Abstract

Diabetes mellitus is a chronic metabolic disorder affecting millions worldwide, characterized by hyperglycemia resulting from defects in insulin secretion or action. While current treatments range from pharmacotherapy to experimental cell-based therapies, progress remains hampered by donor scarcity and an incomplete understanding of islet stress responses. This dissertation investigates cellular stress responses in pancreatic islets and strategies to improve stem cell-derived islet (SC-islet) transplantation. The first chapter provides an overview of diabetes pathophysiology, modeling approaches, and treatment options. In the second chapter, we use single-cell RNA sequencing to investigate cell-type-specific responses to diabetes-associated stress in primary human islets exposed to endoplasmic reticulum and inflammatory stress. Notable, we found that not only do β-cells exhibit a robust response to stress, but α-cells and ductal cells do as well. We also characterized β-cell-specific responses to stress. Building on these findings, the dataset enabled the identification of drug and gene candidates to enhance islet stress resilience, leading to the discovery of CIB1 as a regulator of SC-islet function and apoptosis. The third chapter employs whole-genome CRISPR screening to identify genes that improve SC-islet transplantation in mouse models. FCAMR overexpression significantly reduced blood glucose and increased C-peptide in subcutaneous transplantations, and induced weight gain in intramuscular and kidney transplantation models. Overall, this dissertation analyzes cell-type-specific responses to diabetic-associated stress and establishes FCAMR as a target for enhancing SC-islet transplantation therapy.

Committee Chair

Jeffrey Millman

Committee Members

Farshid Guilak; Fumihiko Urano; Irfan Lodhi; Monika Bambouskova

Degree

Doctor of Philosophy (PhD)

Author's Department

Biology & Biomedical Sciences (Developmental, Regenerative, & Stem Cell Biology)

Author's School

Graduate School of Arts and Sciences

Document Type

Dissertation

Date of Award

12-18-2025

Language

English (en)

Author's ORCID

0000-0002-5135-0938

Included in

Biology Commons

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