Department of Toxicology, Faculty of Pharmacy, Gazi University, Ankara, Turkey.
Department of General Surgery, Faculty of Medicine, Gazi University, Ankara, Turkey.
Adv Exp Med Biol. 2021;1275:195-227. doi: 10.1007/978-3-030-49844-3_8.
Type 2 diabetes (T2D) is a worldwide serious public health problem. Insulin resistance and β-cell failure are the two major components of T2D pathology. In addition to defective endoplasmic reticulum (ER) stress signaling due to glucolipotoxicity, β-cell dysfunction or β-cell death initiates the deleterious vicious cycle observed in T2D. Although the primary cause is still unknown, overnutrition that contributes to the induction of the state of low-grade inflammation, and the activation of various protein kinases-related metabolic pathways are main factors leading to T2D. In this chapter following subjects, which have critical checkpoints regarding β-cell fate and protein kinases pathways are discussed; hyperglycemia-induced β-cell failure, chronic accumulation of unfolded protein in β-cells, the effect of intracellular reactive oxygen species (ROS) signaling to insulin secretion, excessive saturated free fatty acid-induced β-cell apoptosis, mitophagy dysfunction, proinflammatory responses and insulin resistance, and the reprogramming of β-cell for differentiation or dedifferentiation in T2D. There is much debate about selecting proposed therapeutic strategies to maintain or enhance optimal β-cell viability for adequate insulin secretion in T2D. However, in order to achieve an effective solution in the treatment of T2D, more intensive clinical trials are required on newer therapeutic options based on protein kinases signaling pathways.
2 型糖尿病(T2D)是一个全球性的严重公共卫生问题。胰岛素抵抗和β细胞功能衰竭是 T2D 病理的两个主要组成部分。除了由于糖脂毒性导致内质网(ER)应激信号缺陷外,β细胞功能障碍或β细胞死亡启动了 T2D 中观察到的有害恶性循环。尽管主要原因尚不清楚,但导致 T2D 的主要因素是导致低度炎症状态的营养过剩,以及各种蛋白激酶相关代谢途径的激活。在这一章中,我们讨论了与β细胞命运和蛋白激酶途径有关的关键检查点;高血糖诱导的β细胞衰竭、β细胞中未折叠蛋白的慢性积累、细胞内活性氧(ROS)信号对胰岛素分泌的影响、过量饱和游离脂肪酸诱导的β细胞凋亡、线粒体自噬功能障碍、促炎反应和胰岛素抵抗,以及 T2D 中β细胞的分化或去分化重编程。在选择维持或增强 T2D 中最佳β细胞活力以进行充分胰岛素分泌的拟议治疗策略方面存在很多争议。然而,为了在 T2D 的治疗中实现有效的解决方案,需要基于蛋白激酶信号通路的新治疗选择进行更密集的临床试验。