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Substance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies

Access to human pancreas samples from organ donors has greatly advanced our understanding of type 1 diabetes pathogenesis; however, previous studies have shown that donors have a high rate of substance use, and its impact on pancreatic histopathology in this disease is not well described. One-hundre...

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Autores principales: Bruggeman, Brittany S., Campbell-Thompson, Martha, Filipp, Stephanie L., Gurka, Matthew J., Atkinson, Mark A., Schatz, Desmond A., Jacobsen, Laura M.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Frontiers Media S.A. 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8667172/
https://www.ncbi.nlm.nih.gov/pubmed/34912300
http://dx.doi.org/10.3389/fendo.2021.778912
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author Bruggeman, Brittany S.
Campbell-Thompson, Martha
Filipp, Stephanie L.
Gurka, Matthew J.
Atkinson, Mark A.
Schatz, Desmond A.
Jacobsen, Laura M.
author_facet Bruggeman, Brittany S.
Campbell-Thompson, Martha
Filipp, Stephanie L.
Gurka, Matthew J.
Atkinson, Mark A.
Schatz, Desmond A.
Jacobsen, Laura M.
author_sort Bruggeman, Brittany S.
collection PubMed
description Access to human pancreas samples from organ donors has greatly advanced our understanding of type 1 diabetes pathogenesis; however, previous studies have shown that donors have a high rate of substance use, and its impact on pancreatic histopathology in this disease is not well described. One-hundred-thirty-one type 1 diabetes and 111 control organ donor pancreata from persons 12-89 years of age (mean 29.8 ± 15.5 years) within the Network for Pancreatic Organ donors with Diabetes (nPOD) were examined for insulin positivity, insulitis, amyloid staining, acute and chronic pancreatitis, and chronic exocrine changes (acinar atrophy, fibrosis, fatty infiltration, or periductal fibrosis); findings were compared by history of substance use. A secondary analysis compared exocrine pancreatic histopathologic findings in type 1 diabetes versus control organ donors regardless of substance use history. We observed a high but congruent rate of substance use in type 1 diabetes and control organ donors (66.4% and 64% respectively). Among donors with type 1 diabetes (but not controls), islet amyloid (OR 9.96 [1.22, 81.29]) and acute pancreatitis (OR 3.2 [1.06, 9.63]) were more common in alcohol users while chronic exocrine changes (OR 8.86 [1.13, 69.31]) were more common in cocaine users. Substance use impacted the pancreata of donors with type 1 diabetes more than controls. Overall, despite similar rates of substance use, acute pancreatitis (15.3% versus 4.5%, p=0.0061), chronic pancreatitis (29.8% versus 9.9%, p=0.0001), and chronic exocrine changes (73.3% versus 36.9%, p<0.0001) were more common in type 1 diabetes donors than controls. Alcohol and/or cocaine use in type 1 diabetes organ donors increases exocrine pancreas pathology and islet amyloid deposition but does not affect insulitis or insulin positivity. Exocrine pathology in type 1 diabetes donors is common, and further study of the pathophysiology of these changes is needed.
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spelling pubmed-86671722021-12-14 Substance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies Bruggeman, Brittany S. Campbell-Thompson, Martha Filipp, Stephanie L. Gurka, Matthew J. Atkinson, Mark A. Schatz, Desmond A. Jacobsen, Laura M. Front Endocrinol (Lausanne) Endocrinology Access to human pancreas samples from organ donors has greatly advanced our understanding of type 1 diabetes pathogenesis; however, previous studies have shown that donors have a high rate of substance use, and its impact on pancreatic histopathology in this disease is not well described. One-hundred-thirty-one type 1 diabetes and 111 control organ donor pancreata from persons 12-89 years of age (mean 29.8 ± 15.5 years) within the Network for Pancreatic Organ donors with Diabetes (nPOD) were examined for insulin positivity, insulitis, amyloid staining, acute and chronic pancreatitis, and chronic exocrine changes (acinar atrophy, fibrosis, fatty infiltration, or periductal fibrosis); findings were compared by history of substance use. A secondary analysis compared exocrine pancreatic histopathologic findings in type 1 diabetes versus control organ donors regardless of substance use history. We observed a high but congruent rate of substance use in type 1 diabetes and control organ donors (66.4% and 64% respectively). Among donors with type 1 diabetes (but not controls), islet amyloid (OR 9.96 [1.22, 81.29]) and acute pancreatitis (OR 3.2 [1.06, 9.63]) were more common in alcohol users while chronic exocrine changes (OR 8.86 [1.13, 69.31]) were more common in cocaine users. Substance use impacted the pancreata of donors with type 1 diabetes more than controls. Overall, despite similar rates of substance use, acute pancreatitis (15.3% versus 4.5%, p=0.0061), chronic pancreatitis (29.8% versus 9.9%, p=0.0001), and chronic exocrine changes (73.3% versus 36.9%, p<0.0001) were more common in type 1 diabetes donors than controls. Alcohol and/or cocaine use in type 1 diabetes organ donors increases exocrine pancreas pathology and islet amyloid deposition but does not affect insulitis or insulin positivity. Exocrine pathology in type 1 diabetes donors is common, and further study of the pathophysiology of these changes is needed. Frontiers Media S.A. 2021-11-29 /pmc/articles/PMC8667172/ /pubmed/34912300 http://dx.doi.org/10.3389/fendo.2021.778912 Text en Copyright © 2021 Bruggeman, Campbell-Thompson, Filipp, Gurka, Atkinson, Schatz and Jacobsen https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
spellingShingle Endocrinology
Bruggeman, Brittany S.
Campbell-Thompson, Martha
Filipp, Stephanie L.
Gurka, Matthew J.
Atkinson, Mark A.
Schatz, Desmond A.
Jacobsen, Laura M.
Substance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies
title Substance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies
title_full Substance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies
title_fullStr Substance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies
title_full_unstemmed Substance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies
title_short Substance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies
title_sort substance use affects type 1 diabetes pancreas pathology: implications for future studies
topic Endocrinology
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8667172/
https://www.ncbi.nlm.nih.gov/pubmed/34912300
http://dx.doi.org/10.3389/fendo.2021.778912
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