Immunology and Diabetes Unit, St. Vincent's Institute of Medical Research, Fitzroy, VIC 3065, Australia.
Department of Population Health and Immunity Walter and Eliza Hall Institute of Medical Research, Parkville, VIC 3052, Australia.
Proc Natl Acad Sci U S A. 2018 Oct 16;115(42):10732-10737. doi: 10.1073/pnas.1809208115. Epub 2018 Oct 1.
Type 1 diabetes (T1D) is an autoimmune disease in which insulin-producing beta cells, found within the islets of Langerhans in the pancreas, are destroyed by islet-infiltrating T cells. Identifying the antigenic targets of beta-cell reactive T cells is critical to gain insight into the pathogenesis of T1D and develop antigen-specific immunotherapies. Several lines of evidence indicate that insulin is an important target of T cells in T1D. Because many human islet-infiltrating CD4 T cells recognize C-peptide-derived epitopes, we hypothesized that full-length C-peptide (PI), the peptide excised from proinsulin as it is converted to insulin, is a target of CD4 T cells in people with T1D. CD4 T cell responses to full-length C-peptide were detected in the blood of: 14 of 23 (>60%) people with recent-onset T1D, 2 of 15 (>13%) people with long-standing T1D, and 1 of 13 (<8%) HLA-matched people without T1D. C-peptide-specific CD4 T cell clones, isolated from six people with T1D, recognized epitopes from the entire 31 amino acids of C-peptide. Eighty-six percent (19 of 22) of the C-peptide-specific clones were restricted by HLA-DQ8, HLA-DQ2, HLA-DQ8, or HLA-DQ2, HLA alleles strongly associated with risk of T1D. We also found that full-length C-peptide was a much more potent agonist of some CD4 T cell clones than an 18mer peptide encompassing the cognate epitope. Collectively, our findings indicate that proinsulin C-peptide is a key target of autoreactive CD4 T cells in T1D. Hence, full-length C-peptide is a promising candidate for antigen-specific immunotherapy in T1D.
1 型糖尿病(T1D)是一种自身免疫性疾病,其中位于胰腺胰岛内的胰岛素产生β细胞被胰岛浸润的 T 细胞破坏。确定β细胞反应性 T 细胞的抗原靶标对于深入了解 T1D 的发病机制和开发抗原特异性免疫疗法至关重要。有几条证据表明胰岛素是 T1D 中 T 细胞的重要靶标。由于许多人胰岛浸润的 CD4 T 细胞识别 C 肽衍生的表位,我们假设全长 C 肽(PI),即胰岛素原转化为胰岛素时被切除的肽,是 T1D 患者 CD4 T 细胞的靶标。在以下人群的血液中检测到全长 C 肽的 CD4 T 细胞反应:23 名近期发病的 T1D 患者中有 14 名(>60%),15 名长期 T1D 患者中有 2 名(>13%),13 名匹配 HLA 的无 T1D 患者中有 1 名(<8%)。从 6 名 T1D 患者中分离出的 C 肽特异性 CD4 T 细胞克隆识别 C 肽全长 31 个氨基酸的表位。22 个 C 肽特异性克隆中有 86%(19 个)受到 HLA-DQ8、HLA-DQ2、HLA-DQ8 和 HLA-DQ2 的限制,这些 HLA 等位基因与 T1D 的发病风险强烈相关。我们还发现全长 C 肽是一些 CD4 T 细胞克隆的比包含同源表位的 18 肽更有效的激动剂。总之,我们的研究结果表明,胰岛素原 C 肽是 T1D 中自身反应性 CD4 T 细胞的关键靶标。因此,全长 C 肽是 T1D 抗原特异性免疫治疗的有前途的候选物。