Disrupting the DREAM complex enables proliferation of adult human pancreatic [beta] cells

Resistance to regeneration of insulin-producing pancreatic [beta] cells is a fundamental challenge for type 1 and type 2 diabetes. Recently, small molecule inhibitors of the kinase DYRK1A have proven effective in inducing adult human [beta] cells to proliferate, but their detailed mechanism of action is incompletely understood. We interrogated our human insulinoma and [beta] cell transcriptomic databases seeking to understand why [beta] cells in insulinomas proliferate, while normal [beta] cells do not. This search reveals the DREAM complex as a central regulator of quiescence in human [beta] cells. The DREAM complex consists of a module of transcriptionally repressive proteins that assemble in response to DYRK1A kinase activity, thereby inducing and maintaining cellular quiescence. In the absence of DYRK1A, DREAM subunits reassemble into the pro-proliferative MMB complex. Here, we demonstrate that small molecule DYRK1A inhibitors induce human [beta] cells to replicate by converting the repressive DREAM complex to its pro-proliferative MMB conformation.