Sulfonylurea induced beta-cell apoptosis in cultured human islets

J Clin Endocrinol Metab. 2005 Jan;90(1):501-6. doi: 10.1210/jc.2004-0699. Epub 2004 Oct 13.


Loss of beta-cell mass and function raises a concern regarding the application of sulfonylureas for the treatment of type 2 diabetes because previous studies have shown that agents that cause closure of inwardly rectifying K(+) sulfonylurea receptor subtype of ATP-sensitive potassium channels, such as tolbutamide and glibenclamide, induce apoptosis in beta-cell lines and rodent islets. Therefore, we investigated the effect of the new insulin secretagogues, repaglinide and nateglinide, and the sulfonylurea, glibenclamide, on beta-cell apoptosis in human islets. Human islets from six organ donors were cultured onto extracellular matrix-coated plates and exposed to glibenclamide, repaglinide, or nateglinide. The doses of the three compounds were chosen according to detected maximal effects, i.e. efficacy. Exposure of human islets for 4 h to 0.1 and 10 microm glibenclamide induced a 2.09- and 2.46-fold increase in beta-cell apoptosis, respectively, whereas repaglinide (0.01 and 1 microm) did not change the number of apoptotic beta-cells. At low concentration (10 microm), nateglinide did not induce beta-cell apoptosis. However, at high concentration of 1000 microm, it induced a 1.49-fold increase in the number of apoptotic beta-cells. Prolonged exposure for 4 d of the islets to the secretagogues induced beta-cell apoptosis. The increase was of 3.71- and 4.4-fold at 0.1 and 10 microm glibenclamide, 2.37- and 3.8-fold at 0.01 and 1 microm repaglinide, and of 3.2- and 4.6-fold at 10 and 1000 microm nateglinide, respectively. Glibenclamide at 0.1-10 nm (doses that were less efficient on insulin secretion) did not induce beta-cell apoptosis after 4 h incubation as well as 0.1 nm after 4 d incubation. However, 1 and 10 nm glibenclamide for 4 d induced a 2.24- and 2.53-fold increase in beta-cell apoptosis, respectively. Taken together, closure of the inwardly rectifying K(+) sulfonylurea receptor subtype of ATP-sensitive potassium channels induces beta-cell apoptosis in human islets and may precipitate the decrease in beta-cell mass observed in patients with type 2 diabetes.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Adult
  • Aged
  • Apoptosis / drug effects*
  • Calcium / metabolism
  • Carbamates / pharmacology
  • Cells, Cultured
  • Cyclohexanes / pharmacology
  • Dose-Response Relationship, Drug
  • Glyburide / pharmacology*
  • Humans
  • Hypoglycemic Agents / pharmacology*
  • Insulin / pharmacology
  • Islets of Langerhans / cytology
  • Islets of Langerhans / drug effects*
  • Middle Aged
  • Nateglinide
  • Phenylalanine / analogs & derivatives*
  • Phenylalanine / pharmacology
  • Piperidines / pharmacology


  • Carbamates
  • Cyclohexanes
  • Hypoglycemic Agents
  • Insulin
  • Piperidines
  • Nateglinide
  • Phenylalanine
  • repaglinide
  • Glyburide
  • Calcium