Glucagon is a peptide hormone produced by the alpha cells of the pancreas. Its primary function is to elevate the concentration of glucose in the blood by promoting gluconeogenesis and glycogenolysis. It also decreases fatty acid synthesis in adipose tissue and the liver, as well as promotes lipolysis in these tissues, causing them to release fatty acids into circulation where they can be catabolized to generate energy. Its effect is opposite to that of insulin, which lowers the extracellular glucose.
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Glucagon belongs to the secretin family of hormones and together with insulin, it forms part of the feedback system that keeps blood glucose levels stable. Glucagon increases energy expenditure and is elevated under conditions of stress. A glucagon diagnostic assay is primarily useful for detecting a glucagon-secreting tumor of the pancreas (glucagonomas). Glucagonoma tumor cells produce large amounts of glucagon, and these high levels create severe, painful, and life-threatening symptoms. About 5-10% of neuroendocrine tumors that develop in the pancreas are glucagonomas and 75% of the time these glucagonomas are malignant.
Glucagon diagnostic tests are typically quantitative two-site sandwich immunoassays and the performance between manufacturers can vary significantly due to antibody cross-reactivity. It is important to select highly specific antibodies to glucagon in order to reduce the potential for cross-reactive binding to other circulating pro-glucagon-derived peptides, such as glicentin. In addition, cross-reactivity can occur with different isoforms of glucagon, not all of which are biologically active. Some diagnostic assays remove the biologically inactive isoforms before measurement, while others do not.
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