The pathogenesis of type 2 diabetes is characterized by a progressive β-cell dysfunction resulting in both quantitative and qualitative loss of insulin secretion. However, the molecular mechanisms underlying this progressive functional loss are still unknown. The aim of the study is to highlight changes in the proteome of pancreatic human islets that can anticipate and eventually predict diabetes’ onset. High performance liquid chromatography mass spectrometry (HPLC-MS) analysis was applied to islets isolated by laser capture microdissection (LCM) from human samples of both diabetic and no diabetic subjects, underwent to duodeno-cefalopancreatectomy for extra-pancreatic, low grading tumors. The subjects were classified on the basis of glucose tolerance assessed by an OGTT before surgery in normal tolerant (NGT, n:7), glucose intolerant (IGT, n:5) and diabetic subjects (T2DM, n:2). Qualitative and quantitative analysis were performed to detect differential protein expression among the 3 study’s groups. Sixty-seven proteins were found to be differentially regulated in diabetic subjects compare to NGT, with 29 upregulated and 38 downregulated proteins, while 95 proteins were differentially expressed in IGT compare to NGT with 49 upregulated and 46 downregulated. These proteins are mainly involved in cellular and metabolic processes. In particular IGT and DM, compared to NGT, showed a lower expression of proteins involved in cell proliferation such as PURA and NAP1L1, as well as proteins involved in the insulin cleavage process, like ERO1B. While other proteins involved in endoplasmic reticulum stress, CASP14, ERP27 and PDIA3, resulted upregulated in both IGT and DM compare to NGT. Our data suggest that metabolic and cellular processes of islet cells are already dysregulated in patients with impaired glucose tolerance, highlighting some proteins as potential early markers of β-cell dysfunction and novel therapeutic targets to slow the progression to type 2 diabetes.


C. Cefalo: None. T. Mezza: None. R. Kulkarni: None. A. Giaccari: Advisory Panel; Self; Sanofi-Aventis. Speaker's Bureau; Self; AstraZeneca, Merck Sharp & Dohme Corp., Amgen Inc..

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