Conversion of Mature Human β-Cells Into Glucagon-Producing α-Cells

Conversion of one terminally differentiated cell type into another (or transdifferentiation) usually requires the forced expression of key transcription factors. We examined the plasticity of human insulin-producing beta-cells in a model of islet cell aggregate formation. Here, we show that primary human beta-cells can undergo a conversion into glucagon-producing alpha-cells without introduction of any genetic modification. The process occurs within days as revealed by lentivirus-mediated beta-cell lineage tracing. Converted cells are indistinguishable from native alpha-cells based on ultrastructural morphology and maintain their alpha-cell phenotype after transplantation in vivo. Transition of beta-cells into alpha-cells occurs after beta-cell degranulation and is characterized by the presence of beta-cell specific transcription factors Pdx1 and Nkx6.1 in glucagon(+) cells. Finally, we show that lentivirus-mediated knock-down of Arx, a determinant of the alpha-cell lineage, inhibits the conversion. Our findings reveal an unknown plasticity of human adult endocrine cells that can be modulated. This endocrine cell plasticity could have implications for islet development, (patho) physiology, and regeneration.