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La rosa e lanello (Italian Edition)

Longitudinal studies in rodent models of diabetes clearly indicate that islets can compensate for the insulin resistance by replication and neogenesis [11] , [12] , [13]. Thus, most studies to date have focused on studying post-mortem pancreas sections [12] , [14] , [15] , [16] , [17] and in some cases using islets isolated from patients with type 2 diabetes [18] , [19] , [20] , [21]. The clinical characteristics and laboratory data of the group of patients with T2DM and controls are provided in Table 1 and Table 2.

The pancreatic specimens were carefully selected in relation to their morphological quality and all routine immunohistochemical staining performed using antibodies directed against pancreatic hormones were subject to quality control using appropriate positive and negative controls. Five micrometer thick sections were stained with hematoxylin-eosin for morphological evaluation.

Human pancreas specimens from donors were fixed and immunostained as previously described [8] , [9] , [35] , [36]. All experiments in regard to use of human tissues were in compliance with and following approval of the Institutional Review Board of the Joslin Diabetes Center. Human pancreata were collected from brain-dead organ donors after informed consent was obtained in writing from family members, as previously reported [37].

The islet isolation centers had approval to isolate islets for scientific research if they were not considered suitable for clinical islet transplantation, and were in accordance with the Institutional ethical requirements. To reduce the bleed through from below, confocal images were acquired sequentially, using the LaserSharp software with a low iris diameter. Identical parameters laser power, iris diameter and gain were maintained to acquire images from all sections. The confocal imaging techniques employed in these studies are consistent with previously published methods [8].

Immunofluorescence studies reported in figure 1c—i were performed on seven different control and T2D subjects and similar results were obtained.


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Yellow in merged images indicates co-localization between insulin staining and insulin signalling proteins. Immunostaining was performed as described in Methods. Analysis was performed on seven healthy controls and seven T2D subjects, and a total of controls and T2D islets were analysed. Fourteen to 16 islets per subject were randomly selected and imaged with a confocal microscope and the number of insulin-, glucagon- or somatostatin-positive cells per islet was manually counted in blind by two independent observers.

Islets with less then 30 endocrine cells were not included in this analysis. The number of PCNA-positive cells was manually counted blind by two independent observers. Data are expressed as a percentage of total insulin-, glucagon- or somatostatin-positive cells per islet. To evaluate Ki67 protein expression, immunohistochemical staining using the ABC peroxidase technique was performed on formalin fixed and paraffin embedded tissues [36].

Briefly, three micrometer thick sections were mounted on poly-L-lysine coated slides, de-paraffinized and hydrated through graded alcohol to water. Sections were then immersed in 0. Isolated islets were purified from five type 2 diabetic subjects and seven normoglycemic controls using the modified Ricordi method as described in Gunton et al.

Semi-quantitative-PCR of insulin receptor isoforms was performed as described previously [19]. Insulin receptor IR , insulin receptor substrate-1 IRS1 , insulin receptor substrate 2 IRS2 and phosphatidylinositol 3-kinase p alpha PI3K expression was determined by immunoblotting as reported previously [38].

After immunoprecipitation, bound antibodies were detected using procedures performed according to the manufacturer's instructions ECL, Amersham Biosciences, Buckinghamshire, UK. For islet studies, islets were isolated by the intraductal technique [40]. The islets were then exposed to culture media containing 10 mM hydroxyurea for 16 hours. The hydroxyurea was removed by carefully rinsing islets in RPMI media before continuing culture.

The fixed cells were washed with PBS, stained with propidium iodide solution and analyzed using flow cytometry. Cell-cycle profiles were determined by Cell Quest and ModFit softwares. Cytosolic and nuclear fractions were prepared by lysing cells [42]. The fractionated lysates were subjected to immunoblotting and visualized by an enhanced chemiluminescence system Roche.

To evaluate the relative proportion of islet cells we immunostained pancreas sections with antibodies against insulin, glucagon and somatostatin. We did not observe differences in islet numbers between groups. In addition, we did not detect Kiimmunoreactivity in islets cells in diabetic pancreases data not shown.

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Whether this occurs in vivo in humans is unknown. A reduced expression in insulin receptor levels was evident in islets and acinar tissues of patients with T2DM Fig. Next, we examined expression of downstream signaling proteins BAD and phospho-BAD that are known to be important in the apoptotic pathway [45].

Insulin receptors exist as two isoforms in mammalian tissues — A and B [9] , [46]. Consistent with our earlier reports, we observed the expression of both A and B isoforms were significantly reduced in diabetes patients compared to controls Fig. However, when the data were expressed as a ratio of the two isoforms we did not observe significant differences between groups normal 0.

We examined the alterations in the expression of proteins in the insulin signaling pathway in islets isolated from controls and patients with T2D. We did not observe significant alterations between groups in the expression of insulin receptors suggesting a differential regulation of the mRNA and protein Fig. Data in 2d—i are immunoprecipitates. Analyses were performed by FACS. To analyze the expression of proteins in regulation of cell-cycle progression we examined cyclins, cyclin-dependent kinases CDK and CDK inhibitors [47].

Representative data from at least 3 independent Western blotting experiments from at least 2 independent clones are shown. The plots below the blots are shown in arbitrary units. The loading control for experiments in Fig. Alterations in phosphorylation of the pro-apoptotic protein BAD are known to modulate apoptosis. Thus, a reduced phosphorylation of BAD in the diabetic pancreas is consistent with an increased apoptosis in type 2 diabetes that possibly occurs, in part, secondary to hyperglycemia [8] , [15].

This is compounded by a concomitant reduction in the expression of CDK2, CDK4 and cyclin E proteins, which are essential for multiple steps in the transition from G1 to S phase of the cell cycle. FoxO proteins, including FoxO1, have been implicated in cell cycle regulation [58]. For example, stress-induced FoxO activation has been reported to alter the expression of genes that contribute to cell cycle arrest [59].

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Additional studies are necessary to investigate the proteins that are directly activated by FoxO1 to modulate islet cell cycle progression. Free fatty acids are also known to modulate expression of insulin signaling proteins in vitro [53]. Although we did not observe alterations in expression of enzymes involved in lipid metabolism in diabetic islets data not shown , it is possible that ectopic lipid deposition in islets could produce some of the changes observed in the diabetic group and requires further study.

The authors thank C. DeFronzo MD for critical comments on the manuscript. The authors have declared that no competing interests exist. JG was supported by a C.

Altered Insulin Receptor Signalling and β-Cell Cycle Dynamics in Type 2 Diabetes Mellitus

The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript. National Center for Biotechnology Information , U. Published online Nov Author information Article notes Copyright and License information Disclaimer. Received Dec 27; Accepted Oct Copyright Folli et al. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited.

This article has been cited by other articles in PMC. Introduction Type 2 diabetes mellitus results from a combination of insulin resistance, defects in insulin secretion and hyperglucagonemia. Materials and Methods Patients The clinical characteristics and laboratory data of the group of patients with T2DM and controls are provided in Table 1 and Table 2. Table 1 Non-diabetic multiorgan donors. Perry Lake Gialli Vol. Una scusa per amare Italian Edition.

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