The long-acting somatostatin analogue octreotide alleviates symptoms by reducing posttranslational conversion of prepro-glucagon to glucagon in a patient with malignant glucagonoma,but does not prevent tumor growth

A 52-year-old female with metastatic glucagonoma secreting glucagon and chromogranin A was treated with the somatostatin analogue octreotide for 2 years without any additional tumor-reducing interventions. Before therapy plasma glucagon was above 8 g/l (normal <0.2) and within 2 days 3 × 200 g octreotide daily suppressed plasma glucagon to 2.2–2.5 g/l. Concomitantly, chromogranin A dropped from 0.85 mg/l (normal <0.1) to 0.2. After 3 weeks the preexisting disabling necrolytic migratory erythema had vanished completely, and weight loss was temporarily stopped. During therapy chromogranin A and plasma glucagon rose, exceeding pretreatment levels after 3 and 14 months, respectively. After 1 year the erythema recurred, responding only transiently to increasing doses of octreotide. The patient died after 2 years of therapy of tumor cachexy despite very highdosesof octreotide (4 × 600 g/day). Throughout treatment octreotide did not prevent tumor growth, as demonstrated by computed tomography and sonography. Determination of immunoreactive glucagon before and during octreotide therapy in fractions of plasma samples subjected to gel chromatography revealed a reduction in the ratio of glucagon to preproglucagon from 1.83 (before) to 0.56 (during therapy), indicating inhibition of posttranslational processing of preproglucagon by octreotide, thereby reducing circulating bioactive glucagon. In summary, octreotide induced a remission of clinical symptoms by inhibiting posttranslational conversion of preproglucagon to glucagon but did not prevent tumor growth. Therefore, octreotide is a valuable therapy for rapid relief of clinical symptoms, thereby improving the possibilities for other tumor-reducing therapies.Abbreviations CGA chromogranin A - IRG immunoreactive glucagon - OC octreotide Correspondence to: D. Reinwein     

胰高血糖素衍生物在大肠杆菌的克隆表达和纯化

 目的 通过基因工程途径获得胰高血糖素衍生物。 方法 根据胰高血糖素基因及凝血酶酶切位点序列，分段合成引物行 PCR 扩增，以 PCR 扩增得到的胰高血糖素-甘氨酸基因序列和 pET-30a 质粒转化 E.coli DH5α，获得重组质粒 pET-G。将重组质粒 pET-G 转化至 E.coli BL21(DE3)，重组菌株命名为 E.coli BL21[pET-G]。以异丙基-β-D-硫代半乳糖苷（IPTG）诱导表达，对表达产物进行SDS-Tricine- PAGE[十二烷基硫酸钠-三（羟甲基）甲基甘氨酸-聚丙烯酰胺凝胶电泳]分析和蛋白质印迹分析。对表达产物行Ni2+-NTA亲和层析纯化、凝血酶酶切和高效液相色谱（HPLC）纯化后，行 SDS-Tricine-PAGE分析和飞行质谱分析，并以 ELISA 方法检测其免疫活性。 结果 PCR 扩增获得的条带与预期的DNA表达片段大小一致，重组质粒 pET-G 测序结果与预期完全一致。SDS- Tricine-PAGE 和蛋白质印迹分析显示 E.coli BL21（DE3）的表达产物相对分子质量与预期相符。经亲和层析纯化、凝血酶酶切和 HPLC 纯化后得到了完整的重组胰高血糖素-甘氨酸衍生物，SDS-Tricine-PAGE 分析显示其相对分子质量约为 3500，飞行质谱分析相对分子质量为 3531，二者基本一致。ELISA 检测表明重组胰高血糖素-甘氨酸衍生物具有胰高血糖素免疫活性。 结论 采用基因工程技术在大肠杆菌中成功表达了胰高血糖素-甘氨酸衍生物，为通过体外酰胺化途径研制酰胺化胰高血糖素奠定了基础。     

Effect of training on hormonal responses to exercise in competitive swimmers

Summary The effects of 9 weeks of training on responses of plasma hormones to swimming were studied in eight competitive swimmers who had not trained for several months. Two types of swimming tests were used: (1) 200 yd, a high intensity, exhausting type of exercise in which maximal effort was required both before and after training, and (2) 1000 yd, a pace type of exercise in which subjects swam as fast as possible prior to training and at the same rate after training. Plasma levels of glucagon increased and of insulin decreased during 1000 yd of swimming, but were not altered by 200 yd of swimming. No training effects were apparent in responses of plasma insulin and glucagon to these short-term, high intensity exercise tests. During the 1000 yd swim, plasma adrenaline was 0.8 ng/ml before vs. 0.1 ng/ml after training. Plasma noradrenaline response decreased from 3.4 to 1.2 ng/ml as a result of training. In the 200 yd swim, adrenaline, but not noradrenaline, was lower after training.R. C. Hickson and R. K. Conlee were postdoctoral research trainees supported by NIH Training Grant AM-05341.J. M. Hagberg was a postdoctoral research trainee supported by NIH Training Grant HL-07081.     

Hormonal and metabolic response to three types of exercise of equal duration and external work output

Summary Five normal men, aged 20–30 years, participated in three types of exercise (I, II, III) of equal duration (20 min) and total external work output (120–180 kJ) separated by ten days of rest. Exercises consisted of seven sets of squats with barbells on the shoulders (I; Maximal Power Output _max=600−900 W), continuous cycling at 50 rev · min⁻¹ (II; _max=100−150 W) and seven bouts of intermittent cycling at 70 rev · min⁻¹ (III; _max=300−450 W). Plasma cortisol, glucagon and lactate increased significantly (P<0.05) during the exercise and recovery periods of the anaerobic, intermittent exercise (I and III) but not in the continuous, aerobic exercise (II). No consistent significant changes were found in plasma glucose. Plasma insulin levels decreased only during exercise II. The highest increase in cortisol and glucagon was not associated with the highest , , _max or HR; however it was associated with the anaerobic component of exercise (lactic acid). It is suggested that in exercises of equal duration and total external work output, the continuous, aerobic exercise (II) led to lowest levels of glucogenic hormones.     

Der Stoffwechsel bei vollständigem Fasten. Unterschiedliches Verhalten bei Männern und Frauen sowie bei Normalpersonen und Adipösen

Zusammenfassung Bei 24 idealgewichtigen und 24 adipösen Personen beiderlei Geschlechts wurden zirkulierende Substrate (Blutzucker, freie Fettsäuren, Ketonkörper) und Hormone (Insulin, Wachstumshormon, Pankreasglukagon) während sechstägigem Fasten bestimmt. Der Blutzucker sank bei Normalpersonen unter Nulldiät auf tiefere Werte als bei Adipösen. Der Konzentrationsanstieg der freien Fettsäuren und Ketonkörper erfolgte bei Normalgewichtigen rascher als bei Fettsüchtigen und bei Frauen rascher als bei Männern. Das Plasmainsulin fiel bei Adipösen stärker ab als bei Normalpersonen. Alle untersuchten Gruppen wiesen nach 1–3 Fastentagen einen signifikanten Anstieg des Pankreasglukagons auf, dieser erfolgte jedoch bei normalgewichtigen Frauen rascher als bei Männern. Wachstumshormon (GH) stieg bei normalgewichtigen Männern unter Nulldiät signifikant an, bei adipösen Männern jedoch nicht. Bei z.T. auffallend hohen Nüchternwerten zeigten normalgewichtige Frauen keinen signifikanten GH-Anstieg, jedoch signifikant höhere GH-Konzentrationen als adipöse Frauen nach 1–6 Fastentagen. Ausgehend von den allen untersuchten Gruppen gemeinsamen Stoffwechselveränderungen bei Nulldiät werden die diesbezüglichen Unterschiede zwischen männlichen und weiblichen sowie zwischen normalgesichtigen und adipösen Personen diskutiert.     

Increase of food intake induced by glucagon in the rat

The effect of intraperitoneal administration of saline, glucose (25 mg/100 g b.w.), insulin (0.025 U/100 g b.w.) and glucagon (50 micrograms/kg b.w.) on glycemia, liver glycogen concentration and food intake was studied on 104 male adult Wistar rats. When saline was injected the amount of food ingested was similar to that expected at the metabolic moment selected for the tests. Glucose administration did not reduce food intake but both insulin and glucagon provoked a threefold increase during the 60 minutes ensuing the injection. The overall ingestion of food during the 24 hours after the injection of the hormones was significantly higher (about 10%) than the control values during the preceding or the succeeding 24 hours. A hyperphagic, rather than a hypophagic effect of glucagon administration is possibly related to the small dose used in the experiments. The mechanisms involved in the increase of food intake due to glucagon are discussed in terms of acceleration of the metabolic reactions that normally prevent large drops of glycemia as glucose utilization proceeds during the inter-meal periods and that in physiological conditions build up until the need for food arises.     

Comparison of the effects of intravenous and intrasplenic infusions of glucagon on cardiac output and its distribution in the rat

Summary In order to determine whether or not glucagon released from the pancreas might have local vascular effects, the actions upon regional haemodynamics in the anaesthetised rat of two doses of glucagon (2 and 10 g kg^–1 min^–1) infused intrasplenically (and thus into the portal vein) were compared with those of a single dose (2 g kg^–1 min^–1) infused i. v. Infusion of glucagon i. v. produced a significantly increased heart rate (by 6%) and cardiac output (by 23%) in the experimental animals compared to those receiving saline by the same route. Total peripheral resistance fell by 24%. A greater proportion of the cardiac output passed to the coronary and renal vascular beds and blood flow was increased in the spleen, testes, pectoral skeletal muscle, stomach and small intestine as well as the heart and kidneys.The lower dose infused intrasplenically had no significant effect on cardiac output or total peripheral resistance but significantly increased the proportion of cardiac output passing both to the stomach and the small intestine such that the percentage of cardiac output flowing through the portal vein increased from 19.1 ± 1.1% to 23.8 ± 1.7%.Intrasplenic infusion of 10 g kg^–1 min^–1 significantly increased cardiac output (by 29%) but reduced total peripheral resistance by 37%. Greater fractions of the cardiac output were received by the spleen, small intestine and epididymides. Blood flow was increased in these organs and the skin, kidneys, stomach, large intestine and the mesentery.It is concluded that pharmacologically effective amounts of glucagon only passed into the systemic circulation with the higher dose infused intrasplenically. Thus the redistribution of cardiac output in favour of the splanchnic bed with the lower dose of glucagon infused into the portal region is most likely the result of local mechanisms rather than a direct effect of the hormone on the inflow vasculature resulting from recirculation. Send offprint requests to C. R. Hiley at the above address     

肝硬化患者胰高糖素负荷的血c—AMP及血糖反应性观察

目的观察肝硬化患者对胰高糖素负荷后的血c-AMP及血糖反应能力.方法38例肝硬化患者按Child-Pugh肝功能分级,分为A级(10例),B级(14例),C级(14例)三个亚组.11例健康者为对照组.清晨空腹静卧,套管针肘静脉穿刺并固定15min后采集基础血c-AMP和血糖标本,即刻以每公斤体重2.5μg胰高糖素快速静脉注射(30s内),分别于注射后5,15,30及45min采集血c-AMP和血糖标本.以放射免疫法测定血浆c-AMP浓度.以葡萄糖氧化酶法测定血糖浓度.结果肝硬化各组与对照组比较,基础血浆c-AMP浓度均显著高于对照组,而基础血糖无显著差异.胰高糖素负荷后5min血浆c-AMP浓度即明显增高,于10～15min达高峰,多数达峰时间在10min;血糖于5min开始升高,15～30min达高峰,多数达峰时间在30min,肝硬化各组的血c-AMP及血糖反应曲线均低于对照组,且肝硬化严重程度愈重,血c-AMP及血糖反应曲线愈低,峰值血浆c-AMP及峰值血糖浓度,肝硬化总体(122.08±84.39pmol/ml,5.71±0.75mmol/LA级(148.07±85.08pmol/ml,6.25±0.48mmol/L)、B级(120.47±173.34pmol/ml,5.84±0.60mmol/L)及C级(83.04±50.96pmol/ml,5.11±0.67mmol/L)均显著低于对照组(219.47±173.34pmol/ml,7.28±0.89mmol/L),且随肝硬化严重程度增加而显著降低.结论肝硬化患者对胰高糖负荷的血c-AMP及血糖反应能力减弱,且随肝硬化严重程度增加而减弱.     

Rapid rise in plasma glucagon induced by acute cold exposure in man and rat

The effect of acute cold exposure on the concentration of glucagon in the blood was investigated in man and in intact and adrenalectomized rats.In man fasted overnight acute cold exposure, which caused a twofold increase in O₂-consumption resulted in a rapid rise in plasma glucagon. The levels of insulin and blood glucose remained unaltered, while the concentration of serum free fatty acids and -hydroxybutyrate increased.In fasted intact rats acute cold exposure lead to similar effects. A close parallelism between the rise in plasma glucagon and the concentration of hepatic cycloAMP was observed. Adrenalectomy did not impair the cold induced rise in plasma glucagon and hepatic cycloAMP.It is concluded that acute cold exposure caused a rapid rise in the concentration of plasma glucagon leading to an increase in the concentration of hepatic cycloAMP, thus enhancing the rate of hepatic gluconeogenesis and ketogenesis. As these alterations were similar in the absence of glucocorticoids and medulla-derived catecholamines, it is suggested that glucagon may play a role in the metabolic adaptation to acute cold exposure.     

胰高血糖素对胆道梗阻大鼠肝脏葡萄糖和酮体合成的作用

目的观察胰高血糖素对胆道梗阻大鼠肝脏葡萄糖和酮体合成作用的影响。方法大鼠胆道结扎４８小时后,用胶原酶灌流后分离肝细胞,加入胰高血糖素温育,用分光光度计按标准酶学方法检测葡萄糖、乙酰乙酸和三羟基丁酸。结果在基础或最大刺激条件下,加胰高血糖素结扎组、假手术组葡萄糖异生均明显大于未加胰高血糖素组（Ｐ＜０．０５）,加胰高血糖素对结扎组和假手术组的酮体异生无促进作用。结论胰高血糖素对胆道梗阻４８小时大鼠肝细胞的糖异生存在有意义的刺激作用,对酮体异生则无刺激作用