Targeted pharmacological therapy restores β-cell function for diabetes remission
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- Sachs et al_Nature Metabolism_2020_Vol 2(2)_192-209
Final published version, 16.3 MB, PDF document
Dedifferentiation of insulin-secreting β cells in the islets of Langerhans has been proposed to be a major mechanism of β-cell dysfunction. Whether dedifferentiated β cells can be targeted by pharmacological intervention for diabetes remission, and ways in which this could be accomplished, are unknown as yet. Here we report the use of streptozotocin-induced diabetes to study β-cell dedifferentiation in mice. Single-cell RNA sequencing (scRNA-seq) of islets identified markers and pathways associated with β-cell dedifferentiation and dysfunction. Single and combinatorial pharmacology further show that insulin treatment triggers insulin receptor pathway activation in β cells and restores maturation and function for diabetes remission. Additional β-cell selective delivery of oestrogen by Glucagon-like peptide-1 (GLP-1–oestrogen conjugate) decreases daily insulin requirements by 60%, triggers oestrogen-specific activation of the endoplasmic-reticulum-associated protein degradation system, and further increases β-cell survival and regeneration. GLP-1–oestrogen also protects human β cells against cytokine-induced dysfunction. This study not only describes mechanisms of β-cell dedifferentiation and regeneration, but also reveals pharmacological entry points to target dedifferentiated β cells for diabetes remission.
Original language | English |
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Journal | Nature Metabolism |
Volume | 2 |
Issue number | 2 |
Pages (from-to) | 192-209 |
Number of pages | 18 |
ISSN | 2522-5812 |
DOIs | |
Publication status | Published - 2020 |
Bibliographical note
A correction to this publication has been published at: https://doi.org/10.1038/s42255-020-0201-1
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