[HTML][HTML] CD4+ CD25+ CD127hi cell frequency predicts disease progression in type 1 diabetes

A Narsale, B Lam, R Moya, TT Lu, A Mandelli… - JCI insight, 2021 - ncbi.nlm.nih.gov
A Narsale, B Lam, R Moya, TT Lu, A Mandelli, I Gotuzzo, B Pessina, G Giamporcaro…
JCI insight, 2021ncbi.nlm.nih.gov
Transient partial remission, a period of low insulin requirement experienced by most patients
soon after diagnosis, has been associated with mechanisms of immune regulation. A better
understanding of such natural mechanisms of immune regulation might identify new targets
for immunotherapies that reverse type 1 diabetes (T1D). In this study, using Cox model
multivariate analysis, we validated our previous findings that patients with the highest
frequency of CD4+ CD25+ CD127 hi (127-hi) cells at diagnosis experience the longest …
Abstract
Transient partial remission, a period of low insulin requirement experienced by most patients soon after diagnosis, has been associated with mechanisms of immune regulation. A better understanding of such natural mechanisms of immune regulation might identify new targets for immunotherapies that reverse type 1 diabetes (T1D). In this study, using Cox model multivariate analysis, we validated our previous findings that patients with the highest frequency of CD4+ CD25+ CD127 hi (127-hi) cells at diagnosis experience the longest partial remission, and we showed that the 127-hi cell population is a mix of Th1-and Th2-type cells, with a significant bias toward antiinflammatory Th2-type cells. In addition, we extended these findings to show that patients with the highest frequency of 127-hi cells at diagnosis were significantly more likely to maintain β cell function. Moreover, in patients treated with alefacept in the T1DAL clinical trial, the probability of responding favorably to the antiinflammatory drug was significantly higher in those with a higher frequency of 127-hi cells at diagnosis than those with a lower 127-hi cell frequency. These data are consistent with the hypothesis that 127-hi cells maintain an antiinflammatory environment that is permissive for partial remission, β cell survival, and response to antiinflammatory immunotherapy.
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