Loss of the Exocrine Pancreas Improves Glucose Tolerance and Insulin Secretion

外分泌胰腺的丧失可改善葡萄糖耐量和胰岛素分泌

• 批准号: 10675473
• 负责人: Mohamed Saleh
• 金额: $ 16.32万
• 依托单位: UNIVERSITY OF PITTSBURGH AT PITTSBURGH
• 依托单位国家: 美国
• 财政年份: 2022
• 资助国家: 美国
• 起止时间: 2022-09-01 至 2027-07-31
• 项目状态: 未结题
• 来源: https://reporter.nih.gov/project-details/10675473
• 关键词: Ablation; Acetic Acids; Acinar Cell; Acinus organ component; Adult; Adverse effects; Affect; Anabolism; Animals; Attention; Beta Cell; Biphasic Pattern; Cause of Death; Cell membrane; Cell physiology; Cellular biology; Characteristics; Closure by clamp; Coculture Techniques; Communication; Cytoplasmic Granules; Data; Defect; Development; Diabetes Mellitus; Diagnosis; Diphtheria Toxin; Duct (organ) structure; Economic Burden; Elastases; Endothelial Cells; Enzymes; Excision; Exocrine pancreas; Exocytosis; Financial Hardship; Funding; Genetic Models; Genetic Transcription; Glucose; Glucose tolerance test; Goals; Health; High Fat Diet; Human; Hyperglycemia; Hypoglycemia; Image; In Situ; Infusion procedures; Institution; Insulin; Intercellular Fluid; Intervention; Islets of Langerhans; Mediating; Modeling; Molecular; Morbidity - disease rate; Mus; Non-Insulin-Dependent Diabetes Mellitus; Obesity; Operative Surgical Procedures; Pancreas; Pancreatic Ductal Adenocarcinoma; Pancreatic duct; Pancreatic enzyme; Pathway interactions; Patients; Peptide Hydrolases; Phase; Phenotype; Physiological; Physiology; Prediabetes syndrome; Preparation; Prevalence; Reporting; Research; Research Personnel; Resources; Reverse Transcriptase Polymerase Chain Reaction; Rodent; Serine Proteinase Inhibitors; Signal Transduction; Streptozocin; Supervision; Surgical Models; Testing; Tissues; Translations; Transplantation; United States; Universities; Viral; Viral Genes; Work; allotransplant; blood glucose regulation; cancer cell; design; diphtheria toxin receptor; economic cost; gene therapy; glucose tolerance; impaired glucose tolerance; improved; in vivo; insulin granule; insulin secretion; insulin sensitivity; islet; knock-down; mortality; mouse model; negative affect; nerve supply; nonhuman primate; novel therapeutics; peripheral blood; promoter; radiological imaging; response; selective expression; small hairpin RNA; therapeutic target; trafficking; transcriptome sequencing; tumor

Abstract Type 2 diabetes (T2D) is a major health problem in the US and worldwide, causing high morbidity and mortality. According to the CDC, in 2017, ~32.5 million had T2D, and an estimated 88 million adults in the United States had prediabetes. Diabetes is the seventh leading cause of death and has become the number one biomedical financial burden in the US, with an estimated national economic cost of $327 billion in 2017. Currently, there is no radical cure for T2D. Studies have demonstrated that glucose induces insulin secretion in a biphasic pattern: an initial first-phase, which develops rapidly but lasts only a few minutes, followed by a nadir, then a sustained second-phase. Loss of first-phase insulin secretion and reduced second-phase secretion are characteristic features of T2D. It is well known that a decrease in the first-phase insulin secretion is the earliest and detrimental defect detected in impaired glucose tolerance (prediabetes) and T2D. Although studies have highlighted the existence of two intra- pancreatic axes of communication between the endocrine and exocrine pancreas (the insular–acinar axis and the acinar–insular axis), little attention has been paid to any direct effect of the exocrine pancreas on β-cell function. We recently designed a surgical mouse model wherein a pancreatic ductal infusion of 1% acetic acid (AcA) led to complete ablation of the exocrine pancreas, but importantly with complete sparing of the islets. This model allows us to study β-cell function in-situ in the pancreas, with the islets retaining their native innervation and vasculature, but in the absence of the exocrine pancreas. We also established a genetic model that uses the diphtheria toxin receptor selectively expressed in acinar cells via the elastase promoter to quickly ablate acinar cells using diphtheria toxin. Our preliminary data in mice, and now in non-human primates, show a significant improvement in glucose tolerance and first-phase insulin secretion to supranormal levels following exocrine pancreas ablation. Observing a similar phenotype with both acinar-only ablation in the genetic model and global exocrine (acini and ducts) ablation in the surgical model supports our hypothesis that it is the acinar cells that are specifically detrimental to the β-cells. This proposal aims to understand the improvements in the physiology of glucose homeostasis in this model by performing the hyperglycemic clamp. It also aims to test the potential translatability of this study by examining the effect of exocrine pancreas loss in a mouse model of obesity-induced hyperglycemia and identifying the underlying causes of the improved insulin secretion following the loss of the exocrine tissue. Also, an important aim of this study is to try to identify the acinar-secreted factor that has an adverse effect on β-cell function. Successful completion of this project will provide the basis for the ultimate objective of this study of generating a therapeutic target for T2D that can physiologically increase insulin secretion, particularly the first-phase, without causing hypoglycemia.

摘要 2型糖尿病（T2 D）是美国和世界范围内的主要健康问题，导致高发病率和死亡率。 根据CDC的数据，2017年，约有3250万人患有T2 D，美国估计有8800万成年人患有T2 D。 有前驱糖尿病糖尿病是第七大死亡原因，已成为头号生物医学疾病。 美国的财政负担，2017年估计国家经济成本为3270亿美元。目前还 2型糖尿病没有根治方法 研究表明，葡萄糖以双相模式诱导胰岛素分泌：最初的第一相， 它发展迅速，但只持续几分钟，然后是一个最低点，然后是一个持续的第二阶段。损失 第一时相胰岛素分泌减少和第二时相分泌减少是T2 D的特征性特征。公 已知第一时相胰岛素分泌的减少是胰岛素分泌中检测到的最早和有害的缺陷。 葡萄糖耐量受损（前驱糖尿病）和T2 D。虽然研究表明，存在两个内部- 内分泌和外分泌胰腺之间的胰腺轴（胰岛-腺泡轴和 腺泡-岛叶轴），很少注意胰腺外分泌对β细胞的任何直接影响。 功能我们最近设计了一种外科小鼠模型，其中胰管输注1%乙酸 (AcA)导致外分泌胰腺的完全消融，但重要的是胰岛的完全保留。这 模型使我们能够研究胰岛原位β细胞功能，胰岛保留其天然神经支配 和脉管系统，但没有外分泌胰腺。我们还建立了一个基因模型， 白喉毒素受体通过弹性蛋白酶启动子在腺泡细胞中选择性表达， 腺泡细胞使用白喉毒素。我们在小鼠和非人类灵长类动物中的初步数据显示， 葡萄糖耐量和第一时相胰岛素分泌显著改善至超正常水平， 胰腺外分泌消融术在遗传模型中观察到两种仅腺泡消融的相似表型 手术模型中的整体外分泌（腺泡和导管）消融支持了我们的假设，即它是腺泡 对β细胞特别有害的细胞。 该建议旨在通过以下方式了解该模型中葡萄糖稳态生理学的改善： 进行高血糖钳夹。同时，本文还通过对英汉两种语言的对比分析来检验本研究的可译性 胰腺外分泌丧失在肥胖诱导的高血糖小鼠模型中的作用， 外分泌组织丧失后胰岛素分泌改善的根本原因。此外，一个重要的 本研究的目的是试图鉴定对β细胞功能具有不利影响的腺泡分泌因子。 该项目的成功完成将为本研究的最终目标奠定基础， T2 D的治疗靶点，可以在生理上增加胰岛素分泌，特别是第一阶段，而不 引起低血糖。