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Proinsulin: a unique autoantigen triggering autoimmune diabetes
Sylvaine You, Lucienne Chatenoud
Sylvaine You, Lucienne Chatenoud
Published December 1, 2006
Citation Information: J Clin Invest. 2006;116(12):3108-3110. https://doi.org/10.1172/JCI30760.
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Commentary

Proinsulin: a unique autoantigen triggering autoimmune diabetes

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Abstract

In healthy individuals the immune system does not react aggressively toward host cells, a phenomenon defined as self tolerance. If self tolerance is broken autoimmune disease can develop, during which autoreactive lymphocytes are directed to a variety of autoantigenic epitopes. However, researchers have yet to determine whether immune responses to multiple autoantigens develop independently of each other or are the result of the response “spreading” from one autoantigen to another. In a study of NOD mice in this issue of the JCI, Krishnamurthy et al. show that the autoreactive T cell response to the autoantigen proinsulin lies upstream of that to islet-specific glucose-6-phosphatase catalytic subunit–related protein, suggesting that the pathogenic autoimmune response to proinsulin subsequently spreads to other antigens (see the related article beginning on page 3258). These data support the current view that this pancreatic β cell hormone is the first autoantigen targeted by the immune response in autoimmune diabetes.

Authors

Sylvaine You, Lucienne Chatenoud

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Figure 1

Epitope spreading versus bystander suppression.

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Epitope spreading versus bystander suppression.
(A) In the event that an...
(A) In the event that an autoimmune response is triggered by a primary autoantigen (Ag1), the cytokine-mediated proinflammatory environment favors first the development of a Th1 effector cell–mediated immune response to Ag1 (Th1/Ag1), then the release from the damaged target tissue of other autoantigens (Ag2, Ag3, etc.), which trigger specific responses. This spread of specificity of the autoimmune response is one major molecular basis for its chronicity. (B) Bystander suppression operates when self tolerance is induced to one of the candidate autoantigens. The antiinflammatory environment generated may in turn downregulate the autoimmune responses to the other autoantigens involved in the autoimmune response. Major cytokines participating in this antiinflammatory effect are IL-4 and TGF-β, which are produced by Th2 and Th3 regulatory cells, respectively.

Copyright © 2022 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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