L-leucine and L-phenylalanine induced insulin release and the influence of D-glucose. Kinetic studies with the perfused rat pancreas

Ingestion of leucine + phenylalanine with glucose produces an additive effect on serum insulin but less than additive effect on plasma glucose

Most individual amino acids stimulate insulin secretion and attenuate the plasma glucose response when ingested with glucose. We determined whether ingestion of two amino acids simultaneously with glucose would result in an additive effect on the glucose area response compared with ingestion of amino acids individually. Leucine and phenylalanine were chosen because they were two of the most potent glucose-lowering amino acids when given individually. Eight healthy subjects were studied on four separate days. Test meals were given at 0800. The first meal was a water control. Subjects then received 25 g glucose or leucine + phenylalanine (1 mmol/kg fat free body mass each) ±25 g glucose in random order. Glucose, insulin and glucagon were measured frequently for 2.5 hours thereafter. Net areas under the curves were calculated using the mean fasting value as baseline. The insulin response to leucine + phenylalanine was additive. In contrast, the decrease in glucose response to leucine + phenylalanine + glucose was less than additive compared to the individual amino acids ingested with glucose. Interestingly, the insulin response to the combination was largely due to the leucine component, whereas the glucose response was largely due to the phenylalanine component. Glucose was unchanged when leucine or phenylalanine, alone or in combination, was ingested without glucose. This trial is registered with ClinicalTrials.gov NCT01471509.

Role of proteins in insulin secretion and glycemic control

Dietary proteins are essential for the life of all animals and humans at all stages of the life cycle. They serve many structural and biochemical functions and have significant effects on health and wellbeing. Dietary protein consumption has shown an upward trend in developed countries in the past two decades primarily due to greater supply and affordability. Consumption is also on the rise in developing countries as affluence is increasing. Research shows that proteins have a notable impact on glucose homeostasis mechanisms, predominantly through their effects on insulin, incretins, gluconeogenesis, and gastric emptying. Since higher protein consumption and impaired glucose tolerance can be commonly seen in the same population demographics, a thorough understanding of the former's role in glucose homeostasis is crucial both toward the prevention and management of the latter. This chapter reviews the current state of the art on proteins, amino acids, and their effects on blood glucose and insulin secretion.

Plasma glucagon and insulin responses depend on the rate of appearance of amino acids after ingestion of different protein solutions in humans

To find out whether the hormonal response to feeding with protein solutions is influenced by the nature and degree of protein fractionation, we examined insulin and glucagon responses after intake of protein solutions containing the same amount of nitrogen (2.9 g each) in three men and three women. Four test meals (600 mL) [glucose (419 kJ/L), pea (PPH) and whey peptide hydrolysates (WPH) (921 and 963 kJ/L, respectively) and a cow's milk solution (MS) containing complete milk proteins (2763 kJ/L)] were tested. Peptide hydrolysates elicited a faster increase in venous plasma amino acids than did MS (P < 0.05). Despite the higher carbohydrate content of the MS, the peptide hydrolysates elicited a peak insulin response that was two and four times greater than that evoked by the MS and glucose solutions, respectively (P < 0.05). The insulin response was closely related to the increase in plasma amino acids, especially leucine, isoleucine, valine, phenylalanine and arginine, regardless of the rate of gastric emptying. The three protein solutions elicited similar increases of plasma glucagon; however, the response was fastest for both peptide hydrolysates (P < 0.05) and more prolonged for the MS (P < 0.05). The glucagon response was linearly related to the increase in plasma amino acids, regardless of the rate of gastric emptying or meal composition (r = 0.93, r = 0.96 and r = 0.78, all P < 0.05, for the PPH, WPH and MS). Among the plasma amino acids, tyrosine (r = 0.82-0.98, P < 0.05) and methionine (r = 0.98, P < 0.001) were most closely related to the plasma glucagon response. This study shows that the glucagon response to feeding with protein solutions depends on the increase in plasma amino acid concentrations. The combined administration of glucose and peptide hydrolysates stimulates a synergistic release of insulin, regardless of the protein source.

Leucine and tissue distribution of bulky and small neutral amino acids in rats: dissociation between transport and insulin-mediated effects

The mechanism of the observed decrease in the plasma concentration of several amino acids in the presence of high levels of Leu has remained unexplained. In the present study a decrease in the plasma concentration of Ile, Val, Phe, Tyr, Met, Ala, Pro and Gly was observed after the intraperitoneal injection of Leu to weanling rats. Decreases in net intracellular concentrations in muscle accompanied the decrease in plasma of all of these amino acids except Pro and Gly. An increase in the distribution ratio muscle/plasma was observed exclusively for Gly after administration of Leu or of a non-insulinogenic transport system L analogue. Diazoxide suppressed the Leu-induced decreases in plasma and muscle intracellular concentrations of Ile and Val as well as of Pro in plasma. An increase in the distribution ratio liver/plasma was observed for Pro and Gly in the absence but not in the presence of diazoxide. All the above changes were statistically significant. Hence insulin probably mediates Leu effects, promoting an increased utilization of Ile and Val in muscle and of Pro in liver. A more direct effect of Leu appears to be involved in the apparent increased utilization of Phe, Tyr and Ala in the same tissue. Gly depletion in plasma can be explained by its trapping by inhibitory action of Leu on the exodus of Gly through transport system L.

L-leucine or its keto acid potentiate but do not initiate insulin release in chicken

In the isolated perfused chicken pancreas, 20 and 40 mM L-leucine or 10-40 mM alpha-ketoisocaproic acid (alpha-KIC) did not initiate insulin release. In the presence of 14 mM glucose (a noninsulinotropic concentration), 20 mM L-leucine and 10 mM alpha-KIC evoked a slight biphasic insulin release. The response to 20 mM L-leucine was further increased when 14 mM glucose was combined with 10 mM L-glutamine (10 mM glutamine alone did not induce insulin release and did not potentiate the response to 10 mM L-leucine). At 1 mM, 8-bromo-adenosine 3',5'-cyclic monophosphate (8-BrcAMP) alone caused a slight and progressive increase in insulin secretion but did not sensitize the pancreas to either 20 mM L-leucine or 10 mM alpha-KIC, whereas it facilitated a marked insulin release in response to 14 mM glucose. On the other hand, 10-40 mM K+ or 20 mM L-arginine induced a rapid monophasic insulin output. In conclusion, L-leucine or alpha-KIC, which do not initiate insulin release alone and are not potentiated by 8-BrcAMP, may not be regarded as primary insulinotropic agents in the chicken. This result, together with the previously documented resistance of the chicken pancreas to glucose alone or to D-glyceraldehyde, strongly suggests that the mechanisms initiating insulin secretion are different in chickens and mammals, whereas potentiating mechanisms (low glucose concentration, arginine, acetylcholine, and cAMP) and membrane depolarization events (K+ and arginine) are present in both chickens and mammals.

Evidence for inhibition of exodus of small neutral amino acids from non-brain tissues in hyperphenylalaninaemic rats

The mechanism of the depletion of several plasma amino acids in PKU has remained unexplained. In the present study, a statistically significant decrease in the plasma concentration of several amino acids was observed 2 h after the intraperitoneal injection of Phe to weanling rats. The pattern was very similar to the one observed in PKU patients. Statistically significant increases in the distribution ratios liver/plasma and, mainly, muscle/plasma ratios accompanied in most of the cases the corresponding decreases in plasma concentrations. Equimolar injection under the same conditions of the non-insulinogenic transport system L analogue, the a(+/-) isomer of the 2-aminonorbornane-2-carboxylic acid, produced, in a parallel effect to Phe, statistically significant increases in the distribution ratios of Ala and Gly, and probably of Pro in muscle, as well as of Ala in liver. These results seem to indicate that the high intracellular Phe attained inhibits the exodus of small neutral amino acids through system L, causing their depletion in plasma and ultimately in the brain. This effect may be additive to the inhibition by Phe of the entry of bulky neutral amino acids at the level of the blood-brain barrier. Further study is needed to assess the relevance of these effects to PKU.

Secretagogues for pancreatic hormone release in the channel catfish (Ictalurus punctatus)

We investigated the effect of several potential carbohydrate secretagogues, amino acids, a ketoacid, and potassium chloride on insulin, glucagon, and somatostatin release from the in vitro perfused Brockmann body of channel catfish (Ictalurus punctatus). Mannose (15 mM) stimulated the release of insulin and somatostatin. Fructose (30 mM) induced only a small and transient release of somatostatin. Galactose (15 mM) was not a secretagogue. Likewise, glyceraldehyde failed to stimulate hormone release. Among the amino acids newly tested, alanine and leucine, and also alpha-ketoisocaproic acid were without effect. A high concentration of potassium (25 mEq/liter) induced a pronounced release of insulin and glucagon and a moderate release of somatostatin. In conclusion, a striking similarity exists between catfish and higher vertebrates in their pancreatic endocrine response to hexoses; on the other hand, the catfish Brockmann body appears to respond only to a few of the common stimuli of pancreatic hormone release in mammals.

Plasma amino acid values and pancreatic beta-cell function in phenylketonuria

In 16 phenylketonuric (PKU) patients aged 5-12 years, plasma glucose, immunoreactive insulin (IRI), C-peptide (CP) and plasma amino acids were measured in basal conditions and under a standard oral glucose tolerance test (OGTT). The beta-cell response to OGTT was higher in PKU patients than in normal subjects as demonstrated by peak levels and areas under the curves of plasma concentrations of IRI and of CP. A significant correlation was observed between plasma phenylalanine values and both IRI and CP 'output' in PKU patients. Mean concentrations of branched chain amino acids and tyrosine in plasma decreased significantly during OGTT, while phenylalanine values increased in PKU subjects.

Potentiation of insulin release in response to amino acid methyl esters correlates to activation of islet glutamate dehydrogenase activity

Column perifusion of mouse pancreatic islets was used to study the ability of amino acids and their methyl esters to influence insulin release and activate islet glutamate dehydrogenase activity. In the absence of L-glutamine, L-serine and the methyl ester of L-phenylalanine, but neither L-phenylalanine nor L-serine methyl ester, stimulate insulin secretion. In the presence of L-glutamine, however, the effect of L-serine was additive, while the methyl esters of L-serine and L-phenylalanine as well as native L-phenylalanine, potentiated the glucose-stimulated release of insulin. Measurements of islet glutamate dehydrogenase activity showed that only the two methyl esters of L-phenylalanine and L-serine activated the enzyme. It is concluded that the mechanism by which methyl esters of amino acids potentiate insulin release is most likely to be mediated by the activation of pancreatic beta-cell glutamate dehydrogenase activity.

Effect of amino-acids on secretion of insulin by isolated islets of the monkey

Insulin secretion was monitored in monkey islets isolated by collagenase digestion and exposed to leucine and arginine with and without glucose. Leucine by itself (10 to 40 mmol/l) elicited concentration-dependent insulin secretion. At 40 mmol/l, leucine was approximately 60% as effective as glucose (16.7 mmol/l). The response to leucine was increased at low glucose concentrations. In high concentrations (20 and 40 mmol/l), arginine by itself was a poor stimulant. The effect of arginine was enhanced at low glucose concentrations (2.8 to 5.6 mmol/l). At high glucose concentrations neither amino-acid produced any significant further increase in insulin release.

Effects of alloxan on the islets of Langerhans: inhibition of leucine metabolism and insulin secretion

The action of alloxan on the metabolism of the islets of Langerhans was studied in vitro. Isolated mouse islets were exposed to the drug at 4 degrees C to prevent its decomposition. Islet uptake of leucine was subsequently estimated at 37 degrees C, and was found not to be affected by the drug. However, islet leucine oxidation was strongly inhibited by the preceding alloxan exposure. The islets were protected against this inhibition by an incubation at a high glucose concentration prior to alloxan exposure. In contrast, a high concentration of leucine failed to provide full protection of either islet leucine oxidation or islet glucose oxidation. Furthermore, it was shown that alloxan impeded islet insulin response to both leucine and glucose. In addition, the potentiation of insulin release by theophylline was abolished after alloxan treatment of the islets. The results reinforce the hypothesis that the B-cytotoxicity of alloxan reflects an interaction with intracellular sites involved in the oxidative metabolism of the B-cell, and that these sites may be protected against the action of the drug by some metabolite of glucose.

Previous exposure to glucose enhances somatostatin secretion from the isolated perfused rat pancreas

Previous exposure to glucose enhances insulin and depresses glucagon secretion by the pancreas. We have investigated whether secretion of somatostatin is also influenced by a glucose priming effect. In perfused rat pancreas from 36 h fasted rats a 5 min pulse of arginine (8 mmol/l) rapidly elicited a peak of somatostatin release. A similar somatostatin response was evoked by a second, identical, pulse of arginine after perfusion with "basal" glucose (3.9 mmol/l) for 45 min. On the other hand when 27.7 mmol/l D-glucose, was administered for 20 min between arginine pulses, there was significant stimulation of somatostatin secretion. When arginine was re-introduced 15 min after the cessation of the pulse of elevated glucose the magnitude of the arginine-induced peak (min 0-2 of stimulation) was increased from 16.2 +/- 4.1 to 33.1 +/- 4.7 pg/2 min, p less than 0.01, relative to the first stimulation with arginine. None of these effects of glucose could be reproduced by D-galactose. The somatostatin response to arginine was higher in pancreata from fed than from 36 h fasted animals as was also basal release (22.8 +/- 5.0 vs 9.0 +/- 2.0 pg/min). In the fed state the response to the second pulse of arginine was however reduced by 50% after perfusion with "basal" glucose. This decrease in responsiveness was counteracted by perfusion with 27.7 mmol/l glucose for 20 min between the arginine pulses. It is concluded that previous exposure to an elevated concentration of glucose enhanced D-cell responsiveness to arginine in the fasted as well as the fed state.

Time and dose dependencies for priming effect of glucose on insulin secretion

Short-term exposure to glucose increases insulin secretion during subsequent stimulation. This priming effect of glucose was further investigated in the perfused rat pancreas. A 5-min pulse of 27.7 mM glucose enhanced the response to a second pulse of the sugar after a 5- or 30-min period of 3.9 mM glucose. With a 10-min pulse of 27.7 mM glucose, the priming effect tended to persist also after a 60-min but not after a 90-min rest period. The priming effects of glucose were also evaluated from enhancement of stimulation 15 min later with 3-isobutyl-l-methylxanthine (IBMX). A 10-min pulse of 8.3 and 27.7, but not 5.6 mM glucose enhanced IBMX-induced insulin secretion. Cycloheximide did not abolish the priming effect of glucose on IBMX-induced insulin secretion. Conclusions are 1) priming is rapidly induced; 2) it persists longer than the time of induction; 3) threshold concentrations of glucose that induce priming are similar to those that initiate insulin secretions; and 4) mechanisms causing priming may not involve protein synthesis.

Depression of leucine and isoproterenol induced insulin secretions in the spontaneously diabetic New Zealand white rabbit

Rabbits were studied from a closed colony of NZW rabbits which exhibits a 19% occurrance of spontaneous diabetes mellitus. Six overtly diabetic rabbits and eight rabbits with normal glucose disposal were tested with intravenous glucose challenge (500 mg/kg), L-leucine administration (125 mg/kg), and 30 minute infusions with isoproterenol (10 microgram/kg/min.). These agents were shown to be ineffective insulin secretogogues in the overtly diabetic group when compared to the highly significant IRI response observed in colony rabbits with normal glucose disposal. The data indicate that the defect in IRI secretion observed in the spontaneously diabetic NZW rabbits is not confined to stimulation by glucose, but represents an abnormal IRI release mechanism which appears to lack secretogogue specificity.

Sulphydryl requirement for insulin release from the perfused pancreas. Studies with ethacrynic acid and dithiothreitol

Using the isolated, perfused rat pancreas the importance of sulphydryl groups for the secretory process of insulin was investigated. It was found that ethacrynic acid (EA, 0.075-0.6 mmol/1) caused a dose-dependent, monophasic insulin release. Addition of EA to a glucose-stimulated (20 mmol/1) pancreas led to a sudden increase in hormone release, followed by a dose-dependent inhibition of release, which was not reversible after removal of EA. The same phenomenon was seen in the presence of 20 mmol/1 leucine. Dithiothreitol (DTT, 0.1 and 1 mmol/1) had no effect on basal insulin secretion. Added to a glucose-stimulated pancreas DTT (1 mmol/1) caused a reversible inhibition of insulin release. The persistent inhibitory action of EA on glucose-induced insulin release could be reversed by simultaneous perfusion of EA and DTT. Sequential exposure of a glucose-stimulated pancreas to EA and DTT led to a rapid release of insulin, due to DTT; however, the EA-induced inhibition of insulin secretion could not be prevented. Two kinds of thiol groups in the plasma membrane and in the beta cell might be responsible for the various kinetics of insulin release induced by EA and DTT.