Abstract. the islet contains a dense vascular structure of several features. the expression of vascular endothelial growth factor (VEGF)-A in beta cells is indispensable for the formation of this structure. Thus, the beta-cell-specific VEGF-Adeficient mouse (RIP-Cre:Vegf fl/fl ) is useful for studying the role of the islet vasculature on the function of islets and regulation of beta-cell mass. Studies using RIP-Cre:Vegf fl/fl mice revealed that defects in the normal vascular structure are associated with abnormal insulin secretion and concluded that the islet vascular system is essential for normal insulin secretion into the blood stream. on the other hand, whereas the endothelial cells might be involved in regulation of islet mass and the mouse model of diabetes shows that the number of endothelial cells correlate with the islet mass, RIPCre:Vegf fl/fl mice show almost normal response of islet expansion in the presence of insulin resistance. on the other hand, whereas bone marrow transplantation induces islet expansion in wildtype mice, it does not induce the proper expansion of beta-cell mass in RIP-Cre:Vegf fl/fl mice. these data indicate that the roles of VEGF-a and islet vasculature on the regulation of beta-cell mass depends on the stimulus for the islets.
Key words: VEGF-a, islet, Endothelial cells, Beta-cell massThe Two mAjor AbnormAliTies in type 2 diabetes mellitus are the failure of beta-cell function and deterioration of systemic insulin sensitivity. While insulin resistance is an abnormality common to almost all type 2 diabetes mellitus, insulin resistance is also observed in many subjects who never develop type 2 diabetes mellitus. thus, insulin resistance cannot be a specific determinant of the onset of type 2 diabetes. in the presence of insulin resistance, normal beta cells can increase insulin secretion to amounts sufficient to maintain glucose homeostasis as a compensatory response. on the other hand, in type 2 diabetes or subjects who will progress to type 2 diabetes mellitus in the future, beta cells fail to adapt to systemic insulin resistance, leading to hyperglycemia. in this regard, the onset of type 2 diabetes is determined by the failure of the compensatory response of beta cells for insulin resistance. Furthermore, the progression of beta-cell dysfunction is a common event in most people with established type 2 diabetes mellitus and is associated with worsening glycemic control. thus, type 2 diabetes should be regarded as a disease of "pancreatic beta-cell failure." one of the earliest signs of beta-cell failure in the natural history of type 2 diabetes is a specific loss of glucose-induced insulin secretion, whereas secretion in response to other secretagogues is maintained at the stage. At that situation, a decrease of first phase insulin release, and delayed insulin secretion in response to oral glucose load is typically observed. another defect is decreased beta-cell mass. Pathological studies demonstrated that in patients with type 2 diabetes mellitus, the islet size is small and...