For many years, scientists believed that all insulin-making cells in the pancreas worked in basically the same way.
But a new study from Weill Cornell Medicine has revealed something surprising: some of these cells are much more powerful and important than others.
The discovery could change how doctors understand and treat type 2 diabetes in the future. Researchers say they have identified a special group of beta cells that are especially good at controlling blood sugar. Losing these cells may play a major role in the development of diabetes.
The pancreas is an organ that helps the body manage blood sugar levels. Inside the pancreas are beta cells, which make insulin.
Insulin is the hormone that helps move sugar from the blood into the body’s cells, where it can be used for energy. Without enough insulin, blood sugar levels rise too high, which can damage organs and increase the risk of serious health problems.
Type 2 diabetes affects hundreds of millions of people worldwide. It happens when the body either does not make enough insulin or cannot use insulin properly. Scientists have spent decades trying to understand exactly why beta cells stop working well in people with diabetes.
The new research, led by Dr. James Lo and published in Nature Cell Biology, found that beta cells are not all identical. Instead, the researchers discovered four different groups of beta cells in the pancreas. Among these groups, one stood out clearly from the others.
The scientists called this group “cluster 1 beta cells.” These cells were much better at sensing sugar and producing insulin compared to the other beta cells.
To make the discovery, the research team used an advanced method called single-cell transcriptomics. This technology allows scientists to study the activity of genes inside individual cells one at a time. By doing this, they could see important differences between the beta cells that had previously been hidden.
The cluster 1 beta cells showed very high activity in genes linked to sugar breakdown and insulin production. One gene, called CD63, was especially active in these cells. Because of this, scientists realized that the CD63 protein could serve as a marker to identify these powerful beta cells.
The researchers then studied both mouse and human beta cells. They found that cells with high levels of CD63 released much more insulin when sugar levels increased. This showed that the cluster 1 cells were highly effective at helping control blood sugar.
However, the team also made another important discovery. In overweight mice and mice with type 2 diabetes, there were far fewer of these high-performing cluster 1 beta cells.
This finding suggests that diabetes may partly develop because the body gradually loses its best insulin-producing cells. As these important cells disappear, the pancreas becomes less able to control blood sugar levels.
The researchers then tested whether replacing these cells could help treat diabetes. In one experiment, they transplanted healthy cluster 1 beta cells into diabetic mice.
The results were dramatic. After receiving the transplant, the diabetic mice returned to normal blood sugar levels. But when the scientists later removed the transplanted cells, the mice quickly developed high blood sugar again.
The team also tested weaker beta cells that had low levels of CD63. These cells did not improve blood sugar levels in diabetic mice. This showed how important the cluster 1 cells really are.
The findings may open the door to new ways of treating diabetes. Today, some experimental diabetes treatments already involve transplanting insulin-producing cells into patients. But this research suggests doctors may get much better results by focusing specifically on the strongest cluster 1 beta cells.
If scientists can isolate and grow these cells more efficiently, it may even be possible to treat diabetes using fewer transplanted cells than before. Researchers also hope future treatments might protect these powerful cells from disappearing in the first place.
Dr. Lo’s team now wants to understand why cluster 1 beta cells are lost during diabetes. Scientists also want to learn whether modern diabetes medicines can help weaker beta cells behave more like the powerful cluster 1 cells.
One important group of medicines they plan to study is called GLP-1 agonists. These drugs, which include some popular modern diabetes and weight-loss treatments, help the body release more insulin after eating. Researchers hope these medicines may strengthen beta cell function and possibly preserve the most effective cells.
The study also highlights how quickly diabetes research is advancing. Scientists are learning that even cells once thought to be simple and identical may actually have highly specialized roles.
Researchers believe discoveries like this may eventually lead to more personalized and effective diabetes treatments. Instead of treating all beta cells the same way, future therapies may focus on protecting or replacing the most important insulin-producing cells.
The research was published in the journal Nature Cell Biology.
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