In individuals with type 1 diabetes (T1D), the immune system erroneously destroys insulin-producing beta cells. In turn, this leads to an inability of the body to control blood sugar. As a result, individuals must monitor and adjust their blood sugar on their own using a combination of finger sticks, continuous glucose monitors (CGM), insulin pumps, or insulin injections.
However, in a recent study, researchers explored the potential of reprogramming alpha cells in the pancreas to either become or function as beta cells. They used an adeno-associated virus to administer two different transcription factors – Pdx1 and MafA – into the pancreases of diabetic mice. With the overexpression of these factors, alpha cells developed into beta-like cells.
Alpha cells are ideal for reprogramming for numerous reasons including the fact that they naturally occur in abundance in the pancreas, they already function alongside beta cells in islets, and there are no apparent negative effects on glucose metabolism from reducing alpha cell levels, among other reasons.
Upon administering the transcription factors, euglycemia was restored within two weeks and maintained for four months. In addition, glucose response improved as well. After four months, autoimmune diabetes returned. However, this sheds light on potential therapeutic approaches for treating and managing diabetes and could be used in conjunction with immunosuppression for improved insulin production and blood glucose management.
Further testing is needed to determine if this approach is as effective in human pancreatic cells as it is in mouse models, though there have been some studies involving human islets in which alpha-to-beta-cell conversion occurred.
It is these types of studies that increase understanding of T1D and potential therapeutic treatment options. The Diabetes Research Connection (DRC), though not involved in this study, strives to support early career scientists in pursuing novel research studies aligned with preventing and curing T1D as well as improving quality of life for those living with the disease. DRC raises critical funds to enable these projects to move forward.