Do glucagonomas always produce glucagon?

• Main Authors: Nicolai Jacob Wewer Albrechtsen, Benjamin Challis, Ivan Damjanov, Jens Juul Holst
• Format: Article
• Language: English
• Published: Association of Basic Medical Sciences of Federation of Bosnia and Herzegovina 2016-02-01
• Series: Bosnian Journal of Basic Medical Sciences
• Subjects: Glucagonoma; neuroendocrine tumours; NETs; hyperglucagonemia; GLP-1; Proglucagon
• Online Access: https://bjbms.org/ojs/index.php/bjbms/article/view/794

Pancreatic islet α-cell tumours that overexpress proglucagon are typically associated with the glucagonoma syndrome, a rare disease entity characterised by necrolytic migratory erythema, impaired glucose tolerance, thromboembolic complications and psychiatric disturbances. Paraneoplastic phenomena associated with enteric overexpression of proglucagon-derived peptides are less well recognized and include gastrointestinal dysfunction and hyperinsulinaemic hypoglycaemia. The diverse clinical manifestations associated with glucagon-expressing tumours can be explained, in part, by the repertoire of tumorally secreted peptides liberated through differential post-translational processing of tumour-derived proglucagon. Proglucagon-expressing tumours may be divided into two broad biochemical subtypes defined by either secretion of glucagon or GLP-1, GLP-2 and the glucagon-containing peptides, glicentin and oxyntomodulin, due to an islet α-cell or enteroendocrine L-cell pattern of proglucagon processing, respectively. In the current review we provide an updated overview of the clinical presentation of proglucagon-expressing tumours in relation to known physiological actions of proglucagon-derived peptides and suggest that detailed biochemical characterisation of the peptide repertoire secreted from these tumours may provide new opportunities for diagnosis and clinical management.