Departments of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL 32610, USA.
Department of Biochemistry School of Dental Medicine, University of Pennsylvania, Philadelphia, PA 19104, USA.
Sci Rep. 2017 Feb 13;7:42372. doi: 10.1038/srep42372.
Autoantigen-specific immunological tolerance represents a central objective for prevention of type 1 diabetes (T1D). Previous studies demonstrated mucosal antigen administration results in expansion of Foxp3 and LAP regulatory T cells (Tregs), suggesting oral delivery of self-antigens might represent an effective means for modulating autoimmune disease. Early preclinical experiments using the non-obese diabetic (NOD) mouse model reported mucosal administration of T1D-related autoantigens [proinsulin or glutamic acid decarboxylase 65 (GAD)] delayed T1D onset, but published data are conflicting regarding dose, treatment duration, requirement for combinatorial agents, and extent of efficacy. Recently, dogma was challenged in a report demonstrating oral insulin does not prevent T1D in NOD mice, possibly due to antigen digestion prior to mucosal immune exposure. We used transplastomic plants expressing proinsulin and GAD to protect the autoantigens from degradation in an oral vaccine and tested the optimal combination, dose, and treatment duration for the prevention of T1D in NOD mice. Our data suggest oral autoantigen therapy alone does not effectively influence disease incidence or result in antigen-specific tolerance assessed by IL-10 measurement and Treg frequency. A more aggressive approach involving tolerogenic cytokine administration and/or lymphocyte depletion prior to oral antigen-specific immunotherapy will likely be required to impart durable therapeutic efficacy.
自身抗原特异性免疫耐受是 1 型糖尿病 (T1D) 预防的主要目标。先前的研究表明,黏膜抗原给药会导致 Foxp3 和 LAP 调节性 T 细胞 (Treg) 的扩增,这表明自身抗原的口服给药可能是调节自身免疫性疾病的有效手段。早期使用非肥胖型糖尿病 (NOD) 小鼠模型的临床前实验报告称,黏膜给予与 T1D 相关的自身抗原 [胰岛素原或谷氨酸脱羧酶 65 (GAD)] 可延迟 T1D 发病,但关于剂量、治疗持续时间、组合药物的要求和疗效程度,发表的数据存在冲突。最近,一项报告挑战了口服胰岛素不能预防 NOD 小鼠 T1D 的观点,这可能是由于抗原在黏膜免疫暴露前被消化。我们使用表达胰岛素原和 GAD 的转基因植物来保护自身抗原免受口服疫苗中的降解,并测试了预防 NOD 小鼠 T1D 的最佳组合、剂量和治疗持续时间。我们的数据表明,单独的口服自身抗原治疗并不能有效影响疾病的发病率,也不能通过 IL-10 测量和 Treg 频率来评估抗原特异性耐受。在口服抗原特异性免疫治疗之前,可能需要更积极的方法,包括耐受原性细胞因子给药和/或淋巴细胞耗竭,以产生持久的治疗效果。
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