Latent EBV impairs immune cell signaling and enhances the efficacy of anti-CD3 mAb in Type 1 Diabetes

Teplizumab has been approved for the delay of the onset of type 1 diabetes and may modulate new onset disease. We found that patients who were EBV positive at baseline had a more robust response to drug in two clinical trials and therefore postulated that latent virus has general effects in modifying immune responses. We compared the phenotypes, transcriptomes, and development of peripheral blood cells before and after teplizumab treatment. Higher number of Tregs and partially exhausted CD8 + T cells were found in EBV seropositive individuals at the baseline in the TN10 trial and AbATE trial. Single cell transcriptomics and functional assays identified downregulation of the T cell receptor and other signaling pathways before treatment. Impairments in function of adaptive immune cells were enhanced by teplizumab treatment in EBV seropositive individuals. Our data indicate that EBV can impair signaling pathways generally in immune cells, that broadly redirect cell differentiation.

Endothelial Cell-Specific Molecule-1 Inhibits Albuminuria in Diabetic Mice

Background

Diabetic kidney disease (DKD) is the most common cause of kidney failure in the world, and novel predictive biomarkers and molecular mechanisms of disease are needed. Endothelial cell-specific molecule-1 (Esm-1) is a secreted proteoglycan that attenuates inflammation. We previously identified that a glomerular deficiency of Esm-1 associates with more pronounced albuminuria and glomerular inflammation in DKD-susceptible relative to DKD-resistant mice, but its contribution to DKD remains unexplored.

Methods

Using hydrodynamic tail-vein injection, we overexpress Esm-1 in DKD-susceptible DBA/2 mice and delete Esm-1 in DKD-resistant C57BL/6 mice to study the contribution of Esm-1 to DKD. We analyze clinical indices of DKD, leukocyte infiltration, podocytopenia, and extracellular matrix production. We also study transcriptomic changes to assess potential mechanisms of Esm-1 in glomeruli.

Results

In DKD-susceptible mice, Esm-1 inversely correlates with albuminuria and glomerular leukocyte infiltration. We show that overexpression of Esm-1 reduces albuminuria and diabetes-induced podocyte injury, independent of changes in leukocyte infiltration. Using a complementary approach, we find that constitutive deletion of Esm-1 in DKD-resistant mice modestly increases the degree of diabetes-induced albuminuria versus wild-type controls. By glomerular RNAseq, we identify that Esm-1 attenuates expression of kidney disease-promoting and interferon (IFN)-related genes, including Ackr2 and Cxcl11.

Conclusions

We demonstrate that, in DKD-susceptible mice, Esm-1 protects against diabetes-induced albuminuria and podocytopathy, possibly through select IFN signaling. Companion studies in patients with diabetes suggest a role of Esm-1 in human DKD.

TLR9 limits mouse and human B cell responses

TLR9 can augment B cell activation, but also prevents autoimmune pathogenesis through an unknown mechanism. Herein we describe a cell-intrinsic mechanism that limits the extent of B cell activation by TLR9 ligands delivered by the B cell antigen receptor. This self-limiting response requires that TLR agonists be linked with B cell receptor ligands, as it is not observed with independent B cell receptor and TLR9 ligation. The underlying mechanism involves p38 dependent G1 cell cycle arrest that precedes intrinsic mitochondrial apoptosis, and is shared by all pre-immune murine B cell subsets and CD27− human B cells. B cells can be rescued from this death mechanism by survival or inflammatory cytokines, and preferentially switch to IgG2c producing cells both in vitro and in vivo. These findings reveal a previously unappreciated system of crosstalk that limits responses to antigens containing TLR9 ligands, and suggest that circumventing this response-limiting process can promote sustained autoantibody production.

The role of germinal centers in T cell receptor revision (P1421)

Vβ5 transgenic CD4 T cells are tolerized to the endogenous superantigen Mtv-8 by either deletion or TCR revision. Revision occurs when a peripheral CD4 T cell downregulates Vβ5 and undergoes RAG-mediated recombination and surface expression of an endogenous TCR. Given that revision occurs in germinal centers, and that follicular helper T cells, or Tfh, in Vβ5 Tg mice increase in an Mtv-8-dependent manner, we are studying whether revising cells have a Tfh phenotype and whether germinal center interactions are required for revision. Revising cells have a transcription factor and surface phenotype resembling that of Tfh, with low Blimp-1 and elevated Bcl-6, CXCR5, PD-1, IL-21 receptor, and OX-40 expression. The frequency of post-revision T cells increases in mice heterozygous for Blimp-1, a transcriptional repressor of Tfh formation, but revision intermediates are unaffected. The adaptor molecule SAP is required for prolonged B and T cell interactions in the germinal center, and SAP null mice have reduced numbers of post-revision T cells, but no reduction in revision intermediates. These results suggest that revising T cells share some traits with Tfh and that Tfh formation and prolonged B-T cell interactions are required for the completion, but not initiation, of TCR revision. Ongoing studies will analyze revision in the absence of Bcl-6, a transcription factor required for Tfh formation, and TNFR1, a receptor required for the formation of germinal center structures.

The role of germinal centers in T cell receptor revision (160.10)

CD4+ T cells in Vβ5 transgenic mice become tolerant to an endogenous superantigen through either deletion or T cell receptor (TCR) revision. In the revision process, T cells downregulate surface Vβ5 expression and undergo RAG-mediated rearrangement and expression of endogenous TCRs. Revision occurs in germinal centers (GCs), suggesting that revising T cells may be follicular helper T cells (Tfh). We are studying whether revising T cells have a Tfh phenotype and whether GC interactions are required for revision. Preliminary data indicate that revising T cells have an RNA phenotype closely resembling that of Tfh and distinct from that of post-revision T cells. Studies on the intracellular and surface phenotype of revising and post-revision T cells are ongoing. The importance of GCs to TCR revision is being analyzed using SAP and CXCR5 null mice. SAP is required for prolonged interactions of B and T cells in the GC, and CXCR5 is required for cellular migration into the follicle. Analyses of mixed chimeras generated using CXCR5 null and wildtype bone marrow donors are ongoing. CXCR5 and SAP null mice have reduced numbers of post-revision T cells, but no reduction in revision intermediates. These results suggest that migration into the follicle and prolonged B-T cell interactions are both required for completion, but not initiation, of TCR revision.