Calcium release channel RyR2 regulates insulin release and glucose homeostasis

J Clin Invest. 2015 May;125(5):1968-78. doi: 10.1172/JCI79273. Epub 2015 Apr 6.

Abstract

The type 2 ryanodine receptor (RyR2) is a Ca2+ release channel on the endoplasmic reticulum (ER) of several types of cells, including cardiomyocytes and pancreatic β cells. In cardiomyocytes, RyR2-dependent Ca2+ release is critical for excitation-contraction coupling; however, a functional role for RyR2 in β cell insulin secretion and diabetes mellitus remains controversial. Here, we took advantage of rare RyR2 mutations that were identified in patients with a genetic form of exercise-induced sudden death (catecholaminergic polymorphic ventricular tachycardia [CPVT]). As these mutations result in a "leaky" RyR2 channel, we exploited them to assess RyR2 channel function in β cell dynamics. We discovered that CPVT patients with mutant leaky RyR2 present with glucose intolerance, which was heretofore unappreciated. In mice, transgenic expression of CPVT-associated RyR2 resulted in impaired glucose homeostasis, and an in-depth evaluation of pancreatic islets and β cells from these animals revealed intracellular Ca2+ leak via oxidized and nitrosylated RyR2 channels, activated ER stress response, mitochondrial dysfunction, and decreased fuel-stimulated insulin release. Additionally, we verified the effects of the pharmacological inhibition of intracellular Ca2+ leak in CPVT-associated RyR2-expressing mice, in human islets from diabetic patients, and in an established murine model of type 2 diabetes mellitus. Taken together, our data indicate that RyR2 channels play a crucial role in the regulation of insulin secretion and glucose homeostasis.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Amino Acid Substitution
  • Animals
  • Calcium / metabolism*
  • Diabetes Mellitus, Type 2 / genetics
  • Diabetes Mellitus, Type 2 / metabolism
  • Endoplasmic Reticulum Stress / physiology*
  • Female
  • Glucagon / metabolism
  • Glucose / metabolism*
  • Glucose Intolerance / genetics
  • Homeostasis
  • Humans
  • Insulin / metabolism*
  • Insulin Secretion
  • Ion Transport
  • Islets of Langerhans / metabolism*
  • Male
  • Mice, Obese
  • Mice, Transgenic
  • Mitochondria / metabolism
  • Mutation, Missense
  • Nitrosation
  • Oxidation-Reduction
  • Point Mutation
  • Ryanodine Receptor Calcium Release Channel
  • Tachycardia, Ventricular / genetics*
  • Tachycardia, Ventricular / metabolism
  • Young Adult

Substances

  • Insulin
  • Ryanodine Receptor Calcium Release Channel
  • Glucagon
  • Glucose
  • Calcium

Supplementary concepts

  • Polymorphic catecholergic ventricular tachycardia