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Current Diabetes Reports

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Open Access 01-09-2019 | Insulins | Pathogenesis of Type 1 Diabetes (A Pugliese and SJ Richardson, Section Editors)

Alterations in Beta Cell Identity in Type 1 and Type 2 Diabetes

Authors: Abu Saleh Md Moin, Alexandra E. Butler

Published in: Current Diabetes Reports | Issue 9/2019

Abstract

Purpose of Review

To discuss the current understanding of “β cell identity” and factors underlying altered identity of pancreatic β cells in diabetes, especially in humans.

Recent Findings

Altered identity of β cells due to dedifferentiation and/or transdifferentiation has been proposed as a mechanism of loss of β cells in diabetes. In dedifferentiation, β cells do not undergo apoptosis; rather, they lose their identity and function. Dedifferentiation is well characterized by the decrease in expression of key β cell markers such as genes encoding major transcription factors, e.g., MafA, NeuroD1, Nkx6.1, and Foxo1, and an increase in atypical or “disallowed” genes for β cells such as lactate dehydrogenase, monocarboxylate transporter MCT1, or progenitor cell genes (Neurog3, Pax4, or Sox9). Moreover, altered identity of mature β cells in diabetes also involves transdifferentiation of β cells into other islet hormone producing cells. For example, overexpression of α cell specific transcription factor Arx or ablation of Pdx1 resulted in an increase of α cell numbers and a decrease in β cell numbers in rodents. The frequency of α-β double-positive cells was also prominent in human subjects with T2D. These altered identities of β cells likely serve as a compensatory response to enhance function/expand cell numbers and may also camouflage/protect cells from ongoing stress. However, it is equally likely that this may be a reflection of new cell formation as a frank regenerative response to ongoing tissue injury. Physiologically, all these responses are complementary.

Summary

In diabetes, (1) endocrine identity recapitulates the less mature/less-differentiated fetal/neonatal cell type, possibly representing an adaptive mechanism; (2) residual β cells may be altered in their subtype proportions or other molecular features; (3) in humans, “altered identity” is a preferable term to dedifferentiation as their cellular fate (differentiated cells losing identity or progenitors becoming more differentiated) is unclear as yet.

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Title: Alterations in Beta Cell Identity in Type 1 and Type 2 Diabetes
Authors: Abu Saleh Md Moin
Alexandra E. Butler
Publication date: 01-09-2019
Publisher: Springer US
Keywords: Insulins
Insulins
Type 2 Diabetes
Type 1 Diabetes
Published in: Current Diabetes Reports / Issue 9/2019
Print ISSN: 1534-4827
Electronic ISSN: 1539-0829
DOI: https://doi.org/10.1007/s11892-019-1194-6

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