BACE2 (b-site APP-cleaving enzyme 2) is a protease localized in the brain, where it appears to play a role in the development of Alzheimer disease (AD). It is also found in the pancreas, although its biologic function is not fully known. Amyloidogenic diseases, including AD and type 2 diabetes mellitus (T2D), share the accumulation of abnormally folded and insoluble proteins that interfere with cell function. Islet amyloid polypeptide (IAPP) deposits are a key pathogenic feature of T2D. Within this context, we found by global gene expression profiling that BACE2 was up-regulated in the rat pancreatic b-cell line INS1E stably transfected with human IAPP gene (hIAPP-INS1E). Glucose-stimulated insulin secretion (GSIS) in hIAPP-INS1E cells was 30% lower than in INS1E cells. Additionally, INS1E cells transfected with a transient overexpression of BACE2 showed a 60% decrease in proliferation, a 3-fold increase in reactive oxygen species production, and a 25% reduction in GSIS compared to control cells. Remarkably, silencing of endogenous BACE2 in hIAPP-INS1E cells resulted in a significant improvement in GSIS (3-fold increase vs. untransfected cells), revealing the significant role of BACE2 expression in b-cell function. Thus, BACE2 inhibition may be useful to recover insulin secretion in hIAPP-INS1E defective cells and may be proposed as a therapeutic target for T2D.-Alcarraz-Vizán, G., Casini, P., Cadavez, L., Visa, M., Montane, J., Servitja, J.-M., Novials, A. Inhibition of BACE2 counteracts hIAPP-induced insulin secretory defects in pancreatic b-cells. FASEB J. 29, 95-104 (2015). www.fasebj.org Key Words: amylin • BACE activity • secretase • type 2 diabetes INSULIN SECRETION DEFICIENCY plays a critical role in the onset of type 2 diabetes mellitus (T2D). It is well known that the progressive loss of b-cell mass and function are key features of the manifestation of the underlying disease (1). One of the main factors involved in the process of pancreatic b-cell deterioration is the accumulation of pancreatic amyloid deposits (2), which are considered a hallmark of T2D (3, 4). Because islet amyloid deposits colocalize with areas of b-cell degeneration, the process of amyloidosis has been strongly associated with a progressive loss of pancreatic b-cell mass and therefore with the pathology of T2D (5). Islet amyloid deposits are mainly composed by islet amyloid polypeptide (IAPP), a small peptide physiologically produced by pancreatic b-cells and cosecreted with insulin in response to different secretagogue stimuli (6, 7).The process of ordered aggregation into amyloid fibrils is a common event in many cell-degenerative diseases, such as Alzheimer disease (AD) and other local or systemic amyloidoses (8-10). A number of studies show that the toxicity of the amyloidogenic peptides lies in the oligomeric intermediates rather than in the mature fibrils. Thus, the conversion of a normally soluble protein into amyloid structures can allow for gained toxic function, providing a common mechanism by which amyloid contr...