Combined effect of GABA and glucagon-like peptide-1 receptor agonist on cytokine-induced apoptosis in pancreatic β-cell line and isolated human islets BETA GABA-1 offspring

Background Treatment with GABA or glucagon-like peptide-1 (GLP-1) can preserve pancreatic beta-cell mass and prevent diabetes. Recently, we reported that the combination of GABA and sitagliptin (a dipeptidyl peptidase-4 inhibitor that increases endogenous GLP-1) was more effective than either agent alone in reducing drug-induced beta-cell damage and promoting beta-cell regeneration in mice. However, in human islets, it remains unclear whether GABA and GLP-1 exert similar effects. Methods To investigate GABA and GLP-1 interactions, human islets or INS-1 cells were treated with GABA and/or exendin-4, a GLP-1 receptor agonist (GLP-1RA) in clinical use, and incubated with a cytokine mixture for 24 hours. Cleaved caspase-3 and annexin V binding were measured by western blot and flow cytometry analysis, respectively, to investigate effects on cytokine-induced apoptosis. Results Cytokine-induced apoptosis was reduced by either GABA or exendin-4 alone. This was markedly improved by combining GABA and exendin-4, resulting in a reversal of apoptosis. The combination notably increased Akt pathway signaling. Furthermore, sirtuin-1 (SIRT1) and alpha-Klotho, both reported to have protective effects on beta-cells, were increased. Importantly, the combination ameliorated insulin secretion by human beta-cells. Conclusions The combination of GABA and a GLP-1RA exerted additive effects on beta-cell survival and function, suggesting that this combination may be superior to either drug alone in the treatment of diabetes.