The development of the endocrine pancreas and the differentiation of its five cell types, α, β, δ, ε and pancreatic polypeptide (PP) cells, are a highly complex and tightly regulated process. Proper differentiation and function of α-and β-cells are critical for blood glucose homeostasis. These processes are governed by multiple transcription factors and other signalling systems, and its dysregulation results in diabetes. The differentiation of α-cells and the maintenance of α-cell function can be influenced at several stages during development and in the maturing islet. Many transcription factors, such as neurogenin 3 (Ngn3), pancreatic duodenal homeobox 1 (Pdx1) and regulatory factor x6 (Rfx6), play a crucial role in the determination of the endocrine cell fate, while other transcription factors, such as aristaless-related homeobox (Arx) and forkhead box A2 (Foxa2), are implicated in the initial or terminal differentiation of α-cells. In vivo and in vitro studies have shown that preproglucagon transcription, and therefore the maintenance of α-cell function, is regulated by several factors, including forkhead box A1 (Foxa1), paired box 6 (Pax6), brain4 (Brn4) and islet-1 (Isl-1). Detailed information about the regulation of normal and abnormal α-cell differentiation gives insight into the pathogenesis of diabetes, identifies further targets for diabetes treatment and provides clues for the reprogramming of α-to β-cells for replacement therapy.
Keywords: α-cells, diabetes, pancreatogenesis, transcriptional regulation, transdifferentiation
Date submitted 1 April 2011; date of final acceptance 19 April 2011
IntroductionThe pancreas is a complex organ made up of exocrine and endocrine cells, and is crucial for nutrient digestion and blood glucose homeostasis. In the embryo, the entire pancreas originates as two buds from the foregut endoderm, and initially all pancreatic epithelial precursors express the transcriptional regulator pancreatic duodenal homeobox 1 (Pdx1) [1,2]. Acinar cells, as part of the exocrine compartment, secrete digestive enzymes into the ductal lumen system, which is connected to the duodenum. The five endocrine cell types are α, β, δ, ε and pancreatic polypeptide (PP) cells, which collectively constitute less than 2% of the mass of the pancreas, and are organized into the islets of Langerhans. The islets of Langerhans belong to the neuroendocrine system (NES), which also includes the neuronal cells of the central and peripheral nervous systems and disseminated cells in the gut mucosa [3]. During evolution, islet hormone-producing cells first appeared in the nervous system, were next seen as disseminated cells in the mucosa of the alimentary tract, and did not evolve as a separate functional unit (in the form of the islet) until the appearance of the first vertebrates.Pancreatic α-cells produce glucagon from preproglucagon via prohormone convertase 2 (PC2). Glucagon, a hormone critical for blood glucose homeostasis, stimulates hepatic gluconeogenesis and glycogenolysis. It mobilizes glucose from...