There continues to be a need for immunotherapies sufficiently robust to suppress ongoing ? cell autoimmunity in type 1 diabetic individuals long-term, and reverse clinical diabetes. We found that a short course of nondepleting (ND) antibodies (Ab) specific for the T cell co-receptors CD4 and CD8 reverses diabetes in newly diabetic NOD mice, and prevents recurrent hyperglycemia indefinitely. Induction of remission by co-receptor therapy involves two key events. T cells bound by the ND ?CD4 and ?CD8 Ab are rapidly and selectively purged from the islets and draining pancreatic lymph nodes (PLN) due to altered trafficking properties. Secondly, TGF?1 expression is up-regulated by islet resident antigen presenting cells. On the other hand, maintenance of remission is mediated by PLN-resident Foxp3+Treg, which exhibit enhanced suppressor function. The goal of this proposal is 2-fold: 1) define the mechanisms by which co-receptor therapy induces and maintains remission in an islet/? cell-specific manner in NOD mice, and 2) extend these findings to human T effectors and FOXP3+Treg.
Aim 1 focuses on how co-receptor crosslinking regulates T cell purging in a tissue-specific manner. Efforts will determine if co-receptor crosslinking similarly alters the trafficking properties of human T cells in vitro, as well as in vivo in humanized mice.
Aim 2 investigates the events that promote islet- specific induction of TGF?1, and the role TGF?1 plays in diabetes remission. Finally, Aim 3 will study the direct and indirect effects of CD4 crosslinking on the properties and function of Foxp3+Treg in NOD mice. Whether co-receptor therapy also induces a distinct pool of human FOXP3+Treg with enhanced function in vivo will be tested in a humanized mouse model of islet pathology. Together this study will provide novel insight into mechanisms regulating the specificity and efficacy of ND ?CD4 and ?CD8 Ab treatment, in addition to better establishing the translational potential of co-receptor therapy for the treatment of human T cell-mediated pathologies.

Public Health Relevance

Co-receptor therapy is a highly effective approach to reverse clinical type 1 diabetes, and establish long-term beta cell-specific tolerance. This work will provide key insight into mechanisms by which co-receptor therapy induces and maintains diabetes remission, in addition to further establishing the therapeutic potential of this immunotherapy.

National Institute of Health (NIH)
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Research Project (R01)
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Special Emphasis Panel (ZRG1-IMM-C (02))
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Spain, Lisa M
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University of North Carolina Chapel Hill
Schools of Medicine
Chapel Hill
United States
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