Reinforcing one-carbon metabolism via folic acid/Folr1 promotes β-cell differentiation

Diabetes can be caused by an insufficiency in beta-cell mass. Here, we performed a genetic screen in a zebrafish model of beta-cell loss to identify pathways promoting beta-cell regeneration. We found that both folate receptor 1 (folr1) overexpression and treatment with folinic acid, stimulated beta-cell differentiation in zebrafish. Treatment with folinic acid also stimulated beta-cell differentiation in cultures of neonatal pig islets, showing that the effect could be translated to a mammalian system. In both zebrafish and neonatal pig islets, the increased beta-cell differentiation originated from ductal cells. Mechanistically, comparative metabolomic analysis of zebrafish with/without beta-cell ablation and with/without folinic acid treatment indicated beta-cell regeneration could be attributed to changes in the pyrimidine, carnitine, and serine pathways. Overall, our results suggest evolutionarily conserved and previously unknown roles for folic acid and one-carbon metabolism in the generation of beta-cells. Regeneration of insulin-producing beta-cells may become a future alternative treatment of diabetes. Here the authors report a genetic screen in a zebrafish model that mimics the loss of beta-cells in diabetes, and identified that the folate receptor Folr1 or folinic acid treatment can stimulate beta-cell regeneration.