Abstract

Aims/hypothesisType 1 diabetes is a T cell-mediated autoimmune disease characterised by the destruction of beta cells in the islets of Langerhans, resulting in deficient insulin production. B cell depletion therapy has proved successful in preventing diabetes and restoring euglycaemia in animal models of diabetes, as well as in preserving beta cell function in clinical trials in the short term. We aimed to report a full characterisation of B cell kinetics post B cell depletion, with a focus on pancreatic islets.MethodsTransgenic NOD mice with a human CD20 transgene expressed on B cells were injected with an anti-CD20 depleting antibody. B cells were analysed using multivariable flow cytometry.ResultsThere was a 10 week delay in the onset of diabetes when comparing control and experimental groups, although the final difference in the diabetes incidence, following prolonged observation, was not statistically significant (p = 0.07). The co-stimulatory molecules CD80 and CD86 were reduced on stimulation of B cells during B cell depletion and repopulation. IL-10-producing regulatory B cells were not induced in repopulated B cells in the periphery, post anti-CD20 depletion. However, the early depletion of B cells had a marked effect on T cells in the local islet infiltrate. We demonstrated a lack of T cell activation, specifically with reduced CD44 expression and effector function, including IFN-γ production from both CD4+ and CD8+ T cells. These CD8+ T cells remained altered in the pancreatic islets long after B cell depletion and repopulation.Conclusions/interpretationOur findings suggest that B cell depletion can have an impact on T cell regulation, inducing a durable effect that is present long after repopulation. We suggest that this local effect of reducing autoimmune T cell activity contributes to delay in the onset of autoimmune diabetes.

Highlights

  • Type 1 diabetes, an organ-specific autoimmune disease with a multifactorial aetiology, is characterised by the immunemediated destruction of beta cells in pancreatic islets, resultingDiabetologia (2018) 61:1397–1410 γ in insufficient insulin production [1]

  • We focused on characterising the effects of B cell depletion on peripheral B cells and the characteristics of the cellular infiltrate in the islets of Langerhans in the human CD20 (hCD20)/ NOD mouse

  • Multivariable flow cytometry was carried out using monoclonal antibodies: CD4-FITC (GK1.5 [1:200]), CD8PE-594 (53-6.7 [1:800]), CD103-BV510 (2E7 [1:100]), PD1-BV785 (29F.1A12 [1:200]), IFN-γ-BV711 (XMG1.2 [1:100]), CD107a-PeCy7 (1D4B [1:200]), CD69-AF700 (H1.2F3 [1:100]), TGF-β-BV421 (TW7-16B4 [1:100]), CD38-FITC (90 [1:200]) and CD86-PeCy7 (PO3 [1:200]); IL-10-APC (JES5-16E3 [1:200]), CD1d-BV510 (1B1 [1:200]), CD21-PE-594 (7G6 [1:1000]), CD23-BV711(B3B4 [1:800]), CD24-BV650 (M1/69 [1:400]), CD3-BV786 (145-2C11 [1:100]) and CD80BV650 (16-10A1 [1:100]); CD19-efluor780, CD5PeCy7 (53-7.3 [1:200]), IL-6-PerCP-Cy5.5

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Summary

Introduction

In NOD mice, agents effecting timed depletion of B cells prevent diabetes [7,8,9,10,11] and reverse disease after onset [7, 8, 12] These include anti-human CD20 antibody in human CD20 (hCD20)/NOD transgenic mice (in which the human gene MS4A1, encoding hCD20, is expressed), anti-mouse CD20 antibody, anti-CD22 antibody coupled to immunotoxin, B-Lys/BAFF neutralisation and BCMA-Fc chimerised protein [7, 8, 12]. While these strategies all influence development of diabetes, there are important differences in the effector mechanisms. It is important to understand kinetics and immunological effects following anti-B cell treatment with such agents

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