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      Inhibition of Th17 Cells Regulates Autoimmune Diabetes in NOD Mice

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          Abstract

          OBJECTIVE

          The T helper 17 (Th17) population, a subset of CD4-positive T-cells that secrete interleukin (IL)-17, has been implicated in autoimmune diseases, including multiple sclerosis and lupus. Therapeutic agents that target the Th17 effector molecule IL-17 or directly inhibit the Th17 population (IL-25) have shown promise in animal models of autoimmunity. The role of Th17 cells in type 1 diabetes has been less clear. The effect of neutralizing anti–IL-17 and recombinant IL-25 on the development of diabetes in NOD mice, a model of spontaneous autoimmune diabetes, was investigated in this study.

          RESEARCH DESIGN AND METHODS AND RESULTS

          Although treatment with either anti–IL-17 or IL-25 had no effect on diabetes development in young (<5 weeks) NOD mice, either intervention prevented diabetes when treatment was started at 10 weeks of age ( P < 0.001). Insulitis scoring and immunofluorescence staining revealed that both anti–IL-17 and IL-25 significantly reduced peri-islet T-cell infiltrates. Both treatments also decreased GAD65 autoantibody levels. Analysis of pancreatic lymph nodes revealed that both treatments increased the frequency of regulatory T-cells. Further investigation demonstrated that IL-25 therapy was superior to anti–IL-17 during mature diabetes because it promoted a period of remission from new-onset diabetes in 90% of treated animals. Similarly, IL-25 delayed recurrent autoimmunity after syngeneic islet transplantation, whereas anti–IL-17 was of no benefit. GAD65-specific ELISpot and CD4-positive adoptive transfer studies showed that IL-25 treatment resulted in a T-cell–mediated dominant protective effect against autoimmunity.

          CONCLUSIONS

          These studies suggest that Th17 cells are involved in the pathogenesis of autoimmune diabetes. Further development of Th17-targeted therapeutic agents may be of benefit in this disease.

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          Most cited references32

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          Selective stimulation of T cell subsets with antibody-cytokine immune complexes.

          Interleukin-2 (IL-2), which is a growth factor for T lymphocytes, can also sometimes be inhibitory. Thus, the proliferation of CD8+ T cells in vivo is increased after the injection of a monoclonal antibody that is specific for IL-2 (IL-2 mAb), perhaps reflecting the removal of IL-2-dependent CD4+ T regulatory cells (T regs). Instead, we show here that IL-2 mAb augments the proliferation of CD8+ cells in mice simply by increasing the biological activity of preexisting IL-2 through the formation of immune complexes. When coupled with recombinant IL-2, some IL-2/IL-2 mAb complexes cause massive (>100-fold) expansion of CD8+ cells in vivo, whereas others selectively stimulate CD4+ T regs. Thus, different cytokine-antibody complexes can be used to selectively boost or inhibit the immune response.
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            Molecular antagonism and plasticity of regulatory and inflammatory T cell programs.

            Regulatory T (Treg) and T helper 17 (Th17) cells were recently proposed to be reciprocally regulated during differentiation. To understand the underlying mechanisms, we utilized a Th17 reporter mouse with a red fluorescent protein (RFP) sequence inserted into the interleukin-17F (IL-17F) gene. Using IL-17F-RFP together with a Foxp3 reporter, we found that the development of Th17 and Foxp3(+) Treg cells was associated in immune responses. Although TGF-beta receptor I signaling was required for both Foxp3 and IL-17 induction, SMAD4 was only involved in Foxp3 upregulation. Foxp3 inhibited Th17 differentiation by antagonizing the function of the transcription factors RORgammat and ROR*. In contrast, IL-6 overcame this suppressive effect of Foxp3 and, together with IL-1, induced genetic reprogramming in Foxp3(+) Treg cells. STAT3 regulated Foxp3 downregulation, whereas STAT3, RORgamma, and ROR* were required for IL-17 expression in Treg cells. Our data demonstrate molecular antagonism and plasticity of Treg and Th17 cell programs.
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              Th17: the third member of the effector T cell trilogy.

              T helper responses have now grown to include three T cell subsets: Th1, Th2 and Th17. Th17 cells have recently emerged as a third independent T cell subset that may play an essential role in protection against certain extracellular pathogens. However, Th17 cells with specificity for self-antigens are highly pathogenic and lead to the development of inflammation and severe autoimmunity. A combination of TGF-beta plus IL-6 and the transcription factors STAT3 and RORgammat were recently described to be essential for initial differentiation of Th17 cells and IL-23 for the later stabilization of the Th17 cell subset. Here, we introduce another player IL-21 produced by Th17 themselves, which plays an important role in the amplification of Th17 cells. Thus, Th17 cells may undergo three distinct steps of development: differentiation, amplification and stabilization in which distinct cytokines play a role.
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                Author and article information

                Journal
                Diabetes
                diabetes
                diabetes
                Diabetes
                Diabetes
                American Diabetes Association
                0012-1797
                1939-327X
                June 2009
                16 March 2009
                : 58
                : 6
                : 1302-1311
                Affiliations
                [1] 1Department of Surgery, University of Alberta, Edmonton, Alberta, Canada;
                [2] 2Departments of Medicine and of Medical Microbiology and Immunology, University of Alberta, Edmonton, Alberta, Canada;
                [3] 3Department of Pathology and Laboratory Medicine, University of Alberta, Edmonton, Alberta, Canada;
                [4] 4Clinical Islet Transplant Program, University of Alberta, Edmonton, Alberta, Canada.
                Author notes
                Corresponding author: Juliet Emamaullee, juliete@ 123456ualberta.ca .
                Article
                1113
                10.2337/db08-1113
                2682686
                19289457
                23b51a47-ab6e-430b-bdca-47195824033c
                © 2009 by the American Diabetes Association.

                Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.

                History
                : 14 August 2008
                : 3 March 2009
                Categories
                Original Article
                Immunology and Transplantation

                Endocrinology & Diabetes
                Endocrinology & Diabetes

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