Browsing by Author "Hull, Audrey"

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    Inhibition of polyamine biosynthesis preserves β cell function in type 1 diabetes
    (Elsevier, 2023) Sims, Emily K.; Kulkarni, Abhishek; Hull, Audrey; Woerner, Stephanie E.; Cabrera, Susanne; Mastrandrea, Lucy D.; Hammoud, Batoul; Sarkar, Soumyadeep; Nakayasu, Ernesto S.; Mastracci, Teresa L.; Perkins, Susan M.; Ouyang, Fangqian; Webb-Robertson, Bobbie-Jo; Enriquez, Jacob R.; Tersey, Sarah A.; Evans-Molina, Carmella; Long, S. Alice; Blanchfield, Lori; Gerner, Eugene W.; Mirmira, Raghavendra G.; DiMeglio, Linda A.; Pediatrics, School of Medicine
    In preclinical models, α-difluoromethylornithine (DFMO), an ornithine decarboxylase (ODC) inhibitor, delays the onset of type 1 diabetes (T1D) by reducing β cell stress. However, the mechanism of DFMO action and its human tolerability remain unclear. In this study, we show that mice with β cell ODC deletion are protected against toxin-induced diabetes, suggesting a cell-autonomous role of ODC during β cell stress. In a randomized controlled trial (ClinicalTrials.gov: NCT02384889) involving 41 recent-onset T1D subjects (3:1 drug:placebo) over a 3-month treatment period with a 3-month follow-up, DFMO (125-1,000 mg/m2) is shown to meet its primary outcome of safety and tolerability. DFMO dose-dependently reduces urinary putrescine levels and, at higher doses, preserves C-peptide area under the curve without apparent immunomodulation. Transcriptomics and proteomics of DFMO-treated human islets exposed to cytokine stress reveal alterations in mRNA translation, nascent protein transport, and protein secretion. These findings suggest that DFMO may preserve β cell function in T1D through islet cell-autonomous effects.