Division of Pediatrics, Department of Biomedical and Clinical Sciences, Faculty of Medicine and Health Sciences, Linköping University, Linköping, Sweden.
Core Facility, Flow Cytometry Unit, Linköping University, Linköping, Sweden.
Front Immunol. 2022 Jan 12;12:797172. doi: 10.3389/fimmu.2021.797172. eCollection 2021.
Antigen-specific immunotherapy is an appealing strategy to preserve beta-cell function in type 1 diabetes, although the approach has yet to meet its therapeutic endpoint. Direct administration of autoantigen into lymph nodes has emerged as an alternative administration route that can improve the efficacy of the treatment. In the first open-label clinical trial in humans, injection of aluminum-formulated glutamic acid decarboxylase (GAD-alum) into an inguinal lymph node led to the promising preservation of C-peptide in patients with recent-onset type 1 diabetes. The treatment induced a distinct immunomodulatory effect, but the response at the cell level has not been fully characterized. Here we used mass cytometry to profile the immune landscape in peripheral blood mononuclear cells from 12 participants of the study before and after 15 months of treatment. The immunomodulatory effect of the therapy included reduction of naïve and unswitched memory B cells, increase in follicular helper T cells and expansion of PD-1+ CD69+ cells in both CD8+ and double negative T cells. stimulation with GAD only affected effector CD8+ T cells in samples collected before the treatment. However, the recall response to antigen after 15 months included induction of CXCR3+ and CD11c+Tbet+ B cells, PD-1+ follicular helper T cells and exhausted-like CD8+ T cells. This study provides a deeper insight into the immunological changes associated with GAD-alum administration directly into the lymph nodes.
抗原特异性免疫疗法是一种有吸引力的策略,可以在 1 型糖尿病中保留β细胞功能,尽管该方法尚未达到治疗终点。将自身抗原直接递送至淋巴结已成为一种替代的给药途径,可以提高治疗效果。在首例人类开放性临床试验中,将谷氨酸脱羧酶(GAD)铝制剂注射到腹股沟淋巴结中,导致近期诊断为 1 型糖尿病的患者的 C 肽得到了有希望的保留。该治疗诱导了明显的免疫调节作用,但细胞水平的反应尚未完全描述。在这里,我们使用质谱流式细胞术对 12 名研究参与者治疗前后外周血单核细胞的免疫图谱进行了分析。治疗的免疫调节作用包括减少幼稚和未转换的记忆 B 细胞,增加滤泡辅助 T 细胞,并在 CD8+和双阴性 T 细胞中扩增 PD-1+CD69+细胞。仅在治疗前采集的样本中,用 GAD 刺激会影响效应 CD8+T 细胞。然而,15 个月后抗原的回忆反应包括诱导 CXCR3+和 CD11c+B 细胞、PD-1+滤泡辅助 T 细胞和耗竭样 CD8+T 细胞。这项研究提供了对 GAD 铝制剂直接递送至淋巴结引起的免疫变化的更深入了解。