Physical exercise-induced hypoglycemia caused by failed silencing of monocarboxylate transporter 1 in pancreatic β cells

被引:164
作者
Otonkoski, Timo
Jiao, Hong
Kaminen-Ahola, Nina
Tapia-Paez, Isabel
Ullah, Mohammed S.
Parton, Laura E.
Schuit, Frans
Quintens, Roel
Sipilae, Ilkka
Mayatepek, Ertan
Meissner, Thomas
Halestrap, Andrew P.
Rutter, Guy A.
Kere, Juha
机构
[1] Univ Helsinki, Fac Med, FIN-00014 Helsinki, Finland
[2] Univ Helsinki, Hosp Childerns & Adolescents, FIN-00014 Helsinki, Finland
[3] Univ Helsinki, Dept Med Genet, FIN-00014 Helsinki, Finland
[4] Karolinska Inst, Dept Biochem & Nutr, Stockholm, Sweden
[5] Univ Bristol, Sch Med Sci, Wellcome Labs Integrated Cell Signalling, Bristol BS8 1TD, Avon, England
[6] Univ Bristol, Sch Med Sci, Dept Biochem, Bristol BS8 1TD, Avon, England
[7] Katholieke Univ Leuven, Dept Mol Cell Biol, Louvain, Belgium
[8] Univ Children Hosp, Dept Gen Pediat, Dusseldorf, Germany
[9] Univ London Imperial Coll Sci Technol & Med, Dept Cell Biol, Div Med, London, England
基金
英国惠康基金;
关键词
LACTATE-DEHYDROGENASE; INSULIN-SECRETION; EXPRESSION; GLUCOSE; OVEREXPRESSION; RELEASE; FAMILY; GENE; MCT1; HYPERINSULINISM;
D O I
10.1086/520960
中图分类号
Q3 [遗传学];
学科分类号
071007 ; 090102 ;
摘要
Exercise-induced hyperinsulinism (EIHI) is a dominantly inherited hypoglycemic disorder characterized by inappropriate insulin secretion during anaerobic exercise or on pyruvate load. We aimed to identify the molecular basis of this novel disorder of beta-cell regulation. EIHI mapped to chromosome 1 (LOD score 3.6) in a genome scan performed for two families with 10 EIHI-affected patients. Mutational analysis of the promoter of the SLC16A1 gene, which encodes monocarboxylate transporter 1 (MCT1), located under the linkage peak, revealed changes in all 13 identified patients with EIHI. Patient fibroblasts displayed abnormally high SLC16A1 transcript levels, although monocarboxylate transport activities were not changed in these cells, reflecting additional posttranscriptional control of MCT1 levels in extrapancreatic tissues. By contrast, when examined in S cells, either of two SLC16A1 mutations identified in separate pedigrees resulted in increased protein binding to the corresponding promoter elements and marked (3- or 10-fold) transcriptional stimulation of SLC16A1 promoter-reporter constructs. These studies show that promoter-activating mutations in EIHI induce SLC16A1 expression in (3 cells, where this gene is not usually transcribed, permitting pyruvate uptake and pyruvate-stimulated insulin release despite ensuing hypoglycemia. These findings describe a novel disease mechanism based on the failure of cell-specific transcriptional silencing of a gene that is highly expressed in other tissues.
引用
收藏
页码:467 / 474
页数:8
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