Ma Jinfang, Li Mao, Yang Lingxiao, Xie Qingxing, Fan Rongping, Lu Xi, Huang Xing, Tong Nanwei, Duan Zhenyu
Department of Endocrinology and Metabolism, Center for Diabetes and Metabolism Research, Division of Pancreatic Surgery, Department of General Surgery, Department of Radiology, Huaxi MR Research Center (HMRRC), Institution of Radiology and Medical Imaging, West China Hospital Sichuan University Chengdu China.
MedComm (2020). 2025 Sep 6;6(9):e70359. doi: 10.1002/mco2.70359. eCollection 2025 Sep.
The pancreatic islets of Langerhans, which are composed of α, β, δ, ε, and PP cells, orchestrate systemic glucose homeostasis through tightly regulated hormone secretion. Although the precise mechanisms involving β cells in the onset and progression of diabetes have been elucidated and insulin replacement therapy remains the primary treatment modality, the regulatory processes, functions, and specific roles of other pancreatic islet hormones in diabetes continue to be the subject of ongoing investigation. At present, a comprehensive review of the secretion and regulation of pancreatic islet cell hormones as well as the related mechanisms of diabetes is lacking. This review synthesizes current knowledge on the secretion mechanisms of insulin, glucagon, somatostatin, ghrelin, and pancreatic polypeptides, emphasizing their functional crosstalk in diabetes. Emerging advances include CRISPR-based β-cell regeneration, bioengineered islet transplantation, and bioelectronic interventions aimed at restoring pancreatic function. Future research directions highlight artificial intelligence-guided prediction of hormone dynamics, therapeutics targeting the gut microbiome-islet axis, and tissue-engineered artificial islets. By integrating mechanistic insights, physiological roles, and translational innovations, this review outlines precision strategies for targeting islet hormone networks, offering a roadmap toward restoring metabolic equilibrium in diabetes.
胰岛由α、β、δ、ε和PP细胞组成,通过严格调控激素分泌来协调全身葡萄糖稳态。尽管涉及β细胞在糖尿病发生和发展中的精确机制已被阐明,且胰岛素替代疗法仍然是主要治疗方式,但其他胰岛激素在糖尿病中的调节过程、功能及特定作用仍是正在进行研究的主题。目前,缺乏对胰岛细胞激素分泌与调节以及糖尿病相关机制的全面综述。本综述综合了关于胰岛素、胰高血糖素、生长抑素、胃饥饿素和胰多肽分泌机制的现有知识,强调了它们在糖尿病中的功能相互作用。新出现的进展包括基于CRISPR的β细胞再生、生物工程胰岛移植以及旨在恢复胰腺功能的生物电子干预。未来的研究方向突出了人工智能引导的激素动力学预测、针对肠道微生物群-胰岛轴的治疗以及组织工程人工胰岛。通过整合机制见解、生理作用和转化创新,本综述概述了针对胰岛激素网络的精准策略,为恢复糖尿病患者代谢平衡提供了路线图。