[PDF][PDF] Endogenous reprogramming of alpha cells into beta cells, induced by viral gene therapy, reverses autoimmune diabetes

X Xiao, P Guo, C Shiota, T Zhang, GM Coudriet… - Cell stem cell, 2018 - cell.com
X Xiao, P Guo, C Shiota, T Zhang, GM Coudriet, S Fischbach, K Prasadan, J Fusco
Cell stem cell, 2018cell.com
Successful strategies for treating type 1 diabetes need to restore the function of pancreatic
beta cells that are destroyed by the immune system and overcome further destruction of
insulin-producing cells. Here, we infused adeno-associated virus carrying Pdx1 and MafA
expression cassettes through the pancreatic duct to reprogram alpha cells into functional
beta cells and normalized blood glucose in both beta cell-toxin-induced diabetic mice and in
autoimmune non-obese diabetic (NOD) mice. The euglycemia in toxin-induced diabetic …
Summary
Successful strategies for treating type 1 diabetes need to restore the function of pancreatic beta cells that are destroyed by the immune system and overcome further destruction of insulin-producing cells. Here, we infused adeno-associated virus carrying Pdx1 and MafA expression cassettes through the pancreatic duct to reprogram alpha cells into functional beta cells and normalized blood glucose in both beta cell-toxin-induced diabetic mice and in autoimmune non-obese diabetic (NOD) mice. The euglycemia in toxin-induced diabetic mice and new insulin+ cells persisted in the autoimmune NOD mice for 4 months prior to reestablishment of autoimmune diabetes. This gene therapy strategy also induced alpha to beta cell conversion in toxin-treated human islets, which restored blood glucose levels in NOD/SCID mice upon transplantation. Hence, this strategy could represent a new therapeutic approach, perhaps complemented by immunosuppression, to bolster endogenous insulin production. Our study thus provides a potential basis for further investigation in human type 1 diabetes.
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