Role of hypoxia-inducible factor 1 in type 1 diabetes.

The autoimmune destruction of β-cells in type-1 diabetes (T1D) is a multifactorial and poorly understood phenomenon. A major contribution to this autoimmune attack is the generation of autoantigens triggered by β-cell dysfunction. Under hypoxia, cells shift to anaerobic glycolysis, regulated by hypoxia-inducible factor (HIF)-1α. This adaptation ensures energy production through increased glycolytic flux and decreased oxidative phosphorylation. Dysregulation of glycolysis contributes to β-cell dysfunction in diabetes. HIF-1α activation in β-cells impacts both in vivo and in vitro insulin secretion and systemic glucose levels. HIF-1α also modulates immune cell phenotype, potentially influencing autoimmune destruction of β-cells. Although more studies are needed, prolyl-hydroxylase inhibitors, which stabilize HIF-1α, show promise as T1D therapeutics by protecting β-cells against cellular stress. Type 1 diabetes (T1D) is a common autoimmune disease in which dysregulated glucose metabolism is a key feature. T1D is both poorly understood and in need of improved therapeutics. Hypoxia is frequently encountered in multiple tissues in T1D patients including the pancreas and sites of diabetic complications. Hypoxia-inducible factor (HIF)-1, a ubiquitous master regulator of the adaptive response to hypoxia, promotes glucose metabolism through transcriptional and non-transcriptional mechanisms and alters disease progression in multiple preclinical T1D models. However, how HIF-1 activation in β-cells of the pancreas and immune cells (two key cell types in T1D) ultimately affects disease progression remains controversial. We discuss recent advances in our understanding of the role of hypoxia/HIF-1-induced glycolysis in T1D and explore the possible use of drugs targeting this pathway as potential new therapeutics. [ABSTRACT FROM AUTHOR]