glucagon-Secreting Cells / pathology
  • Humans
  • Hypoglycemic Agents / pharmacology*
  • Insulin / metabolism
  • Insulin-Secreting Cells / drug effects*
  • Insulin-Secreting Cells / metabolism
  • Insulin-Secreting Cells / pathology
  • Islets of Langerhans / metabolism
  • Islets of Langerhans / physiology
  • Islets of Langerhans Transplantation
  • Mice
  • Mice, Inbred NOD
  • Organ Size / drug effects
  • Receptors, Glucagon / antagonists & inhibitors*
  • Receptors, Glucagon / genetics
  • Receptors, Glucagon / metabolism
  • Treatment Outcome

Substances

  • Antibodies, Monoclonal
  • Blood Glucose
  • C-Peptide
  • Hypoglycemic Agents
  • Insulin
  • Receptors, Glucagon
  • Glucagon