Vallera D A, Carroll S F, Brief S, Blazar B R
Department of Therapeutic Radiology, University of Minnesota Hospital and Clinic, Minneapolis 55455.
Diabetes. 1992 Apr;41(4):457-64. doi: 10.2337/diab.41.4.457.
Autoimmune diabetes was induced with an established model in which 3 daily injections of 95 mg/kg body wt/day streptozocin (STZ) and 2 x 10(4) U interferon-gamma (IFN-gamma) were administered to C57BL/6 mice. Diabetes onset was accompanied by precipitous increases in serum glucose levels and validated by immunoperoxidase studies showing diminished islets in pancreatic tissue sections. Administration of two to three doses of a monoclonal antibody (MoAb) or an immunotoxin (IT) directed against the CD3 epsilon-chain before STZ/IFN-gamma treatment prevented increases in serum glucose and protected islets from damage. IT was made by crosslinking anti-CD3 to a low oligosaccharide-containing fraction of purified ricin toxin A chain (RTA; a catalytic inhibitor of protein synthesis) with a stabilized derivative of 2-iminothiolane. Protection was complete, long-lived, and selective because two different control ITs did not prevent diabetes onset. A second pan T-cell-reactive IT was synthesized by linking the MoAb anti-Ly1 to the same RTA toxin. Anti-Ly1 reacts with the murine homologue of human CD5. Anti-Ly1 RTA also protected against diabetes onset in a dose-dependent manner requiring higher doses and a longer schedule than anti-CD3 or anti-CD3 RTA. These studies demonstrate for the first time the importance of CD3+ and CD5+ cells in diabetes onset in the low-dose STZ/IFN-gamma model and show that anti-CD3, anti-CD3 RTA, or anti-CD5 RTA may be useful in vivo for the treatment of diabetes or perhaps other T-cell-mediated autoimmune diseases. These data may have important therapeutic implications for early autoimmune diabetes in humans.
自身免疫性糖尿病通过一种既定模型诱导产生,该模型中,对C57BL/6小鼠每日注射3次,每次注射95 mg/kg体重的链脲佐菌素(STZ)以及2×10⁴ U干扰素-γ(IFN-γ)。糖尿病发病伴随着血清葡萄糖水平的急剧升高,并且通过免疫过氧化物酶研究得以证实,该研究显示胰腺组织切片中的胰岛数量减少。在STZ/IFN-γ治疗前给予两到三剂针对CD3 ε链的单克隆抗体(MoAb)或免疫毒素(IT),可预防血清葡萄糖升高,并保护胰岛免受损伤。IT是通过将抗CD3与纯化的蓖麻毒素A链(RTA;一种蛋白质合成的催化抑制剂)的低聚糖部分用2-亚氨基硫杂环戊烷的稳定衍生物交联而成。保护作用是完全的、持久的且具有选择性,因为两种不同的对照IT并不能预防糖尿病发病。通过将MoAb抗Ly1与相同的RTA毒素连接,合成了第二种全T细胞反应性IT。抗Ly1与人CD5的小鼠同源物发生反应。抗Ly1 RTA也以剂量依赖的方式预防糖尿病发病,与抗CD3或抗CD3 RTA相比,需要更高的剂量和更长的给药方案。这些研究首次证明了在低剂量STZ/IFN-γ模型中,CD3⁺和CD5⁺细胞在糖尿病发病中的重要性,并表明抗CD3、抗CD3 RTA或抗CD5 RTA在体内可能对糖尿病或其他可能由T细胞介导的自身免疫性疾病的治疗有用。这些数据可能对人类早期自身免疫性糖尿病具有重要的治疗意义。