[HTML][HTML] Anti-CD3 and nasal proinsulin combination therapy enhances remission from recent-onset autoimmune diabetes by inducing Tregs

D Bresson, L Togher, E Rodrigo… - The Journal of …, 2006 - Am Soc Clin Investig
D Bresson, L Togher, E Rodrigo, Y Chen, JA Bluestone, KC Herold, M von Herrath
The Journal of clinical investigation, 2006Am Soc Clin Investig
Safe induction of autoantigen-specific long-term tolerance is the “holy grail” for the treatment
of autoimmune diseases. In animal models of type 1 diabetes, oral or in immunization with
islet antigens induces Tregs that are capable of bystander suppression. However, such
interventions are only effective early in the prediabetic phase. Here, we demonstrate that a
novel combination treatment with anti-CD3ε–specific antibody and in proinsulin peptide can
reverse recent-onset diabetes in 2 murine diabetes models with much higher efficacy than …
Safe induction of autoantigen-specific long-term tolerance is the “holy grail” for the treatment of autoimmune diseases. In animal models of type 1 diabetes, oral or i.n. immunization with islet antigens induces Tregs that are capable of bystander suppression. However, such interventions are only effective early in the prediabetic phase. Here, we demonstrate that a novel combination treatment with anti-CD3ε–specific antibody and i.n. proinsulin peptide can reverse recent-onset diabetes in 2 murine diabetes models with much higher efficacy than with monotherapy with anti-CD3 or antigen alone. In vivo, expansion of CD25+Foxp3+ and insulin-specific Tregs producing IL-10, TGF-β, and IL-4 was strongly enhanced. These cells could transfer dominant tolerance to immunocompetent recent-onset diabetic recipients and suppressed heterologous autoaggressive CD8 responses. Thus, combining a systemic immune modulator with antigen-specific Treg induction is more efficacious in reverting diabetes. Since Tregs act site-specifically, this strategy should also be expected to reduce the potential for systemic side effects.
The Journal of Clinical Investigation