Review
Cyclic AMP sensor EPAC proteins and energy homeostasis

https://doi.org/10.1016/j.tem.2013.10.004Get rights and content

Highlights

  • EPAC1 desensitizes leptin signaling in hypothalamus.

  • EPAC2 facilitates GSIS in response to GLP-1 and obesity induced insulin resistance.

  • Small molecule EPAC modulators have therapeutic potential for obesity and T2DM.

The pleiotropic second-messenger cAMP plays a crucial role in mediating the effects of various hormones on metabolism. The major intracellular functions of cAMP are transduced by protein kinase A (PKA) and by exchange proteins directly activated by cAMP (EPACs). The latter act as guanine-nucleotide exchange factors for the RAS-like small G proteins Rap1 and Rap2. Although the role of PKA in regulating energy balance has been extensively studied, the impact of EPACs remains relatively enigmatic. This review summarizes recent genetic and pharmacological studies concerning EPAC involvement in glucose homeostasis and energy balance via the regulation of leptin and insulin signaling pathways. In addition, the development of small-molecule EPAC-specific modulators and their therapeutic potential for the treatment of diabetes and obesity are discussed.

Section snippets

EPAC proteins; new kids on the block

cAMP is the prototypic second messenger discovered by Earl Sutherland and colleagues to play a key role in mediating the intracellular effects of hormones [1]. The deciphering of the cAMP signaling pathway is of major historical significance in biology and has led to scientific breakthroughs including the discoveries of cAMP-dependent protein kinase/protein kinase A (PKA), G proteins, and G protein-coupled receptors (GPCRs), for which Robert Lefkowitz and Brian Kobilka shared the latest Nobel

EPAC and leptin resistance

Obesity is the result of a prolonged imbalance between energy intake and expenditure [11]. The identification of the leptin gene (ob) provided a breakthrough in our understanding of obesity at the molecular level [12]. Leptin, an appetite-suppressing hormone derived from adipose tissue, plays a key role in the central regulation of satiety and energy expenditure [13]. Leptin binds to and activates the ‘long form’ of leptin receptor (OB-Rb or LepRb), a single-transmembrane-domain cytokine

EPAC2 in insulin secretion

GSIS is the fundamental pathway of insulin release from pancreatic β cells [38] (Figure 2A). After transport into β cells by facilitated diffusion, glucose undergoes oxidative phosphorylation, yielding an increase in the ATP/ADP ratio. The rise in ATP levels in turn leads to the closure of ATP-sensitive potassium channels (KATP), triggering membrane depolarization and the opening of L-type voltage-dependent Ca2+ channels (VDCCs) which allow influx of extracellular Ca2+ (Figure 2C). The

Targeting EPAC for therapeutic intervention

The studies reviewed here suggest that EPAC1 and EPAC2 play important roles in regulating leptin and insulin signaling, and represent attractive drug targets for the treatment of obesity and type 2 diabetes mellitus (T2DM). Small-molecule EPAC-selective modulators have been developed (Box 4) and can be further explored for their therapeutic potential 58, 59, 60, 61. Considering that EPAC1 and EPAC2 exert diverse and distinct functions, isoform-specific EPAC modulators, particularly

Concluding remarks

In summary, the roles of EPAC1 and EPAC2 in energy balance are complex. Despite recent major advances, our understanding remains limited and controversy persists in particular cases (Box 5). The generation of additional tissue-specific and conditional EPAC-knockout animal models will help to define further the physiological functions of EPAC. At the molecular and cellular levels, the dissection of EPAC signalosomes within the context of compartmentalized cAMP signaling will lead to further

Acknowledgments

We are indebted to Dr George Holz for providing critical comments. We thank everyone who has contributed to the field of EPAC signaling and apologize to those who were not cited owing to space limitations. M.A. is a recipient of a training fellowship from the Keck Center for Interdisciplinary Bioscience Training of the Gulf Coast Consortia funded by the National Institutes of Health (NIH) National Institute of General Medicine Grant T32GM089657. X.C. is supported by NIH grants R01GM066170 and

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