Results
Incubation of INS-1E cells with cytokines (IL-1

, TNF-

and interferon-

; 10–50 ng/ml) for 18 h significantly decreased cell viability (by 44%,
p<0.001), cell proliferation (by 80%,
p<0.001), and activation of PKB (by 67%,
p<0.001). Pre-treatment with exendin-4 (10
–7 mol/l), a long-acting GLP-1 receptor agonist, partially protected the cells against cytokine-induced toxicity (
p<0.01) in association with a reduction in cytokine-induced inhibition of PKB phosphorylation (
p<0.05). Exendin-4 pre-treatment did not change cell proliferation. Cytokine treatment increased apoptosis (by 156%,
p<0.05) and necrosis (from undetectable to 2.6% of cells). These increases were both reduced by pre-treatment with exendin-4 (
p<0.05–0.01). Furthermore, cytokine-induced apoptosis and necrosis were significantly increased in cells infected with kinase-dead PKB (
p<0.05), and the protective effect of exendin-4 on both parameters was fully abolished in these cells. Similar changes were observed in primary islet cells. In parallel with these changes, exendin-4 decreased the cytokine-induced activation of caspase-3 (by 46%,
p<0.05), and decreased levels of inducible nitric oxide synthase (by 71%,
p<0.05) and reactive oxygen species (by 27%,
p<0.05).