β-adrenergic blockers increase cAMP and stimulate insulin secretion through a PKA/RYR2/TRPM5 pathway in pancreatic β-cells in vitro

{beta}-adrenergic blockers ({beta}-blockers) are extensively used to inhibit {beta}-adrenoceptor activation and subsequent cAMP production in many cell types. In this study, we characterized the effects of {beta}-blockers on mouse pancreatic {beta}-cells. Unexpectedly, high doses (100 M) of {beta}- blockers (propranolol and bisoprolol) led to a 5-10 fold increase in cAMP levels, enhanced intracellular influx, and stimulated a 2-4 fold increase in glucose-and glimepiride-induced insulin secretion in MIN6-K8 clonal {beta}-cells and isolated mouse pancreatic islets. These effects were observed despite minimal expression of {beta}-adrenoceptors in these cells. Mechanistically, cAMP increase led to ryanodine receptor 2 (RYR2) phosphorylation via protein kinase A (PKA), triggering Ca2+-induced Ca2+ release (CICR). CICR then activates transient receptor potential cation channel subfamily M member 5 (TRPM5), resulting in increased Ca2+ influx via voltage-dependent Ca2+ channels. These effects contradict the conventional understanding of the pharmacology of {beta}-blockers, highlighting the variability in {beta}-blocker actions depending on the experimental context. Graphical abstract O_FIG O_LINKSMALLFIG WIDTH=200 HEIGHT=141 SRC="FIGDIR/small/618403v3_ufig1.gif" ALT="Figure 1"> View larger version (26K): org.highwire.dtl.DTLVardef@c9ef31org.highwire.dtl.DTLVardef@176a67aorg.highwire.dtl.DTLVardef@abc69aorg.highwire.dtl.DTLVardef@17ba9d4_HPS_FORMAT_FIGEXP M_FIG C_FIG At high concentrations (> 10 M), the {beta}-adrenergic blocker propranolol paradoxically increased intracellular cAMP levels in pancreatic {beta}-cells. This leads to PKA-induced RYR2 phosphorylation and extracellular Ca2+ influx, leading to CICR from the ER. CICR activated TRPM5, which augmented {beta}-cell electrical activity, extracellular Ca2+ influx, and insulin secretion.