title: Alpha-cells of the endocrine pancreas: 35 years of research but the enigma remains.
abstract: Glucagon, a hormone secreted from the alpha-cells of the endocrine pancreas, is critical for blood glucose homeostasis. It is the major counterpart to insulin and is released during hypoglycemia to induce hepatic glucose output. The control of glucagon secretion is multifactorial and involves direct effects of nutrients on alpha-cell stimulus-secretion coupling as well as paracrine regulation by insulin and zinc and other factors secreted from neighboring beta- and delta-cells within the islet of Langerhans. Glucagon secretion is also regulated by circulating hormones and the autonomic nervous system. In this review, we describe the components of the alpha-cell stimulus secretion coupling and how nutrient metabolism in the alpha-cell leads to changes in glucagon secretion. The islet cell composition and organization are described in different species and serve as a basis for understanding how the numerous paracrine, hormonal, and nervous signals fine-tune glucagon secretion under different physiological conditions. We also highlight the pathophysiology of the alpha-cell and how hyperglucagonemia represents an important component of the metabolic abnormalities associated with diabetes mellitus. Therapeutic inhibition of glucagon action in patients with type 2 diabetes remains an exciting prospect.
authors.affiliation: Novartis Institutes for BioMedical Research, 100 Technology Square, Cambridge, Massachusetts 02139, USA. jesper.gromada@novartis.com
authors.forename: Jesper
authors.initials: J
authors.lastname: Gromada
authors.forename: Isobel
authors.initials: I
authors.lastname: Franklin
authors.forename: Claes B
authors.initials: CB
authors.lastname: Wollheim
mesh_terms: D000818:Animals; D001341:Autonomic Nervous System / Q000502:physiology; D002450:Cell Communication; D003920:Diabetes Mellitus / Q000473:pathology / Q000628:therapy; D050416:Glucagon-Secreting Cells / Q000378:metabolism / Q000473:pathology / Q000502:physiology*; D006801:Humans; D008954:Models, Biological