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p21-senescent cells drive pancreatic islet dysfunction through targetable paracrine signaling in type 2 diabetes
Kanako Iwasaki, Priscila Carapeto, Cristian Abarca, Francesko Hela, Stephanie Sanjines, Sebastian Pena, Sandra Le, Hui Pan, Maya Jackson, Christopher Cahill, Ayush Midha, Juliana Alcoforado Diniz, Dylan Baker, Sergii Domanskyi, Sara Espinoza, Alejandro Peña, Francisco G. Cigarroa, Jillian L. Woodworth, Jeffrey H. Chuang, Vesna D. Garovic, James L. Kirkland, Tamara Tchkonia, Nicolas Musi, George A. Kuchel, Paul Robson, Cristina Aguayo-Mazzucato
Kanako Iwasaki, Priscila Carapeto, Cristian Abarca, Francesko Hela, Stephanie Sanjines, Sebastian Pena, Sandra Le, Hui Pan, Maya Jackson, Christopher Cahill, Ayush Midha, Juliana Alcoforado Diniz, Dylan Baker, Sergii Domanskyi, Sara Espinoza, Alejandro Peña, Francisco G. Cigarroa, Jillian L. Woodworth, Jeffrey H. Chuang, Vesna D. Garovic, James L. Kirkland, Tamara Tchkonia, Nicolas Musi, George A. Kuchel, Paul Robson, Cristina Aguayo-Mazzucato
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Research Article Aging Endocrinology Metabolism

p21-senescent cells drive pancreatic islet dysfunction through targetable paracrine signaling in type 2 diabetes

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Abstract

Cellular senescence is an irreversible stress response, which leads to loss of cellular function and remodeling of the cellular secretory profile. In humans, pancreatic β cells undergo cellular senescence during the progression to type 2 diabetes (T2D). However, the mechanism linking β cell senescence to islet dysfunction remains unknown, and thus the therapeutic potential of targeting senescent cells in T2D is not established. Herein, we identified a subpopulation of senescent β cells expressing p21, which emerged early in the progression of T2D in humans and mice. Spatial transcriptomics and proteomics analyses confirmed senescence and loss of cellular identity in this subpopulation in humans. Functional analysis revealed lack of glucose responsiveness, high basal insulin secretion, and transcription of senescence-associated secretory phenotype (SASP) factors. SASP factors from p21+ β cells induced secondary senescence in neighboring cells, characterized by dysfunction and loss of identity. JAK inhibitors counteracted the induction of secondary senescence and restored β cell function in islets from humans with T2D and in mice fed a high-fat diet. These findings reveal the critical role of p21+ β cells in T2D pathogenesis and the therapeutic potential of targeting this pathophysiological process.

Authors

Kanako Iwasaki, Priscila Carapeto, Cristian Abarca, Francesko Hela, Stephanie Sanjines, Sebastian Pena, Sandra Le, Hui Pan, Maya Jackson, Christopher Cahill, Ayush Midha, Juliana Alcoforado Diniz, Dylan Baker, Sergii Domanskyi, Sara Espinoza, Alejandro Peña, Francisco G. Cigarroa, Jillian L. Woodworth, Jeffrey H. Chuang, Vesna D. Garovic, James L. Kirkland, Tamara Tchkonia, Nicolas Musi, George A. Kuchel, Paul Robson, Cristina Aguayo-Mazzucato

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Figure 7

Effects of JAK1/2i on secretion of human β cell function.

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Effects of JAK1/2i on secretion of human β cell function.
(A) JAK1 prote...
(A) JAK1 protein levels in human islets from donors without diabetes (ND) and with type 2 diabetes (T2D). (B) linear regression of JAK1 protein levels and secretion index from human islets. (C) Analysis of data from Joslin Diabetes Center’s adult clinic. Longitudinal glycated hemoglobin (A1c) levels from individuals with T2D and who had been prescribed JAKi for medical indications independent from diabetes. The effect of the JAKi treatment was measured by the change of A1c. δA1c = (average A1c post) – (average A1c pre). (D) Mean A1c change before and after starting treatment with a specified JAKi in people with T2D. (E) Workflow of human islets from ND and T2D donors treated with JAK1/2i or JAK1/3i for 4 days. (F and G) Heatmap and dot-plot of SASP (log2 protein abundance) secretion in conditioned media collected from human untreated (control) or treated (JAK1/2i). Top upregulated human β cell SASP proteins were selected. Paired analysis per analyte was performed between conditions. Cell numbers varied from one donor to another but were constant across treatments. Donor 1: 526,000 cells/treatment; donor 2: 192,000 cells/treatment; donor 3: 231,000 cells/treatment; donors 4 and 5: 87,500 cells/treatment. (H) p21 mRNA levels in human islets from ND donors. (I) β cell function evaluated by GSIS in human islets from ND donors with 1–3 replicates per donor. (J) Effects of JAK1/2i in p21 mRNA in islets from T2D donors. (K) β cell function evaluated with islet perifusion in islets from 2 donors with T2D, BMI 38.3 and 42.2, age 58 and 55 years old, respectively. (L) Static GSIS from 2 T2D female donors using JAK1/2i (momelotinib: dark green and baricitinib: light green), both BMI 42.2, age 49 and 55 years old. (M) Matched secretion index from untreated and JAK1/2i-treated islets from individuals with T2D.

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