Excess pancreatic elastase alters acinar-β cell communication by impairing the mechano-signaling and the PAR2 pathways

Cell Metab. 2023 Jul 11;35(7):1242-1260.e9. doi: 10.1016/j.cmet.2023.05.007. Epub 2023 Jun 19.


Type 1 (T1D) or type 2 diabetes (T2D) are caused by a deficit of functional insulin-producing β cells. Thus, the identification of β cell trophic agents could allow the development of therapeutic strategies to counteract diabetes. The discovery of SerpinB1, an elastase inhibitor that promotes human β cell growth, prompted us to hypothesize that pancreatic elastase (PE) regulates β cell viability. Here, we report that PE is up-regulated in acinar cells and in islets from T2D patients, and negatively impacts β cell viability. Using high-throughput screening assays, we identified telaprevir as a potent PE inhibitor that can increase human and rodent β cell viability in vitro and in vivo and improve glucose tolerance in insulin-resistant mice. Phospho-antibody microarrays and single-cell RNA sequencing analysis identified PAR2 and mechano-signaling pathways as potential mediators of PE. Taken together, our work highlights PE as a potential regulator of acinar-β cell crosstalk that acts to limit β cell viability, leading to T2D.

Keywords: PAR2; diabetes; endocrine-exocrine crosstalk; human islets; mechano-signaling; pancreatic elastase; protease inhibitor; telaprevir; β cells.

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* / metabolism
  • Humans
  • Insulin / metabolism
  • Insulin-Secreting Cells* / metabolism
  • Mice
  • Pancreatic Elastase / metabolism


  • Pancreatic Elastase
  • Insulin