Human Beta Cell Functional Adaptation and Dysfunction in Insulin Resistance and Its Reversibility

Overview

Journal Nephron

Publisher Karger

Specialty Nephrology

Date 2023 Oct 26

PMID 37883937

Authors

Masa Skelin Klemen

Jan Kopecky

Jurij Dolensek

Andraz Stozer

Affiliations

Soon will be listed here.

Abstract

Background: Beta cells play a key role in the pathophysiology of diabetes since their functional adaptation is able to maintain euglycemia in the face of insulin resistance, and beta cell decompensation or dysfunction is a necessary condition for full-blown type 2 diabetes (T2D). The mechanisms behind compensation and decompensation are incompletely understood, especially for human beta cells, and even less is known about influences of chronic kidney disease (CKD) or immunosupressive therapy after transplantation on these processes and the development of posttransplant diabetes.

Summary: During compensation, beta cell sensitivity to glucose becomes left-shifted, i.e., their sensitivity to stimulation increases, and this is accompanied by enhanced signals along the stimulus-secretion coupling cascade from membrane depolarization to intracellular calcium and the most distal insulin secretion dynamics. There is currently no clear evidence regarding changes in intercellular coupling during this stage of disease progression. During decompensation, intracellular stimulus-secretion coupling remains enhanced to some extent at low or basal glucose concentrations but seems to become unable to generate effective signals to stimulate insulin secretion at high or otherwise stimulatory glucose concentrations. Additionally, intercellular coupling becomes disrupted, lowering the number of cells that contribute to secretion. During progression of CKD, beta cells also seem to drift from a compensatory left-shift to failure, and immunosupressants can further impair beta cell function following kidney transplantation.

Key Messages: Beta cell stimulus-secretion coupling is enhanced in compensated insulin resistance. With worsening insulin resistance, both intra- and intercellular coupling become disrupted. CKD can progressively disrupt beta cell function, but further studies are needed, especially regarding changes in intercellular coupling.

Citing Articles

Calcium Imaging and Analysis in Beta Cells in Acute Mouse Pancreas Tissue Slices.

Leitgeb E, Pohorec V, Krizancic Bombek L, Klemen M, Duh M, Gosak M Methods Mol Biol. 2024; 2861:223-246.

PMID: 39395109 DOI: 10.1007/978-1-0716-4164-4_17.

Western diet-induced ultrastructural changes in mouse pancreatic acinar cells.

Lipovsek S, Dolensek J, Daris B, Valladolid-Acebes I, Vajs T, Leitinger G Front Cell Dev Biol. 2024; 12:1380564.

PMID: 38550379 PMC: 10972872. DOI: 10.3389/fcell.2024.1380564.

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