Aim: To study the effects of Roux-en-Y gastric bypass (RYGB) on the expression of pancreatic duodenal homeobox-1 (PDX-1) and pancreatic beta-cell regeneration/neogenesis, and their possible mechanisms in diabetics.
Methods: Three groups of randomly selected non-obese diabetic Goto-Kakizaki (GK) rats were subjected to RYGB, sham-RYGB and sham-operation (sham-op) surgery, respectively. The rats were euthanized at post-operative 1, 2, 4 and 12 wk. Their pancreases were resected and analyzed using reverse transcription polymerase chain reaction to detect the mRNA of PDX-1. Anti-PDX-1 immunohistochemical (IHC) staining and Western blotting were used to detect the protein of PDX-1. Double IHC staining of anti-Brdu and -insulin was performed to detect regenerated beta-cells. The index of double Brdu and insulin positive cells was calculated.
Results: In comparison with sham-RYGB and sham-op groups, a significant increase in the expressions of PDX-1 mRNA in RYGB group was observed at all experimental time points (1 wk: 0.378 +/- 0.013 vs 0.120 +/- 0.010, 0.100 +/- 0.010, F = 727.717, P < 0.001; 2 wk: 0.318 +/- 0.013 vs 0.110 +/- 0.010, 0.143 +/- 0.015, F = 301.509, P < 0.001; 4 wk: 0.172 +/- 0.011 vs 0.107 +/- 0.012, 0.090 +/- 0.010, F = 64.297, P < 0.001; 12 wk: 0.140 +/- 0.007 vs 0.120 +/- 0.010, 0.097 +/- 0.015, F = 16.392, P < 0.001); PDX-1 protein in RYGB group was also increased significantly (1 wk: 0.61 +/- 0.01 vs 0.21 +/- 0.01, 0.15 +/- 0.01, F = 3031.127, P < 0.001; 2 wk: 0.55 +/- 0.00 vs 0.15 +/- 0.01, 0.17 +/- 0.01, F = 3426.455, P < 0.001; 4 wk: 0.39 +/- 0.01 vs 0.18 +/- 0.01, 0.22 +/- 0.01, F = 882.909, P < 0.001; 12 wk: 0.41 +/- 0.01 vs 0.20 +/- 0.01, 0.18 +/- 0.01, F = 515.833, P < 0.001). PDX-1 mRNA and PDX-1 protein production showed no statistical significance between the two sham groups. Many PDX-1 positive cells could be found in the pancreatic islets of the rats in RYGB group at all time points. In addition, the percentage of Brdu-insulin double staining positive cells was higher in RYGB group than in the other two groups (1 wk: 0.22 +/- 0.13 vs 0.03 +/- 0.06, 0.03 +/- 0.06, P < 0.05; 2 wk: 0.28 +/- 0.08 vs 0.00 +/- 0.00, 0.03 +/- 0.06, P < 0.05; 4 wk: 0.24 +/- 0.11 vs 0.07 +/- 0.06, 0.00 +/- 0.00, P < 0.001; 12 wk: 0.20 +/- 0.07 vs 0.03 +/- 0.06, 0.00 +/- 0.00, P < 0.05).
Conclusion: RYGB can increase the expression of pancreatic PDX-1 and induce the regeneration of beta-cells in GK rats. The associated regeneration of islet cells may be a possible mechanism that how RYGB could improve type 2 diabetes mellitus.