An approach to a molecular understanding of exocytotic insulin release.

By the use of an in vitro insulin releasing system, new insights into the meechanisms underlying the insulin exocytotic process have been gained. It is proposed that insulin release is initiated by glucose interacting with a glucoreceptor on the plasma membrane. Some properties of this receptor are discussed. It is postulated that after initiation of secretion, continued insulin release is under the control of phosphorylated intermediates of glucose metabolism, i.e. glucose-6-phosphate and phosphoenol pyruvate, operating via a membrane-bound protein kinase. The initiation of insulin release by glucose, and the augmentation of this initiation by the above mentioned intermediates, is viewed as a modified cascade system. The cascade theory of insulin secretion is postulated as an alternative to the threshold distribution hypothesis of insulin secretion. The action of tolbutamide in relation to the two pool theory of insulin secretion is discussed.