Fig. 7: The relationship of inosine monophosphate and myeloid cell number in diabetic patient with acute pancreatitis.

a The individual plot provided the distribution of all values measured in patients with diabetes (n = 50) and/or AP, (n = 31). b Volcano blot presented the head-to-head comparison of each purine metabolites. c, d Succinyladenosine and 2′-Deoxyguanosine 5′-monophosphate levels in the blood of diabetic patients with AP and diabetic subjects. Unpaired, 2-tailed Student’s t test for data with normal distribution. Non-parametric Mann–Whitney analysis was used for the data did not follow normal distribution. n = 31–50. e, f Univariate analysis illustrated the opposite correlation of these two purine metabolites with granulocyte proportion in the circulation in the study populations. n = 79. g A proposed working model. Under diabetes, granulocyte-monocyte progenitor cells are proliferative, resulting in enhanced myeloid cell production. By metabolomics, purine metabolism is increased in GMP cells. The key purine metabolite, IMP, stimulates GMP cell proliferation and granulocyte production via S6 phosphorylation, cKit expression onto cell S6membrane and mitochondrial biogenesis in vitro. IMP-modulated GMP cell proliferation was through Akt activation in lineage-/low cells and inhibition of Akt activation diminished IMP-induced pancreas damage upon cell injection.