Exocrine Pancreas in Type 1 and Type 2 Diabetes: Different Patterns of Fibrosis, Metaplasia, Angiopathy, and Adiposity

Year: 2023

Type: article

Abstract: The endocrine and exocrine compartments of the pancreas are spatially related but functionally distinct. Multiple diseases affect both compartments, including type 1 diabetes (T1D), pancreatitis, cystic fibrosis, and pancreatic cancer. To better understand how the exocrine pancreas changes with age, obesity, and diabetes, we performed a systematic analysis of well-preserved tissue sections from the pancreatic head, body, and tail of organ donors with T1D (n = 20) or type 2 diabetes (T2D) (n = 25) and donors with no diabetes (ND; n = 74). Among ND donors, we found that the incidence of acinar-to-ductal metaplasia (ADM), angiopathy, and pancreatic adiposity increased with age, and ADM and adiposity incidence also increased with BMI. Compared with age- and sex-matched ND organs, T1D pancreata had greater rates of acinar atrophy and angiopathy, with fewer intralobular adipocytes. T2D pancreata had greater rates of ADM and angiopathy and a higher total number of T lymphocytes, but no difference in adipocyte number, compared with ND organs. Although total pancreatic fibrosis was increased in both T1D and T2D, the patterns were different, with periductal and perivascular fibrosis occurring more frequently in T1D pancreata and lobular and parenchymal fibrosis occurring more frequently in T2D. Thus, the exocrine pancreas undergoes distinct changes as individuals age or develop T1D or T2D.

Source: Diabetes

DOI: 10.2337/db23-0009

Authors: Jordan J. Wright, Adel Eskaros, Annika Windon, Rita Bottino, Regina Jenkins, Amber M. Bradley, Radhika Aramandla, Sharon Philips, Hakmook Kang, Diane C. Saunders, Marcela Brissova, Alvin C. Powers

Institutions: Vanderbilt University, VA Tennessee Valley Healthcare System, Vanderbilt University Medical Center, Allegheny Health Network, Allegheny-Singer Research Institute

Language: English

Topic: Pancreatitis Pathology and Treatment

Subfield: Surgery

Field: Medicine

Domain: Health Sciences

SDG: Good health and well-being

Open Access status: green

Funders: U.S. Department of Veterans Affairs, Doris Duke Charitable Foundation, Center for Integrated Healthcare, U.S. Department of Veterans Affairs, Leona M. and Harry B. Helmsley Charitable Trust, Juvenile Diabetes Research Foundation United States of America, National Institutes of Health, National Eye Institute, National Institute of Diabetes and Digestive and Kidney Diseases

OpenAlex ID: W4387950584