1. Pharmacological conversion of gut epithelial cells into insulin-producing cells lowers glycemia in diabetic animals
- Author
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Du, Wen, Wang, Junqiang, Kuo, Taiyi, Wang, Liheng, McKimpson, Wendy M, Son, Jinsook, Watanabe, Hitoshi, Kitamoto, Takumi, Lee, Yun-Kyoung, Creusot, Remi J, Ratner, Lloyd E, McCune, Kasi, Chen, Ya-Wen, Grubbs, Brendan H, Thornton, Matthew E, Fan, Jason, Sultana, Nishat, Diaz, Bryan S, Balasubramanian, Iyshwarya, Gao, Nan, Belvedere, Sandro, and Accili, Domenico
- Subjects
Diabetes ,Autoimmune Disease ,Digestive Diseases ,Aetiology ,2.1 Biological and endogenous factors ,Metabolic and endocrine ,Humans ,Mice ,Animals ,Forkhead Box Protein O1 ,Forkhead Transcription Factors ,Mice ,Inbred NOD ,Insulin-Secreting Cells ,Insulin ,Diabetes Mellitus ,Beta cells ,Endocrinology ,Medical and Health Sciences ,Immunology - Abstract
As a highly regenerative organ, the intestine is a promising source for cellular reprogramming for replacing lost pancreatic β cells in diabetes. Gut enterochromaffin cells can be converted to insulin-producing cells by forkhead box O1 (FoxO1) ablation, but their numbers are limited. In this study, we report that insulin-immunoreactive cells with Paneth/goblet cell features are present in human fetal intestine. Accordingly, lineage-tracing experiments show that, upon genetic or pharmacologic FoxO1 ablation, the Paneth/goblet lineage can also undergo conversion to the insulin lineage. We designed a screening platform in gut organoids to accurately quantitate β-like cell reprogramming and fine-tune a combination treatment to increase the efficiency of the conversion process in mice and human adult intestinal organoids. We identified a triple blockade of FOXO1, Notch, and TGF-β that, when tested in insulin-deficient streptozotocin (STZ) or NOD diabetic animals, resulted in near normalization of glucose levels, associated with the generation of intestinal insulin-producing cells. The findings illustrate a therapeutic approach for replacing insulin treatment in diabetes.
- Published
- 2022