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Pancreatic islets

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"Islets of Langerhans" redirects here. Not to be confused with Langerhans cell.
Pancreatic islets
Pancreatic islets are groups of cells found within the pancreas that release hormones
A pancreatic islet from a mouse in a typical position, close to a blood vessel; insulin in red, nuclei in blue.
Details
Part ofPancreas
SystemEndocrine
Identifiers
Latininsulae pancreaticae
MeSHD007515
TA98A05.9.01.019
TA23128
FMA16016
Anatomical terms of microanatomy

The pancreatic islets or islets of Langerhans are the regions of the pancreas that contain its endocrine (hormone-producing) cells, discovered in 1869 by German pathological anatomist Paul Langerhans.[1] The pancreatic islets constitute 1–2% of the pancreas volume and receive 10–15% of its blood flow.[2][3] The pancreatic islets are arranged in density routes throughout the human pancreas, and are important in the metabolism of glucose.[4]

Structure

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There are about 1 million islets distributed throughout the pancreas of a healthy adult human. While islets vary in size, the average diameter is about 0.2 mm.[5]:928 Each islet is separated from the surrounding pancreatic tissue by a thin, fibrous, connective tissue capsule which is continuous with the fibrous connective tissue that is interwoven throughout the rest of the pancreas.[5]:928

Microanatomy

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Hormones produced in the pancreatic islets are secreted directly into the blood flow by (at least) five types of cells. In rat islets, endocrine cell types are distributed as follows:[6]

It has been recognized that the cytoarchitecture of pancreatic islets differs between species.[7][8][9] In particular, while rodent islets are characterized by a predominant proportion of insulin-producing beta cells in the core of the cluster and by scarce alpha, delta and PP cells in the periphery, human islets display alpha and beta cells in close relationship with each other throughout the cluster.[7][9]

The proportion of beta cells in islets varies depending on the species, in humans it is about 40–50%. In addition to endocrine cells, there are stromal cells (fibroblasts), vascular cells (endothelial cells, pericytes), immune cells (granulocytes, lymphocytes, macrophages, dendritic cells,) and neural cells.[10]

A large amount of blood flows through the islets, 5–6 mL/min per 1 g of islet. It is up to 15 times more than in exocrine tissue of the pancreas.[10]

Islets can influence each other through paracrine and autocrine communication, and beta cells are coupled electrically to six to seven other beta cells, but not to other cell types.[11] Pancreatic islets are characterized by rich innervation and vascularization, although there are notable differences between rodent and human islets. Research indicates that the vascular density in human islets is about five times lower than in rodent islets.[12][13] The vascular network within the islets resembles a glomeruli-like structure, consisting of highly fenestrated endothelial cells positioned closely to each endocrine cell.[14] [15] Consequently, the oxygen tension within pancreatic islets is significantly higher than that in the surrounding exocrine tissue.[16]

  • A pancreatic islet, stained.
    A pancreatic islet, stained.
  • A pancreatic islet, showing alpha cells
    A pancreatic islet, showing alpha cells
  • A pancreatic islet, showing beta cells.
    A pancreatic islet, showing beta cells.

Function

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The paracrine feedback system of the pancreatic islets has the following structure:[17]

  • Glucose/Insulin: activates beta cells and inhibits alpha cells.
  • Glycogen/Glucagon: activates alpha cells which activates beta cells and delta cells.
  • Somatostatin: inhibits alpha cells and beta cells. Also inhibits the secretion of pancreatic polypeptide.[18]

A large number of G protein-coupled receptors (GPCRs) regulate the secretion of insulin, glucagon, and somatostatin from pancreatic islets,[19] and some of these GPCRs are the targets of drugs used to treat type-2 diabetes (ref GLP-1 receptor agonists, DPPIV inhibitors).

  • Mouse islet immunostained for pancreatic polypeptide
    Mouse islet immunostained for pancreatic polypeptide
  • Mouse islet immunostained for insulin
    Mouse islet immunostained for insulin
  • Mouse islet immunostained for glucagon
    Mouse islet immunostained for glucagon

Electrical activity

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Electrical activity of pancreatic islets has been studied using patch clamp techniques. It has turned out that the behavior of cells in intact islets differs significantly from the behavior of dispersed cells.[20]

Clinical significance

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Diabetes

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The beta cells of the pancreatic islets secrete insulin, and so play a significant role in diabetes. It is thought that they are destroyed by immune assaults.

Because the beta cells in the pancreatic islets are selectively destroyed by an autoimmune process in type 1 diabetes, clinicians and researchers are actively pursuing islet transplantation as a means of restoring physiological beta cell function, which would offer an alternative to a complete pancreas transplant or artificial pancreas.[21][22] Islet transplantation emerged as a viable option for the treatment of insulin requiring diabetes in the early 1970s with steady progress over the following three decades.[23] Clinical trials as of 2008 have shown that insulin independence and improved metabolic control can be reproducibly obtained after transplantation of cadaveric donor islets into patients with unstable type 1 diabetes.[22] Alternatively, daily insulin injections are an effective treatment for type 1 diabetes patients who are not candidates for islet transplantation.

People with high body mass index (BMI) are unsuitable pancreatic donors due to greater technical complications during transplantation. However, it is possible to isolate a larger number of islets because of their larger pancreas, and therefore they are more suitable donors of islets.[24]

Islet transplantation only involves the transfer of tissue consisting of beta cells that are necessary as a treatment of this disease. It thus represents an advantage over whole pancreas transplantation, which is more technically demanding and poses a risk of, for example, pancreatitis leading to organ loss.[24] Another advantage is that patients do not require general anesthesia.[25]

Islet transplantation for type 1 diabetes (as of 2008) requires potent immunosuppression to prevent host rejection of donor islets.[26]

The islets are transplanted into a portal vein, which is then implanted in the liver.[24] There is a risk of portal venous branch thrombosis and the low value of islet survival a few minutes after transplantation, because the vascular density at this site is after the surgery several months lower than in endogenous islets. Thus, neovascularization is key to islet survival, that is supported, for example, by VEGF produced by islets and vascular endothelial cells.[10][25] However, intraportal transplantation has some other shortcomings, and so other alternative sites that would provide better microenvironment for islets implantation are being examined.[24] Islet transplant research also focuses on islet encapsulation, CNI-free (calcineurin-inhibitor) immunosuppression, biomarkers of islet damage or islet donor shortage.[27]

An alternative source of beta cells, such insulin-producing cells derived from adult stem cells or progenitor cells would contribute to overcoming the shortage of donor organs for transplantation. The field of regenerative medicine is rapidly evolving and offers great hope for the nearest future. However, type 1 diabetes is the result of the autoimmune destruction of beta cells in the pancreas. Therefore, an effective cure will require a sequential, integrated approach that combines adequate and safe immune interventions with beta cell regenerative approaches.[28] It has also been demonstrated that alpha cells can spontaneously switch fate and transdifferentiate into beta cells in both healthy and diabetic human and mouse pancreatic islets, a possible future source for beta cell regeneration.[29] In fact, it has been found that islet morphology and endocrine differentiation are directly related.[30] Endocrine progenitor cells differentiate by migrating in cohesion and forming bud-like islet precursors, or "peninsulas", in which alpha cells constitute the peninsular outer layer and beta cells form later beneath them. Cryopreservation has shown promise to improve the supply chain of pancreatic islets for better transplantation outcomes. [31]

Additional images

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  • Pancreatic islets, the lighter tissue among the darker, acinar pancreatic tissue, hemalum-eosin stain.
    Pancreatic islets, the lighter tissue among the darker, acinar pancreatic tissue, hemalum-eosin stain.
  • Illustration of dog pancreas. 250x.
    Illustration of dog pancreas. 250x.
  • Structural differences between rat islets (top) and humans islets (bottom) as well as the ventral part (left) and the dorsal part (right) of the pancreas. Different cell types are colour-coded. Rodent islets, unlike the human ones, show the characteristic insulin core.
    Structural differences between rat islets (top) and humans islets (bottom) as well as the ventral part (left) and the dorsal part (right) of the pancreas. Different cell types are colour-coded. Rodent islets, unlike the human ones, show the characteristic insulin core.

Research

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Cannabinoid receptors are found widely expressed in islets of Langerhans, and several studies have investigated specific distribution and mechanisms of CB1 versus CB2 receptors in relation to pancreatic endocrine functions, where they play an important homeostatic role, as endocannabinoids modulate pancreatic β-cells function, proliferation, and survival, as well as insulin production, secretion, and resistance.[32][33][34][35]

See also

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References

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  1. ^ Langerhans P (1869). "Beitrage zur mikroscopischen anatomie der bauchspeichel druse". Inaugural-dissertation. Berlin: Gustav Lange.
  2. ^ Barrett KE, Boitano S, Barman SM, Brooks HL (2009-07-22). Ganong's review of medical physiology (23 ed.). McGraw Hill Medical. p. 316. ISBN 978-0-07-160568-7.
  3. ^ Functional Anatomy of the Endocrine Pancreas
  4. ^ Pour PM, Standop J, Batra SK (January 2002). "Are islet cells the gatekeepers of the pancreas?". Pancreatology. 2 (5): 440–448. doi:10.1159/000064718. PMID 12378111. S2CID 37257345.
  5. ^ a b Feldman M, Friedman LS, Brandt LJ, eds. (2015). Sleisenger & Fordtran's gastrointestinal and liver disease pathophysiology, diagnosis, management (10th ed.). St. Louis, Missouri: Elsevier Health Sciences. ISBN 978-1-4557-4989-8.
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  22. ^ a b Hogan A, Pileggi A, Ricordi C (January 2008). "Transplantation: current developments and future directions; the future of clinical islet transplantation as a cure for diabetes". Frontiers in Bioscience. 13 (13): 1192–1205. doi:10.2741/2755. PMID 17981623.
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  25. ^ a b Gamble A, Pepper AR, Bruni A, Shapiro AM (March 2018). "The journey of islet cell transplantation and future development". Islets. 10 (2): 80–94. doi:10.1080/19382014.2018.1428511. PMC 5895174. PMID 29394145.
  26. ^ Chatenoud L (March 2008). "Chemical immunosuppression in islet transplantation--friend or foe?". The New England Journal of Medicine. 358 (11): 1192–1193. doi:10.1056/NEJMcibr0708067. PMID 18337609.
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  28. ^ Pileggi A, Cobianchi L, Inverardi L, Ricordi C (October 2006). "Overcoming the challenges now limiting islet transplantation: a sequential, integrated approach". Annals of the New York Academy of Sciences. 1079 (1): 383–398. Bibcode:2006NYASA1079..383P. doi:10.1196/annals.1375.059. PMID 17130583. S2CID 33009393.
  29. ^ van der Meulen T, Mawla AM, DiGruccio MR, Adams MW, Nies V, Dólleman S, et al. (April 2017). "Virgin Beta Cells Persist throughout Life at a Neogenic Niche within Pancreatic Islets". Cell Metabolism. 25 (4): 911–926.e6. doi:10.1016/j.cmet.2017.03.017. PMC 8586897. PMID 28380380.
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  31. ^ Zhan L, Rao JS, Sethia N, Slama MQ, Han Z, Tobolt D, et al. (April 2022). "Pancreatic islet cryopreservation by vitrification achieves high viability, function, recovery and clinical scalability for transplantation". Nature Medicine. 28 (4): 798–808. doi:10.1038/s41591-022-01718-1. PMC 9018423. PMID 35288694.
  32. ^ Bermúdez-Silva FJ, Suárez J, Baixeras E, Cobo N, Bautista D, Cuesta-Muñoz AL, et al. (March 2008). "Presence of functional cannabinoid receptors in human endocrine pancreas". Diabetologia. 51 (3): 476–487. doi:10.1007/s00125-007-0890-y. PMID 18092149.
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  34. ^ Juan-Picó P, Fuentes E, Bermúdez-Silva FJ, Javier Díaz-Molina F, Ripoll C, Rodríguez de Fonseca F, et al. (February 2006). "Cannabinoid receptors regulate Ca(2+) signals and insulin secretion in pancreatic beta-cell". Cell Calcium. 39 (2): 155–162. doi:10.1016/j.ceca.2005.10.005. PMID 16321437.
  35. ^ Farokhnia M, McDiarmid GR, Newmeyer MN, Munjal V, Abulseoud OA, Huestis MA, et al. (February 2020). "Effects of oral, smoked, and vaporized cannabis on endocrine pathways related to appetite and metabolism: a randomized, double-blind, placebo-controlled, human laboratory study". Translational Psychiatry. 10 (1): 71. doi:10.1038/s41398-020-0756-3. PMC 7031261. PMID 32075958.
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