Type 2 diabetes - a matter of failing beta-cell neogenesis? Clues from the GK rat model.

Now that reduction in beta-cell mass has been clearly established in humans with type 2 diabetes mellitus (T2D), the debate focuses on the possible mechanisms responsible for decreased beta-cell number. Appropriate inbred rodent models are essential tools for this purpose. The information available from the Goto-Kakizaki (GK) rat, one of the best characterized animal models of spontaneous T2D, is reviewed in such a perspective. We propose that the defective beta-cell mass in the GK model reflects mostly a persistently decreased beta-cell neogenesis. The data discussed in this review are consistent with the notion that poor proliferation and/or survival of the endocrine precursor cells during GK foetal life will result in a decreased pool of endocrine precursors in the pancreas, and hence an impaired capacity of beta-cell neogenesis (either primary in the foetus or compensatory in the newborn and the adult). As we also demonstrated that beta-cell neogenesis can be pharmacologically reactivated in the GK model, our work supports, on a more prospective basis, the concept that facilitation of T2D treatment may be obtained through beta-cell mass expansion after stimulation of beta-cell regeneration/neogenesis in diabetic patients.

Impaired beta-cell regeneration after partial pancreatectomy in the adult Goto-Kakizaki rat, a spontaneous model of type II diabetes.

In the Goto-Kakizaki (GK) rat, a genetic model of type II diabetes, there is a restriction of the beta-cell mass as early as fetal age, which is maintained reduced in the adult animal. In order to investigate the beta-cell growth potential in the adult hyperglycemic GK rat, and to determine whether it differs from non-diabetic Wistar (W) rats, we have performed 90% pancreatectomy (Px) in 8- to 10-week-old male animals. Spontaneous beta-cell regeneration and involvement of beta-cell replication, beta-cell neodifferentiation from ductal precursor, and beta-cell apoptosis were evaluated by immunocytochemistry and morphometry at different time points: day 0 (D0), D2, D7, and D14 after Px. In GK rats, deterioration of the diabetic state with severe and chronic hyperglycemia was evident as soon as D2, while in W/Px, normoglycemia to moderate hyperglycemia was observed. In W/Px rats, the total beta-cell mass gradually increased on D2, D7, and D14, as compared to non-Px W rats. By contrast, in GK/Px rats, there was only a non-significant tendency to increased total beta-cell mass, as compared to related non-Px group. Adult GK rats displayed lower beta-cell proliferation rates compared to W. In response to Px, early increase of beta-cell proliferation was present in both W/Px and GK/Px rats on D2, but it returned to non-Px values in GK rats on D7 and D14, while in W/Px rats beta-cell proliferation was maintained increased as compared to non-Px W rats. The very low apoptotic beta-cell frequency on D0, D2, D7, and D14, in both W and GK, either non-Px or Px, did not allow us to conclude that any significant differences exist between the different groups. beta-cell neoformation from ducts, and more specifically from foci of regeneration, was found to be less activated in GK/Px rats as compared to W/Px. Together, these results suggest that in the adult hyperglycemic GK rat undergoing Px, beta-cells still have the capacity to regenerate, but with a lower efficiency as compared to non-diabetic W rats. This defect in the GK rat is the result of both genetic predisposition contributing to an altered beta-cell neogenesis potential already present in the neonatal period, and environmental factors (chronic hyperglycemia) leading to a reduced beta-cell proliferative capacity specific to the adult animals.

Impaired pancreatic duct-cell growth in focal areas of regeneration after partial pancreatectomy in the adult Goto-Kakizaki rat, a spontaneous model of non-insulin dependent diabetes mellitus.

The Paris colony of adult Goto-Kakizaki (GK/Par) rat, a genetic model of non-insulin dependent diabetes mellitus, is characterized by a restriction of the beta-cell mass and reduced beta-cell regeneration capacity. In order to have a better understanding of the impaired mechanism(s) leading to reduced beta-cell plasticity in the GK/Par rat, we have investigated duct-cell growth capacity following 90% pancreatectomy, a well-defined procedure leading in non-diabetic rats, to sequential duct proliferation and subsequent differentiation. To this aim, we have performed pancreatectomy in 8-10-week-old male normoglycaemic Wistar and diabetic GK rats. Duct-cell proliferation and apoptosis were evaluated at different time points: day 0 (D0), day 2 (D2), day 7 (D7) and day 14 (D14) after pancreatectomy. A transient wave of duct-cell proliferation was observed on D2 in both small and main ducts in the pancreatectomized Wistar rats. A similar increase occurred in the similarly treated GK rats, but to a higher extent as compared to the Wistar rats. Thereafter, duct-cell proliferation from main or small ducts returned to non-pancreatectomized values on D7 and remained at this level on D14 in both the Wistar and GK pancreatectomized groups. In the common pancreatic duct, the number of proliferative duct-cells was higher in GK rats compared to Wistar on D0. In both the operated Wistar and GK rats, duct-cell proliferation from the common pancreatic duct similarly decreased on D2. On D7 and D14, the same parameter returned to non-pancreatectomized values in the Wistar rats, while it was maintained lower in the GK rats as compared to the GK values on D0. In focal areas of regeneration, duct-cell proliferation was significantly lower in the pancreatectomized GK group compared to the age-related Wistar group on D7 (Wistar: 5.85+/-0.98%, GK: 3.02+/-0.69%; p < 0.01) and D14 (Wistar: 3.82+/-0.29%, GK: 2.62+/-0.27%; ns). Only a few apoptotic duct-cells were observed, with no difference between the Wistar and GK groups, and that whatever the time after pancreatectomy and the duct category. Together, these results suggest that in the adult hyperglycaemic GK/Par rat facing pancreatectomy, duct-cell proliferation and apoptosis from the common pancreatic duct, main ducts and small ducts were not impaired compared to the Wistar rat. However, reduced duct-cell proliferation capacity in focal areas of regeneration in the treated GK rats probably contributes to the lower beta-cell neogenesis potential previously observed in this model.

beta-cell function and viability in the spontaneously diabetic GK rat: information from the GK/Par colony.

The GK rat model of type 2 diabetes is especially convenient to dissect the pathogenic mechanism necessary for the emergence of overt diabetes because all adult rats obtained in our department (GK/Par colony) to date have stable basal mild hyperglycemia and because overt diabetes is preceded by a period of normoglycemia, ranging from birth to weaning. The purpose of this article is to sum up the information so far available related to the biology of the beta-cell in the GK/Par rat. In terms of beta-cell function, there is no major intrinsic secretory defect in the prediabetic GK/Par beta-cell, and the lack of beta-cell reactivity to glucose (which reflects multiple intracellular abnormalities), as seen during the adult period when the GK/Par rats are overtly diabetic, represents an acquired defect (perhaps glucotoxicity). In terms of beta-cell population, the earliest alteration so far detected in the GK/Par rat targets the size of the beta-cell population. Several convergent data suggest that the permanently reduced beta-cell mass in the GK/Par rat reflects a limitation of beta-cell neogenesis during early fetal life, and it is conceivable that some genes among the set involved in GK diabetes belong to the subset of genes controlling early beta-cell development.