Fellow with Distinction, American College of Endocrinology, Diplomate, American Board of Internal Medicine, Diabetes, Endocrinology and Metabolism, Grand View Health, Lansdale, Pennsylvania, USA.
J Diabetes. 2022 Feb;14(2):104-110. doi: 10.1111/1753-0407.13246. Epub 2021 Dec 30.
On 31 October 1920, Sir Frederick Banting, while preparing for a medical student lecture on diabetes, a topic that he knew little about, learned how pancreatic stones resulted in the formation of new islets of Langerhans. He then scribbled down a potential research study of tying off the ducts of the pancreas and collecting the secretions to improve diabetes. These secretions became known as insulin. A century later, 60 different oral medications and 20 different insulins are available for the treatment of diabetes, yet none stimulate new islet formation. One hundred years later, after the discovery of insulin, more than a dozen research teams from around the world have demonstrated that similar studies to Banting's pancreatic ligation studies have resulted in upregulation of the REG gene. There are now more than 200 publications on the role of Reg gene proteins and shorter Reg peptides in initiating new islet formation islet from exocrine pancreatic ducts and protecting against inflammation to islets resulting in islet death. Human data through Phase 2b in both type 1 and 2 diabetes patients with diabetes for an average of 20 years have demonstrated that the use of a shorter bioactive Reg peptide can generate new endogenous insulin production, resulting in significant reductions in hemoglobin A1C and increases in stimulated C-peptide. The observations of Frederick Banting, one century ago, may now lead to the generation of therapeutics that form new islets without the need for transplantation.
1920 年 10 月 31 日，弗雷德里克·班廷爵士（Sir Frederick Banting）在准备医学系学生关于糖尿病的讲座时，他对这个主题知之甚少，但他了解到胰腺结石如何导致朗格汉斯胰岛的形成。于是，他潦草地写下了一项潜在的研究计划，即结扎胰腺导管并收集分泌物以改善糖尿病。这些分泌物后来被称为胰岛素。一个世纪后，有 60 种不同的口服药物和 20 种不同的胰岛素可用于治疗糖尿病，但没有一种能刺激新的胰岛形成。一个世纪后，在发现胰岛素之后，来自世界各地的十几个研究团队已经证明，类似于班廷的胰腺结扎研究的类似研究导致 REG 基因的上调。现在有 200 多篇关于 Reg 基因蛋白和较短的 Reg 肽在启动新的胰岛形成方面的作用的出版物，这些肽来自外分泌胰腺导管，并防止胰岛炎症导致胰岛死亡。在 1 型和 2 型糖尿病患者中进行的 2b 期人体数据显示，糖尿病患者的平均病程为 20 年，使用较短的生物活性 Reg 肽可以产生新的内源性胰岛素生成，从而显著降低血红蛋白 A1C 并增加刺激 C 肽。弗雷德里克·班廷（Frederick Banting）一个世纪前的观察结果现在可能会产生无需移植即可形成新胰岛的治疗方法。
