长期 1 型糖尿病患者丰富的非β胰岛内分泌细胞中低水平的胰岛素含量。

Low-Level Insulin Content Within Abundant Non-β Islet Endocrine Cells in Long-standing Type 1 Diabetes.

机构信息

McNair Medical Institute, Baylor College of Medicine, Houston, TX.

McNair Medical Institute, Baylor College of Medicine, Houston, TX

出版信息

Diabetes. 2019 Mar;68(3):598-608. doi: 10.2337/db18-0305. Epub 2018 Dec 14.

Abstract

Although most patients with type 1 diabetes (T1D) continue to produce small amounts of insulin decades after disease onset, very few β-cells persist within their pancreata. Consequently, the source of persistent insulin secretion within T1D remains unclear. We hypothesized that low-level insulin content within non-β-cells could underlie persistent T1D insulin secretion. We tested for low levels of insulin (insulin) within a large cohort of JDRF Network for Pancreatic Organ Donors With Diabetes (nPOD) human pancreata across a wide range of ages and T1D disease durations. Long exposures, high-throughput imaging, and blinded parallel examiners allowed precise quantification of insulin cells. Of note, abundant islet endocrine cells with low quantities of insulin were present in most T1D pancreata. Insulin islet abundance and composition were not influenced by age, duration of diabetes, or age of onset. Insulin islets also contained β-cell markers at variable levels, including Pdx1, Nkx6.1, GLUT1, and PC1/3. Most insulin cells contained abundant glucagon and other α-cell markers, suggesting that α-cells drive much of the insulin phenotype in T1D. However, pancreatic polypeptide, somatostatin, and ghrelin cells also contributed to the insulin cell population. Insulin cells represent a potential source of persistent insulin secretion in long-standing T1D and a possible target for regenerative therapies to expand β-cell function in disease.

摘要

尽管大多数 1 型糖尿病(T1D)患者在发病后数十年仍会继续产生少量胰岛素,但他们的胰腺中几乎没有β细胞存活。因此,T1D 中持续胰岛素分泌的来源仍不清楚。我们假设非β细胞内的低水平胰岛素含量可能是 T1D 持续胰岛素分泌的基础。我们在 JDRF 网络用于糖尿病胰腺供体的胰腺组织(nPOD)的大量队列中检测了各种年龄和 T1D 病程范围内的低水平胰岛素(胰岛素)。长时间曝光、高通量成像和盲法平行检查者允许对胰岛素细胞进行精确的定量。值得注意的是,大多数 T1D 胰腺中存在大量具有低胰岛素含量的胰岛内分泌细胞。胰岛的丰度和组成不受年龄、糖尿病病程或发病年龄的影响。胰岛素胰岛也以不同的水平包含β细胞标志物,包括 Pdx1、Nkx6.1、GLUT1 和 PC1/3。大多数胰岛素细胞含有丰富的胰高血糖素和其他α细胞标志物,这表明α细胞在 T1D 中驱动了大部分胰岛素表型。然而,胰多肽、生长抑素和胃饥饿素细胞也为胰岛素细胞群做出了贡献。胰岛素细胞代表长期 T1D 中持续胰岛素分泌的潜在来源,也是一种可能的再生治疗靶点,可以扩大疾病中β细胞的功能。

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