ATP-sensitive K + channels and disease: from molecule to malady
Abstract
This essay is based on a lecture given to the American Physiological Society in honor of Walter B. Cannon, an advocate of homeostasis. It focuses on the role of the ATP-sensitive potassium K(+) (K(ATP)) channel in glucose homeostasis and, in particular, on its role in insulin secretion from pancreatic beta-cells. The beta-cell K(ATP) channel comprises pore-forming Kir6.2 and regulatory SUR1 subunits, and mutations in either type of subunit can result in too little or too much insulin release. Here, I review the latest information on the relationship between K(ATP) channel structure and function, and consider how mutations in the K(ATP) channel genes lead to neonatal diabetes or congenital hyperinsulinism.
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In the intact cell, KATP channel activity is determined by the balance between the stimulatory and inhibitory effects of nucleotides.
“In the intact cell, KATP channel activity is determined by the balance between the stimulatory and inhibitory effects of nucleotides (25).”
From Pancreatic β-Cell Electrical Activity and Insulin Secretion: Of Mice and Men (2018) · cites this paper as [25]
Gain-of-function mutations in either Kir6.2 or SUR1 result in neonatal diabetes, which usually presents within the first six months of life and is associated with a low birth weight.
“Gain-of-function mutations in either Kir6.2 or SUR1 result in neonatal diabetes (ND), which usually presents within the first six months of life and is associated with a low birth weight (25, 29, 32, 43, 215, 255).”
From Pancreatic β-Cell Electrical Activity and Insulin Secretion: Of Mice and Men (2018) · cites this paper as [25]
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“When K ATP channels are shut, insulin is secreted, and when they are open, insulin is inhibited [5].”
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Self-citationAccounting for Near-Normal Glucose Sensitivity in Kir6.2[AAA] Transgenic Mice
Tsaneva-Atanasova, K. T., & Sherman, A. (2009) · Biophysical Journal · doi:10.1016/j.bpj.2009.07.060
Pharmacogenomics of sulfonylureas in type 2 diabetes mellitus; a systematic review
Karkhaneh, L., Tabatabaei-Malazy, O., Bandarian, F., Mohseni, S., & Larijani, B. (2021) · Journal of Diabetes and Metabolic Disorders · doi:10.1007/s40200-021-00908-x · Cited by 7 · see citing works
KATP channel dependent heart multiome atlas
Arrell, D. K., Park, S., Yamada, S., Alekseev, A. E., Garmany, A., Jeon, R., Vučković, I., Lindor, J. Z., & Terzic, A. (2022) · Scientific Reports · doi:10.1038/s41598-022-11323-4 · Cited by 6 · see citing works
Mouse models of β-cell KATP channel dysfunction
Brereton, M. F., & Ashcroft, F. M. (2013) · Drug Discovery Today Disease Models · doi:10.1016/j.ddmod.2013.02.001 · Cited by 5 · see citing works
Self-citationMethods for Characterizing Disease-Associated ATP-Sensitive Potassium Channel Mutations
Kandasamy, B., & Shyng, S. (2017) · Methods in molecular biology · doi:10.1007/978-1-4939-7362-0_8 · Cited by 7 · see citing works
Lin, R., Yen, Y.-K., Lee, C., Hsieh, S., Chang, Y., Juan, Y., Long, C., Shen, K., & Wu, B. (2021) · Biomedicine & Pharmacotherapy · doi:10.1016/j.biopha.2021.112447 · Cited by 4 · see citing works
Sherif, E., Abdelmaksoud, A., Elbarbary, N., & Njølstad, P. (2013) · Acta Diabetologica · doi:10.1007/s00592-010-0217-1 · Cited by 4
“Insulin hypersecretion that characterizes CHI results from permanent depolarization of the b-cell membrane and thereby continuous Ca2? influx and insulin secretion [23].”
BackgroundIon Channels and Regulation of Insulin Secretion in Beta-Cells
Oluwamodupe, C., & Babalola, O. O. (2024) · Current Molecular Biology Reports · doi:10.1007/s40610-024-00162-z · Cited by 3 · see citing works
“It has been shown that pancreatic beta cells can have intra-cellular chloride concentrations greater than 35 mm [38, 47].”
Shen, K., Munhall, A. C., & Johnson, S. (2018) · Brain Research · doi:10.1016/j.brainres.2018.10.027 · Cited by 3 · see citing works
“They are probably best characterized in pancreatic beta-cells where closure of the channel by ATP causes membrane depolarization and calcium influx and thereby triggering insulin release (Ashcroft, 2007).”
BackgroundKaleva, N., Ivanov, I., Panova, M., Shabanova, T. D., & Delgyanska, D. S. (2010) · Folia Medica · doi:10.2478/v10153-010-0008-z · Cited by 3
Hussieny, B. A. A., & Alsahlawi, M. M. R. (2023) · Al-Kufa University Journal for Biology · doi:10.36320/ajb/v13.i2.11759 · Cited by 1 · see citing works
Anti-diabetic drug binding site in KATP channels revealed by Cryo-EM
Martin, G. M., Kandasamy, B., DiMaio, F., Yoshioka, C., & Shyng, S. (2017) · bioRxiv · doi:10.1101/172908 · Cited by 2
Inherited pediatric metabolic epilepsies
Pearl, P. L., & Yu, Y. (2013) · Expert Opinion on Orphan Drugs · doi:10.1517/21678707.2013.758580 · Cited by 2 · see citing works
“These mutations “lock in” the KATP channel in an open state, even under hyperglycemic conditions [29,30].”
BackgroundProtein Kinases and Pancreatic Islet Function
Xavier, G. D. S. (2012) · InTech eBooks · doi:10.5772/37282 · Cited by 1 · see citing works
Advances in Cardiac ATP-Sensitive K+ Channelopathies From Molecules to Populations
Terzic, A., Alekseev, A., Yamada, S., Reyes, S., & Olson, T. M. (2011) · Circulation: Arrhythmia and Electrophysiology · doi:10.1161/circep.110.957662 · Cited by 2 · see citing works
Phenotype of a transient neonatal diabetes point mutation (SUR1-R1183W) in mice
Sachse, G., Haythorne, E., Proks, P., Stewart, M. E., Cater, H. L., Ellard, S., Davies, B., & Ashcroft, F. M. (2020) · Wellcome Open Research · doi:10.12688/wellcomeopenres.15529.2 · Cited by 2 · see citing works
“ATP-sensitive potassium (K ATP ) channels play a pivotal role in coupling blood glucose levels to insulin secretion (Ashcroft, 2007).”
Self-citationDiabetes mellitus beim Frühgeborenen: Erstmalige Behandlung mit Sulfonylharnstoff
Holl, R. (2009) · Klinische Pädiatrie · doi:10.1055/s-0029-1192017 · Cited by 1
Targeted analysis of whole exome sequencing in Thai patients with neonatal diabetes
Plengvidhya, N., Tangjarusritaratorn, T., Teerawattanapong, N., Narkdontri, T., Innang, S., Songlilitchuwong, S., Suthon, S., & Tangjittipokin, W. (2026) · Human Genetics · doi:10.1007/s00439-025-02815-0
“These two genes are the most frequent causes of both transient and permanent NDM. Variants in KCNJ11 or ABCC8 impair the KATP chan - nel’s sensitivity to ATP, causing persistent channel opening, membrane hyperpolarization, and reduced insulin secretion (Ashcroft 2007).”
Benguet Kankanaey self-representations in local films in Benguet, Philippines
Dalocdoc, P. J. (2025) · International journal of humanities, literature & arts · doi:10.21744/ijhla.v8n1.2367
“Coined by Richard Terdiman, it characterizes the “theory and practice of symbolic resistance" (Ashcroft, 2007).”
Fagnen, C., Bannwarth, L., Oubella, I., Zuniga, D., Haouz, A., Forest, E., Scala, R., Bendahhou, S., Zorzi, R. D., Perahia, D., et al. (2021) · International Journal of Molecular Sciences · doi:10.3390/ijms23010335
Knebel, B., Müller-Wieland, D., & Kotzka, J. (2010) · doi:10.1055/s-0030-1247418
The right stuff: beta-cell channels, cycles, and sensors.
Halban, P. (2008) · American Journal of Physiology. Endocrinology and Metabolism · doi:10.1152/ajpendo.90692.2008
Frances Ashcroft: 2007 Walter B. Cannon Physiology in Perspective Lecture.
Benos, D. (2007) · American Journal of Physiology. Endocrinology and Metabolism · doi:10.1152/ajpendo.00530.2007
“This is an example of translational research at its finest! This body of work, summarized in the accompanying article (1), demonstrates unequivocally how a full understanding of the molecular basis of ion channel dysfunction can lead to better disease management.”
BackgroundResearch Progress on the Relationship between KATP Channels and Migraine
阳思绮, 欧. (2026) · Advances in Clinical Medicine · doi:10.12677/acm.2026.1682811
Glucose acts as a ligand for glucokinase to trigger postprandial secretion of GLP-1
Li, C., Li, M., Yang, H.-Y., Tian, X., Zhang, C., Zhao, L., Wu, J., Zhang, C., Liu, S., Yang, X., et al. (2026) · Vita · doi:10.15302/vita.2026.07.0059 · Cited by 1 · see citing works
Infant with diabetes – a diagnostic challenge for paediatricians
Brandt-Varma, A., & Myśliwiec, M. (2020) · Pediatria Polska · doi:10.5114/polp.2020.103508
“It is known that diabetes caused by mutations in the gene KCJN11 is sensitive to sulfonylurea treatment [4, 11].”
Background
- Authors
- Ashcroft, F. M.
- Affiliations
- University of Oxford (GB)
- Corresponding author
- Ashcroft, Frances M.
- ORCID
- Ashcroft, Frances M.
- Venue
- American Journal of Physiology-Endocrinology and Metabolism
- Publisher
- American Physiological Society
- Published
- 2007-10
- Volume
- 293
- Issue
- 4
- Pages
- E880-E889
- ISSN
- 0193-1849 (ISSN-L)
- 1522-1555
- OpenAlex
- W2134991186
- Cited by
- 107
- References
- 0
- Citations by year
- 2026: 3 · 2024: 1 · 2023: 3 · 2022: 1 · 2021: 6 · 2020: 7 · 2019: 1 · 2018: 2 · 2017: 8 · 2016: 10 · 2015: 1 · 2014: 6 · 2013: 10 · 2012: 6
- FWCI
- 12.29
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- American Journal of Physiology-Endocrinology and Metabolism (publishedVersion)
- PubMed (publishedVersion)
- Funders
- Wellcome Trust
- Diabetes UK
- Topics
- Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Ion channel regulation and function
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Ion Transport and Channel Regulation
- Keywords
- ATP-sensitive potassium channels, Kir6.2, SUR1, pancreatic beta cells, insulin secretion, glucose homeostasis, neonatal diabetes, congenital hyperinsulinism, ion channel mutations, channel structure and function
- MeSH terms
- Kcnj11 Channel, Adenosine Triphosphate, Animals, Diabetes Mellitus, Glucose, Homeostasis, Humans, Models, Biological, Models, Molecular, Mutation, Potassium Channels, Potassium Channels, Inwardly Rectifying, Channelopathies
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