Publications


Professor of Pediatrics (Endocrinology) and of Genetics

Publications

  • Diabetes mellitus-Progress and opportunities in the evolving epidemic. Cell Abel, E. D., Gloyn, A. L., Evans-Molina, C., Joseph, J. J., Misra, S., Pajvani, U. B., Simcox, J., Susztak, K., Drucker, D. J. 2024; 187 (15): 3789-3820

    Abstract

    Diabetes, a complex multisystem metabolic disorder characterized by hyperglycemia, leads to complications that reduce quality of life and increase mortality. Diabetes pathophysiology includes dysfunction of beta cells, adipose tissue, skeletal muscle, and liver. Type 1 diabetes (T1D) results from immune-mediated beta cell destruction. The more prevalent type 2 diabetes (T2D) is a heterogeneous disorder characterized by varying degrees of beta cell dysfunction in concert with insulin resistance. The strong association between obesity and T2D involves pathways regulated by the central nervous system governing food intake and energy expenditure, integrating inputs from peripheral organs and the environment. The risk of developing diabetes or its complications represents interactions between genetic susceptibility and environmental factors, including the availability of nutritious food and other social determinants of health. This perspective reviews recent advances in understanding the pathophysiology and treatment of diabetes and its complications, which could alter the course of this prevalent disorder.

    View details for DOI 10.1016/j.cell.2024.06.029

    View details for PubMedID 39059357

  • A global initiative to deliver precision health in diabetes. Nature medicine Cefalu, W. T., Franks, P. W., Rosenblum, N. D., Zaghloul, N. A., Florez, J. C., Giorgino, F., Ji, L., Ma, R. C., Mathieu, C., Misra, S., Ramirez, A. H., Roden, M., Scherer, P. E., Sheu, W. H., Stehouwer, C. D., Woo, M., Pragnell, M., Anand, S. S., Carnethon, M., Chambers, J. C., Dennis, J. M., Gloyn, A. L., Herder, C., Holt, R. I., Manuel, D. G., Redondo, M. J., Tandon, N., Tsang, J. S., Udler, M. S., Rich, S. S. 2024

    View details for DOI 10.1038/s41591-024-03032-4

    View details for PubMedID 38992126

    View details for PubMedCentralID 9522691

  • Proteomic predictors of individualized nutrient-specific insulin secretion in health and disease. Cell metabolism Kolic, J., Sun, W. G., Cen, H. H., Ewald, J. D., Rogalski, J. C., Sasaki, S., Sun, H., Rajesh, V., Xia, Y. H., Moravcova, R., Skovsø, S., Spigelman, A. F., Manning Fox, J. E., Lyon, J., Beet, L., Xia, J., Lynn, F. C., Gloyn, A. L., Foster, L. J., MacDonald, P. E., Johnson, J. D. 2024; 36 (7): 1619-1633.e5

    Abstract

    Population-level variation and mechanisms behind insulin secretion in response to carbohydrate, protein, and fat remain uncharacterized. We defined prototypical insulin secretion responses to three macronutrients in islets from 140 cadaveric donors, including those with type 2 diabetes. The majority of donors' islets exhibited the highest insulin response to glucose, moderate response to amino acid, and minimal response to fatty acid. However, 9% of donors' islets had amino acid responses, and 8% had fatty acid responses that were larger than their glucose-stimulated insulin responses. We leveraged this heterogeneity and used multi-omics to identify molecular correlates of nutrient responsiveness, as well as proteins and mRNAs altered in type 2 diabetes. We also examined nutrient-stimulated insulin release from stem cell-derived islets and observed responsiveness to fat but not carbohydrate or protein-potentially a hallmark of immaturity. Understanding the diversity of insulin responses to carbohydrate, protein, and fat lays the groundwork for personalized nutrition.

    View details for DOI 10.1016/j.cmet.2024.06.001

    View details for PubMedID 38959864

  • CD39 delineates chimeric antigen receptor regulatory T cell subsets with distinct cytotoxic & regulatory functions against human islets FRONTIERS IN IMMUNOLOGY Wu, X., Chen, P., Whitener, R. L., MacDougall, M. S., Coykendall, V. N., Yan, H., Kim, Y., Harper, W., Pathak, S., Iliopoulou, B. P., Hestor, A., Saunders, D. C., Spears, E., Sevigny, J., Maahs, D. M., Basina, M., Sharp, S. A., Gloyn, A. L., Powers, A. C., Kim, S. K., Jensen, K. P., Meyer, E. H. 2024; 15: 1415102

    Abstract

    Human regulatory T cells (Treg) suppress other immune cells. Their dysfunction contributes to the pathophysiology of autoimmune diseases, including type 1 diabetes (T1D). Infusion of Tregs is being clinically evaluated as a novel way to prevent or treat T1D. Genetic modification of Tregs, most notably through the introduction of a chimeric antigen receptor (CAR) targeting Tregs to pancreatic islets, may improve their efficacy. We evaluated CAR targeting of human Tregs to monocytes, a human β cell line and human islet β cells in vitro. Targeting of HLA-A2-CAR (A2-CAR) bulk Tregs to HLA-A2+ cells resulted in dichotomous cytotoxic killing of human monocytes and islet β cells. In exploring subsets and mechanisms that may explain this pattern, we found that CD39 expression segregated CAR Treg cytotoxicity. CAR Tregs from individuals with more CD39low/- Tregs and from individuals with genetic polymorphism associated with lower CD39 expression (rs10748643) had more cytotoxicity. Isolated CD39- CAR Tregs had elevated granzyme B expression and cytotoxicity compared to the CD39+ CAR Treg subset. Genetic overexpression of CD39 in CD39low CAR Tregs reduced their cytotoxicity. Importantly, β cells upregulated protein surface expression of PD-L1 and PD-L2 in response to A2-CAR Tregs. Blockade of PD-L1/PD-L2 increased β cell death in A2-CAR Treg co-cultures suggesting that the PD-1/PD-L1 pathway is important in protecting islet β cells in the setting of CAR immunotherapy. In summary, introduction of CAR can enhance biological differences in subsets of Tregs. CD39+ Tregs represent a safer choice for CAR Treg therapies targeting tissues for tolerance induction.

    View details for DOI 10.3389/fimmu.2024.1415102

    View details for Web of Science ID 001266095000001

    View details for PubMedID 39007132

    View details for PubMedCentralID PMC11239501

  • Electrophysiological characterisation of iPSC-derived human β-like cells and an SLC30A8 disease model. Diabetes Jaffredo, M., Krentz, N. A., Champon, B., Duff, C. E., Nawaz, S., Beer, N., Honore, C., Clark, A., Rorsman, P., Lang, J., Gloyn, A. L., Raoux, M., Hastoy, B. 2024

    Abstract

    iPSC-derived human β-like cells (BLC) hold promise for both therapy and disease modelling, but their generation remains challenging and their functional analyses beyond transcriptomic and morphological assessments remain limited. Here, we validate an approach using multicellular and single cell electrophysiological tools to evaluate function of BLCs from pioneer protocols that can be easily adapted to more differentiated BLCs. The Multi-Electrode Arrays (MEAs) measuring the extracellular electrical activity revealed that BLCs are electrically coupled, produce slow potential (SP) signals like primary β-cells that are closely linked to insulin secretion. We also used high-resolution single-cell patch-clamp measurements to capture the exocytotic properties, and characterise voltage-gated sodium and calcium currents and found that they were comparable to those in primary β and EndoC-βH1 cells. The KATP channel conductance is greater than in human primary β-cells which may account for the limited glucose responsiveness observed with MEA. We used MEAs to study the impact of the type 2 diabetes protective SLC30A8 allele (p.Lys34Serfs*50) and found that BLCs with this allele have stronger electrical coupling activity. Our data suggest that BLCs can be used to evaluate the functional impact of genetic variants on β-cell function and coupling.

    View details for DOI 10.2337/db23-0776

    View details for PubMedID 38985991

Mission Statement

Our mission is to improve understanding of pancreatic islet cell dysfunction in type 2 diabetes using human genetics as a tool to uncover causal disease mechanisms and shed light on potential targets for therapeutic development.

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