Absence of PNET formation and normal longevity in a mouse model of Mahvash disease

Mahvash disease, a rare autosomal recessive metabolic disorder characterized by biallelic loss-offunction mutations in the glucagon receptor gene (GCGR), induces significant pancreatic hyperglucagonemia, resulting in alpha-cell hyperplasia and occasional hypoglycemia. Utilizing CRISPR-Cas9 technology, we engineered a mouse model, designated as GcgrV369M/V369M, harboring a homozygous V369M substitution in the glucagon receptor (GCGR). Although wildtype (WT) and GcgrV369M/V369M mice exhibited no discernible difference in appearance or weight, adult GcgrV369M/V369M mice, approximately 12 months of age, displayed a notable decrease in fasting blood glucose levels and elevated the levels of cholesterol and low-density lipoprotein-cholesterol. Moreover, plasma amino acid levels such as alanine (Ala), proline (Pro) and arginine (Arg) were elevated in GcgrV369M/V369M mice contributing to alpha-cell proliferation and hyperglucagonemia. Despite sustained alpha-cell hyperplasia and increased circulating glucagon levels in GcgrV369M/V369M mice, metabolic disparities between the two groups gradually waned with age accompanied by a reduction in alpha-cell hyperplasia. Throughout the lifespan of the mice (up to approximately 30 months), pancreatic neuroendocrine tumors (PNETs) did not manifest. This prolonged observation of metabolic alterations in GcgrV369M/V369M mice furnishes valuable insights for a deeper comprehension of mild Mahvash disease in humans.