Inflammation is typically induced in response to a microbial infection. The release of proinflammatory cytokines enhances the stimulatory capacity of antigen-presenting cells, as well as recruits adaptive and innate immune effectors to the site of infection. Once the microbe is cleared, inflammation is resolved by various mechanisms to avoid unnecessary tissue damage. Autoimmunity arises when aberrant immune responses target self-tissues causing inflammation. In type 1 diabetes (T1D), T cells attack the insulin producing β cells in the pancreatic islets. Genetic and environmental factors increase T1D risk by in part altering central and peripheral tolerance inducing events. This results in the development and expansion of β cell-specific effector T cells (Teff) which mediate islet inflammation. Unlike protective immunity where inflammation is terminated, autoimmunity is sustained by chronic inflammation. In this review, we will highlight the key events which initiate and sustain T cell-driven pancreatic islet inflammation in nonobese diabetic mice and in human T1D. Specifically, we will discuss: (i) dysregulation of thymic selection events, (ii) the role of intrinsic and extrinsic factors that enhance the expansion and pathogenicity of Teff, (iii) defects which impair homeostasis and suppressor activity of FoxP3-expressing regulatory T cells, and (iv) properties of β cells which contribute to islet inflammation.

The property of functional avidity is recognized to be of critical importance in determining pathogen clearance. An unresolved question with regard to this property is whether distinct naive subsets exist that display inherent differences in their peptide sensitivity requirements for activation, i.e., functional avidity, or whether differences in peptide sensitivity are induced following peptide encounter. In this study, we demonstrate that naive populations that can give rise to both high- and low-avidity cells do not contain subsets that exhibit differences in the amount of peptide required for activation. Furthermore, we show that an individual T cell clone can generate both high- and low-avidity effectors. The work presented here provides the first formal demonstration that an individual cell can give rise to both high- and low-avidity progeny, suggesting that avidity modulation at the level of an individual cell may play an important role in the CD8+ T cell response generated in vivo.

Summary The generation of an optimal CD8+ cytotoxic T lymphocyte (CTL) response is critical for the clearance of many intracellular pathogens. Previous studies suggest that one contributor to an optimal immune response is the presence of CD8+ cells exhibiting high functional avidity. In this regard, CD8 expression has been shown to contribute to peptide sensitivity. Here, we investigated the ability of naive splenocytes to modulate CD8 expression according to the concentration of stimulatory peptide antigen. Our results showed that the level of CD8 expressed was inversely correlated with the amount of peptide used for the primary stimulation, with higher concentrations of antigen resulting in lower expression of both CD8α and CD8β. Importantly the ensuing CD8low and CD8high CTL populations were not the result of the selective outgrowth of naive CD8+ T‐cell subpopulations expressing distinct levels of CD8. Subsequent encounter with peptide antigen resulted in continued modulation of both the absolute level and the isoform of CD8 expressed and in the functional avidity of the responding cells. We propose that CD8 cell surface expression is not a static property, but can be modulated to ‘fine tune’ the sensitivity of responding CTL to a defined concentration of antigen.

Inefficient thymic negative selection of self-specific T cells is associated with several autoimmune diseases, including type 1 diabetes (T1D). The factors that influence the efficacy of thymic negative selection, and the kinetics of thymic output of autoreactive T cells remain ill-defined. We investigated thymic production of β cell-specific T cells using a thymus transplantation model. Thymi from different aged NOD mice representing distinct stages of T1D, were implanted into NOD.scid recipients and the diabetogenicity of the resulting T cell pool examined. Strikingly, the development of diabetes-inducing β cell-specific CD4+ and CD8+ T cells was regulated in an age-dependent manner. NOD.scid recipients of newborn NOD thymi developed diabetes. However, recipients of thymi from 7 and 10 d-old NOD donor mice remained diabetes-free, and exhibited a progressive decline in islet infiltration and β cell-specific CD4+ and CD8+ T cells. A similar temporal decrease in autoimmune infiltration was detected in some but not all tissues of recipient mice implanted with thymi from NOD mice lacking expression of the autoimmune regulator transcription factor, which develop multi-organ T cell-mediated autoimmunity. In contrast, recipients of 10 d or older thymi lacked diabetogenic T cells but developed severe colitis marked by increased effector T cells reactive to intestinal microbiota. These results demonstrate that thymic development of autoreactive T cells is limited to a narrow time-window, and occurs in a reciprocal manner compared to colonic microbiota-responsive T cells in NOD mice.

T cell-mediated autoimmune diseases such as type 1 diabetes (T1D) are believed to be the result in part of inefficient negative selection of self-specific thymocytes. However, the events regulating thymic negative selection are not fully understood. In the current study, we demonstrate that nonobese diabetic (NOD) mice lacking expression of the Mer tyrosine kinase (MerTK) have reduced inflammation of the pancreatic islets and fail to develop diabetes. Furthermore, NOD mice deficient in MerTK expression (Mer ؊/؊ ) exhibit a reduced frequency of ␤ cell-specific T cells independent of immunoregulatory effectors. The establishment of bone marrow chimeric mice demonstrated that the block in ␤ cell autoimmunity required hematopoietic-derived cells lacking MerTK expression. Notably, fetal thymic organ cultures and self-peptide administration showed increased thymic negative selection in Mer ؊/؊ mice. Finally, thymic dendritic cells (DC) prepared from Mer ؊/؊ mice exhibited an increased capacity to induce thymocyte apoptosis in a peptide-specific manner in vitro. These findings provide evidence for a unique mechanism involving MerTK-mediated regulation of thymocyte negative selection and thymic DC, and suggest a role for MerTK in contributing to ␤ cell autoimmunity. can result in the development of T cell mediated autoimmune diseases such as type 1 diabetes (T1D), multiple sclerosis, and rheumatoid arthritis (8-11). The failure in T cell tolerance is generally influenced by a number of genes, most of which have yet to be identified (12). In the nonobese diabetic (NOD) mouse, a spontaneous model for T1D, both inefficient negative selection and dysregulation of peripheral tolerance mechanisms contribute to the development and activation, respectively, of pathogenic T cells that target the insulin producing ␤ cells found in the islets of Langerhans (13). Inefficient negative selection in NOD mice is partly the result of the peptide binding properties of the MHC class II molecule IA g7 , and the relative insensitivity of NOD CD4 ϩ CD8 ϩ double-positive (DP) thymocytes to apoptosis-inducing events (9,14,15). One intriguing possibility is that the efficiency of negative selection is also regulated by the activation and/or functional state of medullary thymic epithelial cells (mTEC) and resident dendritic cells (DC). For instance events that regulate the avidity between DP thymocytes and mTEC and/or thymic DC may influence the efficiency of negative selection. This is likely similar to mechanisms in the periphery.The activation and maturation status of peripheral DC is critical for determining the outcome of a T cell response (16). Immature DC found under homeostatic conditions are characterized by low levels of MHC and T cell costimulatory molecules such as CD40, CD80, and CD86, and typically mediate clonal anergy/deletion of naïve T cells (17). However, upon activation and subsequent maturation, DC upregulate MHC and costimulatory molecules and secrete proinflammatory cytokines to promote robust expansion and effector T cell...

Thymic dendritic cells (DC) delete self-Ag-specific thymocytes, and drive development of FoxP3-expressing immunoregulatory T cells. Unlike medullary thymic epithelial cells (mTEC), which express and present peripheral self-Ag, DC must acquire self-Ag to mediate thymic negative selection. One such mechanism entails the transfer of surface MHC-self peptide complexes from mTEC to thymic DC. Despite the importance of thymic DC “cross-dressing” in negative selection, the factors that regulate the process, and the capacity of different thymic DC subsets to acquire MHC and stimulate thymocytes are poorly understood. Here intercellular MHC transfer by thymic DC subsets was studied using a MHC-mismatch-based in vitro system. Thymic conventional DC (cDC) subsets SIRPα+ and CD8α+ readily acquired MHC class I and II from TEC but plasmacytoid DC (pDC) were less efficient. Intercellular MHC transfer was donor cell-specific; thymic DC readily acquired MHC from TEC plus thymic or splenic DC, whereas thymic or splenic B cells were poor donors. Furthermore DC origin influenced cross-dressing; thymic versus splenic DC exhibited an increased capacity to capture TEC-derived MHC, which correlated with direct expression of EpCAM by DC. Despite similar capacities to acquire MHC-peptide complexes, thymic CD8α+ cDC elicited increased T cell stimulation relative to SIRPα+ cDC. DC cross-dressing was cell-contact dependent and unaffected by lipid raft disruption of donor TEC. Furthermore, blocking PI3K signaling reduced MHC acquisition by thymic CD8α+ cDC and pDC but not SIRPα+ cDC. These findings demonstrate that multiple parameters influence the efficiency of and distinct mechanisms drive intercellular MHC transfer by thymic DC subsets.

Type 1 diabetes (T1D) is a common autoimmune disease with no cure. T1D subjects are dependent on daily exogenous insulin administration, due to the loss of functional insulin-producing β cells. Needed are immunotherapies that prevent and/or treat T1D. One approach of immunotherapy is to administer an autoantigen to selectively tolerize diabetogenic effector T cells without global immunosuppression. To date, however, strategies of antigen-specific immunotherapy are largely ineffective in the clinic. Using an antigen-specific approach, a biodegradable polymeric delivery vehicle, acetalated dextran microparticles (Ace-DEX MPs), is applied and T1D development is prevented through coadministration of the immunosuppressant rapamycin and the diabetogenic peptide P31 (Rapa/P31/MPs), via alterations of both innate and adaptive immunity. Ex vivo, adoptively transferred CD4 T cells exhibit reduced proliferation and an increased ratio of FoxP3 to IFNγ T cells. In vitro analysis indicates dendritic cells exhibit a less mature phenotype following coculture with Rapa/P31/MPs, which results in reduced CD4 T cell proliferation and proinflammatory cytokine production (IFNγ and IL-2), but promotes PD-1 expression. Together these results demonstrate Ace-DEX MP-based antigen-specific therapy effectively tolerizes diabetogenic CD4 T cells to prevent T1D, thereby demonstrating one of the first successful attempts of T1D prevention using a single-formulation particulate delivery platform.

Type 1 diabetes (T1D) is an autoimmune disease that is generally considered to be T cell-driven. Accordingly, most strategies of immunotherapy for T1D prevention and treatment in the clinic have targeted the T cell compartment. To date, however, immunotherapy has had only limited clinical success. Although certain immunotherapies have promoted a protective effect, efficacy is often short-term and acquired immunity may be impacted. This has led to the consideration of combining different approaches with the goal of achieving a synergistic therapeutic response. In this review, we will discuss the status of various T1D therapeutic strategies tested in the clinic, as well as possible combinatorial approaches to restore β cell tolerance.