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Targeting of Pancreatic Glia in Type 1 Diabetes

¹ Department of Pediatrics, Immunology and Genetics, the Research Institute, the Hospital for Sick Children, University of Toronto, Toronto, Ontario, Canada
² Department of Pediatrics, Children's Hospital and University of Pittsburgh, Pittsburgh, Pennsylvania
³ Departments of Medical Biophysics and Immunology, Campbell Family Institute for Breast Cancer Research, Ontario Cancer Institute, University Health Network, University of Toronto, Toronto, Ontario, Canada

Address correspondence and reprint requests to Hans-Michael Dosch, The Hospital for Sick Children, 555 University Ave., 10th Floor Elm Wing, Rm. 10126, Toronto, Ontario, M5G 1X8, Canada. E-mail: hmdosch{at}sickkids.ca

Abbreviations: AIM, adoptive immunotherapy media; β2m, β2-microglobulin; CTL, cytotoxic T-lymphocyte; FDR, first-degree relative; GFAP, glial fibrillary acidic protein; IFA, incomplete Freund's adjuvant; IFN-, -interferon; IL, interleukin; MHC, major histocompatibility complex; pSC, peri-islet Schwann cell; SI, stimulation index; TCR, T-cell receptor

OBJECTIVE— Type 1 diabetes reflects autoimmune destruction of β-cells and peri-islet Schwann cells (pSCs), but the mechanisms of pSC death and the T-cell epitopes involved remain unclear.

RESEARCH DESIGN AND METHODS— Primary pSC cultures were generated and used as targets in cytotoxic T-lymphocyte (CTL) assays in NOD mice. Cognate interaction between pSC and CD8⁺ T-cells was assessed by transgenic restoration of β2-microglobulin (β2m) to pSC in NOD.β2m^–/– congenics. I-A^g7 and K^d epitopes in the pSC antigen glial fibrillary acidic protein (GFAP) were identified by peptide mapping or algorithms, respectively, and the latter tested by immunotherapy.

RESULTS— pSC cultures did not express major histocompatibility complex (MHC) class II and were lysed by ex vivo CTLs from diabetic NOD mice. In vivo, restoration of MHC class I in GFAP-β2m transgenics significantly accelerated adoptively transferred diabetes. Target epitopes in the pSC autoantigen GFAP were mapped to residues 79–87 and 253–261 for K^d and 96–110, 116–130, and 216–230 for I-A^g7. These peptides were recognized spontaneously in NOD spleens as early as 2.5 weeks of age, with proliferative responses peaking around weaning and detectable lifelong. Several were also recognized by T-cells from new-onset type 1 diabetic patients. NOD mouse immunotherapy at 8 weeks with the CD8⁺ T-cell epitope, GFAP 79–87 but not 253–261, significantly inhibited type 1 diabetes and was associated with reduced -interferon production to whole protein GFAP.

CONCLUSIONS— Collectively, these findings elucidate a role for pSC-specific CD8⁺ T-cells in islet inflammation and type 1 diabetes pathogenesis, further supporting neuronal involvement in β-cell demise.

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