Lecture 13 - Endocrine Pancreas Flashcards

1
Q

what is metabolism?

what is anabolic vs catabolic?

what are the two metabolic states in your body?

A
  • sum of all chemical reactions in the body
  • Anabolic: large molecules synthesized from smaller ones
  • Catabolic: breakdown of large molecules into smaller ones

states:
1. Fed (absorptive) anabolic, storing glucose for future energy (fed state starts when your eating till 3-4 hrs later)
2. Fasted (postabsorptive) catabolic, breakdown glucose, fat for energy

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2
Q

what is the basal metabolic rate (BMR)

A

Basal metabolic rate (BMR) = an individual’s energy usage when resting, comfortable temperature, fasted

  • basic metabolism one needs while resting
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3
Q

how do we balance our energy?

A

we control caloric intake & exercise

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4
Q

what are the metabolic chemical processes in the fed and fasted state?

  1. with glucose (3)
  2. with fatty acids, glycerol (3)
  3. with amino acids (2)
  • state product (and where its deposited in body) and substrates. state the process that is used to convert it.
A
  1. with glucose

glucose ⇌ glycogen (liver, muscle)
- glucose to glycogen via glycogenesis
- glycogen to glucose via glycogenolysis

glucose → glycolysis, TCA
+ oxidative phosphorylation = ATP

  1. with fatty acid glycerol

fatty acid, glycolysis ⇌ triglycerides (adipose tissue)
- fatty acid to triglycerides via lipogenesis
- triglycerides to fatty acid via lipolysis

fatty acid, glycerol → beta oxidation of FFA = ATP

  1. with amino acids

amino acid ⇌ protein (muscle)
- amino acid to protein via protein synthesis
- protein to amino acid via protein degradation

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5
Q

what is gluconeogenesis

A

synthesis of glucose from non-carbohydrate substrates such as glycerol and amino acids

  • neo = new (ie not from carbs but from other new substrates)
  • usually takes place in the fasted postabsorptive state
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6
Q

how does glucose get inside the cells? what are the two main systems?
for each system state which somatic cells use that system and if its role with insulin

A

transported in the cells via glucose transporters (GLUT)
- there are around 14 in the body but the main ones are:

GLUT2
–> liver, pancreas, (intestine and kidneys)
–> glucose transport, and insulin secretion

GLUT4
- adipose tissue, skeletal muscle
- glucose transport that is insulin dependent

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7
Q

what hormone are produced by the endocrine pancreas?

A

exocrine = cells that produce bicarbonate and proenzymes that are used for digestion

endocrine = release substances directly into the bloodstream

endocrine tissues of the pancreas release hormones and there are many specialized cell types of the pancreas that does this

Beta cells
- release proinsulin which gets cleaved to insulin in the leftover sequence of the c-peptide

alpha cells
- secrete glucagon

delta cells
- somatostatin

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8
Q

How does insulin and glucagon signal inside the cell and what do they work together to do

A
  • insulin and glucagon are antagonistic to each other - they oppose each others functions
  • they control glucose homeostasis in the cell - switching from fasting and feeding states of metabolism
  • insulin binds to a single receptor enzyme
  • glucagon binds to a g protein coupled receptor
  • both signal a second messenger system, phosphorylate proteins, and conduct a cellular response
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9
Q

how do the levels of insulin and glucagon respond to plasma glucose concentration

A
  • when the glucose levels are high (ie in fed state), [insulin] rises
  • when the glucose levels are low (ie. in fasting state), [glucagon] is high
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10
Q

what is the main hormone of the fed state and what does this hormone aim to do (2)

A
  • when someone eats, insulin (anabolic) is the dominant hormone of the fed state
  • it oxidises glucose when it enters cells and wants to store it as larger molecules, like fat and protein
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11
Q

what type of molecule is insulin, where does it bind, what does it signal, what activity does it stimulate

A
  • insulin is synthesized as a typical peptide
  • it binds to a single transmembrane receptor, tyrosine kinase
  • it signals inside the cell to reduce blood glucose so that it can form glycogen, fat and protein
  • rise [glucose] = rise [insulin] –> dec [glucose]
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12
Q

what is the signalling pathway of insulin

A
  • insulin binds to tyrosine kinase receptor (has its own enzymatic activity since its a kinase receptor)
  • receptor activates kinase activity and phosphorylates a protein called IRS (insulin receptor substrate)
  • stimulates many second messenger pathways which alter existing proteins (ie. enzymatic activity –> affects metabolism) and conduct new protein synthesis (ie. of GLUT4 receptors which transports glucose in the cell – main goal is to get glucose out out the bloodstream and inside the cell).
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13
Q

adipose and muscle tissues:

how is the GLUT4 receptor stimulated to transport from the vesicle to the plasma membrane in response to insulin/glucagon ratio?

how was this seen experimentally?

A

Low insulin/glucagon ratio: (fasted state)
- Low insulin/glucagon = low glucose
- thus, the GLUT4 receptor is NOT stimulated to merge with the adipose/muscle tissue membrane as there is no glucose to be transported in

High insulin/glucagon ratio: (fed state)
- High Low insulin/glucagon ratio = high glucose
- insulin binds to the insulin receptor already present on the muscle/adipose membrane
- causes a signal transduction cascade which stimulates GLUT4 receptors in the tissue on vesicles to exocytosis and merge with the membrane
- free glucose can be transported in through the GLUT4 receptors (goes with concent. gradient)

experimentally:
- GFP tagged to GLUT4 receptors
- normally lit up in the core of the cell
- upon insulin addition, GLUT4 tagged proteins was moved to the membrane

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14
Q

adipose and muscle tissues:

how is GLUT4 transported on the membrane different during exercise?

A
  • during exercise you don’t need insulin for GLUT4 to merge with the muscle membrane
  • something about the stretching of the membrane allows this to happen
  • allows for the immediate use of glucose for energy needed during exercise
  • possibly why diabetics are recommended to exercise to lower glucose in the bloodstream
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15
Q

liver (hepatocyte) tissues:
when is the GLUT2 receptor expressed on the membrane? and which way is glucose being diffused under regular conditions?

what is happening to the glucose in the liver cells in the fed state?
why does this happen?

A
  • The GLUT2 receptor is always present on the plasma membrane both in fed and fasted states (independent of insulin – unlike GLUT4)
  • in liver cells, gluconeogenesis is occuring wherein new glucose molecules are being made in the cell. as gluconeogenesis occurs in the liver cells, the buildup allows for glucose to travel down its concentration gradient through the GLUT2 receptors to enter the bloodstream

In the Fed State
- Insulin binds to its receptor on the liver tissue membrane
- this elicits a signalling cascade which activates an enzyme called hexokinase
- this enzyme phosphorylates glucose so glucose –> glucose-6-phosphate

why does it do this?
- in a fed state there is a lot of glucose in the bloodstream
- if the glucose just naturally diffused in through the GLUT2 receptors, eventually there would be a build up of glucose on the inside of the liver cell
- insulin wants to regulate this
- therefore, the activation of hexokinase via insulin ensures that the concentration of free glucose in the cell is low, relative to the bloodstream, so that the concentration gradient is maintained and glucose can be transported in the liver for future needs.

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16
Q

what are 6 key effects of insulin?

A
  1. Increases glucose transport into insulin-sensitive cells
  2. Activates enzymes involved in glycogenesis, lipogenesis
    and protein synthesis
  3. Inhibits enzymes for glycogenolysis, gluconeogenesis and
    lipolysis
  4. Increases uptake of amino acids into muscle and protein
    synthesis
  5. Promotes lipogenesis and inhibits beta oxidation
  6. Enhances cell proliferation
17
Q

how does the increase of glucose stimulate insulin release? review from last term test.

A
  1. Inc. in blood glucose
  2. enters beta cell through GLUT transporters
  3. causes an inc. in glycolysis and citric acid cycle
  4. ultimately causes an increase in ATP
  5. inc. in ATP thus closes potassium channels so K+ cannot leave the cell
  6. buildup of positive charge from K+ in the cells = cell depolarization
  7. depolarization causes Ca2+ channels to open up = influx of Ca2+ in the cell
  8. Ca2+ floods the cell and triggers exocytosis of insulin that is stored in vesicles in the beta cell

thus: secretion of insulin when glucose is high

18
Q

explain the study of blood glucose and insulin levels after intravenous (directly in the bloodstream) and intrajejunal (in the small intestine then bloodstream) glucose infusion

A
  • they found that as glucose was injected in both the IV and intrajejunal, there was an increase and mirrored insulin response (ie. when glucose decreased/increased so did insulin)
  • however they also found that the intrajejunal small intestine in fact released much more insulin than the IV.
  • this huge discrepancy is known as the incretin effect
19
Q

what is the incretin effect and state the two incretin hormones

A
  • The incretin effect is the phenomenon where intrajejunal glucose intake stimulates a greater insulin response than the same amount of glucose given intravenously.
  • this is due to other incretin hormones present intravenously such as: GIP-1 and GLP-1
20
Q

explain the incretin hormones: GIP-1 and GLP-1
- what do they stand for
- what releases the hormone and where is it released
- what does it do

A

GIP-1
- Glucose-dependent Insulinotropic Polypeptide (previously known as gastric inhibitory peptide)
– Released by K cells in small intestine in response to nutrients in the intestinal lumen
– GIP-1 receptor (GPCR, G alpha s subunit) on beta cells to stimulate insulin release

GLP-1
– Glucagon-Like Peptide
– Released by L cells in small and large intestine in response to nutrients in the intestinal lumen
– GLP-1 receptor (GPCR, G alpha s subunit) on beta cells to stimulate insulin release

  • these receptors are present all over the body, but here we will focus on the receptors in the pancreas, specifically the beta cells
21
Q

how does GLP-1 promote further insulin release?

A
  • produced by the L cells in the intestine
  • travels through the bloodstream to the beta cells in the pancreas
  • The beta cell has the GLP-1R receptor for GLP-1, which is a G protein coupled receptor that triggers the alpha subunit
  • recall that the activation of the alpha subunit leads to activation of adenylyl cyclase, production of cAMP, and PKA. In the beta cell cAMP also triggers EPAC (exchange) proteins
  • eventually the downstream signalling of cAMP by GLP-1 binding causes a further increase in Ca2+ in the cell which triggers more insulin to be released
  • thus more insulin is released in the presence of incretin hormone GLP-1

note: Ca2+ is accumulated in the cell and used to push insulin out by glucose binding to the receptor on the beta cell simultaneously (closing of K+, depolarization, influx Ca2+ etc.)

22
Q

what are regulators of insulin secretion?
4 stimulatory effects, 1 inhibitory effect

look at figure 22.15 in the textbook

A

Stimulation:
1) Increased plasma glucose
2) Intestinal hormones such as GIP-1 and GLP-1 both released in response to nutrient ingestion = feedforward regulation
3) Increased plasma amino acids (dont really need to know why, just know it can stimulate insulin secretion)
4) Parasympathetic nervous system (rest and digest mechanism stimulates insulin for formation of glycogen, fat, protein)

Inhibition
1) Sympathetic nervous system (fight or flight mechanism does not want to store glucose with insulin. it actually wants insulin to be readily available in the bloodstream as a defense mechanism)

23
Q

glucagon
- what state does glucagon dominate
- where is it secreted from
- what is its main target
- what does it do

A
  • dominate hormone in the fasted state
  • secreted from the pancreatic alpha-cells
  • its a large peptide protein

what does it do?
- antagonizes insulins effects on metabolism
- inc. glycogenolysis (breaks down the glycogen stored in the liver to free glucose)
- inc. gluconeogenesis (forms new glucose molecules)
- inc. ketogenesis (not impt)

24
Q

what condition does glucagon help prevent?

A
  • glucagon helps prevent death by hypoglycemia
  • hypoglycemia = the state of having too little circulating blood glucose
  • so when we are fasting/having ate in a long time, and we dont have a high concent of blood glucose, glucagon is released to stimulate release of glucose in blood
25
Q

what is the pathway of glucagon release in the liver

A

in the liver hepatocytes:
- glucagon binds to the alpha cell membrane in the liver
- binds to a Gs alpha subunit g protein –> activates adenylyl cyclase –> produces cAMP with ATP –> activates PKA -> activates phosphorylase a –> downstream signalling –> breaks down glycogen to glucose 1-phosphate to glucose
- glucose diffuses to the bloodstream through the GLUT2 receptors

26
Q

how does cortisol work with glucagon to build up the glucose in the body?

A
  • cortisol is a catabolic hormone as well
  • when you release glucagon, epinephrine, and cortisol on its own separately, the concentration of glucose in the blood plasma increases.
  • they all have small effects on their own
  • but when cortisol is around, it amplifies glucagon and epinephrine to really increase the amount of glucose in the blood
  • physiologically, cortisol is always around at varying concentrations (dependent on circadian levels)
  • therefore, cortisol, no matter what concentration it is at, helps glucagon reach its full effect in releasing glucose
  • this is known as the permissive effect: glucagon needs cortisol to release plasma glucose at significant concentrations
27
Q

what stimulates (3) and inhibits (1) glucagon secretion

A

Stimulation:
1) Decreased plasma glucose
2) Increased plasma amino acids (same as stimulator for insulin - seems contradictory but these are small effects and variable)
3) Sympathetic nervous system (fight or flight – allows free glucose to be used)

Inhibition:
1) glucagon-like peptide-1 (GLP-1) (if there is GLP-1 then there is insulin secreted and thus it makes sense that glucagon would not be secreted)

28
Q

what are the active hormones in proglucagon? where is proglucagon expressed? what are the main products in each of the regions?

A
  • proglucagon has three active hormones: glucagon, GLP-1, GLP-2
  • proglucagon is expressed in alpha cells, L cells of the intestine and brain

in alpha cells: main product is glucagon
in L cells of the intestine and brain: main products are GLP-1 and GLP-2

29
Q

what are some key points about insulin, glucagon, and GLP-1

REVIEW

A

Insulin (prevents hyperglycemia): Beta cells (islet of Langerhans) – secreted in response to glucose, GLP1, PNS, amino acids – decreases blood glucose, promotes anabolic pathways, involved with growth

Glucagon (prevents hypoglycemia): Alpha cells secrete Glucagon in response from low glucose, SNS, amino acids
– increases blood glucose, gluconeogensis, glycogenolysis
– catabolic pathways to increase energy.

GLP-1: released from intestine in response to glucose/amino acids – stimulates insulin secretion, increases beta cell mass, anorexigen, decreases glucagon

30
Q

Type 1 and 2 diabetes
- onset?
- what is it
- how is it treated 1(1), 2(3)

A

Type 1 diabetes:
- it also known as juvenile diabetes = onset in younger children
- when insulin secretion is either absent or severely reduced in individuals
- 10% of all diabetics (minor category)
- treatments is primarily insulin injections or insulin pumps

Type 2 diabetes:
- onset in adults
- defects of insulin secretion or can secrete insulin but the target cells are not responsive to insulin anymore
- treatment is regulating diet (high sugar = high glucose causes desensitization of insulin receptors), exercise (causes translocation of GLUT4 to the membrane which allows intake of glucose in cells), oral hypoglycemics (sometimes insulin injections)

Both types: high blood glucose levels when uncontrolled

31
Q

what is observed in uncontrolled type 1 diabetes:

what happens in normal people vs diabetics when they absorb a meal? what are the three metabolic pathways that are effected?

A
  • In both normal and diabetic cases, if someone eats a meal they have an increase in plasma fatty acids, glucose, and amino acids.
  • however in normal people, this is when insulin will be released as a response
  • in diabetic patients, insulin is NOT released (no GLUT4 transporters in muscle/adipocytes to membrane, no storage of glucose–> glucose-6-phosphate via GLUT 2) . thus the fat, glucose, and protein metabolism is all altered
32
Q

what is observed in uncontrolled type 1 diabetes:

explain glucose metabolism in diabetics?

A
  1. meal is absorbed
  2. inc in plasma glucose
  3. NO INSULIN RELEASED
  4. no insulin = no glucose uptake in muscle and adipose tissue
  5. no glucose uptake = brain thinks we are starving = POLYPHAGIA
  6. no glucose uptake = body thinks we have no glucose = liver starts to break down glycogen for free glucose (glycogenolysis) –> HYPERGLYCEMIA (too much free glucose)

THIS CAN CONTINUE TO DEVELOP SOME MORE SEVERE SYMPTOMS

7.A. HYPERGLYCEMIA = lots of sugar in the blood = lots of glucose cant get reabsorbed by the kidneys = lots of glucose is lossed via urination along with high water content
8. since a lot of water is lost as well = inc. thirst = POLYDIPSIA
9. inc OSMOLARITY (as water is lost but sodium content is the same) = inc ADH SECRETION
10. lots of water loss = DEHYDRATION = dec. blood pressure/volume
11. dec. blood pressure/volume = COMA / DEATH

7.B. HYPERGLYCEMIA = ketoacidosis (use ketones as energy source since glucose isn’t used – by product of fat) = metabolic acidosis = URINE ACIDIFICATION
–> try to compensate of acidosis by breathing off CO2 as fast as possible = HYPERVENTILATION

33
Q

what is observed in uncontrolled type 1 diabetes:

explain protein metabolism in diabetics?

A
  1. meal is absorbed
  2. inc in plasma amino acids
  3. NO INSULIN RELEASED
  4. no insulin = no amino acid uptake in tissues
  5. body thinks we dont have energy = proteins start to break down, especially in muscles = so free energy is released
  6. Results in TISSUE LOSS
34
Q

what is observed in uncontrolled type 1 diabetes:

explain fat metabolism in diabetics?

A
  1. meal is absorbed
  2. inc in plasma fatty acids
  3. NO INSULIN RELEASED
  4. no insulin = no fat uptake in tissues
  5. body thinks we dont have energy = fats start to break down = so free energy is released
  6. Results in TISSUE LOSS –> weight loss
35
Q

how can we treat type 2 diabetes with sulfonylureas drugs?

A
  • normally when we have an inc of glucose in the blood, our beta cells can recognize this and create ATP, close K+ channels, depolarize the cell, flood with Ca2+, and release insulin
  • in type 2 diabetics, the beta cell cannot recognize the inc. glucose in the blood via damaged GLUT transporters
  • therefore sulfonylureas are used to mimic the blocking of k+ channels (since beta cells cant do this on their own since they are damaged)
  • this leads to depolarization, Ca2+ flooding and exocytosis of insulin
36
Q

why are scientists making drugs that mimic GLP-1 to treat type 2 diabetes? (2)

A
  • GLP-1 is the incretin hormone that increases insulin release
  • GLP-1 = insulin production, beta cell proliferation, reducing beta cell apoptosis = overall promotes the health of the beta cell population so insulin can be made
  • GLP-1 = reduces gastric emptying = stomach stays full longer = reduced digestion –> slowing down glucose being released in the bloodstream. Also reduced digestion –> reduced appetite since stomach is staying full longer –> lead to weight loss

now medications are being made to act like GLP-1 hormones to get these effects

37
Q

why are pharmaceutical companies making GLP-1 receptor agonists?

A
  • they are making medications that target GLP-1 receptors
  • they are in pen like devices

why?
- lots of type 2 diabetics and its inc all around the world
- some people also take these drugs for drastic weight loss (lower gastric stomach emptying) ie. ozempic

38
Q

what are the many more actions/effects of GLP-1 medications (not just beta cell health and digestion?)

A
  • they reduce cardiovascular complications like myocardial infarction, atherosclerosis, diabetic kidney disease, metabolic liver disease
  • they can also reduce inflammation
  • they can also possibly reduce neurological diseases such as alzheimer’s, parkinsons, and substance use disorders.