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Improved wound healing by dual inhibition of miR-146a-5p and miR-29a-3p supports a network action of dysregulated miRNAs in diabetic skin. 通过双重抑制miR-146a-5p和miR-29a-3p来改善伤口愈合,支持糖尿病皮肤中失调mirna的网络作用。
IF 10.2 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2026-01-01 Epub Date: 2025-09-03 DOI: 10.1007/s00125-025-06522-3
Marija Petkovic, Ermelindo C Leal, Anja E Sørensen, Per T Jørgensen, Jesper T Wengel, Rosa R Jersie-Christensen, Jesper T Troelsen, Eugenia Carvalho, Louise T Dalgaard

Aims/hypothesis: Upregulation of miR-146a-5p and miR-29-3p is observed in chronic non-healing wounds in diabetes. Their single or combined inhibition's molecular and cellular effects were assessed in human keratinocytes (HaCaT cells) and in vivo using a mouse model of type 1 diabetes.

Methods: As primary outcomes, we screened for proteome changes in HaCaT cells by LC-MS/MS after transfection with miR-146a-5p or miR-29a-3p inhibitors individually or in combination and following stimulation with TNF-α. Moreover, as a secondary outcome, we collected the data and cryopreserved and paraffin-embedded skin biopsies to estimate the tissue response to miRNA inhibition using immunofluorescence and histological analysis. Cryopreserved biopsies were also used for the LC-MS/MS proteome profiling to identify targets and cellular pathways involved in observed tissue changes.

Results: We identified a panel of extracellular matrix proteins, mainly laminins, whose levels changed after transfection with miR-146a-5p or miR-29a-3p inhibitors in HaCaT cells, counteracting TNF-α effects. There was a difference in wound closure rate in vivo between the dual inhibition of miR-146a-5p and miR-29a-3p and scramble controls on day 8 (p<0.01) and day 9 (p<0.05), although not at day 10. Histological analysis at day 10 shows a loose papillary layer in the scramble inhibition group, indicating incomplete wound closure compared with dual miRNA inhibition. Moreover, the dual action of the inhibitors decreased inflammation at day 3 and day 10 (both p<0.001) and reactive oxygen species formation (p<0.01) 3 days post wounding, while increasing the angiogenesis on day 3 (p<0.01) and day 10 (p<0.001). This was consistent with cytoskeletal rearrangements and collagen alterations observed in proteome profiling.

Conclusions/interpretation: These findings demonstrate that dual inhibition of miR-146a-5p and miR-29a-3p in vitro synergises in a bidirectional manner, resulting either in intermediate effects or in cancelling each other's activity for the levels of specific proteins of basal lamina that impair proliferation and cell motility, compared with the individual inhibitors. Topical supplementation of miR-146a-5p and miR-29a-3p inhibitors to diabetic mouse wounds resulted in a reduction in wound size on days 8 and 9, which correspond to the later stages of healing, but did not lead to complete healing by day 10. However, dual inhibition demonstrates favourable effects on high oxidative stress, elevated inflammation and poor angiogenesis. These effects are superior to single miRNA inhibition, suggesting that combined miRNA inhibition could be a promising therapeutic strategy for diabetic wound healing. Nevertheless, further studies in humans are warranted.

目的/假设:在糖尿病慢性不愈合伤口中观察到miR-146a-5p和miR-29-3p的上调。在人类角化细胞(HaCaT细胞)和1型糖尿病小鼠模型中评估了它们单独或联合抑制的分子和细胞效应。方法:作为主要结果,我们在单独或联合转染miR-146a-5p或miR-29a-3p抑制剂以及TNF-α刺激后,通过LC-MS/MS筛选HaCaT细胞的蛋白质组变化。此外,作为次要结果,我们收集数据、冷冻保存和石蜡包埋皮肤活检,利用免疫荧光和组织学分析来评估组织对miRNA抑制的反应。冷冻保存活检也用于LC-MS/MS蛋白质组分析,以确定观察到的组织变化涉及的靶点和细胞途径。结果:我们鉴定了一组细胞外基质蛋白,主要是层粘蛋白,在HaCaT细胞中转染miR-146a-5p或miR-29a-3p抑制剂后,其水平发生变化,抵消TNF-α的作用。在体内,miR-146a-5p和miR-29a-3p的双重抑制与scramble对照组在第8天的伤口愈合率存在差异(p)。这些发现表明,与单个抑制剂相比,miR-146a-5p和miR-29a-3p的双重抑制在体外以双向方式协同作用,导致中间效应或相互抵消损害增殖和细胞运动的基板特定蛋白水平的活性。在糖尿病小鼠伤口局部补充miR-146a-5p和miR-29a-3p抑制剂可在第8天和第9天减少伤口大小,这与愈合的后期阶段相对应,但不能在第10天完全愈合。然而,双重抑制对高氧化应激、炎症升高和血管生成不良有良好的影响。这些效果优于单一miRNA抑制,表明联合miRNA抑制可能是糖尿病伤口愈合的一种有前途的治疗策略。然而,进一步的人体研究是必要的。
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引用次数: 0
Duodenal myoelectrical hyperactivity drives diabetic remission in rat models of type 2 diabetes 十二指肠肌电亢进驱动2型糖尿病大鼠模型的糖尿病缓解
IF 8.2 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-26 DOI: 10.1007/s00125-025-06642-w
Yue Yun, Yu-Dan Liu, Ze-Mian Yang, Yi-Qiao Wang, Nan Zhang, Wen-Jing Li, Di Gao, Lei Sha
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引用次数: 0
Acute and resolving inflammation differentially regulates beta cell function in mice via interactions between peritoneal and islet-associated macrophages 急性和消退炎症通过腹膜和胰岛相关巨噬细胞之间的相互作用对小鼠β细胞功能进行差异调节
IF 8.2 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-26 DOI: 10.1007/s00125-025-06638-6
Liam O’Reilly, Le May Thai, Nancy Sue, Rama Dhenni, Ariel Castro-Martinez, Marcia Munoz, Michael J. Rogers, Tri G. Phan, Carsten Schmitz-Peiffer, Katharine M. Irvine, Trevor J. Biden
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引用次数: 0
Phosphodiesterase ENPP2, which is co-upregulated in obese and pregnant mice, is essential for islet beta cell compensation during obesity 磷酸二酯酶ENPP2在肥胖和怀孕小鼠中共同上调,对肥胖期间胰岛β细胞补偿至关重要
IF 8.2 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-26 DOI: 10.1007/s00125-025-06639-5
Yiqing Zhou, Yongchun Zeng, Yu Chen, Lei Zhang, Qianna Zhen, Yong Chen, Rui Cheng, Yan Wang, Qian Ge
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引用次数: 0
Effects of insulin regimens for type 2 diabetes mellitus: a systematic review and network meta-analysis. 胰岛素方案对2型糖尿病的影响:系统回顾和网络荟萃分析。
IF 8.2 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-24 DOI: 10.1007/s00125-025-06633-x
Vanderlei C Bertuol,Fernando Iorra,Tarsila Vieceli,Nicole T Tonolli,Roberta Zappelini,Luiza van der Sand,Cristiane B Leitão,Dimitris V Rados
AIMS/HYPOTHESISInsulin therapy is essential for managing hyperglycaemia in type 2 diabetes mellitus when oral or non-insulin injectable agents are no longer effective. However, the comparative effectiveness and safety of different insulin regimens remain uncertain. We aimed to compare the effects of basal, basal-bolus, biphasic and prandial insulin regimens on glycaemic management, weight, severe hypoglycaemia, insulin dose and quality of life in adults with type 2 diabetes.METHODSWe conducted a systematic review and network meta-analysis of RCTs. PubMed, EMBASE, the Cochrane Library and ClinicalTrials.gov were searched through to September 2025. The inclusion criteria for studies were RCTs enrolling adults with type 2 diabetes that compared at least two of the specified insulin regimens over ≥12 weeks. Pairs of reviewers independently screened studies, extracted data and assessed risk of bias using the Cochrane RoB-2 tool. Network meta-analyses were performed using a frequentist random-effects model, with basal insulin as the reference.RESULTSFifty-eight RCTs involving 19,122 participants were included. Compared with basal insulin, HbA1c reduction was -3.4 mmol/mol (95% CI -4.9, -1.9 mmol/mol) (-0.31% [95% CI -0.45%, -0.17%]) with a basal-bolus insulin regimen, -2.7 mmol/mol (95% CI -3.7, -1.6 mmol/mol) (-0.24% [95% CI -0.34%, -0.15%]) with biphasic insulin and -4.1 mmol/mol (95% CI -6.2, -2.1 mmol/mol) (-0.38% [95% CI -0.57%, -0.19%]) with prandial insulin. These results were classified as being of moderate confidence due to incoherence. All regimens were associated with approximately 30% increased probability of achieving HbA1c target, 1 kg greater weight gain, and a borderline increase in the risk of severe hypoglycaemia. Insulin doses were slightly higher with basal-bolus and biphasic regimens. Quality-of-life data were limited. Subgroup analyses for insulin initiation and intensification yielded consistent results.CONCLUSIONS/INTERPRETATIONComplex insulin regimens provide modest glycaemic benefits over basal insulin but are associated with greater weight gain and a suggested higher risk of hypoglycaemia. These results are based on evidence of moderate confidence. These trade-offs support the need for individualised regimen selection, informed by clinical context, patient preferences and treatment goals.TRIAL REGISTRATIONPROSPERO registration no. CRD42020181473.FUNDINGThis research was supported by the Committee for the Development of Higher Education Personnel (CAPES) and the Hospital de Clínicas de Porto Alegre - FIPE HCPA.
目的/假设当口服或非胰岛素注射药物不再有效时,胰岛素治疗对于控制2型糖尿病患者的高血糖是必不可少的。然而,不同胰岛素治疗方案的相对有效性和安全性仍不确定。我们的目的是比较基础胰岛素、基础胰岛素、双期胰岛素和餐后胰岛素治疗方案对成人2型糖尿病患者血糖管理、体重、严重低血糖、胰岛素剂量和生活质量的影响。方法对随机对照试验进行系统评价和网络荟萃分析。PubMed、EMBASE、Cochrane图书馆和ClinicalTrials.gov的检索截止到2025年9月。研究的纳入标准是纳入成人2型糖尿病患者的随机对照试验,并在≥12周的时间内比较至少两种指定的胰岛素方案。对审稿人独立筛选研究、提取数据并使用Cochrane rob2工具评估偏倚风险。网络荟萃分析采用频率随机效应模型,以基础胰岛素为参考。结果共纳入58项随机对照试验,共19122名受试者。与基础胰岛素相比,基础胰岛素方案的HbA1c降低值为-3.4 mmol/mol (95% CI -4.9, -1.9 mmol/mol) (-0.31% [95% CI -0.45%, -0.17%]),双相胰岛素方案的HbA1c降低值为-2.7 mmol/mol (95% CI -3.7, -1.6 mmol/mol) (-0.24% [95% CI -0.34%, -0.15%]),餐用胰岛素方案的HbA1c降低值为-4.1 mmol/mol (95% CI -6.2, -2.1 mmol/mol) (-0.38% [95% CI -0.57%, -0.19%])。由于不连贯,这些结果被归类为中等置信度。所有方案均与实现HbA1c目标的可能性增加约30%、体重增加1公斤以及严重低血糖风险的临界增加相关。基础丸和双期方案的胰岛素剂量略高。生活质量数据有限。胰岛素起始和强化的亚组分析结果一致。结论/解释:与基础胰岛素相比,复合胰岛素方案提供了适度的降糖益处,但与更大的体重增加和更高的低血糖风险相关。这些结果是基于中等可信度的证据。这些权衡支持了根据临床情况、患者偏好和治疗目标进行个性化方案选择的必要性。试用注册号普洛斯彼罗注册号CRD42020181473。本研究得到了高等教育人员发展委员会(CAPES)和阿雷格里港医院Clínicas - FIPE HCPA的支持。
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引用次数: 0
Islet amyloid disrupts MHC class II antigen presentation and delays autoimmune diabetes in NOD mice. 胰岛淀粉样蛋白破坏NOD小鼠MHC II类抗原呈递并延缓自身免疫性糖尿病
IF 8.2 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-22 DOI: 10.1007/s00125-025-06622-0
Heather C Denroche,Victoria Ng,Jane Velghe,Imelda Suen,Liam Stanley,Dominika Nackiewicz,Mitsuhiro Komba,Derek L Dai,Galina Soukhatcheva,Sam Chen,C Bruce Verchere
AIMS/HYPOTHESISIslet amyloid contributes to beta cell failure in type 2 diabetes through several mechanisms, one being the potent induction of local islet inflammation through activating inflammatory pathways in islet macrophages. As islet amyloid has recently been reported in pancreases of people with type 1 diabetes, and islet macrophages are thought to play a role in the pathogenesis of type 1 diabetes, we sought to understand the impact of islet amyloid on islet macrophages and beta cell autoimmunity.METHODSWe performed an unbiased phenotypic investigation of islet macrophages in the early stage of islet amyloid formation using single-cell RNA-seq of resident islet macrophages in mice with and without the amyloidogenic form of human islet amyloid polypeptide (hIAPP). The role of islet amyloid in autoimmune diabetes and antigen presentation was assessed in hIAPP-expressing NOD mice and in antigen-presenting cells ex vivo.RESULTSMHC class II (MHCII) antigen presentation genes were strongly downregulated in islet macrophages during islet amyloid formation. NOD mice expressing an hIAPP transgene had delayed diabetes relative to littermate controls (median onset 30.3 vs 19.5 weeks, p=0.016). Likewise, physiological expression of hIAPP by genetic knockin also delayed diabetes in NOD mice relative to littermate controls (median onset 28.2 vs 18.0 weeks, p=0.049), corresponding with decreased markers of antigen presentation and activation, as well as decreased immune cell infiltration in islets. Adoptive transfer studies showed that systemic autoimmune function remained intact and beta cells from hIAPP transgenic mice did not evade immune recognition by diabetogenic T cells, collectively indicating the protection from diabetes was mediated by decreased antigen presentation in the pancreas. Consistent with this, incubation of dendritic cells with islet amyloid polypeptide (IAPP) aggregates decreased MHCII surface expression and diminished antigen-specific T cell activation through a phagocytosis-dependent mechanism.CONCLUSIONS/INTERPRETATIONCollectively, our data reveal a novel role for IAPP aggregates in decreasing MHCII antigen presentation and show that despite the well-established proinflammatory response of macrophages to IAPP aggregates, the uptake of IAPP aggregates during early amyloid formation also disrupts beta cell autoimmunity and delays diabetes in NOD mice.
目的/假设胰岛淀粉样蛋白通过多种机制参与2型糖尿病的β细胞衰竭,其中一种机制是通过激活胰岛巨噬细胞的炎症途径,有效诱导局部胰岛炎症。由于胰岛淀粉样蛋白最近在1型糖尿病患者的胰腺中被报道,并且胰岛巨噬细胞被认为在1型糖尿病的发病机制中发挥作用,我们试图了解胰岛淀粉样蛋白对胰岛巨噬细胞和β细胞自身免疫的影响。方法采用单细胞RNA-seq方法,对具有和不具有人胰岛淀粉样蛋白多肽(hIAPP)的小鼠胰岛巨噬细胞在胰岛淀粉样蛋白形成早期进行了无偏倚的表型研究。在体外表达hiapp的NOD小鼠和抗原呈递细胞中评估了胰岛淀粉样蛋白在自身免疫性糖尿病和抗原呈递中的作用。结果在胰岛淀粉样蛋白形成过程中,MHCII抗原呈递基因在胰岛巨噬细胞中显著下调。与对照组相比,表达hIAPP转基因的NOD小鼠患糖尿病的时间延迟(中位发病时间30.3周vs 19.5周,p=0.016)。同样,通过基因敲入hIAPP的生理表达也会使NOD小鼠的糖尿病延迟(发病中位数28.2周vs 18.0周,p=0.049),这与抗原呈递和激活标记物减少以及胰岛免疫细胞浸润减少相对应。过继性转移研究表明,hIAPP转基因小鼠的全身自身免疫功能保持完整,并且来自hIAPP转基因小鼠的β细胞没有逃避糖尿病源性T细胞的免疫识别,共同表明对糖尿病的保护是由胰腺中抗原呈递减少介导的。与此一致的是,树突状细胞与胰岛淀粉样多肽(IAPP)聚集体的孵化会通过吞噬依赖机制降低MHCII表面表达和抗原特异性T细胞活化。总的来说,我们的数据揭示了IAPP聚集体在减少MHCII抗原呈递中的新作用,并表明尽管巨噬细胞对IAPP聚集体有良好的促炎反应,但在淀粉样蛋白形成的早期,IAPP聚集体的摄取也会破坏β细胞自身免疫并延缓NOD小鼠的糖尿病。
{"title":"Islet amyloid disrupts MHC class II antigen presentation and delays autoimmune diabetes in NOD mice.","authors":"Heather C Denroche,Victoria Ng,Jane Velghe,Imelda Suen,Liam Stanley,Dominika Nackiewicz,Mitsuhiro Komba,Derek L Dai,Galina Soukhatcheva,Sam Chen,C Bruce Verchere","doi":"10.1007/s00125-025-06622-0","DOIUrl":"https://doi.org/10.1007/s00125-025-06622-0","url":null,"abstract":"AIMS/HYPOTHESISIslet amyloid contributes to beta cell failure in type 2 diabetes through several mechanisms, one being the potent induction of local islet inflammation through activating inflammatory pathways in islet macrophages. As islet amyloid has recently been reported in pancreases of people with type 1 diabetes, and islet macrophages are thought to play a role in the pathogenesis of type 1 diabetes, we sought to understand the impact of islet amyloid on islet macrophages and beta cell autoimmunity.METHODSWe performed an unbiased phenotypic investigation of islet macrophages in the early stage of islet amyloid formation using single-cell RNA-seq of resident islet macrophages in mice with and without the amyloidogenic form of human islet amyloid polypeptide (hIAPP). The role of islet amyloid in autoimmune diabetes and antigen presentation was assessed in hIAPP-expressing NOD mice and in antigen-presenting cells ex vivo.RESULTSMHC class II (MHCII) antigen presentation genes were strongly downregulated in islet macrophages during islet amyloid formation. NOD mice expressing an hIAPP transgene had delayed diabetes relative to littermate controls (median onset 30.3 vs 19.5 weeks, p=0.016). Likewise, physiological expression of hIAPP by genetic knockin also delayed diabetes in NOD mice relative to littermate controls (median onset 28.2 vs 18.0 weeks, p=0.049), corresponding with decreased markers of antigen presentation and activation, as well as decreased immune cell infiltration in islets. Adoptive transfer studies showed that systemic autoimmune function remained intact and beta cells from hIAPP transgenic mice did not evade immune recognition by diabetogenic T cells, collectively indicating the protection from diabetes was mediated by decreased antigen presentation in the pancreas. Consistent with this, incubation of dendritic cells with islet amyloid polypeptide (IAPP) aggregates decreased MHCII surface expression and diminished antigen-specific T cell activation through a phagocytosis-dependent mechanism.CONCLUSIONS/INTERPRETATIONCollectively, our data reveal a novel role for IAPP aggregates in decreasing MHCII antigen presentation and show that despite the well-established proinflammatory response of macrophages to IAPP aggregates, the uptake of IAPP aggregates during early amyloid formation also disrupts beta cell autoimmunity and delays diabetes in NOD mice.","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"1 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-12-22","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145801339","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Prevalence of type 2 diabetes among global Indigenous adult populations: a systematic review 2型糖尿病在全球土著成人人群中的患病率:一项系统综述
IF 8.2 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-21 DOI: 10.1007/s00125-025-06624-y
Courtney Claussen, Emily Papadimos, Dianna J. Magliano, Cheri Hotu, Hiliary Monteith, Baiju Shah, Louise Maple-Brown, Alex Brown, Odette Pearson, Donald Warne, Melanie Nadeau, Elizabeth L. M. Barr, Anthony J. Hanley
{"title":"Prevalence of type 2 diabetes among global Indigenous adult populations: a systematic review","authors":"Courtney Claussen, Emily Papadimos, Dianna J. Magliano, Cheri Hotu, Hiliary Monteith, Baiju Shah, Louise Maple-Brown, Alex Brown, Odette Pearson, Donald Warne, Melanie Nadeau, Elizabeth L. M. Barr, Anthony J. Hanley","doi":"10.1007/s00125-025-06624-y","DOIUrl":"https://doi.org/10.1007/s00125-025-06624-y","url":null,"abstract":"","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"46 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796074","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Characterisation of human pancreatic mesenchymal stromal cells in type 1 diabetes 1型糖尿病患者胰腺间充质间质细胞的特征
IF 8.2 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-21 DOI: 10.1007/s00125-025-06634-w
Rebecca E. Dewhurst-Trigg, Jocelyn Atkins, Noel G. Morgan, Martin Eichmann, Sarah J. Richardson, Chloe L. Rackham
Aims/hypothesis Culture-expanded mesenchymal stromal cells (MSCs) reduce immune cell activation and improve islet functional survival. However, little is known about human pancreatic MSCs (pMSCs) in health or how they are altered in type 1 diabetes. Here, we determined the number, density and islet-protective phenotype of pMSCs in situ in individuals with and without type 1 diabetes. Methods Multiplex immunohistochemistry was used to identify pMSCs (CD90 <jats:sup>+</jats:sup> /CD105 <jats:sup>+</jats:sup> /CD73 <jats:sup>+</jats:sup> /CD31 <jats:sup>−</jats:sup> /CD45 <jats:sup>−</jats:sup> /CD34 <jats:sup>−</jats:sup> ) in human pancreas sections from 38 donors (Network for Pancreatic Organ Donors with Diabetes and Exeter Archival Diabetes Biobank). Donors were categorised as either <13 years at type 1 diabetes diagnosis ( <jats:italic>n</jats:italic> =8) or ≥13 years at type 1 diabetes diagnosis ( <jats:italic>n</jats:italic> =11) or were sex-matched individuals of similar age without diabetes. Consecutive sections were immunostained with antisera against insulin, glucagon and the established islet-protective and immunomodulatory factors annexin A1 (ANXA1) and indoleamine 2,3-dioxygenase 1. Whole-slide scans were acquired and pMSCs either inside or at the periphery (within 10 µm) of islets were quantified on an individual-islet basis. We identified 53,375 pMSCs and performed an analysis of 26,376 individual islets. Culture-expanded MSCs were exposed to cytokines and viability and proliferation were assessed by flow cytometry. Results pMSCs were identified in situ in the human pancreas where they wrap around the islet periphery in an expected spindle-like morphology. ANXA1 was expressed by 33.2% of pMSCs and was expressed constitutively among individuals with or without diabetes. The density of both intraislet pMSCs and pMSCs within 10 µm of the islet periphery was increased for insulin-containing islets in individuals with type 1 diabetes compared with individuals without diabetes ( <jats:italic>p</jats:italic> <0.001). pMSC density within 10 µm of the islet periphery was preferentially increased in individuals ≥13 years at type 1 diabetes diagnosis compared with individuals <13 years at type 1 diabetes diagnosis ( <jats:italic>p</jats:italic> <0.001). pMSC density was reduced around insulin-deficient islets compared with insulin-containing islets in individuals with diabetes ( <jats:italic>p</jats:italic> <0.001), consistent with an islet-protective role for pMSCs. Exposure of culture-expanded MSCs to an aggressive cytokine combination led to increased cell death and reduced proliferation. Conclusions/interpretation pMSCs express ANXA1 constitutively, suggesting an islet-protective role in health. The density of pMSCs was increased around insulin-containing islets and lost around insulin-deficient islets in individuals with type 1 diabetes which aligns with this hypothesis. pMSC density at the periphery of insulin-containing is
目的/假设培养扩增间充质间质细胞(MSCs)可降低免疫细胞活化,提高胰岛功能存活。然而,对于健康的人胰腺间充质干细胞(pMSCs)或它们在1型糖尿病中如何改变知之甚少。在这里,我们测定了1型糖尿病患者和非1型糖尿病患者原位pMSCs的数量、密度和胰岛保护表型。方法采用多重免疫组织化学方法鉴定来自38个供体(糖尿病胰腺器官供体网络和埃克塞特糖尿病档案生物库)的人胰腺切片的pMSCs (CD90 + /CD105 + /CD73 + /CD31−/CD45−/CD34−)。供者被分类为1型糖尿病诊断年龄≥13岁(n =8)或1型糖尿病诊断年龄≥13岁(n =11)或性别匹配的年龄相近且无糖尿病的个体。连续切片用抗胰岛素、胰高血糖素和已建立的胰岛保护和免疫调节因子膜联蛋白A1 (ANXA1)和吲哚胺2,3-双加氧酶1的抗血清进行免疫染色。获得全片扫描,并在单个胰岛的基础上定量胰岛内部或周围(10µm内)的pMSCs。我们确定了53375个pMSCs,并对26376个个体胰岛进行了分析。培养扩增的MSCs暴露于细胞因子中,并通过流式细胞术评估其活力和增殖能力。结果在人胰腺中原位鉴定出pMSCs,它们以预期的纺锤状形态包裹在胰岛周围。ANXA1在33.2%的pMSCs中表达,并且在有或没有糖尿病的个体中组成性表达。与非糖尿病患者相比,1型糖尿病患者含胰岛素的胰岛中,胰岛内pMSCs和胰岛周围10µm内pMSCs的密度均有所增加(p <0.001)。与诊断为1型糖尿病≥13岁的个体相比,诊断为1型糖尿病≥13岁的个体胰岛周围10µm内的pMSC密度优先增加(p <0.001)。与糖尿病患者含胰岛素的胰岛相比,胰岛素缺乏的胰岛周围的pMSC密度降低(p <0.001),这与pMSC对胰岛的保护作用一致。将培养扩增的间充质干细胞暴露于侵袭性细胞因子组合中导致细胞死亡增加和增殖减少。pMSCs组成性地表达ANXA1,提示其在健康中具有胰岛保护作用。在1型糖尿病患者中,含胰岛素的胰岛周围pMSCs密度增加,而缺乏胰岛素的胰岛周围pMSCs密度减少,这与这一假设相一致。在晚发型1型糖尿病患者中,含胰岛素胰岛周围的pMSC密度优先较高,这与免疫细胞浸润强度较低相关。在年轻发病的1型糖尿病患者中,pMSCs在胰岛周围更强的促炎环境中存活的能力降低,可能导致这些个体中β细胞的快速损失。图形化的
{"title":"Characterisation of human pancreatic mesenchymal stromal cells in type 1 diabetes","authors":"Rebecca E. Dewhurst-Trigg, Jocelyn Atkins, Noel G. Morgan, Martin Eichmann, Sarah J. Richardson, Chloe L. Rackham","doi":"10.1007/s00125-025-06634-w","DOIUrl":"https://doi.org/10.1007/s00125-025-06634-w","url":null,"abstract":"Aims/hypothesis Culture-expanded mesenchymal stromal cells (MSCs) reduce immune cell activation and improve islet functional survival. However, little is known about human pancreatic MSCs (pMSCs) in health or how they are altered in type 1 diabetes. Here, we determined the number, density and islet-protective phenotype of pMSCs in situ in individuals with and without type 1 diabetes. Methods Multiplex immunohistochemistry was used to identify pMSCs (CD90 &lt;jats:sup&gt;+&lt;/jats:sup&gt; /CD105 &lt;jats:sup&gt;+&lt;/jats:sup&gt; /CD73 &lt;jats:sup&gt;+&lt;/jats:sup&gt; /CD31 &lt;jats:sup&gt;−&lt;/jats:sup&gt; /CD45 &lt;jats:sup&gt;−&lt;/jats:sup&gt; /CD34 &lt;jats:sup&gt;−&lt;/jats:sup&gt; ) in human pancreas sections from 38 donors (Network for Pancreatic Organ Donors with Diabetes and Exeter Archival Diabetes Biobank). Donors were categorised as either &lt;13 years at type 1 diabetes diagnosis ( &lt;jats:italic&gt;n&lt;/jats:italic&gt; =8) or ≥13 years at type 1 diabetes diagnosis ( &lt;jats:italic&gt;n&lt;/jats:italic&gt; =11) or were sex-matched individuals of similar age without diabetes. Consecutive sections were immunostained with antisera against insulin, glucagon and the established islet-protective and immunomodulatory factors annexin A1 (ANXA1) and indoleamine 2,3-dioxygenase 1. Whole-slide scans were acquired and pMSCs either inside or at the periphery (within 10 µm) of islets were quantified on an individual-islet basis. We identified 53,375 pMSCs and performed an analysis of 26,376 individual islets. Culture-expanded MSCs were exposed to cytokines and viability and proliferation were assessed by flow cytometry. Results pMSCs were identified in situ in the human pancreas where they wrap around the islet periphery in an expected spindle-like morphology. ANXA1 was expressed by 33.2% of pMSCs and was expressed constitutively among individuals with or without diabetes. The density of both intraislet pMSCs and pMSCs within 10 µm of the islet periphery was increased for insulin-containing islets in individuals with type 1 diabetes compared with individuals without diabetes ( &lt;jats:italic&gt;p&lt;/jats:italic&gt; &lt;0.001). pMSC density within 10 µm of the islet periphery was preferentially increased in individuals ≥13 years at type 1 diabetes diagnosis compared with individuals &lt;13 years at type 1 diabetes diagnosis ( &lt;jats:italic&gt;p&lt;/jats:italic&gt; &lt;0.001). pMSC density was reduced around insulin-deficient islets compared with insulin-containing islets in individuals with diabetes ( &lt;jats:italic&gt;p&lt;/jats:italic&gt; &lt;0.001), consistent with an islet-protective role for pMSCs. Exposure of culture-expanded MSCs to an aggressive cytokine combination led to increased cell death and reduced proliferation. Conclusions/interpretation pMSCs express ANXA1 constitutively, suggesting an islet-protective role in health. The density of pMSCs was increased around insulin-containing islets and lost around insulin-deficient islets in individuals with type 1 diabetes which aligns with this hypothesis. pMSC density at the periphery of insulin-containing is","PeriodicalId":11164,"journal":{"name":"Diabetologia","volume":"10 1","pages":""},"PeriodicalIF":8.2,"publicationDate":"2025-12-21","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"145796075","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":1,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}
引用次数: 0
Efficacy of tirzepatide versus semaglutide in achieving therapeutic targets in type 2 diabetes: a post hoc analysis of the SURPASS-2 Trial. 替西帕肽与西马鲁肽在实现2型糖尿病治疗目标方面的疗效:对SURPASS-2试验的事后分析
IF 8.2 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-19 DOI: 10.1007/s00125-025-06637-7
João Sérgio Neves,Ana Rita Leite,Catarina Vale,Pedro Marques,Francisco Vasques-Nóvoa,Adelino Leite-Moreira,João Pedro Ferreira
AIMS/HYPOTHESISSimultaneous control of HbA1c, lipid profile, BP and body weight is essential for preventing chronic complications of type 2 diabetes. Glucagon-like peptide-1 (GLP-1)-based therapies improve all these variables but whether the dual GLP-1 / glucose-dependent insulinotropic polypeptide (GIP) agonist tirzepatide is superior to semaglutide in attaining therapeutic targets remains unclear.METHODSWe performed a post hoc analysis of the SURPASS-2 trial, a randomised phase 3 study including 1879 adults with type 2 diabetes. Participants were randomised to receive tirzepatide (5, 10 or 15 mg) or semaglutide (1 mg). In this analysis, we compared the effects of tirzepatide vs semaglutide on the attainment of standard (HbA1c <53 mmol/mol [7%], BP <140/90 mmHg, LDL-cholesterol <1.8 mmol/l, >10% weight loss) and intensive (HbA1c <48 mmol/mol [6.5%], BP <130/80 mmHg, LDL-cholesterol <1.4 mmol/l , >15% weight loss) therapeutic targets at 40 weeks.RESULTSIn the SURPASS-2 trial, at baseline, 19% of participants were on target for attaining no standard goals, 59% for one goal and 21% for two or more goals. For intensive therapeutic targets, 58% of participants were on target for attaining zero goals, 38% for one goal and 4% for two goals. All doses of tirzepatide increased the number of achieved standard and intensive targets compared with semaglutide. For standard targets, 34% of participants treated with semaglutide met three or more targets, compared with 42%, 53% and 57% with tirzepatide 5, 10 and 15 mg, respectively. For intensive targets, 8% of participants treated with semaglutide met three or more targets, vs 15%, 20% and 29% with tirzepatide. Regarding specific therapeutic goals, tirzepatide increased the odds of achieving standard and intensive targets for HbA1c (HbA1c <53 mmol/mol [7%], OR 1.50 [95% CI 1.12, 2.00]; HbA1c <48 mmol/mol [6.5%], OR 1.88 [95%CI 1.49, 2.36]) and weight loss (weight loss >10%, OR 2.72 [95% CI 2.14, 3.47]; weight loss >15%, OR 3.86 [95% CI 2.69, 5.55]) and the intensive target for BP (OR 1.45 [95% CI 1.17, 1.81]).CONCLUSIONS/INTERPRETATIONTirzepatide improves therapeutic target attainment compared with semaglutide in type 2 diabetes. Longer trials are needed to confirm benefits on long-term prognosis.DATA AVAILABILITYData for this post hoc analysis was accessed through the Vivli (Center for Global Clinical Research Data) platform ( https://vivli.org ) with the Vivli ID 00009964.
目的/假设同时控制HbA1c、血脂、血压和体重对于预防2型糖尿病的慢性并发症至关重要。以胰高血糖素样肽-1 (GLP-1)为基础的治疗改善了所有这些变量,但GLP-1 /葡萄糖依赖性胰岛素多肽(GIP)激动剂替西帕肽在达到治疗目标方面是否优于半马鲁肽尚不清楚。方法:我们对SURPASS-2试验进行了事后分析,该试验是一项包括1879名2型糖尿病成人患者的随机3期研究。参与者随机接受替西帕肽(5、10或15毫克)或西马鲁肽(1毫克)治疗。在这项分析中,我们比较了替西帕肽和西马鲁肽在40周时达到标准(HbA1c减轻10%体重)和强化(HbA1c减轻15%体重)治疗目标的效果。结果在SURPASS-2试验中,在基线时,19%的参与者没有达到标准目标,59%达到一个目标,21%达到两个或更多目标。对于强化治疗目标,58%的参与者达到了零目标,38%达到了一个目标,4%达到了两个目标。与西马鲁肽相比,所有剂量的替西帕肽都增加了达到标准和强化目标的数量。对于标准目标,接受西马鲁肽治疗的参与者中有34%达到了三个或更多的目标,而接受替西帕肽5、10和15mg治疗的参与者分别为42%、53%和57%。对于强化靶标,8%的接受西马鲁肽治疗的受试者达到三个或更多靶标,而接受替西帕肽治疗的受试者达到15%、20%和29%。关于特定的治疗目标,替西帕肽增加了HbA1c标准和强化目标(HbA1c 10%, OR 2.72 [95% CI 2.14, 3.47];体重减轻15%,OR 3.86 [95% CI 2.69, 5.55])和BP强化目标(OR 1.45 [95% CI 1.17, 1.81])的实现几率。结论/解释:与西马鲁肽相比,替西帕肽可提高2型糖尿病患者的治疗目标。需要更长时间的试验来证实对长期预后的益处。数据可用性通过Vivli(全球临床研究数据中心)平台(https://vivli.org)访问该事后分析的数据,Vivli ID为00009964。
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引用次数: 0
Dietary intake of vitamins A, B, C, D and E and risk of islet autoimmunity and type 1 diabetes in genetically at-risk children: a prospective study from the DIPP birth cohort. 饮食中维生素A、B、C、D和E的摄入与遗传风险儿童胰岛自身免疫和1型糖尿病的风险:一项来自DIPP出生队列的前瞻性研究
IF 8.2 1区 医学 Q1 ENDOCRINOLOGY & METABOLISM Pub Date : 2025-12-19 DOI: 10.1007/s00125-025-06635-9
Markus Mattila,Peppi Haario,Leena Hakola,Hanna-Mari Takkinen,Essi J Peltonen,Tuuli E Korhonen,Suvi Ahonen,Jorma Ilonen,Jorma Toppari,Mikael Knip,Riitta Veijola,Sari Niinistö,Suvi M Virtanen
AIMS/HYPOTHESISIn this prospective birth cohort study, we examined whether the dietary intake of A, B, C, D and E vitamins is associated with the risk of islet autoimmunity or type 1 diabetes in children who are genetically at risk for type 1 diabetes.METHODSData on vitamin intakes in the Finnish Type 1 Diabetes Prediction and Prevention (DIPP) cohort study were available for 5674 children born between September 1996 and September 2004 in Oulu University Hospital or Tampere University Hospital. Diet was assessed using 3-day food records at the age of 3 and 6 months, and annually from 1 to 6 years. The primary outcomes were: (1) islet autoimmunity defined as repeated positivity for islet cell autoantibodies and at least one out of three type 1 diabetes-related biochemical autoantibodies or a diagnosis of type 1 diabetes; and (2) a diagnosis of type 1 diabetes.RESULTSDuring the 6-year follow-up, 247 children (4.4%) developed islet autoimmunity and 94 (1.7%) developed type 1 diabetes. When adjusted for total energy intake, sex, HLA genotype and family history of diabetes, the intakes of retinol (HR 0.91; 95% credible interval [CrI] 0.86, 0.97 per 10 µg/MJ increase in intake), vitamin C (HR 0.70; 95% CrI 0.54, 0.90 per 10 µg/MJ) and vitamin E (HR 0.93; 95% CrI 0.89, 0.97 per 0.1 mg/MJ) were associated with decreased risk of islet autoimmunity and also with the risk of type 1 diabetes (retinol: HR 0.83; 95% CrI 0.74, 0.96 per 10 µg/MJ; vitamin C: HR 0.45; 95% CrI 0.23, 0.84 per 10 µg/MJ; vitamin E: HR 0.89; 95% CrI 0.80, 0.99 per 0.1 mg/MJ). The associations remained statistically significant after multiple testing correction for the risk of islet autoimmunity but not for type 1 diabetes. The association between retinol intake and islet autoimmunity risk was not significant when the 3-month age point, during which the child is primarily breastfed, was excluded. We observed a weak inverse association for vitamin D and islet autoimmunity, and no associations for B vitamins.CONCLUSIONS/INTERPRETATIONHigh intake of vitamin C and vitamin E was associated with a decreased risk of islet autoimmunity.
目的/假设在这项前瞻性出生队列研究中,我们研究了在遗传上有1型糖尿病风险的儿童中,饮食中摄入A、B、C、D和E维生素是否与胰岛自身免疫或1型糖尿病风险相关。方法对1996年9月至2004年9月在奥卢大学医院或坦佩雷大学医院出生的5674名芬兰1型糖尿病预测与预防(DIPP)队列研究中的维生素摄入量数据进行分析。在3岁和6个月时使用3天饮食记录评估饮食,并在1至6岁期间每年进行一次。主要结果是:(1)胰岛自身免疫定义为胰岛细胞自身抗体和至少三分之一的1型糖尿病相关生化自身抗体重复阳性或诊断为1型糖尿病;(2)诊断为1型糖尿病。结果在6年的随访中,247名儿童(4.4%)发生胰岛自身免疫,94名儿童(1.7%)发生1型糖尿病。调整后的总能量摄入、性别、HLA基因型和糖尿病的家族史,视黄醇的摄入量(HR 0.91; 95%可信区间(CrI) 0.86,每10µg / 0.97 MJ增加摄入),维生素C (HR 0.70; 95%中国国际广播电台0.54,0.90每10µg / MJ)和维生素E (HR 0.93; 95% CrI 0.89, 0.97 0.1毫克/ MJ)风险的降低胰岛自身免疫有关,也与1型糖尿病的风险(视黄醇:人力资源0.83;95%中国国际广播电台0.74,0.96每10µg /乔丹;维生素C:人力资源0.45;95% CrI 0.23, 0.84 / 10µg/MJ;维生素E: HR 0.89;95% CrI 0.80, 0.99 / 0.1 mg/MJ)。在对胰岛自身免疫风险进行多次检测校正后,这种关联仍然具有统计学意义,但对1型糖尿病的风险则无统计学意义。视黄醇摄入量与胰岛自身免疫风险之间的关联在排除3个月的年龄点时不显着,在此期间儿童主要是母乳喂养。我们观察到维生素D和胰岛自身免疫有弱的负相关,而B族维生素没有关联。结论/解释大量摄入维生素C和维生素E与降低胰岛自身免疫风险相关。
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Diabetologia
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