Modulation of glucagon-induced glucose production by dexfenfluramine in rat hepatocytes.

The mechanism of the antihyperglycaemic action of dexfenfluramine (DEXF) was investigated in isolated rat hepatocytes exposed to glucagon. Preincubation of hepatocytes with DEXF caused a dose-dependent inhibition of cyclic AMP formation by 100 nM glucagon (Ki = 0.29 mM) that was almost complete at 1 mM DEXF. Surprisingly, glucagon-induced phosphorylase activation was not affected by DEXF despite the significant drop in cyclic AMP levels. Glucose production stimulated by glucagon was inhibited by up to 48% by 1 mM DEXF, and the rate of glucose production correlated positively with the steady-state concentration of glucose 6-phosphate. DEXF also partially restored lactate + pyruvate production which was abolished by an optimal concentration of glucagon. Although DEXF was not able to prevent the inactivation of pyruvate kinase by glucagon, the lack of further accumulation of phosphoenolpyruvate in DEXF-treated cells supports the conclusion that the flux through pyruvate kinase is stimulated, probably via the increase in fructose 2,6-bisphosphate, thereby increasing glycolysis. Our results thus indicate that DEXF counteracts the inhibition of glycolysis by glucagon and that this property might contribute to the antihyperglycaemic effect of this drug. Furthermore, this study shows that, in the presence of the drug, glucagon caused phosphorylase activation and pyruvate kinase inactivation without a significant increase in cyclic AMP levels.