Decreased pancreatic acinar cell number in type 1 diabetes – published online 09/05/2020

Jordan J. Wright, Diane C. Saunders, Chunhua Dai, Greg Poffenberger, Brynn Cairns, David V. Serreze, David M. Harlan, Rita Bottino, Marcela Brissova, Alvin C. Powers

Individuals with type 1 diabetes have a reduced total pancreas size; however, the cellular and tissue changes responsible for this size reduction are not well characterised. In this issue, Wright et al (https://doi.org/10.1007/s00125-020-05155-y) report that  pancreases from donors with type 1 diabetes were approximately 45% smaller than those from non-diabetic donors. They also had fewer total acinar cells and, as expected, a lower beta cell mass. Acinar cell size was similar between pancreases from diabetic and non-diabetic donors, regardless of location within pancreatic lobes or proximity to islets. Compared with non-diabetic donors, pancreases from donors with type 1 diabetes also had increased fibrosis. Based on the analysis of size and cell composition of pancreases from donors with a wide range of type 1 diabetes duration, the authors speculate that the decline in acinar cell number begins very early in disease progression and that type 1 diabetes pathogenesis involves both the exocrine and endocrine compartments of the pancreas.

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