Pancreas Biology Overview and Diabetes Overview
Type 1 diabetes (T1D) affects over half a million US citizens under the age of 19 each year. Type I diabetes is a disease that is caused by auto-reactive (link) immune cells in the body that have been programmed, for some unknown reason, to attack specific cells in the pancreas, called β-cells. The β-cells are amongst the most important components in the endocrine system and arguably in our entire body. They are responsible for knowing when to secrete the hormone insulin into the blood stream to help our bodies make energy from the food we eat. This energy drives everyday processes such as the beating of our heart, movement of our muscles, and engagement of our nervous system. The cells of the pancreas help our bodies to maintain a constant state of normality. The insulin secreted by the pancreas is used by every cell in the body, therefore, when it is no longer produced due to damaged β-cells, the outcome is fatal if not treated properly.
Failure to produce insulin and dysregulation of glucose in the blood stream are not the only complications that accompany type 1 diabetes; the laundry list includes but is not limited to kidney damage (nephropathy), decreased function of the nervous system (neuropathy), increased risk for heart disease and stroke, eye damage leading to blindness (diabetic retinopathy), and even death. At this time, there are several drugs available to help alleviate the effects of these complications, but unfortunately there is no way they can be completely eliminated without addressing the root of the problem: inability to regulate insulin production due to the lack of functional β-cells.
Still, much is unknown about the cause and progression of β-cell destruction in type I diabetes. We do know that the damage inducing culprits are cells of the immune system that have been incorrectly programmed to attack cells within the body. This is known as an autoimmune disorder (link). Normally our immune system is in charge of protecting our bodily systems from everyday invaders that can harm us, such as viruses and bacteria. This system even works to protect our bodies from cancer forming cells. In the case of type 1 diabetes, however, T cells have been programmed (for reasons still unknown) to specifically attack the insulin producing β-cells within the pancreas. Our immune systems are so powerful that they can entirely kill off what they perceive to be invaders, and unfortunately, in the context of type 1 diabetes, they target and kill every last functional β-cell within the pancreas. Consequently, Type 1 diabetes is a multifactorial disease, and in terms of treatment it will be necessary to utilize several avenues to treat both symptoms and disease.
Therefore, four main problems need to be addressed if a cure is to be discovered:
- Genetic influence on disease risk and onset
- Environmental impact on disease development
- Correction of autoimmune responses to restore proper immune function
- Regeneration of functional β-cell mass within the pancreas
The Pancreas Project within the regenerative medicine program here at UNMC seeks to address these issues to find ways to offer patients better therapies to manage and one day cure their diabetes.