Diabetes recovery by age-dependent conversion of pancreatic δ-cells into insulin producers

Nature. 2014 Oct 23;514(7523):503-7. doi: 10.1038/nature13633. Epub 2014 Aug 20.

Abstract

Total or near-total loss of insulin-producing β-cells occurs in type 1 diabetes. Restoration of insulin production in type 1 diabetes is thus a major medical challenge. We previously observed in mice in which β-cells are completely ablated that the pancreas reconstitutes new insulin-producing cells in the absence of autoimmunity. The process involves the contribution of islet non-β-cells; specifically, glucagon-producing α-cells begin producing insulin by a process of reprogramming (transdifferentiation) without proliferation. Here we show the influence of age on β-cell reconstitution from heterologous islet cells after near-total β-cell loss in mice. We found that senescence does not alter α-cell plasticity: α-cells can reprogram to produce insulin from puberty through to adulthood, and also in aged individuals, even a long time after β-cell loss. In contrast, before puberty there is no detectable α-cell conversion, although β-cell reconstitution after injury is more efficient, always leading to diabetes recovery. This process occurs through a newly discovered mechanism: the spontaneous en masse reprogramming of somatostatin-producing δ-cells. The juveniles display 'somatostatin-to-insulin' δ-cell conversion, involving dedifferentiation, proliferation and re-expression of islet developmental regulators. This juvenile adaptability relies, at least in part, upon the combined action of FoxO1 and downstream effectors. Restoration of insulin producing-cells from non-β-cell origins is thus enabled throughout life via δ- or α-cell spontaneous reprogramming. A landscape with multiple intra-islet cell interconversion events is emerging, offering new perspectives for therapy.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Aging / physiology*
  • Animals
  • Cell Dedifferentiation
  • Cell Proliferation
  • Cell Transdifferentiation*
  • Diabetes Mellitus, Experimental / pathology*
  • Diabetes Mellitus, Experimental / therapy
  • Diabetes Mellitus, Type 1 / pathology
  • Diabetes Mellitus, Type 1 / therapy
  • Forkhead Box Protein O1
  • Forkhead Transcription Factors / metabolism
  • Glucagon-Secreting Cells / cytology
  • Glucagon-Secreting Cells / metabolism
  • Humans
  • Insulin / biosynthesis*
  • Insulin / metabolism
  • Insulin Secretion
  • Insulin-Secreting Cells / cytology*
  • Insulin-Secreting Cells / metabolism
  • Mice
  • Regeneration*
  • Sexual Maturation
  • Somatostatin / biosynthesis
  • Somatostatin / metabolism
  • Somatostatin-Secreting Cells / cytology*
  • Somatostatin-Secreting Cells / metabolism

Substances

  • Forkhead Box Protein O1
  • Forkhead Transcription Factors
  • Foxo1 protein, mouse
  • Insulin
  • Somatostatin