Abstract
Type 1 diabetes is an autoimmune disease where β-cells are in a constant process of
death and renewal. Reg genes play a role in β-cells regeneration. Reg proteins may
be target of an autoimmune response in type 1 diabetes with consequent production
of autoantibodies and failure of regeneration. The objective of this work was to characterize
the role of Reg1α proteins and anti-Reg1α antibodies as biomarkers of β-cell regeneration
and damage. Serum levels of Reg1α protein were investigated in 87 type 1 diabetic
subjects (31 newly diagnosed and 56 long standing), 63 type 2 diabetic subjects, 39
subjects with systemic lupus erythematosus (SLE), a nonpancreatic autoimmune disorder,
and 64 healthy subjects. The presence of anti-Reg1α antibodies and correlation with
metabolic, immune, and genetic parameters were analyzed in diabetic subjects. Increased
levels of Reg1α protein were observed in newly diagnosed (p=0.002), and long standing
(p=0.001) type 1 diabetes patients and type 2 diabetic subjects (p<0.001). Anti-Reg1α
antibodies were found in 47% of patients with type 1 diabetes. No correlation was
found with metabolic, immune, and genetic parameters. Patients with SLE showed no
increase in Reg1α protein. We report here for the first time raised serum Reg1α protein
in type 1 and type 2 diabetes and anti-Reg1α antibodies in type 1 diabetes. Reg1α
levels appear not to be influenced by genetic or metabolic control. These findings
allow considering future studies on Reg1α protein and autoantibody as new tools in
the evaluation and monitoring of β-cells regeneration and autoimmunity.
Key words
type 1 diabetes - β-cell regeneration - Reg1α
References
1
Concannon P, Rich SS, Nepom GT.
Genetics of type 1A diabetes.
N Engl J Med.
2009;
360
1646-1654
2
Daneman D.
Type 1 diabetes.
Lancet.
2006;
367
847-858
3
Tews D, Lehr S, Hartwig S, Osmers A, Paslack W, Eckel J.
Anti-apoptotic action of exendin-4 in INS-1 beta cells: comparative protein pattern
analysis of isolated mitochondria.
Horm Metab Res.
2009;
41
294-301
4
Lonyai A, Kodama S, Burger D, Davis M, Faustman DL.
The promise of Hox11+ stem cells of the spleen for treating autoimmune diseases.
Horm Metab Res.
2008;
40
137-146
5
Park SY, Bell GI.
Noninvasive monitoring of changes in pancreatic beta-cell mass by bioluminescent imaging
in MIP-luc transgenic mice.
Horm Metab Res.
2009;
41
1-4
6
Akirav E, Kushner JA, Herold KC.
Beta-cell mass and type 1 diabetes: going, going, gone?.
Diabetes.
2008;
57
2883-2888
7
Okamoto H.
The Reg gene family and Reg proteins: with special attention to the regeneration of
pancreatic beta-cells.
J Hepatobiliary Pancreat Surg.
1999;
6
254-262
8
Watanabe T, Yonemura Y, Yonekura H, Suzuki Y, Miyashita H, Sugiyama K, Moriizumi S,
Unno M, Tanaka O, Kondo H.
Pancreatic beta-cell replication and amelioration of surgical diabetes by Reg protein.
Proc Natl Acad Sci U S A.
1994;
91
3589-3592
9
Kobayashi S, Akiyama T, Nata K, Abe M, Tajima M, Shervani NJ, Unno M, Matsuno S, Sasaki H,
Takasawa S, Okamoto H.
Identification of a receptor for reg (regenerating gene) protein, a pancreatic beta-cell
regeneration factor.
J Biol Chem.
2000;
275
10723-10726
10
Okamoto H, Takasawa S.
Recent advances in the Okamoto model: the CD38-cyclic ADP-ribose signal system and
the regenerating gene protein (Reg)-Reg receptor system in beta-cells.
Diabetes.
2002;
51
(S 03)
S462-S473
11
Dusetti NJ, Frigerio JM, Fox MF, Swallow DM, Dagorn JC, Iovanna JL.
Molecular cloning, genomic organization, and chromosomal localization of the human
pancreatitis-associated protein (PAP) gene.
Genomics.
1994;
19
108-114
12
Miyashita H, Nakagawara K, Mori M, Narushima Y, Noguchi N, Moriizumi S, Takasawa S,
Yonekura H, Takeuchi T, Okamoto H.
Human REG family genes are tandemly ordered in a 95-kilobase region of chromosome
2p12.
FEBS Lett.
1995;
377
429-433
13
Nata K, Liu Y, Xu L, Ikeda T, Akiyama T, Noguchi N, Kawaguchi S, Yamauchi A, Takahashi I,
Shervani NJ, Onogawa T, Takasawa S, Okamoto H.
Molecular cloning, expression and chromosomal localization of a novel human REG family
gene, REG III.
Gene.
2004;
340
161-170
14
Sekikawa A, Fukui H, Fujii S, Takeda J, Nanakin A, Hisatsune H, Seno H, Takasawa S,
Okamoto H, Fujimori T, Chiba T.
REG Ialpha protein may function as a trophic and/or anti-apoptotic factor in the development
of gastric cancer.
Gastroenterology.
2005;
128
642-653
15
Gurr W, Yavari R, Wen L, Shaw M, Mora C, Christa L, Sherwin RS.
A Reg family protein is overexpressed in islets from a patient with new-onset type
1 diabetes and acts as T-cell autoantigen in NOD mice.
Diabetes.
2002;
51
339-346
16
Shervani NJ, Takasawa S, Uchigata Y, Akiyama T, Nakagawa K, Noguchi N, Takada H, Takahashi I,
Yamauchi A, Ikeda T, Iwamoto Y, Nata K, Okamoto H.
Autoantibodies to REG, a beta-cell regeneration factor, in diabetic patients.
Eur J Clin Invest.
2004;
34
752-758
17
Pozzilli P, Mesturino CA, Crino A, Gross TM, Jeng LM, Visalli N.
Is the process of beta-cell destruction in type 1 diabetes at time of diagnosis more
extensive in females than in males?.
Eur J Endocrinol.
2001;
145
757-761
18
Crino A, Schiaffini R, Manfrini S, Mesturino C, Visalli N, Beretta Anguissola G, Suraci C,
Pitocco D, Spera S, Corbi S, Matteoli MC, Patera IP, Manca Bitti ML, Bizzarri C, Pozzilli P.
A randomized trial of nicotinamide and vitamin E in children with recent onset type
1 diabetes (IMDIAB IX).
Eur J Endocrinol.
2004;
150
719-724
19
Crino A, Schiaffini R, Ciampalini P, Suraci MC, Manfrini S, Visalli N, Matteoli MC,
Patera P, Buzzetti R, Guglielmi C, Spera S, Costanza F, Fioriti E, Pitocco D, Pozzilli P.
A two year observational study of nicotinamide and intensive insulin therapy in patients
with recent onset type 1 diabetes mellitus.
J Pediatr Endocrinol Metab.
2005;
18
749-754
20
Monetini L, Cavallo MG, Sarugeri E, Sentinelli F, Stefanini L, Bosi E, Thorpe R, Pozzilli P.
Cytokine profile and insulin antibody IgG subclasses in patients with recent onset
type 1 diabetes treated with oral insulin.
Diabetologia.
2004;
47
1795-1802
21
Pitocco D, Crino A, Di Stasio E, Manfrini S, Guglielmi C, Spera S, Anguissola GB,
Visalli N, Suraci C, Matteoli MC, Patera IP, Cavallo MG, Bizzarri C, Pozzilli P.
The effects of calcitriol and nicotinamide on residual pancreatic beta-cell function
in patients with recent-onset Type 1 diabetes (IMDIAB XI).
Diabet Med.
2006;
23
920-923
22
Power D.
Standards of medical care in diabetes.
Diabetes Care.
2006;
29
476
; author's reply 476–477
23
The American Diabetes Association (ADA).
.
has been actively involved in the development and dissemination of diabetes care standards,
guidelines, and related documents for many years. Introduction.
Diabetes Care.
2009;
32
(S 01)
S1-S2
24
Hochberg MC.
Updating the American College of Rheumatology revised criteria for the classification
of systemic lupus erythematosus.
Arthritis Rheum.
1997;
40
1725
25
Gill JM, Quisel AM, Rocca PV, Walters DT.
Diagnosis of systemic lupus erythematosus.
Am Fam Physician.
2003;
68
2179-2186
26
Stejskal D, Lacnak B, Karpisek M, Kaminek M.
Our experiences with measurement of new potential biomarkers in the diagnosis of latent
forms of myocardial ischemia.
Biomed Pap Med Fac Univ Palacky Olomouc Czech Repub.
2006;
150
239-244
27
Haneji N, Nakamura T, Takio K, Yanagi K, Higashiyama H, Saito I, Noji S, Sugino H,
Hayashi Y.
Identification of alpha-fodrin as a candidate autoantigen in primary Sjogren's syndrome.
Science.
1997;
276
604-607
28
Wiedmeyer HM, Polonsky KS, Myers GL, Little RR, Greenbaum CJ, Goldstein DE, Palmer JP.
International comparison of C-peptide measurements.
Clin Chem.
2007;
53
784-787
29
Todd JA.
Etiology of type 1 diabetes.
Immunity.
32
457-467
30
Einarsdottir E, Soderstrom I, Lofgren-Burstrom A, Haraldsson S, Nilsson-Ardnor S,
Penha-Goncalves C, Lind L, Holmgren G, Holmberg M, Asplund K, Holmberg D.
The CTLA4 region as a general autoimmunity factor: an extended pedigree provides evidence
for synergy with the HLA locus in the etiology of type 1 diabetes mellitus, Hashimoto's
thyroiditis and Graves’ disease.
Eur J Hum Genet.
2003;
11
81-84
31
Ueda H, Howson JM, Esposito L, Heward J, Snook H, Chamberlain G, Rainbow DB, Hunter KM,
Smith AN, Di Genova G, Herr MH, Dahlman I, Payne F, Smyth D, Lowe C, Twells RC, Howlett S,
Healy B, Nutland S, Rance HE, Everett V, Smink LJ, Lam AC, Cordell HJ, Walker NM,
Bordin C, Hulme J, Motzo C, Cucca F, Hess JF, Metzker ML, Rogers J, Gregory S, Allahabadia A,
Nithiyananthan R, Tuomilehto-Wolf E, Tuomilehto J, Bingley P, Gillespie KM, Undlien DE,
Ronningen KS, Guja C, Ionescu-Tirgoviste C, Savage DA, Maxwell AP, Carson DJ, Patterson CC,
Franklyn JA, Clayton DG, Peterson LB, Wicker LS, Todd JA, Gough SC.
Association of the T-cell regulatory gene CTLA4 with susceptibility to autoimmune
disease.
Nature.
2003;
423
506-511
32
Bottini N, Musumeci L, Alonso A, Rahmouni S, Nika K, Rostamkhani M, MacMurray J, Meloni GF,
Lucarelli P, Pellecchia M, Eisenbarth GS, Comings D, Mustelin T.
A functional variant of lymphoid tyrosine phosphatase is associated with type I diabetes.
Nat Genet.
2004;
36
337-338
33
Le Stunff C, Fallin D, Schork NJ, Bougneres P.
The insulin gene VNTR is associated with fasting insulin levels and development of
juvenile obesity.
Nat Genet.
2000;
26
444-446
34
Eizirik DL, Colli ML, Ortis F.
The role of inflammation in insulitis and beta-cell loss in type 1 diabetes.
Nat Rev Endocrinol.
2009;
5
219-226
35
Xu X, D’Hoker J, Stange G, Bonne S, De Leu N, Xiao X, Van de Casteele M, Mellitzer G,
Ling Z, Pipeleers D, Bouwens L, Scharfmann R, Gradwohl G, Heimberg H.
Beta cells can be generated from endogenous progenitors in injured adult mouse pancreas.
Cell.
2008;
132
197-207
36
Akiyama T, Takasawa S, Nata K, Kobayashi S, Abe M, Shervani NJ, Ikeda T, Nakagawa K,
Unno M, Matsuno S, Okamoto H.
Activation of Reg gene, a gene for insulin-producing beta-cell regeneration: poly(ADP-ribose)
polymerase binds Reg promoter and regulates the transcription by autopoly(ADP-ribosyl)ation.
Proc Natl Acad Sci U S A.
2001;
98
48-53
37
Halban PA, German MS, Kahn SE, Weir GC.
Current status of islet cell replacement and regeneration therapy.
J Clin Endocrinol Metab.
2010;
95
1034-1043
38
Edlund H.
Factors controlling pancreatic cell differentiation and function.
Diabetologia.
2001;
44
1071-1079
39
Lencioni C, Lupi R, Del Prato S.
Beta-cell failure in type 2 diabetes mellitus.
Curr Diab Rep.
2008;
8
179-184
40
Pan QR, Li WH, Wang H, Sun Q, Xiao XH, Brock B, Schmitz O.
Glucose, metformin, and AICAR regulate the expression of G protein-coupled receptor
members in INS-1 beta cell.
Horm Metab Res.
2009;
41
799-804
Correspondence
Dr. E. Astorri
Centre for Experimental Medicine and Rheumatology
William Harvey Research Institute
Queen Mary's School of Medicine and Dentistry
Bart's and The London
John Vane Science Centre
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London EC1M 6BQ
UK
Phone: +44/2078828193
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Email: e.astorri@qmul.ac.uk