Abstract:
A transgenic animal containing germ cells and somatic cells which contain a non-native recombinant gene which codes upon expression hexokinase capable of expressing hexokinase at significantly increased levels for study of the role of hexokinase in diabetes and other diseases. When these transgenic animals were exposed to a calmodulin stimulated model of diabetes increased levels of hexokinase activity were able to promote insulin secretion thereby reducing glucose levels in blood and transiently reduce the effects of diabetes.

Description:
BACKGROUND OF THE INVENTION 
     Diabetes is a disease which effects many Americans. It is a disorder of carbohydrate metabolism characterized by hyperglycemia and glycosuria and resulting from inadequate production or utilization of insulin. The disease takes several different forms and is generally classified into two syndromes: Type I, or insulin-dependent diabetes mellitus (IDDM) and type II, or non-insulin-dependent diabetes mellitus (NIDDM). In Type I the patients secrete little or no insulin. In Type II the individual is able to produce insulin but for whatever reason the individual does not secrete enough insulin to control hyperglycemia. Type II is the most prevalent form of the disease and effects approximately 2-4% of individuals. Current treatment of diabetes Type II (NIDDM) involves constant maintenance of diet and often insulin therapy. 
     Ordinarily, after insulin is secreted by the β cells of the pancreas it is transported to the cells of the body where it binds to specific insulin receptors. The insulin then acts to promote glucose metabolism in the cell and to inhibit glucose production by the liver. 
     The basic cause for diabetes is still uncertain but the pathological defect involves failure of the β cells of the pancreas to secrete an adequate amount of insulin. In the absence of sufficient insulin, gluconeogenesis is stimulated, glycolysis is adversely affected and glucose uptake is reduced. All of these factors contribute to diabetic hyperglycemia. 
     Glucose is the primary regulator of insulin secretion. It is well established that glucose must be metabolized for insulin secretion to ensue. The rate of insulin secretion closely parallels its metabolic rate and inhibitors of glucose metabolism effectively block insulin secretion. In all cells glucose metabolism is initiated by hexokinase-catalyzed phosphorylation. Unique to the pancreatic β cell and the hepatocyte of the liver, this reaction is catalyzed by an unusual hexokinase isoform, hexokinase IV (commonly referred to as glucokinase due to its relative specificity for glucose as a substrate). Hexokinase IV has a K m  for glucose in the physiological range of glucose levels, ≈10 mM. This is almost two orders of magnitude higher than any other mammalian hexokinase. Therefore, in vivo hexokinase IV-catalyzed phosphorylation is proportional to blood glucose levels, whereas phosphorylation by other hexokinases is saturated at physiological glucose levels. Hexokinase IV is also distinct from other hexokinases in that it is not allosterically inhibited by its product, glucose 6-phosphate (G6P). Due to the high K m  of hexokinase IV and the absence of end-product inhibition, glucose phosphorylation in the β cell closely parallels circulating glucose concentrations. It has therefore been proposed that hexokinase IV functions as the glucose receptor or glucose sensor of the pancreatic β cell. 
     In non-insulin-dependent diabetes mellitus (NIDDM), there is a failure to secrete adequate amounts of insulin despite the fact that pancreatic islets retain significant levels of insulin. (Stefan, Y. et al. (1982) Diabetes 31,694-700.) The secretory deficit appears to be specific for glucose-induced secretion as other secretagogues retain normal efficacy. (Palmer, J. P. et al, (1976) J. Clin. Invest. 58,565-570). The hypothesis that hexokinase IV may serve as the β-cell glucose sensor has taken on great clinical significance recently since it has been demonstrated that a nonsense mutation in only one allele of the hexokinase IV gene predisposes to some types of NIDDM. (Vionnet, N. et al (1992) Nature (London) 356,721-722.) As hexokinase IV is a monomeric enzyme, these results suggest that a simple 50% reduction in hexokinase IV activity due to mutational inactivation of one allele may lead to diabetes. 
     Thus it can be seen a need exists in the art for further study of the causes of diabetes which may lead to a potential cure, as well as a test of the hypothesis that hexokinase IV may serve as the glucose β-cell sensor. It is an object of the present invention to provide a transgene which expresses a 2-fold increase in hexokinase activity for study of the role of hexokinase in insulin secretion and diabetes. 
     It is another object of the present invention to provide a method of decreasing diabetes by stimulating hexokinase activity and thereby increase insulin secretion for Type II diabetic patients. 
     It is yet another object of the present invention to provide an animal model for study of diabetes or other glucose regulatory mechanisms in which the animal model experiences a 2-fold increase in hexokinase activity which is specific to the β cell. 
     SUMMARY OF THE INVENTION 
     The present invention relates to construction of a transgene comprising the yeast hexokinase B gene (yeast hexokinase B like hexokinase IV is not allosterically inhibited by intracellular levels of G6P) operatively linked to an insulin promoter. The transgene, when inserted into mice resulted in a 2-fold increase in hexokinase activity. The increase was found to significantly augment glucose stimulated insulin secretion of isolated pancreatic islets, to increase serum insulin levels in vivo, and to lower blood glucose levels of transgenic animals by 20-50% below control levels. 
     The transgene of the present invention may be introduced into an animal model for study of the disease, or may be used for direct manipulation of pancreatic β cells for possible treatment for diabetes. 
    
    
     DESCRIPTION OF THE DRAWINGS 
     FIG. 1 is a schematic of the transgene constructed to elevate hexokinase levels in pancreatic β cells of transgenic mice. The /box designated as RIP indicates the first of 709 base pairs of the rat insulin II gene. The open box designated as hexokinase indicates the complete coding sequence of the yeast hexokinase β gene. The hatched region indicates sequences from the SV40 virus to provide polyadenylation sequences. The polyadenylation and initiation codon are indicated by AATAAA and ATG respectively. 
     FIG. 2 is a bar graph depicting increased hexokinase activity in the islets of transgenic mice as compared to islets isolated from their non-transgenic siblings. Hexokinase activity was determined from homogenates of islets isolated from transgenic mice (HEX) and their non-transgenic siblings (CON). Assays were performed at the indicated glucose concentrations in the presence of 3 μM glucose 6-phosphate. Islets were isolated and assayed as described in the materials and methods. Different from control **P&lt;0.025, *P&lt;0.05. 
     FIG. 3 is a graph depicting the ratio of transgenic to control levels of hexokinase activity in homogenates of various tissues obtained from transgenic and control mice. Four or more assays were performed for each tissue at 0.5 μM glucose in the presence of 3 μM glucose 6-phosphate. Vertical lines are the standard error of the mean. Indicated tissues are H, heart; K, kidney; B, brain; L, liver; I, islets. 
     FIG. 4 is a graph depicting glucose stimulated insulin secretion increased in transgenic islets. Transgenic (HEX) and control (CON) islets were isolated in parallel and assayed by consecutive thirty minute incubations at the indicated concentration of glucose. After the last incubation islets were extracted to determine insulin content. Essentially the same results have been obtained in multiple perfusion assays of microdisected islets (data not shown). *different from control P&lt;0.025. 
     FIG. 5 is a graph depicting lower blood glucose levels of transgenic mice which express hexokinase than control mice. Transgenic mice (HEX) and their non-transgenic siblings (CON) were fasted overnight and then administered in IP injection of 1 mg glucose per gram of body weight. Blood samples were taken at the indicated times from the tail. Blood glucose was determined from a Life Scan glucometer. N=9 or 10 per point. Different from control; *P&lt;0.01, **P&lt;0.001. 
     FIG. 6 is a bar graph depicting serum insulin levels relative to blood glucose level for transgenic and control mice. 40-60 day old transgenic (HEX) or normal (CON) mice were free-fed or fasted for 4 to 6 hours. Blood samples were obtained on sacrifice for determination of blood glucose and serum insulin. Samples were grouped on the basis of blood glucose level. At least three determinations were obtained for each point. No control mice had blood glucose levels below 5 mM and no transgenic mice had blood glucose above 8 mM Vertical bars indicate the standard error of the mean. 
     FIGS. 7A-7D is the genetic sequence which was introduced into mice to create the transgenic animals of the invention. Nucleotides 1-709 are from the rat insulin promoter and gene (1-695) are the promoter and 696-709 are untranslated sequences which were part of the mRNA. Nucleotides 710-714 are from a Hind III linker, and nucleotides 715 to 2395 are from the yeast hexokinase B gene. (Nucleotides 2396-3261 are SV-40 sequences from a commercial plasmid MSG (Pharmacia); and nucleotides 3262-3318 are from plasmid PVC18 which are without function.) 
    
    
     DETAILED DESCRIPTION OF THE INVENTION 
     The present invention relates to an animal model of hypoglycemia for use in study and a genetic construct which may be transformed to animals to reduce the affects of diabetes. Such model could be useful for study of the role of hexokinase in diabetes, and regulation of the glucose set point of individuals, as well as a potential treatment for direct manipulation of pancreatic β cells for possible treatment of diabetes. Other attempts to try to increase hexokinase activity have proved largely unsuccessful to date. Applicant&#39;s invention comprises a workable model for elevation of hexokinase levels by use of a hexokinase gene (the yeast hexokinase IV gene) preferably in combination with an operable promoter. 
     In one embodiment of the invention, the exogenous sequences encoding hexokinase IV may be introduced to a non-human vertebrae animal model (preferably a mammal such as a rodent e.g. a mouse) to create an animal model which over expresses hexokinase. The resulting transgenic mouse may be used to study the effects of hexokinase on overall glucose and insulin regulation in the individual and may be crossbred with a diabetic mouse to determine effects of hexokinase over expression on diabetic (NIDDM) individuals. Generally the transgenic sequence is introduced into the animal, or an ancestor of the animal, at an embryonic stage (preferably one cell or fertilized oocyte, stage, and generally not later than about the 8-cell stage). The transgene preferably is substantially homologous with hexokinase IV and in a preferred embodiment is linked to an operable promoter for controlled expression of the hexokinase. 
     There are several means by which transgenic animals can be made known to those of skill in the art. One method involves use of transfecting retrovirus or adenovirus containing the transgenic sequence. Another method involves directly injecting the transgene into the embryo. Another method employs the embryonic stem cell methodology known to workers in this field. 
     Introduction of the recombinant gene at the fertilized oocyte stage insures that the gene sequence will be present in half of the germ cells and all of the somatic cells of the transgenic (founder) animal. The presence of the recombinant gene sequence in the germ cells of the transgenic founder animal in turn means that approximately half of the founder animals descendants will carry the activated hexokinase over expression sequence in half of their germ cells and all of their somatic cells. Introduction of the recombinant gene sequence at a later embryonic stage might result in the gene&#39;s absence from some somatic cells of the founder animal, but the descendants of such animal that inherit the gene will carry the recombinant gene in half of the germ and all of the somatic cells. 
     The animals of the invention can be used as models as potential use for the treatment of diabetes as well as the role of hexokinase in the overall glucose insulin regulation of the animal. Further the animals of the invention can be used as a source for cells for cell culture, to study the in vitro effects of hexokinase or for a source of islets or beta cells for transplantation. 
     The transgenic segment also optionally includes a promoter which is very active in pancreatic β cells such as rat insulin promoter. Other useful promoters include the CMV promotor from cytomegalovirus or the RSV LTR promoter from Rous saroma virus. These promoters should have the effect of inducing expression of the hexokinase in the pancreatic B cell. 
     A transgene designated Inshex was constructed consisting of 709 bp of the rat insulin II gene including the promoter linked to the intronless yeast hexokinase B gene as disclosed in Stachelek, et al (1986) Nucleic Acids Res. 14:945-963 and polyadenylylation sequences derived from the simian virus 40 early region. The yeast hexokinase gene was chosen because yeast hexokinase B, like hexokinase IV, is free from allosteric inhibition by G-6-P and catalyzes the same reaction as hexokinase IV. Additionally yeast hexokinase B has a higher affinity for glucose than hexokinase IV and, therefore, should produce a more obvious effect on β-cell function. It should be noted for purposes of the invention that several different transgenic sequences may be created for introduction into the mice of the invention as known by those of skill in the art and at its simplest level, the invention embodies a transgene which may be inserted into expression systems comprising a sequence which encodes upon expression, hexokinase, and which is linked to an operable promoter which is active in the cell. 
     EXAMPLES 
     Construction of the Inshex Gene and Production of Transgenic Mice 
     A transgenic sequence was constructed, (named Inshex) according to the present invention. The Inshex gene comprised a yeast hexokinase B gene linked to rat insulin II promoter. The fragment of the rat insulin II promoter utilized to direct β-cell-specific expression has been described. Hanahan, D. (1985) Nature (London) 315, 115-122. This promoter fragment contains 695 base pairs (bp) of sequence 5′ to the insulin transcription initiation site and 14 bp 3′ to the insulin transcription initiation site. A HindIII linker was inserted 3′ to the initiation site as described in Epstein, P. N., (1989) Cell 58, 1063-1073. The yeast hexokinase B gene (provided by W. Konigsberg, Yale University, New Haven, Conn.), contained in a 1681-bp Ssp I fragment that included the entire coding sequence, was inserted behind the insulin promoter by blunt-end ligation using the HindIII linker mentioned above. An 866-bp Sal I-BamHI fragment of simian virus 40 (derived from the plasmid PMSG; Pharmacia) containing a simian virus 40 early region splice and polyadenylylation site was inserted behind the hexokinase B gene. For production of transgenic mice, most plasmid sequences were removed from the gene by BamHI/Nde I digestion, and the resultant 3316-bp fragment was purified as described in the Cell publication. The sequence is disclosed as SEQ ID NO.:1 and is listed in FIG.  7 . 
     Transgenic mice were generated by microinjection of the DNA construct into single-cell embryos by standard techniques. Gordon et al (1983) Method Enzymol. 101, 411-433. Embryos were isolated from superovulated 4- to 6-week-old FVB/N females. Microinjections of purified DNA at 2 μg/ml in 10 mM Tris-HCl/0.1 mM EDTA, pH 7.6, were into one pronucleus for each embryo, 12-14 hours after fertilization. Embryos that survived microinjection were implanted into pseudopregnant females and allowed to develop to term. Founder mice were crossed with ICR mates and transgenic lines were maintained on an ICR background. 
     DNA and RNA Analyses 
     Founder mice were identified on Southern blots prepared with 10 μg of tail DNA digested with EcoRI. Blots were hybridized to a 1200-bp HindIII-Xho I fragment of the Inshex gene radiolabeled with  32 P by random priming. Routine identification of transgenic mice was made by PCR analysis with oligonucleotides identical to the rat insulin II promoter between positions 88 and 113 (GCTCTGAAGCAAGCACCTCTTATG) SEQ ID NO:3 and complementary to the yeast hexokinase coding sequence 125 bp 3′ to the translation start site (GGAAATGAAGTGCTTGGTAACG) SEQ ID NO:4. 
     Expression of yeast hexokinase RNA was determined by S1 nuclease protection analysis of poly(A) +  pancreatic RNA. Poly(A) +  RNA was prepared on oligo(dT) columns from pancreatic RNA isolated by the guanidinium thiocyanate method. An RNA probe was prepared from an 1125-bp fragment of the Inshex gene, from position 75 in the insulin promoter to a HindIII site in the hexokinase coding sequence, 505 bp 3′ of the expected transcription initiation site of the insulin promoter. 
     This fragment was inserted into plasmid pSP64, cut with EcoRI in the insulin promoter and in the pSP64 polylinker and radiolabeled with SP6 polymerase and [ 32 P]CTP. The radiolabeled RNA probe was hybridized to pancreatic poly(A) +  RNA in 80% (vol/vol) formamide at 50° C. and digested with 1000 units of S1 nuclease at 37° C. Protected products were identified by PAGE and autoradiography.  32 P-end-labeled Hae III digests of plasmid φ-174 served served as molecular size standards. 
     Islet Isolation 
     Transgenic and normal islets were isolated in parallel from 1- to 2-week old litters. Genotype was determined by PCR analysis as described above. Islets were released from pancreatic acinar tissue by digestion with collagenase P (Boehringer). After two washes in Hanks&#39; balanced salt solution, islets were purified by centrifugation on Percoll (Pharmacia) gradients. Brunstedt, J. (1980) Diabete Metab. 6, 87-89. Islets were then further purified by picking under a dissection microscope. In most instances, islets were cultured overnight in RPMI 1640 medium (GIBCO) containing 10% (vol/vol) fetal calf serum, 5 mM glucose, and 10 mM Hepes (pH 7.4). In these experiments overnight cultured and freshly isolated islets yielded equivalent results. 
     Islet Assays 
     Measurement of hexokinase activity was performed by the radiometric procedure of Bedoya et al (1985) Anal. Biochem. 144, 504-513. In brief, batches of 25-50 islets were homogenized in 100 μl of extraction buffer [30 mM Hepes, pH 7.6/130 mM KCl/4 mM MgCl 2 /14 mM 2-mercaptoethanol/0.2% (wt/vol) bovine serum albumin] and then centrifuged at 60,000×g for 30 minutes and 4° C. Pellets were used for measurement of DNA content. Aliquots (10 μl) of the extract were assayed for hexokinase activity in incubation buffer [50 mM Hepes, pH 7.6/120 mM KCl/8 mM MgCl 2 /14 mM 2-mercaptoethanol/5 mM ATP/0.1% bovine serum albumin/3 μCi of D-[2- 3 H(N)glucose/3 mM G6P]. Assays were performed for 60 minutes at 30° C. After the initial incubation, the reaction products were quantitated by measuring the release of  3 H 2 O from [ 3 H]G6P by the action of phosphoglucose isomerase (Boehringer). Determinations of hexokinase activity in other tissues were performed by the same procedure. 
     Insulin secretion was assayed by consecutive static assays of isolated islets in increasing concentrations of glucose (3-15 mM) or ketoisocaproic acid (KIC, 1-9 mM). Assays were performed in modified Krebs-Ringer bicarbonate buffer (KRB =133 mM NaCl/5 mM NaHCO 3 /5 mM KCl/1.2 mM MgSO 4 /1.2 mM KH 2 PO 4 /2.5 mM CaCl 2 /15 mM Hepes, pH 7.4/0.1% bovine serum albumin. Briefly, batches of 10-20 islets were picked into tubes containing KRB for a,30-minute preincubation at 37° C. and then the medium was replaced with 0.4 ml of KRB containing the lowest concentration of glucose or KIC to be tested. After 30 minutes at 37° C., the medium was removed for radioimmunoassay of insulin and the incubation medium was replaced with the next higher concentration of secretagogue. After the last incubation, islets were extracted with acidifed ethanol for measurement of islet insulin content. Perifusion assays were performed as described in the method of Atwater et al (1981) J. Physiol. (London) 314, 195-212 on freshly microdissected islets from 3- to 4-month-old transgenic and control mice. 
     Measurement of Glucose and Insulin 
     Determinations of insulin levels in serum samples and secretion assays were made by double-antibody RIA using a coated-tube insulin RIA kit (Diagnostic Products, Los Angeles) and rat insulin standards (Novo Biolabs, Danbury, Conn.). Blood samples sufficient for RIA were obtained by decapitation. Serum samples were prepared by centrifugation after incubating blood samples overnight at 4° C. Glucose assays were performed on whole blood with the One Touch blood glucose monitor (Lifescan, Mountain View, Calif.). 
     Four founder lines were produced initially that carried one or more copies of the Inshex gene. To determine whether the transgene was expressed pancreatic RNA was isolated from members of each line and subjected to an S1 nuclease protection assay. As shown in FIG. 1A only mice of trangenic line 5032 produced significant levels of RNA complimentary to an antisense yeast hexokinase RNA probe. 
     An S1 nuclease protection assay of pancreatic RNA indicated that the Inshex gene was transcribed in line 5032. S1 protection assays were performed on pancreatic RNA by using a 32P-labeled RNA probe derived from the Inshex gene. Arrow, predicted position for a 505-nucleotide RNA probe fragment protected by a properly initiated transcript from the Inshex transgene. Sources of pancreatic RNA are as follows: Lanes, 1, control mice; 2, line 5032 mice; 3, line 5039 mice; 4, line 5040 mice; 5, line 5041 mice. 
     Two additional transgenic lines were made but these also failed to express the transgene. Lack of expression in 5 of 6 transgenic lines may have been due to the absence of introns in the yeast hexokinase gene. Palmiter et al (1991) Proc. Natl. Acad. Sci. USA 88, 478-482. 
     To determine whether production of yeast hexokinase mRNA resulted in elevated enzyme levels, pancreatic islets were isolated from transgenic and non-transgenic siblings of line 5032 and assayed for hexokinase activity. Bedoya, F. J. et al (1985) Anal. Biochem. 144, 504-513. Results are shown in FIG.  2 . Transgenic high affinity hexokinase activity was increased 5-fold over normal when measured at 0.5 mM glucose. At 5 mM glucose, selected because it is in the physiological range of glucose concentration, hexokinase activity was increased 2-fold. This moderate increase would be sufficient to affect β-cell function in vivo, if secretion is directly regulated by the rate of glucose phosphorylation. These assays were performed in the presence of 3 mM G6P since G6P is a potent endogenous inhibitor of all mammalian hexokinases except hexokinase IV: in the β cell, intracellular G6P inhibits the endogenous high affinity hexokinase by &lt;90%. Trus, M. C. et al (1981) Diabetes 30, 911-922. To confirm tissue specificity of expression in the pancreatic β cells, hexokinase assays were also performed on brain, liver, kidney and heart from transgenic and non-transgenic mice and the results are shown in FIG.  3 . Despite the fact that these assays were performed under conditions of maximal sensitivity for yeast hexokinase (0.5 mM glucose/3 mM G6P), no significant increase in enzyme activity was apparent in these tissues. 
     Insulin Secretion Increases in in Vitro Isolated Islets 
     The most direct measurements of β-cell glucose sensitivity can be made in isolated pancreatic islets. Islets were isolated from transgenic mice of line 5032 and their nontransgenic littermates. Insulin secretion was measured by incubating islets successively in increasing concentrations of glucose (FIG.  4 ). Since yeast hexokinase B has a high affinity for glucose, the greatest effect of this transgene would be at relatively low concentrations of glucose, as was found. At the lower concentrations of glucose tested, 3-9 mM, transgenic secretion rates were ≈2-fold higher than normal (P &lt;0.025). At 15 mM glucose, transgenic and normal secretion rates were essentially the same. If this enhanced secretion to glucose was a direct effect of the enzymatic activity of yeast hexokinase then the secretory response to secretagogues that are not hexokinase substrates should not be affected. KIC was chosen for this test since KIC, like glucose, is a fuel secretagogue dependent on metabolism to induce secretion. However, unlike glucose, KIC is not a substrate for hexokinase; therefore the transgenic hexokinase should not augment KIC-induced secretion. At no concentration of KIC did the transgenic islets demonstrate increased secretion relative to normal islets. These results demonstrate that the enhanced secretion response of transgenic islets was specific to substrates of the transgene and a direct effect of elevated hexokinase activity. 
     Yeast Hexokinase Responses in Vivo 
     The 2-fold elevation of islet hexokinase activity measured at physiological glucose concentrations and the enhancement of glucose-stimulated insulin secretion in isolated islets leads to the conclusion that alterations in β-cell function might be reflected in altered glucose homeostasis of the whole animal. Random blood glucose assays indicated that glucose levels were reduced in line 5032, which expressed the hexokinase transgene and that blood glucose levels were normal in the five nonexpressing lines of transgenic mice. To analyze the reduction in glucose levels of line 5032 systematically, intraperitoneal glucose tolerance tests were performed on overnight-fasted transgenic mice and their nontransgenic siblings (age, 20-30 days). These results, shown in FIG. 5 confirmed that relative to their normal siblings transgenic mice of line 5032 had significantly lower fasted glucose levels, and their peak glucose levels after i.p. administration of glucose were also much lower. In addition, within 180 minutes of glucose administration, transgenic blood glucose values returned to near their original low fasted level. These results indicate that the level of β-cell hexokinase activity controls whole-animal glucose homeostasis. Thus the transgene of the present invention produces a permanent reduction of blood glucose values. 
     To determine in vivo glucose levels and whether they were a function of enhanced insulin secretion, age-matched transgenic and nontransgenic mice were sacrificed to obtain samples adequate for measurement of serum insulin levels. Prior to sacrifice mice were either free-fed or fasted for 5 hours so that insulin levels could be determined over a broad range of glucose values. Serum insulin and blood glucose levels were determined from the same sample. As shown in FIG. 6, the relationship between blood glucose and serum insulin was markedly shifted by the transgene. Insulin levels in transgenic mice were higher at all glucose values (no control values are shown for 3 and 4 mM glucose since no control mice had glucose levels &lt;5 mM; no transgenic mice had glucose values &gt;8 mM). In addition, the rise in serum insulin levels of hexokinase mice was steeper with increasing blood glucose levels than was seen in control mice. The elevation of serum insulin could not have been due to increased levels of pancreatic insulin, as observed in some transgene-induced β-cell tumors, Hanahan, D. (1985) Nature (London) 315, 115-122, since several assays of total pancreatic insulin content indicated an ≈50% reduction in pancreatic insulin content of hexokinase transgenic mice in both neonates and adults (data not shown). The elevated serum insulin values of transgenic mice over a broad range of glucose values demonstrate in vivo that increased hexokinase activity enhanced insulin secretion and confirmed the altered whole animal glucose homeostasis is a function of enhanced insulin secretion rather than a nutritional or peripheral metabolic effect. 
     Inshex Transgenic Mice Tested in a Diabetes Model 
     To determine whether increasing β-cell glucose phosphorylation could be beneficial in diabetes, hexokinase transgenic mice from line 5032 were bred to a diabetic transgenic line. The diabetic line selected was the line OVE26 which overexpresses calmodulin in pancreatic β cells. OVE26 transgenic mice develop diabetes due to an insulin secretory defect and a depletion of pancreatic insulin. Four litters from these crosses were assayed for blood glucose at 24 days of age, which is after the onset of diabetes but before complete destruction of the β-cell population. The results are seen in Table 1 (Genotypes were determined by PCR analysis). 
     
       
         
               
             
               
               
               
               
               
             
           
               
                 TABLE I 
               
             
             
               
                   
               
               
                 REDUCTION OF DIABETIC GLUCOSE LEVELS 
               
               
                 BY THE YEAST HEXOKINASE TRANSGENE 
               
             
          
           
               
                   
                 CaM−/Hex+ 
                 CaM−/Hex− 
                 CaM+/Hex+ 
                 Cam+/Hex− 
               
               
                 GENOTYPE 
                 (5) 
                 (10) 
                 (10) 
                 (6) 
               
               
                   
               
               
                 Glucose mM 
                 4.6 ± 0.5 
                 8.0 ± 0.3 
                 11.6 ± 0.7* 
                 13.9 ± 0.7 
               
               
                   
               
               
                 N values (in parenthesis) indicate the number of separate mice of each genotype assayed.  
               
               
                 *CaM+/Hex+ blood glucose values are less than CaM+/Hex− glucose values, p &lt; 0.025 and CaM+/Hex+ glucose values are greater than CaM−/Hex− glucose values (normal littermates) p &lt; 0.01.  
               
             
          
         
       
     
     Hexokinase transgenes significantly reduced diabetic blood glucose levels produced by the calmodulin transgene. Blood glucose values of CaM + /Hex +  mice (transgenic for calmodulin and yeast hexokinase; 11.6 ±0.7 mM glucose; n =10) were 2.3 mM lower than glucose levels of CaM + /Hex −  mice (transgenic for calmodulin only; 13.9 ±0.7; n=6) (P &lt;0.025). 
     This hexokinase reduction corresponds to approximately 40% of the difference between blood glucose levels of CaM + /Hex −  mice and normal mice (CaM − /Hex − ; 8.0 ±0.3; N =10(P&lt;0.01). Measurements of pancreatic insulin content from several of these mice indicated that the hexokinase transgene exacerbated the calmodulin/induced depletion of pancreatic insulin (data not shown). Apparently the hexokinase activity did not directly reverse the defect produced by calmodulin, however secretion was enhanced despite the defect. Tests on older individuals have revealed that this effect in the calmodulin-induced diabetes model may be transient, as mice who at 21-26 days of age were shown to have the positive benefits of the hexokinase stimulated insulin secretion were later shown by 33-40 days that the benefits were no longer present. However, the blood glucose values of normal mice or mice transgenic for hexokinase alone during the same time period remained constant. Additionally, mice with the hexokinase transgene were found to have lower blood glucose values and higher serum insulin levels than normal mice. 
     
       
         
               
             
               
               
               
               
               
               
             
           
               
                 TABLE II 
               
             
             
               
                   
               
               
                 PHENOTYPIC COMPARISON OF NORMAL MICE 
               
               
                 AND MICE HETEROZYNGOUS AND HOMOZYGOUS 
               
               
                 FOR THE HEXOKINASE TRANSGENE 
               
             
          
           
               
                   
                   
                   
                   
                   
                 PER- 
               
               
                   
                 uU INSU- 
                 uU INSU- 
                 BLOOD 
                   
                 CENT 
               
               
                   
                 LIN/mg 
                 LIN/mg 
                 GLU- 
                 SERUM 
                 GLYCO- 
               
               
                   
                 PAN- 
                 PAN- 
                 COSE 
                 INSULIN 
                 SYLATED 
               
               
                 GENO- 
                 CREAS 
                 CREAS 
                 (mg/dl) 
                 (uU/ml) 
                 HEMO- 
               
               
                 TYPE 
                 day 0 
                 day 60-73 
                 day 59-70 
                 day 59-70 
                 GLOBIN 
               
               
                   
               
               
                 NORMAL 
                 15300 ± 
                 5100 ± 
                 168 ± 
                 27 ± (9) 
                 3.87 ± 
               
               
                   
                  3000(4) 
                  500(10) 
                  8(9) 
                   
                 0.18(7) 
               
               
                 HEXO- 
                 18600 ± 
                 3000 ± 
                 119 ± 
                 41 ± 4(5)* 
                 ND 
               
               
                 KINASE 
                  2000(11) 
                  800(4)* 
                  5(5)** 
               
               
                 HETERO- 
               
               
                 ZYGOUS 
               
               
                 HEXO- 
                  9500 ± 
                 2000 ± 
                 125 ± 
                 39 ± 4(9)* 
                 2.99 ± 
               
               
                 KINASE 
                  900(4)# 
                  200(6)** 
                  7(9)** 
                   
                 0.08(8)* 
               
               
                 HOMO- 
               
               
                 ZYGOUS 
               
               
                   
               
               
                 Values show the mean and the standard error of the mean for each parameter. Values in parentheses indicate the number of animals tested. Day 0 mice are between 0 and 24 hours old. Blood glucose and serum insulin values were obtained from avertin anesthetized mice. Other procedures are described in Materials and Methods. (ND) not determined.  
               
               
                 *different from normal by student&#39;s t-test, p &lt; 0.25  
               
               
                 **different from normal by student&#39;s t-test, p &lt; 0.001  
               
               
                 #difference from heterozygous student&#39;s t-test, p &lt; 0.05  
               
             
          
         
       
     
     This is the first report of a transgene which enhances β-cell function by positively effecting glucose homeostasis. Thus it can be seen that the invention accomplishes at least all of its objectives.