Early Pathogenesis of Cystic Fibrosis Related Diabetes

1个项目摘要 囊性纤维化(CF)是高加索人群中最常见的致命性常染色体隐性遗传病， 3囊性纤维化传导调节因子氯通道缺陷所致。Cf是一个多器官 4影响肺、胰腺、肝、肠、胆的疾病。囊性纤维化相关糖尿病(CFRD)是 5 CF最常见的严重并发症，与增加的发病率和死亡率有关。CFRD， 在病理生理上与1型和2型糖尿病不同，它显著恶化了营养和 7慢性阻塞性肺疾病患者的肺部健康状况。我们对CF雪貂和3个月至6岁儿童的研究表明 8 CFRD的基础发生在生命的早期，此时腺泡细胞丢失，炎症/纤维化重塑。 9发生。在cf雪貂中，这种外分泌驱动的胰腺重塑导致b细胞丢失引起的血糖升高危机。 10和/或功能障碍。有趣的是，在CF雪貂中新形成的b细胞的出现恰好与一种短暂的 11血糖控制恢复正常。尽管如此，那些早期血糖紊乱最严重的CF雪貂 12继续在以后的生活中开发面板堆石坝。我们还报告了类似的血糖紊乱和 13恢复发生在年幼的CF儿童。我们的中心假说认为，CF雪貂胰腺中的新b细胞 14来源于外分泌祖细胞和/或承诺的去分化b细胞。三只血统溯源雪貂 15个模型将用于绘制b细胞前体细胞(INS-IRES-CreERT2)的命运图，即导管来源的内分泌前体细胞 16(KRT7-IRES-CreERT2)和腺泡来源的内分泌祖细胞(PTF1A-IRES-CreERT2)。使用附加的 17 CFTRG551D雪貂模型，该模型使用CFTR调节器提供胰腺疾病发病的时间控制 18 VX-770，将允许解剖胰腺炎的发育时间如何影响祖细胞状态 19和面板堆石坝的长期进展。我们的体内和体外初步数据也表明，CF雪貂导管 20细胞获得与胰腺祖细胞的转录和表观遗传状态一致的特性 21.在发展中。这种改变的机制将通过体外模型和研究来探讨。 22在CF雪貂胰腺的宫内发育过程中，胰祖细胞的特性。建议数 23研究汇集了两个在慢性胰腺炎动物模型方面具有专业知识的机构， 24胰岛内分泌前体的谱系追踪和CFRD的综合生理学研究 25使用有史以来第一个非啮齿动物谱系追踪模型，在CF中胰岛复活。这些研究预计将 26确定不仅与CFRD有关的机制，而且还确定其他形式的胰源性糖尿病。

1 Project Summary 2 Cystic Fibrosis (CF) is the most common lethal autosomal recessive disorder in Caucasian populations and is 3 caused by defects in the cystic fibrosis conductance regulator (CFTR) chloride channel. CF is a multi-organ 4 disease affecting the lung, pancreas, liver, intestine, and gallbladder. Cystic fibrosis related diabetes (CFRD) is 5 the most common severe complication of CF and is associated with increased morbidity and mortality. CFRD, 6 which is pathophysiologically distinct from type 1 and type 2 diabetes, significantly worsens the nutritional and 7 pulmonary health of CF patients. Our studies in CF ferrets and children 3 months to 6 years of age suggest that 8 the underpinnings of CFRD occur very early in life when acinar cells are lost and inflammatory/fibrotic remodeling 9 occurs. In CF ferrets, this exocrine-driven pancreatic remodeling leads to a glycemic crisis caused by b-cell loss 10 and/or dysfunction. Interestingly, the emergence of newly formed b-cells in CF ferrets coincides with a transient 11 recovery in glycemic control. Nonetheless, those CF ferrets with the greatest early-life glycemic disturbances go 12 on to develop CFRD later in life. We have also reported that a similar pattern of glycemic disturbance and 13 recovery occurs in young CF children. Our central hypothesis proposes that new b-cells in the CF ferret pancreas 14 are derived from exocrine progenitors and/or committed dedifferentiated b-cells. Three lineage tracing ferret 15 models will be used to fate map b-cell progenitors (INS-IRES-CreERT2), ductal-derived endocrine progenitors 16 (KRT7-IRES-CreERT2), and acinar-derived endocrine progenitors (PTF1A-IRES-CreERT2). The use of an additional 17 CFTRG551D ferret model, which affords temporal control of pancreatic disease onset using the CFTR modulator 18 VX-770, will allow for dissection of how the developmental timing of pancreatitis impact progenitor cell states 19 and longer-term progression of CFRD. Our in vivo and in vitro preliminary data also show that CF ferret ductal 20 cells acquire properties consistent with the transcriptional and epigenetic states found in pancreatic progenitors 21 during development. The mechanisms of this alteration will be investigated by using in vitro models and the study 22 of pancreatic progenitor cell specification during in utero development of the CF ferret pancreas. The proposed 23 research has brought together two institutions with expertise in animal modeling of CF pancreatic disease, 24 lineage-tracing of islet endocrine precursors, and integrated physiology of CFRD to delineate the mechanism of 25 islet resurgence in CF using the first ever non-rodent lineage-tracing models. These studies are expected to 26 identify mechanisms not only relevant to CFRD, but also other forms of pancreatogenic diabetes.