Despite improvement in insulin delivery, maintaining tight control of glucose homeostasis continues to be a challenge that results in bouts of severe hypo and hyperglycemia and serious long-term complications in many type 1 diabetes (T1D) patients. Therefore, developing an immunotherapy for the disease remains a major goal. Reaching this goal, however, requires deep knowledge of all facets of the diabetogenic process - which is generally believed to be initiated by an imbalance between pathogenic and regulatory mechanisms that allows diabetogenic T cells to infiltrate pancreatic islets and destroy insulin-producing ss-cells. Therefore, identifying and understanding roles of various molecules and cell types that tip the balance towards the immunopathogenic pathways in susceptible individuals and animal models is important for developing effective immunotherapy. This proposal investigates mechanisms that powerfully control ss-cell specific autoreactive T cells when Fas ligand (FasL), an apoptosis-inducing member of TNF family, is genetically or pharmacologically inactivated. Previously, the lack of appropriate models and efficacious FasL blocking mAb has severely hampered such investigation. In this application, we will use NOD mice that are haploinsufficient for FasL (NOD-gld/+ mouse) and a FasL- neutralizing mAb (MFL4 clone) to investigate the underlying mechanisms and therapeutic significance of FasL blockade using the MFL4 mAb. NOD-gld/+ mice are completely protected from T1D, immunocompetent, and have normal immune homeostasis. In addition, MFL4 mAb protects NOD-wt mice from diabetes without altering immune homeostasis and, more importantly, our preliminary data show it has promising efficacy in reversing hyperglycemia in new-onset cases. Based on our preliminary data generated using these model systems, we hypothesize that an IL-10-producing regulatory B cell subset that suppresses diabetogenic autoreactive T cells are negatively regulated by FasL. In NOD-wt mice, FasL-mediated apoptosis eliminates IL- 10-producing regulatory B cells thereby removing the brakes on autoreactive T-cells (tested Aim 1). We hypothesize that the MFL4 mAb can be used to reverse new-onset diabetes (tested in Aim 2). In NOD mice, haploinsufficiency for FasL (gld/+) or mAb blockade of FasL prevents IL-10-producing B cell elimination, leading to control of diabetogenic T cells and suppression of insulitis (tested in Aim 3). In this revised application, we will also assess relevance of our preclinical data to the human disease in samples from newly diagnosed patients at Hopkins and tissues provided by the JDRF sponsored nPOD project (Aim 3). Because the role of FasL in normal immune response and ss-cell death are dispensable, understanding how FasL modulates the diabetogenic process can lead to new mechanistic insights into the disease pathogenesis that could have important therapeutic implications.

Public Health Relevance

Developing an immunotherapy for type 1 diabetes is a major goal. Understanding how Fas ligand potently prevents the disease in mouse model, focus of this application, may lead to designing new therapeutic approaches.

National Institute of Health (NIH)
National Institute of Allergy and Infectious Diseases (NIAID)
Research Project (R01)
Project #
Application #
Study Section
Hypersensitivity, Autoimmune, and Immune-mediated Diseases Study Section (HAI)
Program Officer
Bourcier, Katarzyna
Project Start
Project End
Budget Start
Budget End
Support Year
Fiscal Year
Total Cost
Indirect Cost
Johns Hopkins University
Schools of Medicine
United States
Zip Code
Fousteri, Georgia; Ippolito, Elio; Ahmed, Rizwan et al. (2017) Beta-cell Specific Autoantibodies: Are they Just an Indicator of Type 1 Diabetes? Curr Diabetes Rev 13:322-329
Giwa, Adebola; Ahmed, Rizwan; Donner, Thomas et al. (2017) Editorial: Ying and Yang Members of the Tumor Necrosis Factor Superfamily: Friends or Foes in Immune-Mediated Diseases and Cancer. Front Immunol 8:1584
Martina, Maria N; Noel, Sanjeev; Saxena, Ankit et al. (2016) Double-Negative ?? T Cells Are Early Responders to AKI and Are Found in Human Kidney. J Am Soc Nephrol 27:1113-23
Hamad, Abdel Rahim A; Ahmed, Rizwan; Donner, Thomas et al. (2016) B cell-targeted immunotherapy for type 1 diabetes: What can make it work? Discov Med 21:213-9
Dai, Hong; Rahman, Ayesha; Saxena, Ankit et al. (2015) Syndecan-1 identifies and controls the frequency of IL-17-producing naïve natural killer T (NKT17) cells in mice. Eur J Immunol 45:3045-51
Ramirez, Lourdes; Hamad, Abdel Rahim A (2015) From non-obese diabetic to Network for the Pancreatic Organ Donor with Diabetes: New heights in type 1 diabetes research. World J Diabetes 6:1309-11
Saxena, Ankit; Khosraviani, Sam; Noel, Sanjeev et al. (2015) Interleukin-10 paradox: A potent immunoregulatory cytokine that has been difficult to harness for immunotherapy. Cytokine 74:27-34
Martina, Maria N; Noel, Sanjeev; Saxena, Ankit et al. (2015) Double negative (DN) ?? T cells: misperception and overdue recognition. Immunol Cell Biol 93:305-10
Martina, M N; Noel, S; Bandapalle, S et al. (2014) T lymphocytes and acute kidney injury: update. Nephron Clin Pract 127:51-5
Noel, Sanjeev; Martina-Lingua, Maria N; Bandapalle, Samatha et al. (2014) Intestinal microbiota-kidney cross talk in acute kidney injury and chronic kidney disease. Nephron Clin Pract 127:139-43

Showing the most recent 10 out of 13 publications