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Rat pancreatic beta and alpha 2 cells were purified by autofluorescence-activated cell sorting and used for electrophysiological patch clamp studies and measurements of the initial uptake of 45Ca. Both beta and alpha 2 cells were electrically active, the action potentials of the latter cells also were detected in the absence of glucose. Furthermore, alpha 2 cells differed from beta cells in lacking a glucose-sensitive K+ channel with a single conductance of 50-60 pS (in symmetric 140 mM K+ solutions). The rate of Ca2+ entry into the alpha 2 cells was slower than that into the beta cells, being equivalent to 0.2 mmol, kg-1 dry wt min-1. Whereas raising the glucose concentration to 20 mM significantly increased the amount of Ca2+ entering the beta cells, the sugar was without effect on Ca2+ entry into the alpha 2 cells.

Surface major histocompatibility complex (MHC) class I and class II expression by pancreatic islet cells is considered a local initiator or regulator of immune processes that can lead to diabetes. Locally released cytokines, in particular interferon-gamma, are known to stimulate MHC antigen expression by islet cells. The present study quantifies MHC expression in cultured pancreatic beta- and non-beta-cells from both rat and human organs. Interferon-gamma increased MHC class I expression in endocrine beta- and non-beta-cells as well as in pancreatic ductal cells. The cytokine induced a 6-fold increase in the MHC class I messenger ribonucleic acid levels in pancreatic beta-cells; this effect was 2-fold amplified in the presence of elevated glucose levels (20 mmol/L instead of 6 mmol/L). No MHC class II expression was observed in endocrine beta- or non-beta-cells; human, but not rat, ductal cells exhibited MHC class II expression that increased in the presence of interferon-gamma. These data indicate that the increase in beta-cell MHC class I expression described in the pancreata of diabetic patients may result from stimulated transcription after exposure to locally released interferon-gamma and/or to a hyperglycemic state. The association of human islets with ductal cells in which MHC class II expression is stimulated by interferon-gamma makes these cells potential participants in the autoimmune process in diabetes.

The islet amyloid polypeptide (IAPP) immunoreactivity of the adult rat pancreas is located in insulin-containing B cells as well as in somatostatin-containing D cells. In both cell types, the IAPP immunoreactivity is identical to rat synthetic IAPP in terms of its elution position after reversed phase HPLC and its binding to IAPP antibodies. The IAPP content per 106 B-cells is more than 100 fold lower than the corresponding insulin content, but comparable to the IAPP content of D cells. After induction of diabetes by streptozotocin, pancreatic IAPP seems predominantly located in somatostatin-containing cells. In normal rats, pancreatic insulin and IAPP content increase 20 fold from birth to 12 weeks of age; beyond week 12, the further rise in pancreatic insulin was not parallelled by an increase in IAPP content.

In vitro incubated rat islet B cells differ in their individual rates of protein synthesis. The number of cells in biosynthetic activity increases with the glucose concentration. Flow cytometric monitoring of the cellular redox states indicated that islet B cells differ in their individual metabolic responsiveness to glucose. A shift from basal to increased NAD(P)H fluorescence occurred for 18% of the cells at 1 mM glucose, for 43% at 5 mM, and for 70% at 20 mM. The functional significance of this metabolic heterogeneity was assessed by comparing protein synthesis in metabolically responsive and unresponsive subpopulations, shortly after their separation by autofluorescence-activated cell sorting. The glucose-sensitive subpopulation exhibited four- to fivefold higher rates of insulin synthesis during 60-min incubations at 2.5-10 mM glucose. Its higher biosynthetic activity was mainly caused by recruitment of cells into active synthesis and, to a lesser extent, by higher biosynthetic activity per recruited cell. Cells from the glucose-sensitive subpopulation were larger, and presented a threefold higher density of a pale secretory vesicle subtype, which is thought to contain unprocessed proinsulin. It is concluded that intercellular differences in metabolic responsiveness result in functional heterogeneity of the pancreatic B cell population.

Lymph node cells derived from T. brucei-infected mice fail to produce interleukin 2-(IL2) subsequent to a potent mitogenic trigger and actively suppress the capacity of normal cells to produce IL2 in co-culture experiments. The depletion of Thy-1+ cells does not decrease but rather increases the suppressive potential of the LNC derived from infected mice. A T cell-enriched nylon wool-nonadherent fraction, on the other hand, is not suppressive. The suppression of IL2 production is promptly restored by the addition of prostaglandin synthesis inhibitors suggesting a key role of the prostaglandin-producing macrophages. Our data indicate that such macrophages do not act indirectly through the induction of suppressor T cells, but rather directly interfere with the normal lymph node cells. In contrast to the essential role of prostaglandins in the impairment of IL2 production, these mediators are not involved in the suppression of IL2 receptor expression. Lymph node cells derived from Trypanosoma brucei-infected mice fail to produce interleukin 2 (IL2) subsequent to a potent mitogenic trigger and actively suppress the capacity of normal cells to produce IL2 in co-culture experiments. The depletion of Thy-1+ cells does not decrease but rather increases the suppressive potential of the LNC derived from infected mice. A T cell-enriched nylon wool-nonadherent fraction, on the other hand, is not suppressive. The suppression of IL2 production is promptly restored by the addition of prostaglandin synthesis inhibitors suggesting a key role of the prostaglandin-producing macrophages. Our data indicate that such macrophages do not act indirectly through the induction of suppressor T cells, but rather interfere directly with the normal lymph node cells.

Similar to other endocrine glands, the endocrine pancreas displays a characteristic topography of its constituent cells. The functional significance of this structural organization was examined by measuring the secretory activity of the B cell in rat islet cell preparations of different composition. Glucose released 30-fold more insulin from B cells lodged within intact islets as from purified single B cells; structurally coupled B cells and single B cells isolated with A cells or incubated with glucagon responded 4- and 2-fold, respectively, more effectively to glucose than single B cells alone. Glucose homeostasis is thus dependent not only on the number and integrity of the insulin-containing B cells but also on their interactions with neighboring B and non-B cells. This study provides direct support for the concept that the microanatomy of the islet creates the anatomical basis for functional cooperation between islet cells and hence for an appropriate glucose-induced insulin release.

A method is developed for the preparation of single, pure, and viable rat pancreatic A and B cells in numbers sufficient for in vitro analysis. Islet isolation and dissociation techniques have been modified to increase the yield in islet cells per pancreas and per experiment. Islet cells are separated on the basis of their light scatter activity and flavin adenine dinucleotide autofluorescence into single non-B cells, single B cells, and structurally coupled B cells. Islet non-B cells are further purified into single A cells by autofluorescence-activated sorting according to the cellular nicotinamide adenine dinucleotide phosphate content at 20 mM glucose. Apart from offering the advantage of separating cells according to their functional characteristics, this procedure succeeds in the simultaneous isolation of 95-100% pure A and B cells. More than 50% of the cells in the initial islet preparation are recovered as single purified cells which can be maintained in culture. The isolated pancreatic A and B cells have been defined in terms of their cell volume, DNA and hormone content, and ultrastructural characteristics. The availability of pure pancreatic A and B cells is expected to contribute to our understanding of the regulation of glucagon and insulin release.

Single pancreatic B cells are purified by autofluorescence-activated cell sorting, and their secretory activity is measured after overnight culture. Compared to intact islets, the isolated cells release 2-fold more insulin under basal conditions and 5-fold less during nutrient stimulation. Their secretory activity can be induced by glucose, leucine, or arginine, but only 0.3-1.7% of their hormone content is liberated at 20 mM nutrient concentrations. This poor nutrient-induced insulin release from purified B cells is attributed to their low cAMP levels and is markedly increased after addition of (Bu)2cAMP, of glucagon, or of pancreatic A cells. These results strongly support the concept that the potent in vivo insulin-releasing action of glucose and leucine is not only dependent on their fuel capacity in pancreatic B cells but also on the concurrent cAMP levels in these cells. In isolated islets, endogenously released glucagon apparently determines the cAMP production in B cells and thus participates in the nutrient-induced secretory process. Somatostatin and epinephrine were shown to exert their suppressive effects via the glucagon-dependent messenger system. It is concluded that nutrients and hormones interact with two different messenger systems which amplify each others' stimulatory effect upon insulin release. cAMP might represent the hormone-induced messenger which sets the B cell's sensitivity and secretory capacity for nutrient stimuli such as glucose. The higher insulin secretory response observed after reaggregation of single B cells could not be attributed to an altered activity in the nutrient or hormonal regulatory units, raising the possibility that the aggregated state of the cells is rather responsible for a better organization or cooperation of the secretory effector unit.

Publisher Summary This chapter discusses the methods for the separation of pancreatic islet cells according to functional characteristics. The physical properties of cells, such as their size and density, have served as a basis for their isolation. The ability to isolate cells according to the functional characteristics would permit a more precise cellular analysis of the tissue function, and it could also provide the appropriate in vitro models for investigating the physiopathological basis of certain diseases. In the study of diabetes mellitus, it is not clear whether and how the various pancreatic islet cells cooperate in the generation of the in vivo insulin response. A separation of the various islet cell types and their further distribution into the functionally homogeneous subpopulations may provide an experimental approach to the questions. The autofluorescence-activated cell sorting permits the isolation of islet cells with similar size and density, but with a different metabolic responsiveness to their physiological regulator glucose. The chapter reviews the work on islet cells and addresses investigations involved in diabetes research. It also intends for cell biologists in search of ways to isolate cells according to functional criteria.

Insulin-dependent diabetes develops when more than 90% of the insulin containing B cells are destroyed. The present study investigates whether the target B cells can counteract the damaging effects of cytotoxic substances. Purified islet cells were first exposed for 3-10 min to t-butylhydroperoxide, alloxan, streptozotocin, or B-cell surface antibodies plus complement, then cultured for 20 hr before the percent of dead cells was counted. t-Butylhydroperoxide destroyed all islet cell types whereas the three other agents exerted a dose-dependent toxicity upon islet B cells only. The survival of drug- and complement-treated cells varied with the culture conditions present between the initial cellular attack and the moment of cell death. For the four B-cell toxic agents tested, an increase in medium glucose following any of these treatments reduced the percent of dead cells. This protective effect was not observed with galactose or fructose, nor could it be induced in islet non-B cells; it was additive to the protective action glucose induced during preincubation of the cells prior to their exposure to certain cytotoxic agents such as alloxan. Nicotinamide also enhanced the survival of drug-treated B cells, irrespective of the damaging compound. The vitamin was most effective when applied immediately after the initial drug or complement treatment; it also protected islet non-B cells--in contrast to glucose. The present in vitro study has led to the recognition of defense mechanisms in pancreatic B cells. Physiologic compounds such as glucose and nicotinamide were found to stimulate islet B cells to counteract the damaging effects of B-cell toxic conditions. It is conceivable that the events involved in this protection are implicated in the pathogenesis and/or prevention of insulin-dependent diabetes.

Viable rat islet cells were used to detect islet cell surface antibodies (ICSA) in the sera of diabetic and control patients. ICSA were present in almost all recent-onset insulin-dependent diabetics younger than 30 yr (15/16); their incidence in other diabetics (6/22) was also higher than in normal controls (1/18) or in patients with autoimmune thyroiditis (1/12). The varying specificity of the ICSA for the different islet cell types led to the recognition of class I sera, whose ICSA bind exclusively to B cells, class II sera, binding only to A and pancreatic polypeptide (PP) cells and class III sera, reacting with the three islet cell types but not with D cells. Most recent-onset insulin-dependent diabetics younger than 30 contained class I-ICSA, which is consistent with an autoimmune basis of their disease and with an involvement of surface antibodies in the B cell destruction. The presence of class II ICSA in three older diabetics and in one normal control raises the question whether autoimmune reactions against A and PP cells exist and are associated with a distinct entity in islet disease. It is concluded that the autoimmune form of diabetes mellitus represents a heterogeneous group, in which ICSA-positive patients can be distinguished on the basis of their ICSA-binding to one or more islet cell types. Three techniques can be used for the further identification of circulating ICSA, namely binding experiments with purified A or B cells, electron microscopical analysis of ICSA-binding islet cells purified by fluorescence-activated cell sorting, and the immunocytochemical characterization of ICSA-positive cells.

Autofluorescence-activated cell sorting can be employed for the subfractionation of insulin-containing islet B-cells according to their responsiveness to their physiologic stimulus, glucose. The method utilizes a flow cytometric detection of the rapid variations in endogenous NAD (P) H - and FAD - fluorescence after exposure to 20 mM glucose. Under these conditions, a two-fold increase in NAD (P) H and a 40% decrease in FAD was observed in more than 75% of B-cells isolated from fed normal rats. The technique makes it possible to study the metabolic behaviour of the B-cell population in (physio)pathological conditions of impaired glucose-induced insulin release; the availability of functionally homogenous B-cell preparations facilitates studies on stimulus-secretion coupling. In view of the universal role of the cellular metabolic redox state in cell regulation, it is suggested that similar techniques can be developed for the metabolic analysis of other cell types and for their purification according to their responsiveness to specific stimuli.

Publisher Summary This chapter reviews the technique of autofluorescence-activated cell sorting and discusses its usefulness in recognizing and isolating cell preparations with different functional properties. Earlier studies demonstrated how the measurement of the cellular FAD and NAD(P)H fluorescent intensities allows the distinction and isolation of various types of pancreatic endocrine cells. Autofluorescence-activated cell sorting permitted the preparation of pure and single insulin-containing B cells, which were used to investigate the functional properties of this cell type without interference from other cell types. In the course of these studies, it was noticed that this endocrine cell population does not represent a homogeneous group of identical cells, but rather is composed of functionally diverse subpopulations. Several of these subpopulations have been recognized during flow cytometric analysis, whereby the cellular autofluorescent compounds FAD and NAD(P)H appeared again to be particularly powerful discriminators. The observation that a pure pancreatic B-cell population is composed of functionally diverse subpopulations underlines the need to purify cells according to their functional properties rather than according to their structural characteristics.

A standardized method has been developed for the assay of cell surface antibodies in IgM- and IgG-fractions from human serum. Suspensions of adult rat islet beta cells, islet non-beta cells, and anterior pituitary cels were used as antigen source and a cell sorter as analyser of the immunoglobulin binding to individual cells. Assay conditions were selected wherein no surface antibodies were detected in 33 control subjects younger than 20 years. In 30% of type 1 (insulin-dependent) diabetic patients, surface antibodies were measured with rat anterior pituitary cells as well as with rat isle beta cells. Binding to pituitary cells occured with IgM- and IgG-fractions and correlated positively with IgG binding to islet beta cells. At onset of the disease, the prevalence of IgM-rat anterior pituitary cell surface antibodies was higher than that of IgG-rat anterior pituitary cell surface antibodies. Cell surface antibodies were also detected in first-degree relatives of type 1 diabetic patients, but corresponded primarily to IgM-rat anterior pituitary cell surfaca antibodies. It is concluded that the development of type 1 diabetes in subjects younger than 20 years is associated with the generation of both IgM and IgG cell surface antibodies. The IgM surface antibodies may result from stimulated production of polyreactive natural autoantibodies and could precede the switch to the formation of monoreactive IgG autoantibodies. The assay of IgM cell surface antibodies can be useful in studies on the sequence of immune events in diabetes and other autoimmune disease.

A standardized cell surface antibody assay was used to measure binding of circulating human immunoglobulins to rat or piglet splenocytes. In 100-fold diluted serum fractions, lymphocyte surface antibodies were detected in 30% of type 1 (insulin-dependent) diabetic patients under 20 years of age but in none of 33 control subjects. Binding occurred with T and B lymphocytes, appeared unrelated to Fc receptors or protein glycosylation and was not attributable to insulin or albumin antibodies. At clinical onset of the disease, the lymphocyte surface antibodies belonged primarily to the IgM-class. Their presence was positively correlated to that of IgM-pituitary cell surface antibodies and their absorption by anterior pituitary cells occurred as well as by splenocytes. Lymphocyte surface antibodies remained present during the first years of insulin, treatment. They were also detected in first degree relatives of lymphocyte surface antibody-positivie patients. It is unlikely that IgM-lymphocyte surface antibodies mark the destructive process in the pancreatic B cell population. They may, instead, express a stat of immune reactivity which precedes the formation of IgG-autantibodies and therefore be associated with an event in the development of diseases such as type 1 (insulin-dependent) diabetes.

Insulin-dependent diabetes is the clinical definition for a condition of absolute insulin deficiency which leads to ketosis when no exogenous insulin is administered (Lefebvre, this volume). The syndrome was attributed to an insufficient number of pancreatic B-cells after it became clear that newly diagnosed cases contained at least a five-fold smaller B-cell mass than normal controls [1-5]. Little is known about the events which lead to such quantitative deficit. Clarification of the underlying mechanisms has been hindered by two major obstacles. The first is the inability to measure the pancreatic B-cell mass in vivo, which prevents the detection of the disease at an earlier stage and hence its follow-up in the light of extrapancreatic events. Secondly, it has been impossible so far to screen for agents which impair the growth or survival of the pancreatic B-cells or their precursor cells. During recent years, both issues have been investigated in man and in rodents with a genetic predisposition for insulin-dependent diabetes. It was shown that abnormal glucose tolerance curves can precede the onset of clinical diabetes and may thus serve as a more sensitive parameter for a reduced B-cell mass [6-8]. It remains nevertheless questionable whether this functional test can be employed as a reliable index for the actual number of pancreatic B-cells. Observations in recent-onset diabetic patients also suggested a heterogeneous origin of the disease, but succeeded only in exceptional cases in identifying an agent which was primarily responsible for the killing of B-cells [9-11].

Glucose caused a sustained and dose-related increase in the fructose 2,6-bisphosphate content of isolated pancreatic islets, as well as of purified pancreatic B-cells. With isolated B-cells, the glucose saturation curve was sigmoidal and superimposable on that obtained with hepatocytes isolated from unfed rats. However, the response to glucose was notably faster in purified B-cells than in isolated hepatocytes. In contrast again with the situation prevailing in the liver, glucagon failed to decrease significantly the concentration of fructose 2,6-bisphosphate in either islets or purified B-cells. It is proposed that, in the process of glucose-stimulated insulin secretion, an early increase in fructose 2,6-bisphosphate formation may, by causing activation of 6-phosphofructo-1-kinase, allow glycolysis to keep pace with the rate of glucose phosphorylation.

Islet cell surface antibodies (ICSA) have been detected in insulin-dependent diabetes (IDD). Current techniques for the detection of ICSA often suffer from a lack of standardization and from a poorly defined specificity. We have developed a standardized method to quantify binding of circulating IgM and IgG fractions with the surface of purified rat pancreatic B cells; parallel experiments on islet non-B cells serve as control for islet cell specificity. Using this procedure no abnormalities were detected in the binding of circulating IgM from 30 recent onset IDD to islet B or non-B cells, comparison being made with 30 healthy age-matched controls. On the other hand, the IgG fraction from IDD patients was found to bind selectively to islet B cells (p 0.01) while no binding was observed with IgG from the normal controls. It is concluded that the developed procedure allows the recognition, quantification and specification of autoimmune reactions against surface components of islet cells.