The role of calcium in stimulation of sugar transport in muscle by lithium

Inhibition of glycogen synthase kinase 3 improves insulin action and glucose metabolism in human skeletal muscle

Glycogen synthase kinase (GSK)-3 has been implicated in the regulation of multiple cellular physiological processes in skeletal muscle. Selective cell-permeable reversible inhibitors (INHs) of GSK-3 (CT98014 and CHIR98023 [Chiron, Emeryville, CA] and LiCl) were used to evaluate the role of GSK-3 in controlling glucose metabolism. Acute treatment (30 min) of cultured human skeletal muscle cells with either INH resulted in a dose-dependent activation of glycogen synthase (GS) with a maximally effective concentration of approximately 2 micromol/l. The maximal acute effect of either INH on GS (103 +/- 25% stimulation over basal) was greater than the maximal insulin response (48 +/- 9%, P < 0.05 vs. INH); LiCl was as effective as insulin. The GSK-3 inhibitor effect, like that of insulin, was on the activation state (fractional velocity [FV]) of GS. Cotreatment of muscle cells with submaximal doses of INH and insulin resulted in an additive effect on GS FV (103 +/- 10% stimulation, P < 0.05 vs. either agent alone). Glucose incorporation into glycogen was also acutely stimulated by INH. While prolonged (6-24 h) insulin exposure led to desensitization of GS, INH continued to activate GS FV for at least 24 h. Insulin and LiCl acutely activated glucose uptake, whereas INH stimulation of glucose uptake required more prolonged exposure, starting at 6 h and continuing to 24 h. Chronic (4-day) treatment with INH increased both basal (154 +/- 32% of control) and insulin-stimulated (219 +/- 74%) glucose uptake. Upregulation of uptake activity occurred without any change in total cellular GLUT1 or GLUT4 protein content. Yet the same chronic treatment resulted in a 65 +/- 6% decrease in GSK-3 protein and a parallel decrease (61 +/- 11%) in GSK-3 total activity. Together with the INH-induced increase in insulin-stimulated glucose uptake, there was an approximately 3.5-fold increase (P < 0.05) in insulin receptor substrate (IRS)-1 protein abundance. Despite upregulation of IRS-1, maximal insulin stimulation of Akt phosphorylation was unaltered by INH treatment. The results suggest that selective inhibition of GSK-3 has an impact on both GS and glucose uptake, including effects on insulin action, using mechanisms that differ from and are additive to those of insulin.

Lithium's effects on rat liver glucose metabolism in vivo

Oral administration of lithium carbonate to fed-healthy rats strongly decreased liver glycogen content, despite the simultaneous activation of glycogen synthase and the inactivation of glycogen phosphorylase. The effect seemed to be related to a decrease in glucose 6-phosphate concentration and to a decrease in glucokinase activity. Moreover, in these animals lithium markedly decreased liver fructose 2,6-bisphosphate, which could be a consequence of the fall in glucose 6-phosphate and of the inactivation of 6-phosphofructo-2-kinase. Liver pyruvate kinase activity and blood insulin also decreased after lithium administration. Lower doses of lithium carbonate had less intense effects. Lithium administration to starved-healthy and fed-streptozotocin-diabetic rats caused a slight increase in blood insulin, which was simultaneous with increases in liver glycogen, glucose 6-phosphate, and fructose 2, 6-phosphate. Glucokinase, 6-phosphofructo-2-kinase, and pyruvate kinase activities also increased after lithium administration in starved-healthy and fed-diabetic rats. Lithium treatment activated glycogen synthase and inactivated glycogen phosphorylase in a manner similar to that observed in fed-healthy rats. Glycemia was not modified in any group of animals. These results indicate that lithium acts on liver glycogen metabolism in vivo in at least two different ways: one related to changes in insulinemia, and the other related to the direct action of lithium on the activity of some key enzymes of liver glucose metabolism.

Effects of lithium deficiency in some insulin-sensitive tissues of diabetic Chinese hamsters

In this work, we report the effect of low-dose lithium carbonate on blood glucose levels and tissue lithium content in hereditary spontaneous diabetic Chinese hamsters (HSDCHs). Hepatic lithium levels are significantly lower in diabetic hamsters when compared to healthy controls: 2.05 +/- 0.26 and 3.04 +/- 0.11 micrograms/g, respectively. The same trend was observed in kidney and muscle: 18.26 +/- 0.24 vs 20.23 +/- 1.10 micrograms/g and 4.66 +/- 0.17 vs 5.95 +/- 0.67 micrograms/g, respectively. The significance level was p < 0.05 in all cases. Supplementation with lithium carbonate eliminated tissue lithium deficiency, and had a normalizing effect on blood glucose and glycosylated serum protein levels. The insulin sensitivity index (ISI) increased, thus reducing insulin resistance. Our results suggest that lithium deficiency in certain insulin-sensitive tissues may be associated with blood glucose imbalance resulting from insulin resistance.

Effect of chronic lithium chloride on membrane adenosine triphosphatases in certain postural muscles of rats

Lithium has been extensively used as an antidepressant in the treatment of manic depressive disorders requiring chronic administration. Here, we report a study of the effect of long-term lithium treatment on the activities of membrane adenosine triphosphatases (ATPases) in certain postural muscles of rat. Specifically, Ca(2+)-ATPase, Na+,K(+)-ATPase and Mg(2+)-ATPase activities were measured in the soleus, extensor digitorum longus and plantaris muscles following 6 weeks of treatment with LiCl. Increases were observed in the Na+,K(+)-ATPase activity whereas the Mg(2+)-ATPase activity decreased with prolonged LiCl treatment. The most pronounced effect was a highly significant (P < 0.001) increase in the mitochondrial Ca(2+)-ATPase and Na+,K(+)-ATPase activity to almost 50-100% above the control. The increases in the mitochondrial Ca(2+)-ATPase activity of extensor digitorum longus and plantaris were 70% and 100%, respectively. The corresponding increases in the Na+,K(+)-ATPase activity were 127%, 99% and 87% for soleus, extensor digitorum longus and plantaris, respectively. Irrespective of the differences in the fiber pattern and physiological function, all three muscles responded in a similar way to Li+. The changes in the membrane ATPases reflect a deranged ATP turnover, thus affecting the overall energy state of the animal. Based on these results, we hypothesize that Li+ produces its effects by interfering with cation transport processes. Since Li+ affects the neural excitability of the cell it is suggested that the stimulation of the ATPases may be important in the psychotropic properties of the ion.

The effect of short term lithium treatment on the leukocyte, liver and muscle carbohydrate metabolism of guinea-pigs

1. The effect of lithium treatment on the leukocyte, liver and muscle glycogen levels of guinea-pigs has been studied. 2. A 4-week treatment with lithium chloride (5 mmol/l i.p. in saline) increased leukocyte, liver and muscle glycogen and decreased blood glucose levels. 3. These results strongly suggest that a lithium-induced insulin-like effect may be related to the long term effect.

Control of placental glucose transfer

There is little evidence to suggest that the membrane transfer mechanism of the placenta for glucose becomes saturated until maternal blood glucose concentrations are quite high. Also, recent evidence suggests that the membrane transport system for glucose in the placenta is not stimulated by maternal or fetal insulin. Furthermore, there is no solid evidence that hormonal or non-hormonal factors function in vivo to limit membrane transport of glucose in the placenta. Therefore, the limited data which are available suggest that there are no specific mechanisms which acutely regulate placental membrane transport of glucose, and that this membrane transport mechanism operates to maximize maternal-to-fetal glucose transfer. The rate of maternal-to-fetal glucose transfer is a function of the transplacental concentration gradient. This gradient appears to be under the control of fetal insulin and placental lactogen. The available data suggest that both hormones act to increase this concentration gradient: insulin by decreasing fetal blood glucose, and placental lactogen by both decreasing fetal and increasing maternal blood glucose concentrations. Furthermore, high rates of glucose uptake by fetal erythrocytes tend to promote maintenance of this concentration gradient. Therefore, these influences of the maternal-fetal concentration gradient promote transplacental glucose flux to the fetus. As illustrated by the fetal complications associated with maternal hyperglycaemia, the cellular and organismic physiology of the fetus and placenta appears to maximize, rather than optimize, glucose availability to the fetus. It may be, however, that during normal pregnancy, maximal availability is optimal for fetal development.

Regulation of 3-O-methyl-D-glucose uptake in isolated bovine adrenal chromaffin cells

We showed earlier that insulin stimulated sugar transport in adrenal chromaffin cells (Bigornia, L. and Bihler, I. Biochim. Biophys. Acta 885, 335-344). Transport regulation and its Ca2+ -dependence was further investigated in isolated bovine adrenal chromaffin cells, serving as a model of a homogeneous neuronal cell population. Uptake of the nonmetabolizable glucose analogue, 3-O-methyl-D-glucose was stimulated by hyperosmolar medium, and this effect was abolished in the absence of external Ca2+, or depressed in the presence of La3+ or the slow Ca2+ channel blocker methoxyverapamil. Basal transport was also stimulated by factors (acetylcholine, carbamylcholine, low-Na+ medium), which cause Ca2+ -dependent catecholamine release, and these effects were abolished in Ca2+ -free medium. In addition insulin, acetylcholine, hyperosmolar and low-Na+ medium significantly increased 45Ca uptake. Thus, glucose transport in adrenal chromaffin cells was stimulated by insulin and hyperosmolarity in a Ca2+ -dependent manner, as in muscle. Sensitivity to secretory stimuli, a regulatory feature perhaps characteristic of this cell type, was also demonstrated. In contrast to muscle, sugar transport was not affected by Na+ -pump inhibition, metabolic inhibitors or the Na+ ionophore monensin, suggesting that Ca2+ influx by Na+/Ca2+ exchange does not play a significant role in the activation of sugar transport in chromaffin cells.

Monensin stimulates sugar transport in avian erythrocytes

The cell-medium distribution of the nonmetabolized glucose analog, 3-O-methyl-D-glucose was studied in pigeon erythrocytes. The sodium ionophore monensin increased in parallel and in a dose-dependent manner the influx of hexose and of Na+. These effects were independent of external Ca2+ and there was no alteration in 45Ca influx. If, as suggested previously, hexose transport in these cells is modulated by cytoplasmic Ca2+, the stimulatory effect of monensin on hexose transport may be due to increased mitochondrial Ca2+ efflux via Na+-Ca2+ exchange, owing to the elevation of cytoplasmic Na+. Such a mechanism is consistent with the observed failure of monensin to affect 3-O-methyl-D-glucose transport in cells partially depleted of Ca2+. Monensin also depressed cellular ATP levels but the data favour a Ca2+-dependent mechanism of hexose transport regulation rather than a direct effect of metabolic depletion. The inhibitor of specific-mediated hexose transport, cytochalasin B was found to inhibit equally basal and stimulated 3-O-methyl-D-glucose uptake but there was a cytochalasin B-insensitive uptake component in excess of L-glucose uptake. This appears to reflect a greater diffusional permeability of 3-O-methyl-D-glucose than of L-glucose.

Stimulation of glucose transport in skeletal muscle by the sodium ionophore monensin

The tissue/medium distribution of the nonmetabolized glucose analog 3-O-methyl-D-glucose was measured in mouse diaphragm muscle and related to changes in 45Ca influx, Na+ content and Na+-pump activity. In the presence of external Ca2+ the sodium ionophore monensin greatly increased cellular Na+ content (and decreased K+ content) although 86Rb uptake, reflecting Na+-pump activity was increased. Concomitantly, 45Ca influx was stimulated, presumably through activation of Na+-Ca2+ exchange. In parallel to the rise in Ca2+ influx sugar transport was also increased. Sugar transport was also increased by monensin in the nominal absence of external Ca2+, when Ca2+ influx was minimal. To test if monensin releases Ca2+ from intracellular storage sites in the absence of external Ca2+, the ionophore was added to medium perfusing rat hind limb preparations and the total Ca content of muscle mitochondria was determined. When Ca2+ was present in the perfusate, monensin increased the mitochondrial Ca content. In the absence of Ca2+, the mitochondrial Ca content was lower and was further depressed by monensin, suggesting that elevation of internal Na+ by monensin may increase mitochondrial Ca2+ loss via activation of Na+-Ca2+ exchange across the mitochondrial membrane. The above results are consistent with the effect of monensin on sugar transport being due to alterations in Ca2+ distribution. They support the earlier conclusion that regulation of sugar transport in muscle is Ca2+ dependent.

Regulation of glucose transport in Ca2+-tolerant myocytes from adult rat heart

Calcium-tolerant cardiac myocytes were isolated from adult rat ventricles and sarcolemmal glucose transport was assessed by measuring linear initial uptake rates of the nonmetabolized glucose analog 3-O-methyl-D-glucose in the presence and absence of Ca2+ in the incubation medium. (1) Agents which are known to increase internal Na+ and thus stimulate Ca2+ influx via Na+-Ca2+ exchange stimulated 3-methylglucose transport in the presence of external Ca2+. These include low-Na+ medium, 10(-6) M ouabain and K+-free medium, cyanide and the sodium ionophore, monensin. Hyperosmolarity stimulated transport also in the absence of Ca2+, consistent with release of Ca2+ from internal stores. Transport was decreased in a hypo-osmolar medium and with 10(-9) M ouabain, a concentration which stimulates the Na+ pump. (2) The calcium ionophore A23187 increased basal 3-methylglucose transport but opposed stimulation of transport by insulin. (3) Insulin-stimulated transport was antagonized by palmitate and this effect was reversed by 2-bromostearate, an inhibitor of fatty acid oxidation. These results are identical in all respects to those obtained in intact cardiac and skeletal muscle preparations, confirming that hexose transport in muscle shows Ca2+ dependence and indicating that isolated cardiac myocytes are suitable for the study of this phenomenon.