Diabetes prone BB rats are severely deficient in natural killer T cells

Rat Models of Human Type 1 Diabetes

Rat models of human type 1 diabetes have been shown to be of great importance for the elucidation of the mechanisms underlying the development of autoimmune diabetes. The three major well-established spontaneous rat models are the BioBreeding (BB) diabetes-prone rat, the Komeda diabetes-prone (KDP) rat, and the IDDM (LEW.1AR1-iddm) rat. Their distinctive features are described with special reference to their pathology, immunology, and genetics and compared with the situation in patients with type 1 diabetes mellitus. For all three established rat models, a distinctive genetic mutation has been identified that is responsible for the manifestation of the diabetic syndrome in these rat strains.

Loss of T cell and B cell quiescence precedes the onset of microbial flora-dependent wasting disease and intestinal inflammation in Gimap5-deficient mice

Homeostatic control of the immune system involves mechanisms that ensure the self-tolerance, survival and quiescence of hematopoietic-derived cells. In this study, we demonstrate that the GTPase of immunity associated protein (Gimap)5 regulates these processes in lymphocytes and hematopoietic progenitor cells. As a consequence of a recessive N-ethyl-N-nitrosourea-induced germline mutation in the P-loop of Gimap5, lymphopenia, hepatic extramedullary hematopoiesis, weight loss, and intestinal inflammation occur in homozygous mutant mice. Irradiated fetal liver chimeric mice reconstituted with Gimap5-deficient cells lose weight and become lymphopenic, demonstrating a hematopoietic cell-intrinsic function for Gimap5. Although Gimap5-deficient CD4(+) T cells and B cells appear to undergo normal development, they fail to proliferate upon Ag-receptor stimulation although NF-kappaB, MAP kinase and Akt activation occur normally. In addition, in Gimap5-deficient mice, CD4(+) T cells adopt a CD44(high)CD62L(low)CD69(low) phenotype and show reduced IL-7ralpha expression, and T-dependent and T-independent B cell responses are abrogated. Thus, Gimap5-deficiency affects a noncanonical signaling pathway required for Ag-receptor-induced proliferation and lymphocyte quiescence. Antibiotic-treatment or the adoptive transfer of Rag-sufficient splenocytes ameliorates intestinal inflammation and weight loss, suggesting that immune responses triggered by microbial flora causes the morbidity in Gimap5-deficient mice. These data establish Gimap5 as a key regulator of hematopoietic integrity and lymphocyte homeostasis.

Culture-independent identification of gut bacteria correlated with the onset of diabetes in a rat model

Bacteria associated with the onset of type 1 diabetes in a rat model system were identified. In two experiments, stool samples were collected at three time points after birth from bio-breeding diabetes-prone (BB-DP) and bio-breeding diabetes-resistant (BB-DR) rats. DNA was isolated from these samples and the 16S rRNA gene was amplified using universal primer sets. In the first experiment, bands specific to BB-DP and BB-DR genotypes were identified by automated ribosomal intergenic spacer analysis at the time of diabetes onset in BB-DP. Lactobacillus and Bacteroides strains were identified in the BB-DR- and BB-DP-specific bands, respectively. Sanger sequencing showed that the BB-DP and BB-DR bacterial communities differed significantly but too few reads were available to identify significant differences at the genus or species levels. A second experiment confirmed these results using higher throughput pyrosequencing and quantitative PCR of 16S rRNA with more rats per genotype. An average of 4541 and 3381 16S rRNA bacterial reads were obtained from each of the 10 BB-DR and 10 BB-DP samples collected at time of diabetes onset. Nine genera were more abundant in BB-DP whereas another nine genera were more abundant in BB-DR. Thirteen and eleven species were more abundant in BB-DP and BB-DR, respectively. An average of 23% and 10% of all reads could be classified at the genus and species levels, respectively. Quantitative PCR verified the higher abundance of Lactobacillus and Bifidobacterium in the BB-DR samples. Whether these changes are caused by diabetes or are involved in the development of the disease is unknown.

Dietary consumption of Echinacea by mice afflicted with autoimmune (type I) diabetes: effect of consuming the herb on hemopoietic and immune cell dynamics

Epidemiological studies indicate that the incidence of Type 1 diabetes, an autoimmune disease, is rising rapidly. However, none of the current therapies produces life long remission, or can prevent the disease onset. The NOD (non-obese diabetic) mouse is currently regarded as an excellent animal model of human Type 1 diabetes. NKT cells are known to be fundamental in modulating the disease, yet they are numerically and functionally deficient in mammals bearing this disease. Indeed, the role of NK cells in inhibiting autoimmunity in general is well established. Immunoregulatory strategies are currently believed to be the way of the future with respect to modulating autoimmune diseases. Based on this hypothesis, and the fact that the herb, Echinacea, is a well demonstrated immunostimulant of NK cells in normal mice/humans, we aimed to investigate, in NOD mice, the effect of short term (days) and long term (months) daily dietary administration of Echinacea, on the absolute levels of NK cells, and five other classes of hemopoietic and immune cells, in the bone marrow and spleen. The results revealed that, in NOD mice, dietary Echinacea, resulted in a significant increase in the absolute numbers of NK cells, irrespective of feeding duration, in the spleen, and moreover, it actually stimulated NK cell production in their bone marrow birth site. We further found that there were transient, early (days), herb exposure-time-dependent, quantitative changes in several of the other hemopoietic and immune cells populations in both the bone marrow and spleen. We conclude that consumption of this herb by NOD mice, at least, has lead to no negative repercussions with respect to the hemopoietic and immune lineages, and secondly, the consistent, long-lasting immunostimulation only of NK cells, may lead to a possible new approach to the treatment of Type 1 diabetes.

Experimental rodent models of prostatitis: limitations and potential

Prostatitis is a polyetiological inflammation of the prostate gland in men characterized by pelvic pain, irritative voiding symptoms, and sexual dysfunction. Histologically prostatitis is characterized by poly- and mononuclear cell infiltrates (neutrophils, lymphocytes, macrophages and plasma cells) in the stromal connective tissue around the acini or ducts. Prostatitis is an important worldwide health problem in men. The pathogenesis and diagnostic criteria for the condition are obscure, with the result that the development of management programs for this condition has been hindered. Animal model(s) might be useful in elucidating mechanisms involved in the molecular pathogenesis of chronic nonbacterial prostatitis and chronic pelvic pain syndrome. Given that prostatitis might have a multifactorial etiology, several animal models with unique features may prove helpful. This review examines a number of experimental rodent models of prostatitis and evaluates their advantages and limitations.

Immune cell infiltration, cytokine expression, and beta-cell apoptosis during the development of type 1 diabetes in the spontaneously diabetic LEW.1AR1/Ztm-iddm rat

The IDDM (LEW.1AR1/Ztm-iddm) rat is a type 1 diabetic animal model characterized by a rapid apoptotic pancreatic beta-cell destruction. Here we have analyzed the time course of islet infiltration, changes in the cytokine expression pattern, and beta-cell apoptosis in the transition from the pre-diabetic to the diabetic state. Transition from normoglycemia to hyperglycemia occurred when beta-cell loss exceeded 60-70%. At the early stages of islet infiltration, macrophages were the predominant immune cell type in the peripherally infiltrated islets. Progression of beta-cell loss was closely linked to a severe infiltration of the whole islet by CD8+ T-cells. With progressive islet infiltration, interleukin-1beta (IL-1beta) and tumor necrosis factor-alpha (TNF-alpha) were expressed in immune cells but not in beta-cells. This proinflammatory cytokine expression pattern coincided with the expression of inducible nitric oxide synthase (iNOS) and procaspase 3 in beta-cells and a peak apoptosis rate of 6.7%. Islet infiltration declined after manifestation of clinical diabetes, yielding end-stage islets devoid of beta-cells and immune cells without any sign of cytokine expression. The observed coincidence of IL-1beta and TNF-alpha expression in the immune cells and the induction of iNOS and procaspase 3 mRNA expression in the beta-cells depicts a sequence of pathological changes leading to apoptotic beta-cell death in the IDDM rat. This chain of events provides a mechanistic explanation for the development of the diabetic syndrome in this animal model of human type 1 diabetes.

THE HEALTHY RAT PROSTATE CONTAINS HIGH LEVELS OF NATURAL KILLER-LIKE CELLS AND UNIQUE SUBSETS OF CD4 + HELPER-INDUCER T CELLS: IMPLICATIONS FOR PROSTATITIS

PURPOSE

Chronic nonbacterial prostatitis spontaneously develops in aged Lewis and Wistar rats but not in Sprague-Dawley rats. We report the unique profile of lymphocyte subsets present in the healthy Sprague-Dawley rat prostate.

MATERIALS AND METHODS

We compared enzymatic and mechanical methods of intraprostatic lymphocyte isolation in healthy 8 to 10-week-old Sprague-Dawley rats. Mechanical isolation was chosen because of its superior preservation of surface antigens. Intraprostatic lymphocyte subsets were analyzed by flow cytometry.

RESULTS

Levels of prostatic alphabetaTCR+ T cells were similar and levels of prostatic B cells were decreased 5 to 10-fold compared with those found in other tissues (p </=0.005). Unexpectedly two-thirds of the total prostatic lymphocytes expressed the natural killer (NK) marker CD161a+. They were divided equally between NK (CD161a+alphabetaTCR) and NKT (CD161a+alphabetaTCR+) cells. Of prostatic CD161a+ cells 50% to 60% were also CD8+. Levels of NKT cells were dramatically lower in other tissues (p </=0.005) and they never accounted for more than 8% of total lymphocytes. The prostate contained lower levels of CD4+ T cells than all tissues except the liver (p </=0.005) and higher levels of CD8+ T cells than any other tissue studied (p </=0.05), resulting in an inverted CD4-to-CD8 ratio. CD45RC+CD4+alphabetaTCR+ T cells and CD161a+CD4+alphabetaTCR+ NKT cells were elevated in the prostate (p </=0.02).

CONCLUSIONS

The healthy rat prostate contains an unusually high proportion of NK and NKT cells. The balance between the CD45RC+CD4+alphabetaTCR+ T cells, which initiate the cell mediated immune response, and CD4+ NKT cells, which can suppress autoimmunity, may be a key in understanding the resistance of Sprague-Dawley rats to chronic nonbacterial prostatitis.

The immunoregulatory role of CD1d-restricted natural killer T cells in disease

Natural killer T (NKT) cells constitute a T cell subpopulation that shares several characteristics with NK cells. NKT cells are characterized by a narrow T cell antigen receptor (TCR) repertoire, recognize glycolipid antigen in the context of the monomorphic CD1d antigen-presenting molecule, and have the unique capacity to rapidly produce large amounts of both T helper (Th) 1 and Th2 cytokines. Important roles of NKT cells have now been demonstrated in the regulation of autoimmune, allergic, antimicrobial, and antitumor immune responses. Here, we review the immunoregulatory role of NKT cells in disease and discuss NKT cell based immunotherapeutic strategies.

Immune response modulation in acutely ethanol-intoxicated, acutely diabetic male and female rats

We examined how acute diabetes mellitus and acute ethanol intoxication modulate factors that mediate immune responses as a basis for explaining the increased susceptibility to infection in these two conditions. Our working hypothesis is that ethanol intoxication in diabetes compromises host defense mechanisms to a greater extent than observed in each condition alone. Male and female rats were made diabetic with streptozotocin (65 mg/kg, i.p.). Forty-eight hours after administration of streptozotocin, rats either received no treatment (control group) or were treated with (1) ethanol (bolus injection of 1.75 g/kg, followed by a 3-h infusion at the rate of 300 mg/kg/h), (2) lipopolysaccharide [(LPS); 0.9 mg/kg], or (3) a combination of LPS+ethanol. At the end of 3 h, rats were killed, and the livers were digested by perfusion with collagenase-containing Hanks' balanced salt solution to isolate hepatocytes and Kupffer cells. To measure chemokine generation, hepatocytes (2.5x10(5) cells per well) and Kupffer cells (1x10(6) cells per well) were cultured for 20 h, and the supernatant was used to measure cytokine-induced neutrophil chemoattractant (CINC) and regulated on activation, normal T-cell expressed and secreted (RANTES) chemokines. Phagocytosis by Kupffer cells was measured by flow cytometry and expressed as mean channel fluorescence intensity (MCF). Induction of diabetes as well as treatment of nondiabetic rats with LPS, ethanol, or LPS+ethanol caused depression of MCF values of Kupffer cells. However, treatment of the diabetic male and female rats with LPS and LPS+ethanol increased the MCF values relative to those of Kupffer cells obtained from untreated diabetic rats, but administration of ethanol to diabetic rats did not have a similar effect. The induction of diabetes caused an increase in CINC generation by Kupffer cells obtained from male rats, but not from female rats. This diabetes-induced elevation of chemoattractant factor was decreased when diabetic animals were treated with LPS, ethanol, or LPS+ethanol, and the sex difference was obliterated. Thus, the induction of diabetes as well as treatment with LPS, ethanol, or LPS+ethanol in nondiabetic rats depressed the phagocytic capability of Kupffer cells, whereas the presence of endotoxemia (administration of the endotoxin LPS) or administration of LPS+ethanol reversed the diabetic effect, but ethanol intoxication did not. These findings seem to indicate a persistence of depression of host defense capacity in the ethanol-intoxicated diabetic condition. This is further reinforced by the depression of the diabetes-induced enhancement of chemotaxis when the diabetic rats became intoxicated.

Cytokine sensitivity of Langerhans' islets of diabetes-prone BB/OK rats under hypoglycemic conditions

Islets of Langerhans isolated from diabetes-prone BB/OK rats were exposed to interleukin-1beta (IL-1beta) or to a combination of tumor necrosis factor-alpha (TNF-alpha) plus interferon-gamma (IFN-gamma) under hypoglycemia at glucose concentrations of 2.2 and 3.2 mmol/l or in the presence of stimulatory conditions at 6.0 and 11 mmol/l glucose. For estimating cytokine effects the islets were functionally assayed by measurement of glucose stimulated insulin secretion. Pancreatic islets exposed for 24 h to IL-1beta at a glucose concentration of 6.0 mmol/l exhibited a reduced insulin secretion following a 48h recovery period compared to islets which were cytokine treated at 2.2 or 3.2mmol/l glucose, respectively. Islets pre-exposed for 24h to TNF-alpha plus IFN-gamma at 2.2, 3.2 or 6.0 mmol/l glucose displayed no alterations of insulin secretion following a 48 h regeneration. A temporary (3 h) influence of IL-1beta under hyperglycemic conditions at 11 mmol/l glucose caused a reduction of the subsequent insulin secretion of Langerhans' islets prior incubated for 24 h at 6.0 mmol/l glucose without cytokines, but not of islets precultured at 2.2 mmol/l glucose. In contrast, a 3 h treatment with TNF-alpha plus IFN-gamma at 11 mmol/l glucose did not affect insulin secretion of islets prior held at 6.0 mmol/l glucose, whereas a transient exposure for 6h to IL-1beta as well as TNF-alpha plus IFN-gamma under similar conditions diminished insulin secretion of islets preincubated at 2.2 or 6.0 mmol/l glucose. In conclusion, hypoglycemia reduces the sensitivity of BB/OK rat islets to IL-1beta, whereas a slight elevation of glucose concentration to 6.0 mmol/l increases again their vulnerability. TNF-alpha plus IFN-gamma at concentrations capable to decrease insulin secretion of islets during hyperglycemia do not affect the insulin output in a range between 2.2 and 6.0 mmol/l glucose. During glucose stimulation at 11 mmol/l islets' insulin secretory machinery is protected from IL-1beta as well as TNF-alpha plus IFN-gamma for 3 h by a preceding 24 h hypoglycemia, but its vulnerability is restored within additional 3 h.

The regulatory role of Valpha14 NKT cells in innate and acquired immune response

A novel lymphocyte lineage, Valpha14 natural killer T (NKT) cells, is now well established as distinct from conventional alphabeta T cells. Valpha14 NKT cells express a single invariant Valpha14 antigen receptor that is essential for their development. Successful identification of a specific ligand, alpha-galactosylceramide(alpha-GalCer), and the establishment of gene-manipulated mice with selective loss of Valpha14 NKT cells helped elucidate the remarkable functional diversity of Valpha14 NKT cells in various immune responses such as host defense by mediating anti-nonself innate immune reaction, homeostatic regulation of anti-self responses, and antitumor immunity.

A functional polymorphism in the promoter/enhancer region of the FOXP3/Scurfin gene associated with type 1 diabetes

FOXP3/Scurfin, a member of forkhead/winged-helix proteins, is involved in the regulation of T-cell activation, and essential for normal immune homeostasis. The FOXP3/Scurfin gene is located on chromosome Xp11.23, which includes one of the type 1 diabetes susceptible loci. Therefore, we investigated whether the human FOXP3/Scurfin gene might be a new candidate gene for type 1 diabetes. We first screened the human FOXP3/Scurfin gene for microsatellite and single nucleotide polymorphisms. Next, we performed an association study between the FOXP3/Scurfin gene and type 1 diabetes. Then, the evaluation of promoter/enhancer activity of the intron with (GT)(n) polymorphism was performed by dual luciferase reporter assay. We demonstrated two regions contained microsatellite polymorphisms; one was (GT)(n), located on intron zero and the other (TC)(n) on intron 5, which were under linkage-disequilibrium. The (GT)(15) allele showed a significantly higher frequency in patients with type 1 diabetes than in controls (43.1% vs 32.6%, P=0.0027). The genotype frequencies of (GT)(15)/(GT)(15) in female patients and of (GT)(15) in male patients tended to be higher than those in female ( P=0.064) and male ( P=0.061) controls, respectively. A significant difference in the enhancer activity between (GT)(15) and (GT)(16) dinucleotide repeats was detected. In conclusion, the FOXP3/Scurfin gene appears to confer a significant susceptibility to type 1 diabetes in the Japanese population.

Infections that induce autoimmune diabetes in BBDR rats modulate CD4+CD25+ T cell populations

Viruses are believed to contribute to the pathogenesis of autoimmune type 1A diabetes in humans. This pathogenic process can be modeled in the BBDR rat, which develops pancreatic insulitis and type 1A-like diabetes after infection with Kilham's rat virus (RV). The mechanism is unknown, but does not involve infection of the pancreatic islets. We first documented that RV infection of BBDR rats induces diabetes, whereas infection with its close homologue H-1 does not. Both viruses induced similar humoral and cellular immune responses in the host, but only RV also caused a decrease in splenic CD4(+)CD25(+) T cells in both BBDR rats and normal WF rats. Surprisingly, RV infection increased CD4(+)CD25(+) T cells in pancreatic lymph nodes of BBDR but not WF rats. This increase appeared to be due to the accumulation of nonproliferating CD4(+)CD25(+) T cells. The results imply that the reduction in splenic CD4(+)CD25(+) cells observed in RV-infected animals is virus specific, whereas the increase in pancreatic lymph node CD4(+)CD25(+) cells is both virus and rat strain specific. The data suggest that RV but not H-1 infection alters T cell regulation in BBDR rats and permits the expression of autoimmune diabetes. More generally, the results suggest a mechanism that could link an underlying genetic predisposition to environmental perturbation and transform a "regulated predisposition" into autoimmune diabetes, namely, failure to maintain regulatory CD4(+)CD25(+) T cell function.

NKT cell defects in NOD mice suggest therapeutic opportunities

Recent studies have reported that immunoregulatory NKT cells are defective in NOD mice and that treatment of mice with alpha-galactosylceramide that selectively stimulate NKT cells, is anti-diabetogenic. The objective of this study was to document the natural history of changes in NKT cells in various organs in NOD mice in the period up to the time of diabetes onset so that novel intervention therapies could be devised. We found that NKT cell-specific receptor (NKT-TCR) Valpha14Jalpha281 expressions by quantitative (RealTime) RT-PCR in thymus, spleen and liver of NOD male and female mice were low at 1-3 months of life compared to BALB/c and C57BL/6 mice, albeit a transient spike in levels occurred in female NOD livers at 2 months. Female pancreases showed low levels of these transcripts despite their active and destructive insulitis. In contrast, NOD males exhibited high expression of this invariant TCR in pancreas, where their insulitis was less destructive. A survey of NKT-TCR expressions in a battery of congenic, non-diabetes prone NOD strains indicated that this NKT phenotype was quite variable but higher than diabetes prone NOD. Bone marrow transplantation of NOD females from B6.NOD-H2(g7) donors raised their NKT-TCR expressions. Tuberculin administrations in the forms of BCG and CFA in a manner known to protect NOD mice from diabetes both raised NKT-TCR levels, as did the anti-inflammatory PPAR-gamma agonist rosiglitazone. These findings provide exciting therapeutic avenues to be explored in the treatment of human immune mediated type-1 diabetes where there are similar immunoregulatory lesions.

Regulatory natural killer T cells protect against spontaneous and recurrent type 1 diabetes

Autoimmune diseases, especially type 1 diabetes (T1D), may be caused by dysregulation of the immune system, which leads to hyporesponsiveness of regulatory T helper 2 (Th2) cells and promotion of autoimmune Th1 cells. Natural killer T (NKT) cells, which comprise a minor subpopulation of T cells, play a critical role in immunoregulation as a result of a rapid burst of IL-4 and IFN-gamma secretion. These cells are functionally and numerically deficient in individuals at risk of T1D, as well as in nonobese diabetic (NOD) mice. It is conceivable that protection from T1D may be achieved by correction of this deficiency. Alpha-galactosylceramide (alpha-GalCer) specifically binds to NKT cells in a CD1-dependent manner and stimulates these cells to proliferate and to produce various cytokines, including IFN-gamma, IL-4, and IL-10. In this review, we present evidence that a multiple-dose alpha-GalCer treatment regimen, which is known to promote a dominant Th2 environment, can prevent the onset of spontaneous and cyclophosphamide (CY)-accelerated T1D. This protection is associated with elevated IL-4 and IL-10 in the spleen and pancreas of protected female NOD mice. Concomitantly, IFN-gamma levels are reduced in both tissues. More importantly, the protective effect of gamma-GalCer in CY-accelerated T1D is abrogated by the in vivo blockade of IL-10 activity. We also show that alpha-GalCer treatment significantly prolongs syngeneic islet graft survival in recipient diabetic NOD mice. These findings raise the possibility that alpha-GalCer treatment may be used therapeutically to prevent the onset and recurrence of human T1D.

T-cell education in autoimmune diabetes: teachers and students

Type 1 diabetes mellitus is a classical example of a T-cell-mediated autoimmune disease. Several aberrations in immune regulation have been described in both human diabetes patients and animal models of type 1 diabetes. In this review, we summarize how proposed immune defects might be implicated in the loss of T-cell tolerance towards self in autoimmune diabetes in humans, nonobese diabetic (NOD) mice and Biobreeding (BB) rats. For this purpose, we will discuss the tolerance-inducing mechanisms that an autoreactive T cell should encounter from its genesis to its pathogenic role in the pancreas, in order of appearance. These comprise central tolerance mechanisms (i.e. positive and negative selection in the thymus) and those mechanisms operative in the periphery (i.e. activation-induced cell death and regulatory T cells).

Activation of CD1d-restricted T cells protects NOD mice from developing diabetes by regulating dendritic cell subsets

CD1d-restricted invariant NKT (iNKT) cells are immunoregulatory cells whose loss exacerbates diabetes in nonobese diabetic (NOD) female mice. Here, we show that the relative numbers of iNKT cells from the pancreatic islets of NOD mice decrease at the time of conversion from peri-insulitis to invasive insulitis and diabetes. Conversely, NOD male mice who have a low incidence of diabetes showed an increased frequency of iNKT cells. Moreover, administration of alpha-galactosylceramide, a potent activating ligand presented by CD1d, ameliorated the development of diabetes in NOD female mice and resulted in the accumulation of iNKT cells and myeloid dendritic cells (DC) in pancreatic lymph nodes (PLN), but not in inguinal lymph nodes. Strikingly, injection of NOD female mice with myeloid DC isolated from the PLN, but not those from the inguinal lymph nodes, completely prevented diabetes. Thus, the immunoregulatory role of iNKT cells is manifested by the recruitment of tolerogenic myeloid DC to the PLN and the inhibition of ongoing autoimmune inflammation.

Clinical application of NKT cell assays to the prediction of type 1 diabetes

Type 1 diabetes is a disease characterised by disturbed glucose homeostasis, which results from autoimmune destruction of the insulin-producing beta cells in the pancreas. The autoimmune attack, while not yet fully characterised, exhibits components of both mis-targeting and failed tolerance induction. The involvement of non-classical lymphocytes in the induction and maintenance of peripheral tolerance has recently been recognised and natural killer T (NKT) cells appear to play such a role. NKT cells are a subset of T cells that are distinct in being able to produce cytokines such as IL-4 and IFN-gamma extremely rapidly following activation. These lymphocytes also express some surface receptors, and the lytic activity, characteristic of NK cells. Deficiencies in NKT cells have been identified in animal models of type 1 diabetes, and a causal association has been demonstrated by adoptive transfer experiments in diabetes-prone NOD mice. Preliminary work suggests that a similar relationship may exist between deficiencies in NKT cells and type 1 diabetes in humans, although the techniques reported to date would be difficult to translate to clinical use. Here, we describe methods appropriate to the clinical assessment of NKT cells and discuss the steps required in the assessment and validation of NKT cell assays as a predictor of type 1 diabetes.

Circulating V(alpha24+) Vbeta11+ NKT cell numbers are decreased in a wide variety of diseases that are characterized by autoreactive tissue damage

Natural killer T (NKT) cells have been implicated as playing an important role in regulating immune responses. Defects in the NKT cell population were reported in animal autoimmune disease models and in distinct human autoimmune diseases. Here, we report that circulating V(alpha24+) Vbeta11+ NKT cell numbers are decreased in a broad variety of disorders with (auto)immune-mediated pathology, affecting the skin, bowel, central nervous system, and joints, regardless of disease duration or activity. Remarkably, normal circulating V(alpha24+) Vbeta11+ NKT cell numbers were found in Graves disease and coeliac disease. Since earlier studies noted a rise in NKT cells in myasthenia gravis, the picture emerges in which a defective NKT cell population is associated with autoreactive tissue damage rather than with the propensity to develop autoimmune disease. The present data support the idea that therapies aiming at the in vivo expansion of regulatory NKT cells might help to control immune-mediated damage in autoimmune disease.

Impaired Th1 cytokine production in spondyloarthropathy is restored by anti-TNFalpha

OBJECTIVES

To evaluate the effect of anti-TNFalpha on the Th1 and Th2 cytokines in patients with spondyloarthropathy (SpA).

METHODS

Peripheral blood mononuclear cells (PBMC) were obtained from 20 patients with active SpA treated with infliximab (5 mg/kg). For comparison, PBMC were also obtained from 15 healthy controls and 19 patients with active rheumatoid arthritis (RA). After stimulation with PMA/ionomycin, the intracellular cytokines interleukin (IL)2, IL4, IL10, and interferon (IFN)gamma were determined in CD3+ T cells and in CD3+/CD56+ natural killer (NK) T cells by flow cytometry.

RESULTS

At baseline the percentage of T cells positive for IFNgamma (p=0.020) and IL2 (p=0.046) was decreased in patients with SpA compared with healthy controls, while IL10 (p=0.001) was increased. This cytokine profile, confirmed by the mean fluorescence intensities (MFI), was more pronounced in CD3+/CD8- cells and contrasted with higher IL2 production in RA. NK T cells, characterised by high IL4 and IL10 numbers, were also increased in patients with SpA (p=0.017). Treatment with infliximab induced a significant and persistent increase in IFNgamma and IL2 in patients with SpA. Moreover, there was a transient decrease in IL10 and NK T cells in patients with high baseline values, resulting in values comparable with those of healthy controls. This switch in cytokine profile was seen in both the CD3+/CD8- and CD3+/CD8+ subsets.

CONCLUSIONS

Before treatment patients with SpA had an impaired Th1 cytokine profile compared with healthy controls and patients with RA. TNFalpha blockade induced restoration of the Th1 cytokines, resulting in a normal cytokine balance. These data confirm the effect of anti-TNFalpha on the immune changes in SpA, and provide insights into the mechanisms involved in TNFalpha blockade.

Insulin binds to glucagon forming a complex that is hyper-antigenic and inducing complementary antibodies having an idiotype-antiidiotype relationship

We demonstrate using physico-chemical techniques that insulin binds to glucagon with a Kd of 0.89 micromolar. While such binding is of little significance physiologically, it has important immunological consequences. Hormone binding is mirrored by specific binding between insulin antibody and glucagon antibody to form idiotype-antiidiotype complexes observable by Ouchterlony immunodiffusion and ELISA. These complexes may provide new insights into the formation of circulating immune complexes in diabetes. The insulin-glucagon complex is hyper-antigenic, inducing antibody production at concentrations that do not elicit immune responses from the individual hormones. The resulting immune response is not primarily against the individual hormones, but against the complex. In fact, all so-called insulin antibodies tested (rabbit, guinea pig, mouse and human) show substantially higher affinity for insulin-glucagon complex than for insulin alone, suggesting that this complex is the primary antigen in most, if not all, cases. These results lead to several testable predictions, including the possibility that glucagon antibody will bind to insulin receptors to cause type 2 (antibody mediated) insulin resistance.

Protection against diabetes and improved NK/NKT cell performance in NOD.NK1.1 mice congenic at the NK complex

The NK1.1 cell surface receptor, which belongs to the NKR-P1 gene cluster, has been bred onto nonobese diabetic (NOD) mice for two purposes. The first was to tag NK and NKT cells for easier experimental identification of those subsets and better analysis of their implication in type 1 diabetes. The second was to produce a congenic strain carrying Idd6, a susceptibility locus that has been repeatedly mapped in the vicinity of the NKR-P1 gene cluster and the NK complex, to explore the impact of this locus upon autoimmune diabetes. NOD.NK1.1 mice express the NK1.1 marker selectively on the surface of their NK and NKT cell subsets. In addition, the mice manifest reduced disease incidence and improved NK and NKT cell performance, as compared with wild-type NOD mice. The association of those two features in the same congenic strain constitutes a strong argument in favor of Idd6 being associated to the NK complex. This could explain at the same time the multiple alterations of innate immunity reported in NOD mice and the fact that disease onset can be readily modified by boosting the innate immune system of the mouse.

NKT cells: facts, functions and fallacies

The proposed roles of NK1.1(+) T (NKT) cells in immune responses range from suppression of autoimmunity to tumor rejection. Heterogeneity of these cells contributes to the controversy surrounding their development and function. This review aims to provide an update on NKT cell biology and, whenever possible, to compare what is known about NKT-cell subsets.