Diabetes mellitus is a chronic metabolic disease resulted from, either decreased production of insulin or increased resistance to it from peripheral tissues or both factors combined together. While medical treatment remains the mainstay of treatment for diabetes, some surgical procedures, such as Roux-en-Y gastric bypass, have demonstrated some potential to be a treatment option for diabetes. Increased insulin activity is observed among the patients who underwent Roux- en-Y gastric bypass（RYGB）surgery and it is possibly associated with increased post-surgical expression of PDX-1(Pancreatic duodenal homeobox-1) and regeneration of pancreatic β-cells. PDX-1 is an important transcription factor expressed during the embryonic development of the pancreas and β-cells are the insulin secreting cells found in the pancreatic islets.
A research group in China conducted a study using Goto-Kakizaki (GK) rats and developed the evidence based hypothesis to explain the mechanism of the effect of Roux-en-Y gastric bypass on diabetes mellitus. This paper will be published on May 14, 2010 in World Journal of Gastroenterology.
Research was conducted by Li Z and his colleagues in Southern Medical University, Institute of Basic Medical Anatomy National Key Disciplines. The article further articulates the relationship of PDX-1 expression and pancreatic β-cells regeneration to the effect of RYGB surgery to treat T2DM. Findings of this study advanced a new basis for a surgical management to treat T2DM in human beings and explain mechanism of the post-surgical nesidioblastosis that occurs among RYGB patient.
Findings of the study also showed that the RYGB could significantly increase the post surgical expression of PDX-1 and promotes regeneration of β-Cells in GK rats. GK rat is a non-obese genetically diabetic animal model commonly used to simulate human diabetes in the laboratory. This study was conducted using three groups of GK rats, RYGB surgery groups and two control groups. Post-surgically, each group was subjected to quantitative analysis of PDX-1 and pancreatic β-cells and result showed significant increase in the expression of PDX-1 as well as regeneration of β-cells in the RYGB surgery group compared to control groups. These findings provided concrete evidence to explain that the increased expression of the PDX-1 and regeneration β-cells are the associated mechanisms of RYGB surgery to treat T2DM. This study could be a turning point and takes diabetic related studies to a new path to develop a curative treatment for diabetes.
Reference: Li Z, Zhang HY, Lv LX, Li DF, Dai JX, Sha O, Li WQ, Bai Y, Yuan L. Roux-en-Y gastric bypass promotes expression of PDX-1 and regeneration of β-cells in Goto-Kakizaki rats. World J Gastroenterol 2010; 16(18): 2244-2251 http://www.wjgnet.com/1007-9327/full/v16/i18/2244.htm
Correspondence to: Lin Yuan, Professor, Southern Medical University, Institute of Basic Medical Anatomy National Key Disciplines, Guangzhou 510515, Guangdong Province, China. lizhen3829@163.com Telephone: +86-20-61648637 Fax: +86-20-61648637
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World Journal of Gastroenterology (WJG), a leading international journal in gastroenterology and hepatology, has established a reputation for publishing first class research on esophageal cancer, gastric cancer, liver cancer, viral hepatitis, colorectal cancer, and H pylori infection and provides a forum for both clinicians and scientists. WJG has been indexed and abstracted in Current Contents/Clinical Medicine, Science Citation Index Expanded (also known as SciSearch) and Journal Citation Reports/Science Edition, Index Medicus, MEDLINE and PubMed, Chemical Abstracts, EMBASE/Excerpta Medica, Abstracts Journals, Nature Clinical Practice Gastroenterology and Hepatology, CAB Abstracts and Global Health. ISI JCR 2008 IF: 2.081. WJG is a weekly journal published by WJG Press. The publication dates are the 7th, 14th, 21st, and 28th day of every month. WJG is supported by The National Natural Science Foundation of China, No. 30224801 and No. 30424812, and was founded with the name of China National Journal of New Gastroenterology on October 1, 1995, and renamed WJG on January 25, 1998.
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