Division of Pharmacoengineering and Molecular Pharmaceutics, Eshelman School of Pharmacy, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
Department of Microbiology and Immunology, School of Medicine, The University of North Carolina at Chapel Hill, Chapel Hill, NC, 27599, USA.
Adv Healthc Mater. 2018 Sep;7(18):e1800341. doi: 10.1002/adhm.201800341. Epub 2018 Jul 26.
Type 1 diabetes (T1D) is a common autoimmune disease with no cure. T1D subjects are dependent on daily exogenous insulin administration, due to the loss of functional insulin-producing β cells. Needed are immunotherapies that prevent and/or treat T1D. One approach of immunotherapy is to administer an autoantigen to selectively tolerize diabetogenic effector T cells without global immunosuppression. To date, however, strategies of antigen-specific immunotherapy are largely ineffective in the clinic. Using an antigen-specific approach, a biodegradable polymeric delivery vehicle, acetalated dextran microparticles (Ace-DEX MPs), is applied and T1D development is prevented through coadministration of the immunosuppressant rapamycin and the diabetogenic peptide P31 (Rapa/P31/MPs), via alterations of both innate and adaptive immunity. Ex vivo, adoptively transferred CD4 T cells exhibit reduced proliferation and an increased ratio of FoxP3 to IFNγ T cells. In vitro analysis indicates dendritic cells exhibit a less mature phenotype following coculture with Rapa/P31/MPs, which results in reduced CD4 T cell proliferation and proinflammatory cytokine production (IFNγ and IL-2), but promotes PD-1 expression. Together these results demonstrate Ace-DEX MP-based antigen-specific therapy effectively tolerizes diabetogenic CD4 T cells to prevent T1D, thereby demonstrating one of the first successful attempts of T1D prevention using a single-formulation particulate delivery platform.
1 型糖尿病(T1D)是一种常见的自身免疫性疾病,尚无治愈方法。由于功能性胰岛素分泌β细胞的丧失,T1D 患者依赖于每日外源性胰岛素给药。需要免疫疗法来预防和/或治疗 T1D。免疫疗法之一是给予自身抗原,以选择性地耐受致糖尿病效应 T 细胞,而不进行全身免疫抑制。然而,迄今为止,抗原特异性免疫疗法的策略在临床上基本上没有效果。本研究采用抗原特异性方法,应用可生物降解的聚合物递送载体乙酰化葡聚糖微球(Ace-DEX MPs),通过共给予免疫抑制剂雷帕霉素和致糖尿病肽 P31(Rapa/P31/MPs),改变固有和适应性免疫,从而预防 T1D 的发展。在体外,过继转移的 CD4 T 细胞表现出增殖减少和 FoxP3 与 IFNγ T 细胞的比例增加。体外分析表明,与 Rapa/P31/MPs 共培养后树突状细胞表现出更不成熟的表型,这导致 CD4 T 细胞增殖和促炎细胞因子(IFNγ 和 IL-2)产生减少,但促进 PD-1 表达。这些结果表明,基于 Ace-DEX MP 的抗原特异性治疗有效地耐受致糖尿病的 CD4 T 细胞,从而预防 T1D,这表明使用单一配方颗粒递送平台预防 T1D 的首次成功尝试之一。
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