β Cell Regeneration in human pancreas is possible

The pancreas has a simplified ductal system surrounding the head, body, and tail of the pancreas, with scattered islets of cells at different sites. Pancreatic products, whether hormonal or non-hormonal, are secreted by distinct populations of cells, each at a specific location and with a specific function.

The exocrine functions of the pancreas are carried out by acinar cells; secrete pancreatic digestive enzymes (e.g. alpha-amylase, proteases and lipases). These cells are involved in regulating the neogenesis of islet cells [3].

The ductal structure of the pancreas is also formed by epithelial cells. The main physiological function of duct cells is to secrete mucus and bicarbonate. Current research suggests that duct cells play an important role in the regenerative process in the pancreas [3]

The pancreas contains exocrine acinar and ductal cells, and endocrine cells that form the Islets of Langerhans. The islet cells can be classified into five distinct glandular cell types: alpha, beta, delta, epsilon and F cells. In humans, the pancreas contains an estimated one million islet cells (Bonner-Weir et al., 2010), and the islets occupy 1–1.5% of the organ’s volume. The exocrine cells occupy 95% of the pancreas in adult humans and rodents. The adult human pancreas contains one million islets and approximately 74% of them are Beta cells [3].

Neogenesis, or the regeneration of endocrine Beta cells, occurs within a cluster of epithelial exocrine duct cells. The process commences when a subset of endocrine progenitor cells, buried within the ductal cells, starts to express Neurogenin3 (Ngn3) to form insulin secreting islets. Endocrine progenitor cells give rise to other exocrine cells including alpha cells [3].

A small peptide secreted by pancreatic acinar cells, known as “islet neogenesis-associated protein” (INGAP).
INGAP can induce Beta cell neogenesis and proliferation. It has been observed that the incubation of the INGAP peptide with human adipose tissue-derived stem cells leads to the differentiation of fat cells into islet-like cells. INGAP peptide has shown beneficial effects in T1D and T2DM. Many clinical trials of INGAP are likely to be initiated in the US [3].
The subject of pancreatic beta cell regeneration is one of the most controversial topics of T1D research and treatment. It is believed that beta cells can regenerate through the replication of pre-existing beta cells or neogenesis from stem cells and progenitor cells inside or outside the islets (Bouwens, Rooman, 2005).
Neogenesis can be originated from different cell types within pancreas: alpha cells, delta cells, duct epithelium, acinar cells, and centroacinar cells. However, this process depends on extra-pancreatic activators including hormones, growth factors, and others (Bouwens, Rooman, 2005).

In adults, turnover of beta cells is slow and reduces with increasing age. However, during body growth and after injury, beta cells can replicate to maintain glucose homeostasis (Avolio et al., 2013). None of approaches under investigation have been approved for use in diabetic patients yet [4].
Early intervention with a healthy low stress lifestyle and antioxidant rich balanced diet can preserve both Beta cells number and function. This forms the fundamental basis of the PROD Initiative.

Many natural compounds from the plant kingdom are known to preserve Beta cells and even help regeneration, if the intervention is in the early stages (2-3 years from diagnosis of diabetes).Pterocarpus marsupium [8], Resveratrol [9], Gymnema sylvestre [6] and Curcumin [10] have proven Beta cell protective and regenerative properties. A synergistic combination of the above, Cresvin Beta, can be used as an adjunct to medication and the PROD Initiative.

Please go to the Reference Articles.

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