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p21-senescent cells drive pancreatic islet dysfunction through targetable paracrine signaling in type 2 diabetes
Kanako Iwasaki, Priscila Carapeto, Cristian Abarca, Francesko Hela, Stephanie Sanjines, Sebastian Pena, Sandra Le, Hui Pan, Maya Jackson, Christopher Cahill, Ayush Midha, Juliana Alcoforado Diniz, Dylan Baker, Sergii Domanskyi, Sara Espinoza, Alejandro Peña, Francisco G. Cigarroa, Jillian L. Woodworth, Jeffrey H. Chuang, Vesna D. Garovic, James L. Kirkland, Tamara Tchkonia, Nicolas Musi, George A. Kuchel, Paul Robson, Cristina Aguayo-Mazzucato
Kanako Iwasaki, Priscila Carapeto, Cristian Abarca, Francesko Hela, Stephanie Sanjines, Sebastian Pena, Sandra Le, Hui Pan, Maya Jackson, Christopher Cahill, Ayush Midha, Juliana Alcoforado Diniz, Dylan Baker, Sergii Domanskyi, Sara Espinoza, Alejandro Peña, Francisco G. Cigarroa, Jillian L. Woodworth, Jeffrey H. Chuang, Vesna D. Garovic, James L. Kirkland, Tamara Tchkonia, Nicolas Musi, George A. Kuchel, Paul Robson, Cristina Aguayo-Mazzucato
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Research Article Aging Endocrinology Metabolism

p21-senescent cells drive pancreatic islet dysfunction through targetable paracrine signaling in type 2 diabetes

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Abstract

Cellular senescence is an irreversible stress response, which leads to loss of cellular function and remodeling of the cellular secretory profile. In humans, pancreatic β cells undergo cellular senescence during the progression to type 2 diabetes (T2D). However, the mechanism linking β cell senescence to islet dysfunction remains unknown, and thus the therapeutic potential of targeting senescent cells in T2D is not established. Herein, we identified a subpopulation of senescent β cells expressing p21, which emerged early in the progression of T2D in humans and mice. Spatial transcriptomics and proteomics analyses confirmed senescence and loss of cellular identity in this subpopulation in humans. Functional analysis revealed lack of glucose responsiveness, high basal insulin secretion, and transcription of senescence-associated secretory phenotype (SASP) factors. SASP factors from p21+ β cells induced secondary senescence in neighboring cells, characterized by dysfunction and loss of identity. JAK inhibitors counteracted the induction of secondary senescence and restored β cell function in islets from humans with T2D and in mice fed a high-fat diet. These findings reveal the critical role of p21+ β cells in T2D pathogenesis and the therapeutic potential of targeting this pathophysiological process.

Authors

Kanako Iwasaki, Priscila Carapeto, Cristian Abarca, Francesko Hela, Stephanie Sanjines, Sebastian Pena, Sandra Le, Hui Pan, Maya Jackson, Christopher Cahill, Ayush Midha, Juliana Alcoforado Diniz, Dylan Baker, Sergii Domanskyi, Sara Espinoza, Alejandro Peña, Francisco G. Cigarroa, Jillian L. Woodworth, Jeffrey H. Chuang, Vesna D. Garovic, James L. Kirkland, Tamara Tchkonia, Nicolas Musi, George A. Kuchel, Paul Robson, Cristina Aguayo-Mazzucato

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Figure 6

Loss of function and identity in human p21+ β cells.

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Loss of function and identity in human p21+ β cells.
(A) CDKN1A mRNA lev...
(A) CDKN1A mRNA levels in islets from human donors without diabetes (ND) and with T2D. (B) Linear correlation between p21 protein levels in human islets and their function as expressed by the secretion index. (C) KAPP-Sen study design aimed at mapping and profiling senescent cells in both whole and dispersed human pancreas. (D and E) Heatmap and dot plot of human β cell scRNA-Seq data for selected β cell functional genes across 3 cell subpopulations: nonsenescent β cells (CDKN1A–/CDKN2A–), CDKN1A+, and CDKN2A+. (F) Pseudo-time trajectory analysis of scRNA-Seq from nonsenescent to senescent human β cells. (G) Heatmap showing expression levels of key senescence genes at various stages during the senescence trajectory. (H) scRNA-Seq expression levels of genes in the senescence Gene Ontology (GO) category and (I) Fridman gene senescent scores. Data shows individual cells in each trajectory state, mean ± SEM; expression levels analyzed via 2-way ANOVA. Quartiles of nuclear P21 protein expression derived from spatial proteomic (CODEX) data, only from β cells. (J) Coexpression of senescence proteins within cells exhibiting quartile distribution of nuclear P21. (K) Coexpression of β cell transcripts within cells exhibiting quartile distribution of nuclear P21. (L) Representative image of integrated CODEX (INSULIN [red] and p21 [green] protein) with Xenium (MAFA [orange] transcript). (M) Quartiles of nuclear CDKN1A mRNA expression from Xenium and coexpression with hallmark β cell genes. (N) Heatmap showing overlapping coexpression of nuclear P21 with β cell hallmark genes.

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