Abnormal exocrine-endocrine cell cross-talk promotes β-cell dysfunction and loss in MODY8

Nat Metab. 2022 Jan;4(1):76-89. doi: 10.1038/s42255-021-00516-2. Epub 2022 Jan 20.


MODY8 (maturity-onset diabetes of the young, type 8) is a dominantly inherited monogenic form of diabetes associated with mutations in the carboxyl ester lipase (CEL) gene expressed by pancreatic acinar cells. MODY8 patients develop childhood-onset exocrine pancreas dysfunction followed by diabetes during adulthood. However, it is unclear how CEL mutations cause diabetes. In the present study, we report the transfer of CEL proteins from acinar cells to β-cells as a form of cross-talk between exocrine and endocrine cells. Human β-cells show a relatively higher propensity for internalizing the mutant versus the wild-type CEL protein. After internalization, the mutant protein forms stable intracellular aggregates leading to β-cell secretory dysfunction. Analysis of pancreas sections from a MODY8 patient reveals the presence of CEL protein in the few extant β-cells. The present study provides compelling evidence for the mechanism by which a mutant gene expressed specifically in acinar cells promotes dysfunction and loss of β-cells to cause diabetes.

Publication types

  • Research Support, N.I.H., Extramural
  • Research Support, Non-U.S. Gov't

MeSH terms

  • Acinar Cells / metabolism
  • Animals
  • Cell Communication*
  • Diabetes Mellitus, Type 2 / etiology*
  • Diabetes Mellitus, Type 2 / metabolism*
  • Humans
  • Immunohistochemistry
  • Insulin-Secreting Cells / metabolism*
  • Islets of Langerhans / metabolism
  • Islets of Langerhans Transplantation
  • Lipase / chemistry
  • Lipase / genetics
  • Lipase / metabolism
  • Mice
  • Mutation
  • Pancreas / metabolism
  • Pancreas / pathology
  • Pancreas, Exocrine / metabolism*
  • Protein Transport
  • Solubility


  • CEL protein, human
  • Lipase

Supplementary concepts

  • Maturity-Onset Diabetes of the Young, Type 8, with Exocrine Dysfunction