Journal article
A tale of two pancreases: exocrine pathology and endocrine dysfunction
Diabetologia, Vol.63(10), pp.2030-2039
10/01/2020
DOI: 10.1007/s00125-020-05210-8
PMCID: PMC7646259
PMID: 32894313
Abstract
The islets of Langerhans are well embedded within the exocrine pancreas (the latter comprised of ducts and acini), but the nature of interactions between these pancreatic compartments and their role in determining normal islet function and survival are poorly understood. However, these interactions appear to be critical, as when pancreatic exocrine disease occurs, islet function and insulin secretion frequently decline to the point that diabetes ensues, termed pancreatogenic diabetes. The most common forms of pancreatogenic diabetes involve sustained exocrine disease leading to ductal obstruction, acinar inflammation, and fibro-fatty replacement of the exocrine pancreas that predates the development of dysfunction of the endocrine pancreas, as seen in chronic pancreatitis-associated diabetes and cystic fibrosis-related diabetes and, more rarely, MODY type 8. Intriguingly, a form of tumour-induced diabetes has been described that is associated with pancreatic ductal adenocarcinoma. Here, we review the similarities and differences among these forms of pancreatogenic diabetes, with the goal of highlighting the importance of exocrine/ductal homeostasis for the maintenance of pancreatic islet function and survival and to highlight the need for a better understanding of the mechanisms underlying these diverse conditions.
Graphical abstract
Details
- Title: Subtitle
- A tale of two pancreases: exocrine pathology and endocrine dysfunction
- Creators
- Michael R. Rickels - Hospital of the University of PennsylvaniaAndrew W. Norris - University of IowaRebecca L. Hull - VA Puget Sound Health Care System
- Resource Type
- Journal article
- Publication Details
- Diabetologia, Vol.63(10), pp.2030-2039
- DOI
- 10.1007/s00125-020-05210-8
- PMID
- 32894313
- PMCID
- PMC7646259
- NLM abbreviation
- Diabetologia
- ISSN
- 0012-186X
- eISSN
- 1432-0428
- Publisher
- Springer Nature
- Number of pages
- 10
- Grant note
- R01 DK115791; R01 DK097830; R01 DK088082; P30 DK054759; R56 DK097830; P30 DK017047 / NIDDK NIH HHS; United States Department of Health & Human Services; National Institutes of Health (NIH) - USA; NIH National Institute of Diabetes & Digestive & Kidney Diseases (NIDDK) I01 BX004063 / BLRD VA
- Language
- English
- Date published
- 10/01/2020
- Academic Unit
- Endocrinology and Diabetes; Stead Family Department of Pediatrics; Biochemistry and Molecular Biology
- Record Identifier
- 9984293090502771
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