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:	Brittany S. Bruggeman, Martha Campbell-Thompson, Stephanie L. Filipp, Matthew J. Gurka, Mark A. Atkinson, Desmond A. Schatz, Laura M. Jacobsen
Formato:	article
Lenguaje:	EN
Publicado:	Frontiers Media S.A. 2021
Materias:	islet amyloid polypeptide islets of langerhans pancreatitis pathology substance-related disorders tissue donors Diseases of the endocrine glands. Clinical endocrinology RC648-665
Acceso en línea:	https://doaj.org/article/9fcb09c6bd724f0792d6b2f5202af3fe
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spelling	oai:doaj.org-article:9fcb09c6bd724f0792d6b2f5202af3fe2021-12-01T13:27:03ZSubstance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies1664-239210.3389/fendo.2021.778912https://doaj.org/article/9fcb09c6bd724f0792d6b2f5202af3fe2021-11-01T00:00:00Zhttps://www.frontiersin.org/articles/10.3389/fendo.2021.778912/fullhttps://doaj.org/toc/1664-2392Access 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.Brittany S. BruggemanBrittany S. BruggemanMartha Campbell-ThompsonMartha Campbell-ThompsonStephanie L. FilippMatthew J. GurkaMark A. AtkinsonMark A. AtkinsonMark A. AtkinsonDesmond A. SchatzDesmond A. SchatzDesmond A. SchatzLaura M. JacobsenLaura M. JacobsenFrontiers Media S.A.articleislet amyloid polypeptideislets of langerhanspancreatitispathologysubstance-related disorderstissue donorsDiseases of the endocrine glands. Clinical endocrinologyRC648-665ENFrontiers in Endocrinology, Vol 12 (2021)
institution	DOAJ
collection	DOAJ
language	EN
topic	islet amyloid polypeptide islets of langerhans pancreatitis pathology substance-related disorders tissue donors Diseases of the endocrine glands. Clinical endocrinology RC648-665
spellingShingle	islet amyloid polypeptide islets of langerhans pancreatitis pathology substance-related disorders tissue donors Diseases of the endocrine glands. Clinical endocrinology RC648-665 Brittany S. Bruggeman Brittany S. Bruggeman Martha Campbell-Thompson Martha Campbell-Thompson Stephanie L. Filipp Matthew J. Gurka Mark A. Atkinson Mark A. Atkinson Mark A. Atkinson Desmond A. Schatz Desmond A. Schatz Desmond A. Schatz Laura M. Jacobsen Laura M. Jacobsen Substance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies
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.
format	article
author	Brittany S. Bruggeman Brittany S. Bruggeman Martha Campbell-Thompson Martha Campbell-Thompson Stephanie L. Filipp Matthew J. Gurka Mark A. Atkinson Mark A. Atkinson Mark A. Atkinson Desmond A. Schatz Desmond A. Schatz Desmond A. Schatz Laura M. Jacobsen Laura M. Jacobsen
author_facet	Brittany S. Bruggeman Brittany S. Bruggeman Martha Campbell-Thompson Martha Campbell-Thompson Stephanie L. Filipp Matthew J. Gurka Mark A. Atkinson Mark A. Atkinson Mark A. Atkinson Desmond A. Schatz Desmond A. Schatz Desmond A. Schatz Laura M. Jacobsen Laura M. Jacobsen
author_sort	Brittany S. Bruggeman
title	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_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_sort	substance use affects type 1 diabetes pancreas pathology: implications for future studies
publisher	Frontiers Media S.A.
publishDate	2021
url	https://doaj.org/article/9fcb09c6bd724f0792d6b2f5202af3fe
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Substance Use Affects Type 1 Diabetes Pancreas Pathology: Implications for Future Studies

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