Carboxyl-ester lipase maturity-onset diabetes of the young is associated with development of pancreatic cysts and upregulated MAPK signaling in secretin-stimulated duodenal fluid.
Carboxyl-ester lipase (CEL) maturity-onset diabetes of the young (MODY) is a monogenic form of diabetes and pancreatic exocrine dysfunction due to mutations in the CEL gene encoding CEL. The pathogenic mechanism for diabetes development is unknown. Since CEL is expressed mainly in pancreatic acinar cells, we asked whether we could find structural pancreatic changes in CEL-MODY subjects during the course of diabetes development. Furthermore, we hypothesized that the diseased pancreas releases proteins that are detectable in pancreatic fluid and potentially reflect activation or inactivation of disease-specific pathways. We therefore investigated nondiabetic and diabetic CEL-mutation carriers by pancreatic imaging studies and secretin-stimulated duodenal juice sampling. The secretin-stimulated duodenal juice was studied using cytokine assays, mass spectrometry (MS) proteomics, and multiplexed MS-based measurement of kinase activities. We identified multiple pancreatic cysts in all eight diabetic mutation carriers but not in any of the four nondiabetic mutation carriers or the six healthy controls. Furthermore, we identified upregulated mitogen-activated protein kinase (MAPK) target proteins and MAPK-driven cytokines and increased MAPK activity in the secretin-stimulated duodenal juice. These findings show that subjects with CEL-MODY develop multiple pancreatic cysts by the time they develop diabetes and that upregulated MAPK signaling in the pancreatic secretome may reflect the pathophysiological development of pancreatic cysts and diabetes.
Section of Islet Cell Biology and Regenerative Medicine, Joslin Diabetes Center, Harvard Medical School, Boston, MA.
Helge
H
Ræder
Fiona E
FE
McAllister
Erling
E
Tjora
Shweta
S
Bhatt
Ingfrid
I
Haldorsen
Jiang
J
Hu
Stefan M
SM
Willems
Mette
M
Vesterhus
Abdelfattah
A
El Ouaamari
Manway
M
Liu
Maria B
MB
Ræder
Heike
H
Immervoll
Dag
D
Hoem
Georg
G
Dimcevski
Pål R
PR
Njølstad
Anders
A
Molven
Steven P
SP
Gygi
Rohit N
RN
Kulkarni
D061354:Acinar Cells / Q000378:metabolism / Q000473:pathology; D000293:Adolescent; D000328:Adult; D000368:Aged; D001826:Body Fluids; D043182:Carboxylesterase / Q000235:genetics* / Q000378:metabolism; D002648:Child; D003924:Diabetes Mellitus, Type 2 / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D005260:Female; D006801:Humans; D020935:MAP Kinase Signaling System / Q000502:physiology*; D008297:Male; D008875:Middle Aged; D010179:Pancreas / Q000378:metabolism / Q000473:pathology; D010181:Pancreatic Cyst / Q000235:genetics / Q000378:metabolism* / Q000473:pathology; D012633:Secretin / Q000235:genetics / Q000378:metabolism*
D012633:Secretin; D043182:Carboxylesterase