Casares Sofia, Lin Marvin, Zhang Nan, Teijaro John R, Stoica Cristina, McEvoy Robert, Farber Donna L, Bona Constantin, Brumeanu Teodor D
Department of Microbiology, Mount Sinai School of Medicine, New York, NY, USA.
Transplantation. 2008 Jun 27;85(12):1717-25. doi: 10.1097/TP.0b013e31817752cc.
Transplantation of pancreatic islets showed a tremendous progress over the years as a promising, new therapeutic strategy in patients with type 1 diabetes. However, additional immunosuppressive drug therapy is required to prevent rejection of engrafted islets. The current immunosuppressive therapies showed limited success in maintaining long-term islet survival as required to achieve insulin independence in type 1 diabetes, and they induce severe adverse effects. Herein, we analyzed the effects of a soluble peptide-major histocompatibility complex (MHC) class II chimera aimed at devising an antigen-specific therapy for suppression of anti-islet T cell responses and to improve the survival of pancreatic islets transplants.
Pancreatic islets from transgenic mice expressing the hemagglutinin antigen in the beta islets under the rat insulin promoter (RIP-HA) were grafted under the kidney capsule of diabetic, double transgenic mice expressing hemagglutinin in the pancreas and T cells specific for hemagglutinin (RIP-HA, TCR-HA). The recipient double transgenic mice were treated or not with the soluble peptide-MHC II chimera, and the progression of diabetes, graft survival, and T cell responses to the grafted islets were analyzed.
The peptide-MHC II chimera protected syngeneic pancreatic islet transplants against the islet-reactive CD4 T cells, and prolonged the survival of transplanted islets. Protection of transplanted islets occurred by polarization of antigen-specific memory CD4 T cells toward a Th2 anti-inflammatory response.
The peptide-MHC II chimera approach is an efficient and specific therapeutic approach to suppress anti-islet T cell responses and provides a long survival of pancreatic grafted islets.
多年来,胰岛移植作为1型糖尿病患者一种有前景的新治疗策略取得了巨大进展。然而,需要额外的免疫抑制药物治疗来防止移植胰岛的排斥反应。目前的免疫抑制疗法在维持1型糖尿病患者实现胰岛素自主所需的长期胰岛存活方面成效有限,并且会引发严重的不良反应。在此,我们分析了一种可溶性肽 - 主要组织相容性复合体(MHC)II类嵌合体的作用,旨在设计一种抗原特异性疗法来抑制抗胰岛T细胞反应并提高胰腺胰岛移植的存活率。
将在大鼠胰岛素启动子(RIP - HA)控制下在β胰岛中表达血凝素抗原的转基因小鼠的胰岛移植到糖尿病双转基因小鼠的肾被膜下,这些双转基因小鼠在胰腺中表达血凝素且具有针对血凝素的T细胞(RIP - HA,TCR - HA)。受体双转基因小鼠接受或不接受可溶性肽 - MHC II嵌合体治疗,并分析糖尿病进展、移植物存活以及对移植胰岛的T细胞反应。
肽 - MHC II嵌合体保护同基因胰腺胰岛移植免受胰岛反应性CD4 T细胞的攻击,并延长了移植胰岛的存活时间。移植胰岛的保护是通过抗原特异性记忆CD4 T细胞向Th2抗炎反应极化实现的。
肽 - MHC II嵌合体方法是一种有效且特异性的治疗方法,可抑制抗胰岛T细胞反应,并使胰腺移植胰岛长期存活。