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CD19+IgM+ cells demonstrate enhanced therapeutic efficacy in type 1 diabetes mellitus
Andrew D. Vonberg, Maria Acevedo-Calado, Aaron R. Cox, Susan L. Pietropaolo, Roberto Gianani, Steven K. Lundy, Massimo Pietropaolo
Andrew D. Vonberg, Maria Acevedo-Calado, Aaron R. Cox, Susan L. Pietropaolo, Roberto Gianani, Steven K. Lundy, Massimo Pietropaolo
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Research Article Immunology

CD19+IgM+ cells demonstrate enhanced therapeutic efficacy in type 1 diabetes mellitus

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Abstract

We describe a protective effect on autoimmune diabetes and reduced destructive insulitis in NOD.scid recipients following splenocyte injections from diabetic NOD donors and sorted CD19+ cells compared with NOD.scid recipients receiving splenocytes alone. This protective effect was age specific (only CD19+ cells from young NOD donors exerted this effect; P < 0.001). We found that the CD19+IgM+ cell is the primary subpopulation of B cells that delayed transfer of diabetes mediated by diabetogenic T cells from NOD mice (P = 0.002). Removal of IgM+ cells from the CD19+ pool did not result in protection. Notably, protection conferred by CD19+IgM+ cotransfers were not dependent on the presence of Tregs, as their depletion did not affect their ability to delay onset of diabetes. Blockade of IL-10 with neutralizing antibodies at the time of CD19+ cell cotransfers also abrogated the therapeutic effect, suggesting that IL-10 secretion was an important component of protection. These results were strengthened by ex vivo incubation of CD19+ cells with IL-5, resulting in enhanced proliferation and IL-10 production and equivalently delayed diabetes progression (P = 0.0005). The potential to expand CD19+IgM+ cells, especially in response to IL-5 stimulation or by pharmacologic agents, may be a new therapeutic option for type 1 diabetes.

Authors

Andrew D. Vonberg, Maria Acevedo-Calado, Aaron R. Cox, Susan L. Pietropaolo, Roberto Gianani, Steven K. Lundy, Massimo Pietropaolo

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Figure 4

Dual-sorting B cells to purify CD19+IgM+ leads to increased protection over CD19+ single sorting, but removal of IgM+ cells inhibits the protective effect of CD19+ cell cotransfers.

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Dual-sorting B cells to purify CD19+IgM+ leads to increased protection o...
(A) Survival curve for group comparison between female NOD.scid mice receiving diabetic splenocytes (n = 6, solid line), splenocytes plus CD19+ cells from 6-week-old NOD donors (n = 5, dashed line), splenocytes plus CD19+IgM+ dual-sorted cells from 6-week-old NOD donors (n = 8, dotted line), and splenocytes plus CD19+IgM– dual-sorted cells from 6-week-old NOD donors (n = 6, dot-dashed line). The population values represent number of diabetes-free mice at each time-point. (B) Insulitis scoring results from pancreatic sections stained with H&E of NOD.scid recipients that received either diabetic splenocytes (n = 6 mice), splenocytes cotransferred with bead-purified CD19+IgM+ cells from 6-week-old NOD donors (n = 8 mice), or splenocytes cotransferred with CD19+IgM– cells purified from 6-week-old NOD female donors (n = 6 mice). Islets were individually scored on a 1–4 scale of increasing insulitis severity, and the percentage of each score as a part of the whole was graphically represented. (C) B cell repertoire of CD19+IgM+ cells taken from the pancreatic lymph nodes of a NOD.scid recipient receiving dual-sorted CD19+IgM+ cells. Cells initially gated on CD19+IgM+ and then subgated by CD21/35 and CD23.

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