Autophagy and the pancreatic beta-cell in human type 2 diabetes.

Pancreatic beta-cell dysfunction is central to the development and worsening of type 2 diabetes. Whereas beta-cell apoptosis plays a major role in reducing beta-cell mass in diabetes, alterations of autophagy can also lead to beta-cell death, as recently demonstrated in type 2 diabetic subjects. In addition, several studies with cell lines and rodent models have shown the importance of autophagy in regulating beta-cell survival and function. Although most of the underlying molecular mechanisms remain to be elucidated, this growing evidence raises interest in the role of autophagy in beta-cell pathophysiology and suggests the possibility of exploring autophagic processes to develop tools for protection of the pancreatic beta-cell in type 2 diabetes.