The overall goal of this application is to expand our studies on a novel approach for assessing Type 1 diabetes risk in humans. This approach relies on a minimally invasive procedure such as the analysis of autoreactive CD4 T cells directly in the blood using FACS and specific ligands for cognate TCR/CD4 (soluble, dimeric MHC ll-peptide, DEF). Quantifying and phenotyping autoreactive CD4 T cells in mice allowed us not only to predict the onset of diabetes but also to gain insights into the pathogenesis of T1D. We found that disease progression is marked by an imbalance between regulatory CD4+CD25+ and activated CD4+CD69+ (autoreactive) T cells in pancreas, and that such event is mirrored in the phenotype of autoreactive CD4 T cells circulating in the blood. Our studies also revealed the """"""""hit-and-run"""""""" nature of the autoimmune attack on pancreas by recruitment of activated (CD69+) T cells from the blood. Several such """"""""hits"""""""" damage enough number of beta-cells so that the insulin production decreases and over the time leads to the onset. Our studies in humans also showed the potential of this approach for assessing T1D risk. We found that autoreactive CD4 T cells specific for GAD65 autoantigen are commonly present in blood of those expressing diabetes-susceptible HLA-DR*0401 molecules. The risk for diabetes can be assessed upon the imbalance between CD4+CD25+ and CD4+CD69+ T cells specific for GAD65 T cells. Like we found in mice, the autoreactive T cell imbalance followed by the disappearance of these T cells from the blood (the """"""""hit"""""""") associated in some cases with the clinical onset of T1D. ? ? In this application, we pursue 2 specific aims:
In aim 1 we will test the hypothesis that tracing autoreactive CD4 T cells in peripheral blood is a specific marker of the autoimmune process that leads to human T1 D.
In aim 2 we will test the hypothesis that the autoimmune attack on pancreas is a hit-and-run process mediated by the recruitment of activated T cells from the blood. Relatives of patients with T1D and controls will undergo physiological examination for insulin release to correlate changes in the specific CD4 T cells in blood with pancreatic beta-cell function. This study is expected to increase our understanding of T1D pathogenesis and provide new methods for assessing T1D risk. ? ? ?

Agency
National Institute of Health (NIH)
Institute
National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK)
Type
Exploratory/Developmental Grants (R21)
Project #
1R21DK077521-01
Application #
7224450
Study Section
Special Emphasis Panel (ZDK1-GRB-G (O1))
Program Officer
Spain, Lisa M
Project Start
2006-09-30
Project End
2007-08-31
Budget Start
2006-09-30
Budget End
2007-08-31
Support Year
1
Fiscal Year
2006
Total Cost
$217,478
Indirect Cost
Name
Mount Sinai School of Medicine
Department
Microbiology/Immun/Virology
Type
Schools of Medicine
DUNS #
078861598
City
New York
State
NY
Country
United States
Zip Code
10029
Lin, Marvin; Stoica-Nazarov, Cristina; Surls, Jacqueline et al. (2010) Reversal of type 1 diabetes by a new MHC II-peptide chimera: ""Single-epitope-mediated suppression"" to stabilize a polyclonal autoimmune T-cell process. Eur J Immunol 40:2277-88
Duncan, Beverly; Nazarov-Stoica, Cristina; Surls, Jacqueline et al. (2010) Double negative (CD3+ 4- 8-) TCR alphabeta splenic cells from young NOD mice provide long-lasting protection against type 1 diabetes. PLoS One 5:e11427
Nazarov-Stoica, Cristina; Surls, Jacqueline; Bona, Constantin et al. (2009) CD28 signaling in T regulatory precursors requires p56lck and rafts integrity to stabilize the Foxp3 message. J Immunol 182:102-10