Vnitr Lek 2014, 60(9):684-690

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

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

Centrum výzkumu diabetu, metabolizmu a výživy 3. LF UK a FN Královské Vinohrady Praha, přednosta prof. MUDr. Michal Anděl, CSc.

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.

Keywords: pancreatic islet beta-cells of Langerhans; factors damaging or destroying beta-cells; insulin secretion

Received: July 21, 2014; Accepted: July 24, 2014; Published: September 1, 2014  Show citation