B lymphocyte depletion by CD20 monoclonal antibody prevents diabetes in nonobese diabetic mice despite isotype-specific differences in FcγR effector functions

Y Xiu, CP Wong, JD Bouaziz, Y Hamaguchi… - The Journal of …, 2008 - journals.aai.org
Y Xiu, CP Wong, JD Bouaziz, Y Hamaguchi, Y Wang, SM Pop, RM Tisch, TF Tedder
The Journal of Immunology, 2008journals.aai.org
NOD mice deficient for B lymphocytes from birth fail to develop autoimmune or type 1
diabetes. To assess whether B cell depletion influences type 1 diabetes in mice with an
intact immune system, NOD female mice representing early and late preclinical stages of
disease were treated with mouse anti-mouse CD20 mAbs. Short-term CD20 mAb treatment
in 5-wk-old NOD female mice reduced B cell numbers by∼ 95%, decreased subsequent
insulitis, and prevented diabetes in> 60% of littermates. In addition, CD20 mAb treatment of …
Abstract
NOD mice deficient for B lymphocytes from birth fail to develop autoimmune or type 1 diabetes. To assess whether B cell depletion influences type 1 diabetes in mice with an intact immune system, NOD female mice representing early and late preclinical stages of disease were treated with mouse anti-mouse CD20 mAbs. Short-term CD20 mAb treatment in 5-wk-old NOD female mice reduced B cell numbers by∼ 95%, decreased subsequent insulitis, and prevented diabetes in> 60% of littermates. In addition, CD20 mAb treatment of 15-wk-old NOD female mice significantly delayed, but did not prevent, diabetes onset. Protection from diabetes did not result from altered T cell numbers or subset distributions, or regulatory/suppressor T cell generation. Rather, impaired CD4+ and CD8+ T cell activation in the lymph nodes of B cell-depleted NOD mice may delay diabetes onset. B cell depletion was achieved despite reduced sensitivity of NOD mice to CD20 mAbs compared with C57BL/6 mice. Decreased B cell depletion resulted from deficient FcγRI binding of IgG2a/c CD20 mAbs and 60% reduced spleen monocyte numbers, which in combination reduced Ab-dependent cellular cytotoxicity. With high-dose CD20 mAb treatment (250 μg) in NOD mice, FcγRIII and FcγRIV compensated for inadequate FcγRI function and mediated B cell depletion. Thereby, NOD mice provide a model for human FcγR polymorphisms that reduce therapeutic mAb efficacy in vivo. Moreover, this study defines a new, clinically relevant approach whereby B cell depletion early in the course of disease development may prevent diabetes or delay progression of disease.
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