Factors causing damage and destruction of beta-cells of the islets of Langerhans in the pancreas

Czech version

Authors: Michal Anděl; Vlasta Němcová; Nela Pavlíková; Jana Urbanová; Marie Čecháková; Andrea Havlová; Radka Straková; Livia Večeřová; Václav Mandys; Jan Kovář; Petr Heneberg; Jan Trnka; Jan Polák
Authors‘ workplace: Centrum výzkumu diabetu, metabolizmu a výživy 3. LF UK a FN Královské Vinohrady Praha, přednosta prof. MUDr. Michal Anděl, CSc.
Published in: Vnitř Lék 2014; 60(9): 684-690
Category:

Overview

Insulin secretion in patients with manifested diabetes mellitus tends to disappear months to decades after the diagnosis, which is a clear sign of a gradual loss of pancreatic islet beta-cells. In our sample of 30 type 2 diabetic patients, whose disease manifested between 30 and 45 years of age, about a half have retained or even increased insulin secretion 30 years later, while the other half exhibit a much diminished or lost insulin secretion. Factors that can damage or destroy beta-cells can be divided into the following groups: Metabolic factors: hyperglycemia and glucotoxicity, lipotoxicity, hypoxia, reactive oxygen species; Pharmacological factors: antimicrobial medication pentamidine, SSRI antidepressants; Factors related to impaired insulin secretion: MODY type diabetes; Environmental toxic factors: rat poison Vacor, streptozotocin, polychlorinated and polybrominated hydrocarbons; Disorders of the exocrine pancreas: tumor infiltration, fibrous infiltration, chronic pancreatitis, cystic fibrosis; Infections, inflammation, autoimmunity, viral factors: Coxsackie viruses, H1N1 influenza, enteroviruses. We are currently working on finding other factors leading to beta-cell damage, studying their effect on apoptosis and necrosis and looking for possible protective factors to prevent this damage. We our increasing knowledge about the mechanisms of beta-cell damage and destruction we come ever closer to suggest measures for their prevention. In this review we offer a brief and simplified summary of some of the findings related to this area.

Key words:
pancreatic islet beta-cells of Langerhans – factors damaging or destroying beta-cells – insulin secretion

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