Functional genomics reveals mediators of beta cell survival in ER stress and type 2 diabetes risk

Endoplasmic reticulum (ER) stress in pancreatic beta cells contributes to impaired function and type 2 diabetes (T2D). In this study we performed genome-wide perturbation screens and genomic profiling in beta cells to identify novel mediators of ER stress responses and diabetes risk. We defined gene regulatory networks in beta cells and identified specific beta cell networks enriched for T2D risk variants with altered expression in ER stress. We performed a loss-of-function CRISPR screen for survival under ER stress in EndoC-βH1 cells, which identified 167 pro-survival and 47 pro-death genes involved in processes related to insulin secretion, mitochondrial transport and protein ubiquitination. Beta cell survival genes collectively had limited genomic change in stress yet showed significant, independent enrichment for T2D risk variants, including novel T2D candidate gene DTNB which we validated protects against beta cell death during stress. Overall, our results revealed mediators of ER stress responses in beta cells and identified new therapeutic targets to preserve beta cells in diabetes pathogenesis.