Beta-cell failure as a complication of diabetes.

Beta-cell failure as a complication of diabetes.
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DOI:
10.1007/s11154-008-9101-5
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发表时间:
2008-12
影响因子:
8.2
通讯作者:
Bernal-Mizrachi, E.
Bernal-Mizrachi, E.
中科院分区:
医学2区
文献类型:
--
作者:
Chang-Chen, K. J.;Mullur, R.;Bernal-Mizrachi, E.

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2型糖尿病是一种复杂的疾病,其特征在于胰岛素抵抗背景下的β细胞衰竭。在疾病的早期阶段,胰腺β细胞通过增加质量和功能来适应胰岛素抵抗。由于营养过剩持续存在,高血糖症和游离脂肪酸升高会对β细胞功能产生负面影响。这通过许多机制发生,包括活性氧的产生、代谢途径的改变、细胞内钙的增加和内质网应激的激活。这些过程通过损害胰岛素分泌、降低胰岛素基因表达并最终引起细胞凋亡而对β细胞产生不利影响。在这篇综述中,我们将首先讨论在正常条件下β细胞质量的调节。然后,我们将讨论β细胞衰竭的机制,包括糖毒性、脂毒性和内质网应激。对机制的进一步研究将揭示β细胞衰竭的关键调节剂,从而确定可能的新治疗靶点。
Type 2 diabetes mellitus is a complex disease characterized by β-cell failure in the setting of insulin resistance. In early stages of the disease, pancreatic β-cells adapt to insulin resistance by increasing mass and function. As nutrient excess persists, hyperglycemia and elevated free fatty acids negatively impact β-cell function. This happens by numerous mechanisms, including the generation of reactive oxygen species, alterations in metabolic pathways, increases in intracellular calcium and the activation of endoplasmic reticulum stress. These processes adversely affect β-cells by impairing insulin secretion, decreasing insulin gene expression and ultimately causing apoptosis. In this review, we will first discuss the regulation of β-cell mass during normal conditions. Then, we will discuss the mechanisms of β-cell failure, including glucotoxicity, lipotoxicity and endoplasmic reticulum stress. Further research into mechanisms will reveal the key modulators of β-cell failure and thus identify possible novel therapeutic targets.
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