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Bornstein SR, Guan K, Brunßen C, Mueller G, Kamvissi-Lorenz V, Lechler R, Trembath R, Mayr M, Poston L, Sancho R, Ahmed S, Alfar E, Aljani B, Alves TC, Amiel S, Andoniadou CL, Bandral M, Belavgeni A, Berger I, Birkenfeld A, Bonifacio E, Chavakis T, Chawla P, Choudhary P, Cujba AM, Delgadillo Silva LF, Demcollari T, Drotar DM, Duin S, El-Agroudy NN, El-Armouche A, Eugster A, Gado M, Gavalas A, Gelinsky M, Guirgus M, Hansen S, Hanton E, Hasse M, Henneicke H, Heller C, Hempel H, Hogstrand C, Hopkins D, Jarc L, Jones PM, Kamel M, Kämmerer S, King AJF, Kurzbach A, Lambert C, Latunde-Dada Y, Lieberam I, Liers J, Li JW, Linkermann A, Locke S, Ludwig B, Manea T, Maremonti F, Marinicova Z, McGowan BM, Mickunas M, Mingrone G, Mohanraj K, Morawietz H, Ninov N, Peakman M, Persaud SJ, Pietzsch J, Cachorro E, Pullen TJ, Pyrina I, Rubino F, Santambrogio A, Schepp F, Schlinkert P, Scriba LD, Siow R, Solimena M, Spagnoli FM, Speier S, Stavridou A, Steenblock C, Strano A, Taylor P, Tiepner A, Tonnus W, Tree T, Watt F, Werdermann M, Wilson M, Yusuf N, Ziegler CG. The transCampus Metabolic Training Programme Explores the Link of SARS-CoV-2 Virus to Metabolic Disease. Horm Metab Res 2021; 53:204-206. [PMID: 33652492 DOI: 10.1055/a-1377-6583] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/26/2022]
Abstract
Currently, we are experiencing a true pandemic of a communicable disease by the virus SARS-CoV-2 holding the whole world firmly in its grasp. Amazingly and unfortunately, this virus uses a metabolic and endocrine pathway via ACE2 to enter our cells causing damage and disease. Our international research training programme funded by the German Research Foundation has a clear mission to train the best students wherever they may come from to learn to tackle the enormous challenges of diabetes and its complications for our society. A modern training programme in diabetes and metabolism does not only involve a thorough understanding of classical physiology, biology and clinical diabetology but has to bring together an interdisciplinary team. With the arrival of the coronavirus pandemic, this prestigious and unique metabolic training programme is facing new challenges but also new opportunities. The consortium of the training programme has recognized early on the need for a guidance and for practical recommendations to cope with the COVID-19 pandemic for the community of patients with metabolic disease, obesity and diabetes. This involves the optimal management from surgical obesity programmes to medications and insulin replacement. We also established a global registry analyzing the dimension and role of metabolic disease including new onset diabetes potentially triggered by the virus. We have involved experts of infectious disease and virology to our faculty with this metabolic training programme to offer the full breadth and scope of expertise needed to meet these scientific challenges. We have all learned that this pandemic does not respect or heed any national borders and that we have to work together as a global community. We believe that this transCampus metabolic training programme provides a prime example how an international team of established experts in the field of metabolism can work together with students from all over the world to address a new pandemic.
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Affiliation(s)
- S R Bornstein
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- University Hospital Zurich, Department of Endocrinology and Diabetology, Zurich, Switzerland
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - K Guan
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Brunßen
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - G Mueller
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - V Kamvissi-Lorenz
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | | | - R Trembath
- Department of Medical & Molecular Genetics, King's College London, London, UK
| | - M Mayr
- School of Cardiovascular Medicine and Science, Faculty of Life Science & Medicine, KCL, London, UK
| | - L Poston
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - R Sancho
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - S Ahmed
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - E Alfar
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - B Aljani
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T C Alves
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - S Amiel
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - C L Andoniadou
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Craniofacial Development and Stem Cell Biology, KCL, London, UK
| | - M Bandral
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - A Belavgeni
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - I Berger
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - A Birkenfeld
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Institute for Diabetes Research and Metabolic Diseases of the Helmholtz Center Munich at the University of Tübingen, Tübingen, Germany
| | - E Bonifacio
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - T Chavakis
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - P Chawla
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - P Choudhary
- Division of Diabetes & Nutritional Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - A M Cujba
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - L F Delgadillo Silva
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - T Demcollari
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - D M Drotar
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - S Duin
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty and University Hospital, Technische Universität Dresden, Dresden, Germany
| | - N N El-Agroudy
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - A El-Armouche
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A Eugster
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - M Gado
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - A Gavalas
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - M Gelinsky
- Centre for Translational Bone, Joint and Soft Tissue Research, Medical Faculty and University Hospital, Technische Universität Dresden, Dresden, Germany
| | - M Guirgus
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - S Hansen
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - E Hanton
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - M Hasse
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - H Henneicke
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - C Heller
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - H Hempel
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - C Hogstrand
- Department of Nutritional Sciences, Faculty of Life Sciences & Medicine, KCL, London, UK
| | - D Hopkins
- Department of Diabetic Medicine, King's College Hospital NHS Foundation Trust and KCL, London, UK
| | - L Jarc
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - P M Jones
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - M Kamel
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - S Kämmerer
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A J F King
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - A Kurzbach
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - C Lambert
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | | | - I Lieberam
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - J Liers
- Department of Radiopharmaceutical and Chemical Biology, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - J W Li
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - A Linkermann
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - S Locke
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - B Ludwig
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
- University Hospital Zurich, Department of Endocrinology and Diabetology, Zurich, Switzerland
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T Manea
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - F Maremonti
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - Z Marinicova
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - B M McGowan
- Department of Diabetes and Endocrinology, London, UK
| | - M Mickunas
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - G Mingrone
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
- Fondazione Policlinico Universitario Agostino Gemelli IRCCS, Rome, Italy
- Università Cattolica del Sacro Cuore, Rome, Italy
| | - K Mohanraj
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - H Morawietz
- Division of Vascular Endothelium and Microcirculation, Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - N Ninov
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - M Peakman
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - S J Persaud
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - J Pietzsch
- Department of Radiopharmaceutical and Chemical Biology, Institute of Radiopharmaceutical Cancer Research, Helmholtz-Zentrum Dresden-Rossendorf, Dresden, Germany
| | - E Cachorro
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - T J Pullen
- School of Life Course Sciences, Faculty of Life Sciences & Medicine, KCL, London, UK
| | - I Pyrina
- Institute for Clinical Chemistry and Laboratory Medicine, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - F Rubino
- Department of Diabetes Research, School of Life Course Sciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
| | - A Santambrogio
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - F Schepp
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - P Schlinkert
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - L D Scriba
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - R Siow
- Vascular Biology & Inflammation Section, School of Cardiovascular Medicine & Sciences, British Heart Foundation of Research Excellence, King's College London, London, UK
| | - M Solimena
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
- Molecular Diabetology, University Hospital and Medical Faculty Carl Gustav Carus, TU Dresden, Dresden, Germany
| | - F M Spagnoli
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - S Speier
- Paul Langerhans Institute Dresden (PLID) of the Helmholtz Center Munich at the University Hospital Carl Gustav Carus and Medical Faculty, Dresden, Germany
| | - A Stavridou
- Center for Regenerative Therapies Dresden, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - C Steenblock
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - A Strano
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - P Taylor
- Department of Women and Children's Health, School of Life Course Sciences, King's College London, London, UK
| | - A Tiepner
- Institute of Pharmacology and Toxicology, Medical Faculty Carl Gustav Carus, Technische Universität Dresden, Dresden, Germany
| | - W Tonnus
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - T Tree
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - F Watt
- Centre for Stem Cells and Regenerative Medicine, King's College London, London, UK
| | - M Werdermann
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
| | - M Wilson
- School of Life Course Sciences, Faculty of Life Sciences & Medicine, KCL, London, UK
| | - N Yusuf
- Peter Gorer Department of Immunobiology, Guy's Hospital, London, UK
| | - C G Ziegler
- Department of Medicine III, Medical Faculty Carl Gustav Carus, University Hospital Carl Gustav Carus Dresden, Technische Universität Dresden, Germany
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Abstract
This review takes the reader through 45 years of islet autoantibody research, from the discovery of islet‐cell antibodies in 1974 to today’s population‐based screening for presymptomatic early‐stage type 1 diabetes. The review emphasizes the current practical value of, and factors to be considered in, the measurement of islet autoantibodies.
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Affiliation(s)
- E Bonifacio
- Technische Universität Dresden, DFG Center for Regenerative Therapies Dresden, Dresden, Germany.,Paul Langerhans Institute Dresden of the Helmholtz Center Munich at University Hospital Carl Gustav Carus and Faculty of Medicine, TU Dresden, Dresden, Germany
| | - P Achenbach
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Munich-Neuherberg, Germany.,Technical University of Munich, School of Medicine, Klinikum rechts der Isar, Forschergruppe Diabetes, Munich, Germany
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3
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Müller I, Gottschalk M, Deliviani P, Heinke S, Hommel A, Reichert J, Rodrigues R, Zubizaretta N, Ziegler AG, Berner R, Bonifacio E, Lange K. Welche Folgen hat das Wissen um ein erhöhtes Diabetesrisiko eines Säuglings für dessen Eltern? Erste Ergebnisse des Freder1k-Screenings auf Diabetesrisikogene in Sachsen. DIABETOL STOFFWECHS 2018. [DOI: 10.1055/s-0038-1641781] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
Affiliation(s)
- I Müller
- Medizinische Hochschule Hannover, Medizinische Psychologie, Hannover, Germany
| | - M Gottschalk
- DFG Research Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - P Deliviani
- DFG Research Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - S Heinke
- DFG Research Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - A Hommel
- DFG Research Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - J Reichert
- Universitätsklinikum Carl Gustav Carus; Klinik und Poliklinik für Kinder- und Jugendmedizin, Dresden, Germany
| | - R Rodrigues
- Medizinische Hochschule Hannover, Medizinische Psychologie, Hannover, Germany
| | - N Zubizaretta
- DFG Research Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - AG Ziegler
- Institut für Diabetesforschung, Helmholtz Zentrum München, München, Germany
| | - R Berner
- Universitätsklinikum Carl Gustav Carus; Klinik und Poliklinik für Kinder- und Jugendmedizin, Dresden, Germany
| | - E Bonifacio
- DFG Research Center for Regenerative Therapies Dresden (CRTD), Dresden, Germany
| | - K Lange
- Medizinische Hochschule Hannover, Medizinische Psychologie, Hannover, Germany
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4
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Fuchs (Theil) A, Wilhelm C, Kuhn M, Petzold A, Tuve S, Oelschlägel U, Dahl A, Bornhäuser M, Bonifacio E, Eugster A. Regulatory T cell kinetics following adoptive transfer of expanded allogeneic regulatory T cells into patients with chronic graft-versus host disease. Cytotherapy 2017. [DOI: 10.1016/j.jcyt.2017.02.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
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Theil A, Wilhelm C, Kuhn M, Petzold A, Tuve S, Oelschlägel U, Dahl A, Bornhäuser M, Bonifacio E, Eugster A. T cell receptor repertoires after adoptive transfer of expanded allogeneic regulatory T cells. Clin Exp Immunol 2016; 187:316-324. [PMID: 27774628 DOI: 10.1111/cei.12887] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 10/19/2016] [Indexed: 12/16/2022] Open
Abstract
Regulatory T cell (Treg ) therapy has been exploited in autoimmune disease, solid organ transplantation and in efforts to prevent or treat graft-versus-host disease (GVHD). However, our knowledge on the in-vivo persistence of transfused Treg is limited. Whether Treg transfusion leads to notable changes in the overall Treg repertoire or whether longevity of Treg in the periphery is restricted to certain clones is unknown. Here we use T cell receptor alpha chain sequencing (TCR-α-NGS) to monitor changes in the repertoire of Treg upon polyclonal expansion and after subsequent adoptive transfer. We applied TCR-α-NGS to samples from two patients with chronic GVHD who received comparable doses of stem cell donor derived expanded Treg . We found that in-vitro polyclonal expansion led to notable repertoire changes in vitro and that Treg cell therapy altered the peripheral Treg repertoire considerably towards that of the infused cell product, to different degrees, in each patient. Clonal changes in the peripheral blood were transient and correlated well with the clinical parameters. We suggest that T cell clonotype analyses using TCR sequencing should be considered as a means to monitor longevity and fate of adoptively transferred T cells.
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Affiliation(s)
- A Theil
- DFG-Center for Regenerative Therapies Dresden, Dresden, Germany.,Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - C Wilhelm
- DFG-Center for Regenerative Therapies Dresden, Dresden, Germany
| | - M Kuhn
- Institute for Medical Informatics and Biometry, Faculty of Medicine Carl Gustav Carus, Dresden, Germany
| | - A Petzold
- Deep Sequencing Group, Biotechnology Center, Technische Universität Dresden, Dresden, Germany
| | - S Tuve
- Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - U Oelschlägel
- Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - A Dahl
- Deep Sequencing Group, Biotechnology Center, Technische Universität Dresden, Dresden, Germany
| | - M Bornhäuser
- Internal Medicine I, University Hospital Carl Gustav Carus, Dresden, Germany
| | - E Bonifacio
- DFG-Center for Regenerative Therapies Dresden, Dresden, Germany
| | - A Eugster
- DFG-Center for Regenerative Therapies Dresden, Dresden, Germany
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6
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Vanguelova EI, Bonifacio E, De Vos B, Hoosbeek MR, Berger TW, Vesterdal L, Armolaitis K, Celi L, Dinca L, Kjønaas OJ, Pavlenda P, Pumpanen J, Püttsepp Ü, Reidy B, Simončič P, Tobin B, Zhiyanski M. Sources of errors and uncertainties in the assessment of forest soil carbon stocks at different scales-review and recommendations. Environ Monit Assess 2016; 188:630. [PMID: 27770347 DOI: 10.1007/s10661-016-5608-5] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 02/18/2016] [Accepted: 09/21/2016] [Indexed: 06/06/2023]
Abstract
Spatially explicit knowledge of recent and past soil organic carbon (SOC) stocks in forests will improve our understanding of the effect of human- and non-human-induced changes on forest C fluxes. For SOC accounting, a minimum detectable difference must be defined in order to adequately determine temporal changes and spatial differences in SOC. This requires sufficiently detailed data to predict SOC stocks at appropriate scales within the required accuracy so that only significant changes are accounted for. When designing sampling campaigns, taking into account factors influencing SOC spatial and temporal distribution (such as soil type, topography, climate and vegetation) are needed to optimise sampling depths and numbers of samples, thereby ensuring that samples accurately reflect the distribution of SOC at a site. Furthermore, the appropriate scales related to the research question need to be defined: profile, plot, forests, catchment, national or wider. Scaling up SOC stocks from point sample to landscape unit is challenging, and thus requires reliable baseline data. Knowledge of the associated uncertainties related to SOC measures at each particular scale and how to reduce them is crucial for assessing SOC stocks with the highest possible accuracy at each scale. This review identifies where potential sources of errors and uncertainties related to forest SOC stock estimation occur at five different scales-sample, profile, plot, landscape/regional and European. Recommendations are also provided on how to reduce forest SOC uncertainties and increase efficiency of SOC assessment at each scale.
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Affiliation(s)
- E I Vanguelova
- Centre for Ecosystems, Society and Biosecurity, Forest Research, Alice Holt Lodge, Farnham, GU10 4LH, UK.
| | - E Bonifacio
- DISAFA, Chimica Agraria e Pedologia, University of Torino, Via P. Braccini 2, 10095, Grugliasco, TO, Italy
| | - B De Vos
- Environment & Climate Unit, Research Institute for Nature and Forest (INBO), Gaverstraat 4, 9500, Geraardsbergen, Belgium
| | - M R Hoosbeek
- Department of Soil Quality, Wageningen University, P.O. Box 47, 6700AA, Wageningen, The Netherlands
| | - T W Berger
- Department of Forest- and Soil Sciences, Institute of Forest Ecology, University of Natural Resources and Live Sciences (BOKU), Peter Jordan-Strasse 82, 1190, Vienna, Austria
| | - L Vesterdal
- Department of Geosciences and Natural Resource Management, University of Copenhagen, Rolighedsvej 23, DK-1958, Frederiksberg, Denmark
| | - K Armolaitis
- Department of Ecology, Institute of Forestry, Lithuanian Research Centre for Agriculture and Forestry, Liepu 1, Girionys, LT-53101 Kaunas distr, Lithuania
| | - L Celi
- DISAFA, Chimica Agraria e Pedologia, University of Torino, Via P. Braccini 2, 10095, Grugliasco, TO, Italy
| | - L Dinca
- National Institute for Research and Development in Forestry "Marin Dracea", Brasov, Romania
| | - O J Kjønaas
- Norwegian Institute of Bioeconomy Research (NIBIO), Pb 115, NO-1431, Ås, Norway
| | - P Pavlenda
- National Forest Centre - Forest Research Institute, T.G. Masaryka 22, 962 92, Zvolen, Slovakia
| | - J Pumpanen
- Department of Environmental and Biological Sciences, University of Eastern Finland, PO Box 1627, FI-70211, Kuopio, Finland
| | - Ü Püttsepp
- Institute of Agricultural and Environmental Sciences, Estonian University of Life Sciences, Kreutzwaldi 5, 51014, Tartu, Estonia
| | - B Reidy
- School of Biology and Environmental Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - P Simončič
- Forest Ecology Department, Slovenian Foresty Institute, Vecna pot 2, SI 1000, Ljubljana, Slovenia
| | - B Tobin
- UCD Forestry, School of Agriculture and Food Science, University College Dublin, Belfield, Dublin 4, Ireland
| | - M Zhiyanski
- Forest Research Institute - BAS 132, "Kl. Ohridski" Blvd., 1756, Sofia, Bulgaria
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7
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Walther D, Eugster A, Jergens S, Gavrisan A, Weinzerl C, Telieps T, Winkler C, Ziegler AG, Bonifacio E. Tetraspanin 7 is a novel autoantigen in type 1 diabetes. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1584103] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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8
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Warncke K, Puff R, Eitel S, Beyerlein A, Gloning KP, Bonifacio E, Becker P, Ziegler AG. Einfluss von Diabetes während der Schwangerschaft auf das Immunsystem und die Entwicklung des fetalen Thymus. DIABETOL STOFFWECHS 2016. [DOI: 10.1055/s-0036-1584108] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
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9
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Roberts C, Roberts GA, Löbner K, Bearzatto M, Clark A, Bonifacio E, Christie MR. Expression of the Protein Tyrosine Phosphatase-like Protein IA-2 During Pancreatic Islet Development. J Histochem Cytochem 2016; 49:767-76. [PMID: 11373323 DOI: 10.1177/002215540104900610] [Citation(s) in RCA: 17] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/16/2022] Open
Abstract
A tyrosine phosphatase-like protein, IA-2, is a major autoantigen in Type 1 diabetes but its role in islet function is unclear. Tyrosine phosphorylation mediates regulation of cellular processes such as exocytosis, cell growth, and cell differentiation. To investigate the potential involvement of IA-2 in islet differentiation and insulin secretion, we analyzed by immunohistochemistry expression of IA-2 during islet development in fetal rats and during the maturation of insulin secretory responses after birth. In the fetus, IA-2 immunoreactivity was detected in primitive islets positive for insulin and glucagon at 12 days' gestation. Subsequently, IA-2 was only weakly detectable in the fetal pancreas. In neonatal rat, a progressive increase in IA-2 immunoreactivity was observed in islets from very low levels at 1 day of age to moderate labeling at 10 days. In the adult, relatively high levels of IA-2 were detected in islets, with heterogeneous expression in individual cells within each islet. IA-2 marks a population of endocrine cells that transiently appear early in pancreatic ontogeny. Islet IA-2 expression reappears after birth concomitant with the development of mature insulin secretory responses, consistent with a role for this protein in regulated hormone secretion.
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Affiliation(s)
- C Roberts
- Department of Medicine, Guy's, King's College, and St Thomas' School of Medicine, London, United Kingdom
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10
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Wasserfall C, Montgomery E, Yu L, Michels A, Gianani R, Pugliese A, Nierras C, Kaddis JS, Schatz DA, Bonifacio E, Atkinson MA. Validation of a rapid type 1 diabetes autoantibody screening assay for community-based screening of organ donors to identify subjects at increased risk for the disease. Clin Exp Immunol 2016; 185:33-41. [PMID: 27029857 DOI: 10.1111/cei.12797] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
The Network for Pancreatic Organ donors with Diabetes (nPOD) programme was developed in response to an unmet research need for human pancreatic tissue obtained from individuals with type 1 diabetes mellitus and people at increased risk [i.e. autoantibody (AAb)-positive] for the disease. This necessitated the establishment of a type 1 diabetes-specific AAb screening platform for organ procurement organizations (OPOs). Assay protocols for commercially available enzyme-linked immunosorbent assays (elisas) determining AAb against glutamic acid decarboxylase (GADA), insulinoma-associated protein-2 (IA-2A) and zinc transporter-8 (ZnT8A) were modified to identify AAb-positive donors within strict time requirements associated with organ donation programmes. These rapid elisas were evaluated by the international islet AAb standardization programme (IASP) and used by OPO laboratories as an adjunct to routine serological tests evaluating donors for organ transplantation. The rapid elisas performed well in three IASPs (2011, 2013, 2015) with 98-100% specificity for all three assays, including sensitivities of 64-82% (GADA), 60-64% (IA-2A) and 62-68% (ZnT8A). Since 2009, nPOD has screened 4442 organ donors by rapid elisa; 250 (5·6%) were identified as positive for one AAb and 14 (0.3%) for multiple AAb with 20 of these cases received by nPOD for follow-up studies (14 GADA+, two IA-2A(+) , four multiple AAb-positive). Rapid screening for type 1 diabetes-associated AAb in organ donors is feasible, allowing for identification of non-diabetic, high-risk individuals and procurement of valuable tissues for natural history studies of this disease.
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Affiliation(s)
- C Wasserfall
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL
| | - E Montgomery
- Department of Pathology, Immunology, and Laboratory Medicine, College of Medicine, University of Florida, Gainesville, FL
| | - L Yu
- Univeristy of Colorado, Aurora
| | | | | | | | | | | | - D A Schatz
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
| | - E Bonifacio
- Technical University of Dresden, Dresden, Germany
| | - M A Atkinson
- Department of Pediatrics, College of Medicine, University of Florida, Gainesville, FL, USA
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11
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Link CS, Eugster A, Heidenreich F, Rücker-Braun E, Schmiedgen M, Oelschlägel U, Kühn D, Dietz S, Fuchs Y, Dahl A, Domingues AMJ, Klesse C, Schmitz M, Ehninger G, Bornhäuser M, Schetelig J, Bonifacio E. Abundant cytomegalovirus (CMV) reactive clonotypes in the CD8(+) T cell receptor alpha repertoire following allogeneic transplantation. Clin Exp Immunol 2016; 184:389-402. [PMID: 26800118 DOI: 10.1111/cei.12770] [Citation(s) in RCA: 21] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/20/2015] [Indexed: 12/15/2022] Open
Abstract
Allogeneic stem cell transplantation is potentially curative, but associated with post-transplantation complications, including cytomegalovirus (CMV) infections. An effective immune response requires T cells recognizing CMV epitopes via their T cell receptors (TCRs). Little is known about the TCR repertoire, in particular the TCR-α repertoire and its clinical relevance in patients following stem cell transplantation. Using next-generation sequencing we examined the TCR-α repertoire of CD8(+) T cells and CMV-specific CD8(+) T cells in four patients. Additionally, we performed single-cell TCR-αβ sequencing of CMV-specific CD8(+) T cells. The TCR-α composition of human leucocyte antigen (HLA)-A*0201 CMVpp65- and CMVIE -specific T cells was oligoclonal and defined by few dominant clonotypes. Frequencies of single clonotypes reached up to 11% of all CD8(+) T cells and half of the total CD8(+) T cell repertoire was dominated by few CMV-reactive clonotypes. Some TCR-α clonotypes were shared between patients. Gene expression of the circulating CMV-specific CD8(+) T cells was consistent with chronically activated effector memory T cells. The CD8(+) T cell response to CMV reactivation resulted in an expansion of a few TCR-α clonotypes to dominate the CD8(+) repertoires. These results warrant further larger studies to define the ability of oligoclonally expanded T cell clones to achieve an effective anti-viral T cell response in this setting.
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Affiliation(s)
- C S Link
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus.,DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - A Eugster
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - F Heidenreich
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus
| | - E Rücker-Braun
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus
| | - M Schmiedgen
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus
| | - U Oelschlägel
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus
| | - D Kühn
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - S Dietz
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - Y Fuchs
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - A Dahl
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany.,BIOTEChnology Center, TU Dresden, Dresden, Germany
| | - A M J Domingues
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - C Klesse
- DKMS Clinical Trials Unit, Dresden, Germany
| | - M Schmitz
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany.,Institut Für Immunologie, Medizinische Fakultät, TU Dresden, Dresden, Germany
| | - G Ehninger
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus.,DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - M Bornhäuser
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus.,DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
| | - J Schetelig
- Medizinische Klinik und Poliklinik I, Universitätsklinikum Carl Gustav Carus.,DKMS Clinical Trials Unit, Dresden, Germany
| | - E Bonifacio
- DFG Research Center for Regenerative Therapies Dresden, Dresden, Germany
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12
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Powell M, Amoroso M, Coles R, Furmaniak J, Scholz M, Achenbach P, Ziegler AG, Bonifacio E, Rees Smith B. 3Screen: a sensitive and specific ELISA for the combined measurement of autoantibodies to GAD65, to IA-2 and to ZnT8. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549533] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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13
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Bassy M, Lange K, Ziegler AG, Klingensmith G, Schober E, Roth R, Bingley PJ, Rottenkolber M, Theil A, Peplow C, Eugster A, Eisenbarth G, Puff R, Hasford J, Achenbach P, Bonifacio E. Psychological impact on parents by participating in the Pre-POINT study. DIABETOL STOFFWECHS 2015. [DOI: 10.1055/s-0035-1549639] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
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14
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Theil A, Wilhelm C, Guhr E, Reinhardt J, Bonifacio E. The relative merits of cord blood as a cell source for autologous T regulatory cell therapy in type 1 diabetes. Horm Metab Res 2015; 47:48-55. [PMID: 25372776 DOI: 10.1055/s-0034-1394372] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Abstract
Cord blood has been used as a cell source for therapeutic purposes in children with type 1 diabetes and other disorders. Here, we explore the benefits of cord blood as an autologous source of T regulatory cells for immune cell therapy in patients. CD4(+)CD25(+) T regulatory cells were isolated from cord blood and adult peripheral blood of healthy donors and compared during and after expansion in a 14-day protocol incorporating anti-CD3/anti-CD28 beads, and IL-2 with or without rapamycin. Cord blood T regulatory cells were largely naïve (89±7 vs. 31±10% in young adults, p<0.0001), and had higher expansion yields (median 5,968-fold) than adult T regulatory cells (median 516-fold, p=0.001) and adult naïve T regulatory cells (median 820-fold, p=0.003). Rapamycin reduced expansion yields, but was not necessary to obtain pure expanded cord blood T regulatory cells as judged by FOXP3 staining (94±3%), methylation status of FOXP3 (97%), and intracellular effector cytokine staining (< 6%). Expanded adult T regulatory cells were much less pure in the absence of rapamycin (72±19% FOXP3; 76% by methylation status, <13% INF-γ, <16% IL-4, <5% IL-17 positive), but purity was achieved by inclusion of rapamycin during expansion. Despite differences in purity, all preparations of expanded T regulatory from all sources were able to strongly suppress proliferation of T effector cells in vitro. Our findings suggest that cord blood is an excellent source of T regulatory cells for expansion and autologous cell therapy that may be considered as a strategy to prevent immune-mediated destruction of beta cells in type 1 diabetes.
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Affiliation(s)
- A Theil
- DFG-Center for Regenerative Therapies, Technische Universität Dresden, Dresden, Germany
| | - C Wilhelm
- DFG-Center for Regenerative Therapies, Technische Universität Dresden, Dresden, Germany
| | - E Guhr
- DFG-Center for Regenerative Therapies, Technische Universität Dresden, Dresden, Germany
| | - J Reinhardt
- DFG-Center for Regenerative Therapies, Technische Universität Dresden, Dresden, Germany
| | - E Bonifacio
- DFG-Center for Regenerative Therapies, Technische Universität Dresden, Dresden, Germany
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15
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Bornstein SR, Amiel SA, Rubino F, Mingrone G, Kamvissi V, Solimena M, Bonifacio E, Jones P, Schwarz P, Birkenfeld AL, Behrens A, Barthel A, Lechler R, Peakman M. Creating a "Transcampus" in diabetes research between King's College London and the Technische Universität Dresden: update on islet biology and transplantation. Horm Metab Res 2015; 47:1-3. [PMID: 25478704 DOI: 10.1055/s-0034-1394453] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 10/24/2022]
Affiliation(s)
- S R Bornstein
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - S A Amiel
- Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, UK
| | - F Rubino
- Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, UK
| | - G Mingrone
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - V Kamvissi
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - M Solimena
- Molecular Diabetology, Paul Langerhans Institute Dresden, TU Dresden
| | - E Bonifacio
- German Center for Diabetes Research (DZD e.V.), Dresden, Germany
| | - P Jones
- Diabetes and Nutritional Sciences, Hodgkin Building, Guy's Campus, King's College London, London, UK
| | - P Schwarz
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - A L Birkenfeld
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - A Behrens
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - A Barthel
- Department of Medicine III, Universitätsklinikum Carl Gustav Carus an der Technischen Universität Dresden, Dresden, Germany
| | - R Lechler
- MRC Centre for Transplantation, King's College London, Guy's Hospital, London, UK
| | - M Peakman
- Department of Immunobiology, King's College London School of Medicine, London, UK
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16
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Fuchs YF, Adler K, Lindner A, Karasinsky A, Wilhelm C, Weigelt M, Balke H, Förtsch K, Mortler-Hildebrandt LF, Harlan DM, Pechhold K, Ziegler AG, Bonifacio E. IGRP and insulin vaccination induce CD8+ T cell-mediated autoimmune diabetes in the RIP-CD80GP mouse. Clin Exp Immunol 2014; 176:199-206. [PMID: 24387268 DOI: 10.1111/cei.12263] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 12/27/2013] [Indexed: 01/07/2023] Open
Abstract
Autoimmune diabetes is characterized by autoantigen-specific T cell-mediated destruction of pancreatic islet beta cells, and CD8(+) T cells are key players during this process. We assessed whether the bitransgenic RIP-CD80 x RIP-LCMV-GP (RIP-CD80GP) mice may be a versatile antigen-specific model of inducible CD8(+) T cell-mediated autoimmune diabetes. Antigen-encoding DNA, peptide-loaded dendritic cells and antigen plus incomplete Freund's adjuvant were used for vaccination. Of 14 pancreatic proteins tested by DNA vaccination, murine pre-proinsulin 2 (100% of mice; median time after vaccination, 60 days) and islet-specific glucose-6-phosphatase catalytic subunit-related protein (IGRP) (77%, 58 days) could induce diabetes. Vaccination with DNA encoding for zinc transporter 8, Ia-2, Ia-2β, glutamic acid decarboxylase 67 (Gad67), chromogranin A, insulinoma amyloid polypeptide and homeobox protein Nkx-2.2 induced diabetes development in 25-33% of mice. Vaccination with DNA encoding for Gad65, secretogranin 5, pancreas/duodenum homeobox protein 1 (Pdx1), carboxyl ester lipase, glucagon and control hepatitis B surface antigen (HBsAg) induced diabetes in <20% of mice. Diabetes induction efficiency could be increased by DNA vaccination with a vector encoding a ubiquitin-antigen fusion construct. Diabetic mice had florid T cell islet infiltration. CD8(+) T cell targets of IGRP were identified with a peptide library-based enzyme-linked immunospot assay, and diabetes could also be induced by vaccination with major histocompatibility complex (MHC) class I-restricted IGRP peptides loaded on mature dendritic cells. Vaccination with antigen plus incomplete Freund's adjuvant, which can prevent diabetes in other models, led to rapid diabetes development in the RIP-CD80GP mouse. We conclude that RIP-CD80GP mice are a versatile model of antigen specific autoimmune diabetes and may complement existing mouse models of autoimmune diabetes for evaluating CD8(+) T cell-targeted prevention strategies.
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Affiliation(s)
- Y F Fuchs
- DFG - Center for Regenerative Therapies Dresden (CRTD), Technische Universität Dresden, Dresden, Germany; Paul Langerhans Institute Dresden-German Center for Diabetes Research (DZD), Dresden, Germany
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17
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Giannopoulou E, Beyerlein A, Winkler C, Achenbach P, Bonifacio E, Ziegler AG. Seroconversion incidence of high and low risk antibody phenotypes in genetically at-risk children for type 1 diabetes. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1375061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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18
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D'Orlando O, Puff R, Henniger A, Krause S, Haupt F, Kühn D, Winkler C, Bonifacio E, Ziegler AG. Immune status is associated with the mode of delivery in infants at increased risk for Type 1 Diabetes. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374887] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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19
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Cerdá-Esteban N, Hommel A, Bonifacio E, Spagnoli FM. Stepwise reprogramming of liver to pancreas under the control of a single transcriptional regulator. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1374888] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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20
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Hommel A, Weigelt M, Karasinsky A, Wilhelm C, Lindner A, Anastassiadis K, Bonifacio E. Establishment of an in vivo mouse model that can be induced to produce IL-7. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1375046] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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21
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Upadhyaya B, Kuehn D, Ruhwald S, Bonsack M, Krassner M, Warnke K, Gavrisan A, Ziegler AG, Bonifacio E. Imbalance of rare CCR10+ CD8+ and CD4+ memory T cells in children at onset of type 1 diabetes. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1375048] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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22
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Kühn D, Heninger AK, Eugster A, Dietz S, Winkler C, Scholz M, Ziegler AG, Bonifacio E. Activation of autoreactive CD4+ T cells is synchronous to islet autoantibody seroconversion and shows an IFNγ signature. DIABETOL STOFFWECHS 2014. [DOI: 10.1055/s-0034-1375044] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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23
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Lee HS, Briese T, Winkler C, Rewers M, Bonifacio E, Hyoty H, Pflueger M, Simell O, She JX, Hagopian W, Lernmark Å, Akolkar B, Krischer J, Ziegler AG. Next-generation sequencing for viruses in children with rapid-onset type 1 diabetes. Diabetologia 2013; 56:1705-1711. [PMID: 23657799 PMCID: PMC4019381 DOI: 10.1007/s00125-013-2924-y] [Citation(s) in RCA: 23] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/06/2013] [Accepted: 04/05/2013] [Indexed: 02/02/2023]
Abstract
AIMS/HYPOTHESIS Viruses are candidate causative agents in the pathogenesis of autoimmune (type 1) diabetes. We hypothesised that children with a rapid onset of type 1 diabetes may have been exposed to such agents shortly before the initiation of islet autoimmunity, possibly at high dose, and thus study of these children could help identify viruses involved in the development of autoimmune diabetes. METHODS We used next-generation sequencing to search for viruses in plasma samples and examined the history of infection and fever in children enrolled in The Environmental Determinants of Diabetes in the Young (TEDDY) study who progressed to type 1 diabetes within 6 months from the appearance of islet autoimmunity, and in matched islet-autoantibody-negative controls. RESULTS Viruses were not detected more frequently in plasma from rapid-onset patients than in controls during the period surrounding seroconversion. In addition, infection histories were found to be similar between children with rapid-onset diabetes and control children, although episodes of fever were reported less frequently in children with rapid-onset diabetes. CONCLUSIONS/INTERPRETATION These findings do not support the presence of viraemia around the time of seroconversion in young children with rapid-onset type 1 diabetes.
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Affiliation(s)
- H-S. Lee
- Pediatric Epidemiology Center, Department of Pediatrics, University of South Florida, Tampa, FL, USA
| | - T. Briese
- Center for Infection and Immunity, Mailman School of Public Health, Columbia University, New York, NY, USA
| | - C. Winkler
- Forschergruppe Diabetes e.V., Neuherberg, Germany
- Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany
| | - M. Rewers
- Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, CO, USA
| | - E. Bonifacio
- Center for Regenerative Therapies-Dresden, Dresden University of Technology, Dresden, Germany
| | - H. Hyoty
- Department of Virology, University of Tampere, Finland
| | - M. Pflueger
- Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany
| | - O. Simell
- Department of Pediatrics, Turku University Central Hospital, Turku, Finland
| | - J. X. She
- Center for Biotechnology and Genomic Medicine, Medical College of Georgia, Georgia Regents University, Augusta, GA, USA
| | - W. Hagopian
- Pacific Northwest Diabetes Research Institute, Seattle, WA, USA
| | - Å. Lernmark
- Department of Clinical Sciences, Lund University, Skåne University Hospital SUS, Malmö, Sweden
| | - B. Akolkar
- National Institute of Diabetes & Digestive & Kidney Disorders, Bethesda, MD, USA
| | - J. Krischer
- Pediatric Epidemiology Center, Department of Pediatrics, University of South Florida, Tampa, FL, USA
| | - A. G. Ziegler
- Forschergruppe Diabetes e.V., Neuherberg, Germany
- Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität München, Ingolstädter Landstrasse 1, 85764, Neuherberg, Germany
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24
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Geidel P, Tauer JT, Steinbronn N, Jung R, Bonifacio E, Leuschner I, Strasser RH, Suttorp M. Continuous but not intermittent long-term exposure to the tyrosine kinase inhibitor (TKI) dasatinib causes cardiac failure in juvenile rats. Klin Padiatr 2013. [DOI: 10.1055/s-0033-1343629] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Puff R, Giannopoulou E, Gavrisan A, Wosch A, Bunk M, Bonifacio E, Ziegler AG. Kann eine Transfusion von Nabelschnurblut die β-Zellrestfunktion bei neu diagnostizierten Typ 1 Diabetikern durch Modulation des adaptiven Immunsystems verbessern? DIABETOL STOFFWECHS 2013. [DOI: 10.1055/s-0033-1341731] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/26/2022]
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Winkler C, Krumsiek J, Lempainen J, Achenbach P, Grallert H, Giannopoulou E, Bunk M, Theis FJ, Bonifacio E, Ziegler AG. A strategy for combining minor genetic susceptibility genes to improve prediction of disease in type 1 diabetes. Genes Immun 2012; 13:549-55. [PMID: 22932816 DOI: 10.1038/gene.2012.36] [Citation(s) in RCA: 53] [Impact Index Per Article: 4.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/18/2023]
Abstract
Genome-wide association studies have identified gene regions associated with type 1 diabetes. The aim of this study was to determine how the combined allele frequency of multiple susceptibility genes can stratify islet autoimmunity and/or type 1 diabetes risk. Children of parents with type 1 diabetes and prospectively followed from birth for the development of islet autoantibodies and diabetes were genotyped for single-nucleotide polymorphisms at 12 type 1 diabetes susceptibility genes (ERBB3, PTPN2, IFIH1, PTPN22, KIAA0350, CD25, CTLA4, SH2B3, IL2, IL18RAP, IL10 and COBL). Non-human leukocyte antigen (HLA) risk score was defined by the total number of risk alleles at these genes. Receiver operator curve analysis showed that the non-HLA gene combinations were highly effective in discriminating diabetes and most effective in children with a high-risk HLA genotype. The greatest diabetes discrimination was obtained by the sum of risk alleles for eight genes (IFIH1, CTLA4, PTPN22, IL18RAP, SH2B3, KIAA0350, COBL and ERBB3) in the HLA-risk children. Non-HLA-risk allele scores stratified risk for developing islet autoantibodies and diabetes, and progression from islet autoimmunity to diabetes. Genotyping at multiple susceptibility loci in children from affected families can identify neonates with sufficient genetic risk of type 1 diabetes to be considered for early intervention.
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Affiliation(s)
- C Winkler
- Institute of Diabetes Research, Helmholtz Zentrum München and Forschergruppe Diabetes, Klinikum rechts der Isar, Technische Universität, München, Germany
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Abstract
AIMS/HYPOTHESIS Seroconversion to islet autoantibodies precedes type 1 diabetes. This study aimed to identify periods of high seroconversion incidence, which could be targeted for mechanistic and therapeutic studies. METHODS Incidence of islet autoantibodies was calculated in 1,650 genetically at-risk children followed with measurements of islet autoantibodies and thyroid autoantibodies at age 9 months and 2, 5, 8, 11, 14 and 17 years. Peak incidence periods were confirmed in a second cohort of 150 children followed until age 6 years with three-monthly samples up to age 3 years. RESULTS Islet autoantibody incidence (per 1,000 person-years) was 18.5 until age 9 months, 21 from 9 months to 2 years and <10 for intervals after age 2 years. The second cohort confirmed peak incidence around age 9 months and demonstrated an absence of seroconversion before this age. Seroconversion to insulin autoantibodies occurred earlier than other autoantibodies (p<0.01 against glutamic acid decarboxylase [GAD]-, insulinoma-associated protein 2 [IA-2]- and zinc transporter 8 [ZnT8]-autoantibodies). Early peak seroconversion incidence was most evident in children with high-risk HLA DR3/4-DQ8 or DR4/4-DQ8 genotypes. CONCLUSION The age period 9 months to 2 years is associated with a high incidence of activation of type 1 diabetes associated autoimmunity in genetically at-risk children and should be targeted for effective primary prevention strategies.
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Affiliation(s)
- A-G Ziegler
- Institute of Diabetes Research, Helmholtz Zentrum München, German Research Center for Environmental Health, Ingolstaedter Landstrasse 1, 85764 Neuherberg, Germany.
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Howson JMM, Krause S, Stevens H, Smyth DJ, Wenzlau JM, Bonifacio E, Hutton J, Ziegler AG, Todd JA, Achenbach P. Genetic association of zinc transporter 8 (ZnT8) autoantibodies in type 1 diabetes cases. Diabetologia 2012; 55:1978-84. [PMID: 22526605 PMCID: PMC3369141 DOI: 10.1007/s00125-012-2540-2] [Citation(s) in RCA: 34] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 12/23/2011] [Accepted: 02/23/2012] [Indexed: 12/16/2022]
Abstract
AIMS/HYPOTHESIS Autoantibodies to zinc transporter 8 (ZnT8A) are associated with risk of type 1 diabetes. Apart from the SLC30A8 gene itself, little is known about the genetic basis of ZnT8A. We hypothesise that other loci in addition to SLC30A8 are associated with ZnT8A. METHODS The levels of ZnT8A were measured in 2,239 British type 1 diabetic individuals diagnosed before age 17 years, with a median duration of diabetes of 4 years. Cases were tested at over 775,000 loci genome wide (including 53 type 1 diabetes associated regions) for association with positivity for ZnT8A. ZnT8A were also measured in an independent dataset of 855 family members with type 1 diabetes. RESULTS Only FCRL3 on chromosome 1q23.1 and the HLA class I region were associated with positivity for ZnT8A. rs7522061T>C was the most associated single nucleotide polymorphism (SNP) in the FCRL3 region (p = 1.13 × 10(-16)). The association was confirmed in the family dataset (p ≤ 9.20 × 10(-4)). rs9258750A>G was the most associated variant in the HLA region (p = 2.06 × 10(-9) and p = 0.0014 in family cases). The presence of ZnT8A was not associated with HLA-DRB1, HLA-DQB1, HLA-A, HLA-B or HLA-C (p > 0.05). Unexpectedly, the two loci associated with the presence of ZnT8A did not alter risk of having type 1 diabetes, and the 53 type 1 diabetes risk loci did not influence positivity for ZnT8A, despite them being disease specific. CONCLUSIONS/INTERPRETATION ZnT8A are not primary pathogenic factors in type 1 diabetes. Nevertheless, ZnT8A testing in combination with other autoantibodies facilitates disease prediction, despite the biomarker not being under the same genetic control as the disease.
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Affiliation(s)
- J. M. M. Howson
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Cambridge Institute for Medical Research, Department of Medical Genetics, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0XY UK
| | - S. Krause
- Forschergruppe Diabetes, Munich University of Technology, Munich, Germany
| | - H. Stevens
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Cambridge Institute for Medical Research, Department of Medical Genetics, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0XY UK
| | - D. J. Smyth
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Cambridge Institute for Medical Research, Department of Medical Genetics, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0XY UK
| | - J. M. Wenzlau
- Barbara Davis Diabetes Centre, University of Colorado, Denver, CO USA
| | - E. Bonifacio
- Centre for Regenerative Therapies, Dresden University of Technology, Dresden, Germany
| | - J. Hutton
- Barbara Davis Diabetes Centre, University of Colorado, Denver, CO USA
| | - A. G. Ziegler
- Forschergruppe Diabetes, Munich University of Technology, Munich, Germany
- Institute of Diabetes Research, Helmholtz Centre Munich, Neuherberg, Germany
| | - J. A. Todd
- Juvenile Diabetes Research Foundation/Wellcome Trust Diabetes and Inflammation Laboratory, Cambridge Institute for Medical Research, Department of Medical Genetics, University of Cambridge, Addenbrooke’s Hospital, Hills Road, Cambridge, CB2 0XY UK
| | - P. Achenbach
- Forschergruppe Diabetes, Munich University of Technology, Munich, Germany
- Institute of Diabetes Research, Helmholtz Centre Munich, Neuherberg, Germany
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Winkler C, Lempainen J, Achenbach P, Grallert H, Giannopoulou E, Bunk M, Bonifacio E, Ziegler AG. Ein Typ 1 Diabetes Risikoallelscore verbessert die Stratifizierung des Typ 1 Diabetes Risikos. DIABETOL STOFFWECHS 2012. [DOI: 10.1055/s-0032-1314434] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/28/2022]
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Adler K, Krause S, Fuchs YF, Foertsch K, Ziegler AG, Bonifacio E. The effect of gestation and fetal mismatching on the development of autoimmune diabetes in non-obese diabetic mice. Clin Exp Immunol 2012; 168:274-8. [PMID: 22519589 DOI: 10.1111/j.1365-2249.2012.04579.x] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022] Open
Abstract
The impact of gestation and fetal-maternal interactions on pre-existent autoimmune beta cell destruction is widely unknown. The aim of this study was to investigate the influence of gestation per se and fetal mismatching on the onset of autoimmune diabetes in female non-obese diabetic (NOD) mice. We examined cumulative diabetes frequencies of NOD dams mated to syngeneic NOD, haploidentical CByB6F1/J and fully mismatched C57BL/6J male mice. Pregnancy from NOD males neither increased nor accelerated the diabetes onset of NOD dams (71% by age 28 weeks) compared to unmated female NOD mice (81% by age 28 weeks; P = 0·38). In contrast, delayed diabetes onset was observed when NOD dams were mated at 10 weeks of age with major histocompatibility complex (MHC) haploidentical CByB6F1/J male mice (38% at age 28 weeks; P = 0·01). Mating with fully MHC mismatched C57BL/6J male mice (72% diabetes by age 28 weeks; P = 0·22) or mating with the haploidentical males at the later time-point of age 13 weeks (64% versus 91% in unmated litter-matched controls; P = 0·13) did not delay diabetes significantly in NOD females. Because infusion of haploidentical male mouse splenocytes was found previously to prevent diabetes in NOD mice we looked for, but found no evidence of, persistent chimeric lymphocytes from haploidentical paternal origin within the dams' splenocytes. Gestation per se appears to have no aggravating or ameliorating effects on pre-existent autoimmune beta cell destruction, but pregnancy from MHC partially mismatched males delays diabetes onset in female NOD mice.
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Affiliation(s)
- K Adler
- Diabetes Research Institute, Forschergruppe Diabetes e.V, Munich, Germany
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Angheben A, Anselmi M, Gobbi F, Marocco S, Monteiro G, Buonfrate D, Tais S, Talamo M, Zavarise G, Strohmeyer M, Bartalesi F, Mantella A, Di Tommaso M, Aiello K, Veneruso G, Graziani G, Ferrari M, Spreafico I, Bonifacio E, Gaiera G, Lanzafame M, Mascarello M, Cancrini G, Albajar-Vinas P, Bisoffi Z, Bartoloni A. Chagas disease in Italy: breaking an epidemiological silence. Euro Surveill 2011; 16:19969. [PMID: 21944554] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/31/2023] Open
Abstract
Chagas disease, a neglected tropical disease that due to population movements is no longer limited to Latin America, threatens a wide spectrum of people(travellers, migrants, blood or organ recipients,newborns, adoptees) also in non-endemic countries where it is generally underdiagnosed. In Italy, the available epidemiological data about Chagas disease have been very limited up to now, although the country is second in Europe only to Spain in the number of residents from Latin American. Among 867 at-risk subjectsscreened between 1998 and 2010, the Centre for Tropical Diseases in Negrar (Verona) and the Infectious and Tropical Diseases Unit, University of Florence found 4.2% patients with positive serology for Chagas disease (83.4% of them migrants, 13.8% adoptees).No cases of Chagas disease were identified in blood donors or HIV-positive patients of Latin American origin. Among 214 Latin American pregnant women,three were infected (resulting in abortion in one case).In 2005 a case of acute Chagas disease was recorded in an Italian traveller. Based on our observations, we believe that a wider assessment of the epidemiological situation is urgently required in our country and public health measures preventing transmission and improving access to diagnosis and treatment should be implemented.
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Affiliation(s)
- A Angheben
- Centre for Tropical Diseases, Sacro Cuore - Don Calabria Hospital, Negrar, Italy.
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Angheben A, Anselmi M, Gobbi F, Marocco S, Monteiro G, Buonfrate D, Tais S, Talamo M, Zavarise G, Strohmeyer M, Bartalesi F, Mantella A, Di Tommaso M, Aiello KH, Veneruso G, Graziani G, Ferrari MM, Spreafico I, Bonifacio E, Gaiera G, Lanzafame M, Mascarello M, Cancrini G, Albajar-Viñas P, Bisoffi Z, Bartoloni A. Chagas disease in Italy: breaking an epidemiological silence. Euro Surveill 2011. [DOI: 10.2807/ese.16.37.19969-en] [Citation(s) in RCA: 41] [Impact Index Per Article: 3.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Chagas disease, a neglected tropical disease that due to population movements is no longer limited to Latin America, threatens a wide spectrum of people (travellers, migrants, blood or organ recipients, newborns, adoptees) also in non-endemic countries where it is generally underdiagnosed. In Italy, the available epidemiological data about Chagas disease have been very limited up to now, although the country is second in Europe only to Spain in the number of residents from Latin American. Among 867 at-risk subjects screened between 1998 and 2010, the Centre for Tropical Diseases in Negrar (Verona) and the Infectious and Tropical Diseases Unit, University of Florence found 4.2% patients with positive serology for Chagas disease (83.4% of them migrants, 13.8% adoptees). No cases of Chagas disease were identified in blood donors or HIV-positive patients of Latin American origin. Among 214 Latin American pregnant women, three were infected (resulting in abortion in one case). In 2005 a case of acute Chagas disease was recorded in an Italian traveller. Based on our observations, we believe that a wider assessment of the epidemiological situation is urgently required in our country and public health measures preventing transmission and improving access to diagnosis and treatment should be implemented.
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Affiliation(s)
- A Angheben
- Centre for Tropical Diseases, Sacro Cuore – Don Calabria Hospital, Negrar, Italy
- COHEMI project (COordinating resources to assess and improve HEalth status of MIgrants from Latin America)
| | - M Anselmi
- COHEMI project (COordinating resources to assess and improve HEalth status of MIgrants from Latin America)
- Centre for Tropical Diseases, Sacro Cuore – Don Calabria Hospital, Negrar, Italy
| | - F Gobbi
- Centre for Tropical Diseases, Sacro Cuore – Don Calabria Hospital, Negrar, Italy
- COHEMI project (COordinating resources to assess and improve HEalth status of MIgrants from Latin America)
| | - S Marocco
- Centre for Tropical Diseases, Sacro Cuore – Don Calabria Hospital, Negrar, Italy
| | - G Monteiro
- Centre for Tropical Diseases, Sacro Cuore – Don Calabria Hospital, Negrar, Italy
| | - D Buonfrate
- COHEMI project (COordinating resources to assess and improve HEalth status of MIgrants from Latin America)
- Centre for Tropical Diseases, Sacro Cuore – Don Calabria Hospital, Negrar, Italy
| | - S Tais
- Service of Epidemiology and Laboratory for Tropical Diseases, Sacro Cuore – Don Calabria Hospital, Negrar, Italy
| | - M Talamo
- Infectious Disease Unit, G. Rummo Hospital, Benevento, Italy
| | - G Zavarise
- Paediatric Division, Sacro Cuore – Don Calabria Hospital, Negrar, Italy
| | - M Strohmeyer
- COHEMI project (COordinating resources to assess and improve HEalth status of MIgrants from Latin America)
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - F Bartalesi
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - A Mantella
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
| | - M Di Tommaso
- Obstetric and Gynaecologic Department, Careggi University Hospital, Florence, Italy
| | - K H Aiello
- Obstetric and Gynaecologic Department, Careggi University Hospital, Florence, Italy
| | - G Veneruso
- Infectious Diseases Unit, Anna Meyer Children’s University Hospital, Florence, Italy
| | - G Graziani
- Immunohaematology and Transfusion Unit, Careggi University Hospital, Florence, Italy
| | - M M Ferrari
- Obstetrics and Gynaecology Clinic, L. Mangiagalli Hospital, Milan, Italy
| | - I Spreafico
- Obstetrics and Gynaecology Clinic, L. Mangiagalli Hospital, Milan, Italy
| | - E Bonifacio
- Obstetrics and Gynaecology Division, Sacro Cuore – Don Calabria Hospital, Negrar, Italy
| | - G Gaiera
- Infectious Diseases Division, San Raffaele Hospital, Milan, Italy
| | - M Lanzafame
- Infectious Diseases Division, G.B. Rossi University Hospital, Verona, Italy
| | - M Mascarello
- Infectious Diseases Division, G.B. Rossi University Hospital, Verona, Italy
| | - G Cancrini
- Public Health Sciences Department, La Sapienza University, Rome, Italy
| | - P Albajar-Viñas
- WHO Programme on Control of Chagas disease, Department of Control of Neglected Tropical Diseases, World Health Organization, Geneva, Switzerland
| | - Z Bisoffi
- COHEMI project (COordinating resources to assess and improve HEalth status of MIgrants from Latin America)
- Centre for Tropical Diseases, Sacro Cuore – Don Calabria Hospital, Negrar, Italy
| | - A Bartoloni
- COHEMI project (COordinating resources to assess and improve HEalth status of MIgrants from Latin America)
- Infectious and Tropical Diseases Unit, Careggi University Hospital, Florence, Italy
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Theil A, Monti P, Huchatz J, Wilhelm C, Platz A, Bonifacio E. Therapeutisches Potential regulatorischer T-Zellen aus Nabelschnurblut. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277266] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Fuchs YF, Adler K, Balke H, Foertsch K, Mortler-Hildebrandt LF, Spanner A, Pechhold K, Harlan DM, Ziegler AG, Bonifacio E. Autoimmunen Diabetes auslösende Antigene und Epitope im RIP-CD80+GP+ Mausmodell. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277289] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Heninger AK, Monti P, Wilhelm C, Platz A, Ziegler AG, Bonifacio E. Nachweis, Proliferation and Differenzierung von auf Betazell-Autoantigen reagierenden T-Zellen in Nabelschnurblut. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277512] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Stumpp CB, Paul R, Bonifacio E. Unterdrückung von Autoimmunität und Transplantatabstoßung durch Modulation von Interleukin-7 abhängiger Proliferation autoreaktiver T-Zellen. DIABETOL STOFFWECHS 2011. [DOI: 10.1055/s-0031-1277519] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Adler K, Mueller DB, Achenbach P, Krause S, Heninger AK, Ziegler AG, Bonifacio E. Insulin autoantibodies with high affinity to the bovine milk protein alpha casein. Clin Exp Immunol 2011; 164:42-9. [PMID: 21361910 DOI: 10.1111/j.1365-2249.2011.04324.x] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/31/2022] Open
Abstract
Insulin autoantibodies (IAA) can appear in children within months of introducing solid foods to the diet and before clinical type 1 diabetes. The aim of this study was to determine whether infant dietary antigens could be immunizing agents of IAA. To this end, IAA binding to [(125) I]insulin was competed with food preparations and extracts of foods encountered in the infant diet (milk formulas, bovine milk, wheat flour, fowl meal). Bovine milk powder extracts inhibited IAA-positive samples from six of 53 children (age 0·3-14·0 years) participating in German prospective cohorts. Inhibition in these sera ranged from 23 to 100%. Competition was abolished when hydrolyzed milk powder was used. Competition with protein components of bovine milk found that two of the six milk-reactive sera were inhibited strongly by alpha- and beta-casein; none were inhibited by the milk proteins bovine serum albumin or lactoglobulins. The two casein-reactive sera had high affinity to alpha-casein (1·7×10(9) ; 3·1×10(9) l/mol), and lesser affinity to beta-casein (4·0×10(8) ; 7·0×10(7) l/mol) and insulin (2·6×10(8) ; 1·6×10(8) l/mol). No children with milk-reactive IAA developed autoantibodies to other islet autoantigens or diabetes (median follow-up 9·8 years). These results suggest that autoimmunity to insulin can occur infrequently via cross-reactivity to food proteins, but this form of IAA immunization does not appear to be associated with progression to diabetes.
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Affiliation(s)
- K Adler
- Diabetes Research Institute, Forschergruppe Diabetes e.V., Munich Center for Regenerative Therapies - Dresden, Dresden University of Technology, Dresden, Germany
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Ziegler AG, Mollenhauer U, Achenbach P, Bonifacio E. Anti-CCL3 autoantibodies are not markers of type 1 diabetes when measured by a commercial ELISA method. Diabetologia 2011; 54:699-700. [PMID: 21127833 DOI: 10.1007/s00125-010-1976-5] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 08/12/2010] [Accepted: 10/26/2010] [Indexed: 10/18/2022]
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Piemonti L, Maffi P, Monti L, Lampasona V, Perseghin G, Magistretti P, Secchi A, Bonifacio E. Beta cell function during rapamycin monotherapy in long-term type 1 diabetes. Diabetologia 2011; 54:433-9. [PMID: 21046356 DOI: 10.1007/s00125-010-1959-6] [Citation(s) in RCA: 31] [Impact Index Per Article: 2.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 07/30/2010] [Accepted: 10/11/2010] [Indexed: 10/18/2022]
Abstract
AIMS/HYPOTHESIS Type 1 diabetes is considered non-reversible at end-stage disease when there is no measurable insulin production. However, there are indications that insulin-producing beta cells could be present or return if autoimmunity could be controlled. We therefore sought to determine whether immunosuppression therapy can reinstate beta cell function in patients with long-term type 1 diabetes. METHODS We examined pancreatic beta cell function in 22 patients with long-term type 1 diabetes (median disease duration 27 years), who had been receiving rapamycin monotherapy (0.1 mg/kg; target trough levels 8-10 ng/ml; 26-314 days) as pre-conditioning for islet transplantation. As control, beta cell function was measured in 14 patients (median disease duration 17 years) who were waiting for an islet transplant without rapamycin pre-conditioning. RESULTS Fasting C-peptide increased from <0.03 nmol/l (0.0066 nmol/l, interquartile range [IQR] 0.0003-0.023) at baseline to 0.039 nmol/l (IQR 0.0066-0.096) at end of rapamycin monotherapy (p < 0.005). In 12 patients, fasting C-peptide increased to >0.076 nmol/l (C-peptide responders). Exogenous insulin requirement decreased from 0.64 U/kg daily (IQR 0.56-0.72) to 0.57 U/kg (IQR 0.45-0.70; p = 0.01), but this reduction was significant only in the 12C-peptide-responsive patients. Rapamycin monotherapy was also associated with a decrease in insulin antibody titre (median decrease 110 to 35.9 U/ml; p < 0.001) and fasting serum proinsulin (median decrease 0.51 to 0.28 pmol/l; p = 0.001). All variables remained unchanged in the 14 control patients. CONCLUSIONS/INTERPRETATION Therapies to reinstate beta cell function may be applicable to patients with long-term C-peptide-negative type 1 diabetes. TRIAL REGISTRATION ClinicalTrial.gov NCT01060605.
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Affiliation(s)
- L Piemonti
- Diabetes Research Institute (HSR-DRI), San Raffaele Scientific Institute, Via Olgettina 60, 20132 Milan, Italy.
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Schlosser M, Mueller PW, Törn C, Bonifacio E, Bingley PJ. Diabetes Antibody Standardization Program: evaluation of assays for insulin autoantibodies. Diabetologia 2010; 53:2611-20. [PMID: 20871974 DOI: 10.1007/s00125-010-1915-5] [Citation(s) in RCA: 117] [Impact Index Per Article: 8.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/12/2010] [Accepted: 08/05/2010] [Indexed: 12/01/2022]
Abstract
AIMS/HYPOTHESIS Insulin autoantibodies (IAA) are important in type 1 diabetes risk assessment. However, their determination varies more between laboratories than other diabetes autoantibodies. The Diabetes Antibody Standardization Program (DASP) aims to improve and standardise measurement of autoantibodies associated with type 1 diabetes. We report the results of measurement of IAA from DASP workshops in 2002, 2003 and 2005. METHODS Up to 32 laboratories in 14 countries participated in each workshop. Aliquots of coded sera from 50 patients with newly diagnosed type 1 diabetes and 100 blood donor controls were circulated to participating laboratories. Reported results were analysed using receiver operator characteristic (ROC) curves. We compared concordance of antibody levels by ranking, IAA and insulin antibody (IA) indices and units derived from an IA standard curve. RESULTS In all three workshops IAA assay performance had improved compared with DASP 2000. The median area under the ROC curve was 0.73 in DASP 2002, 0.78 in 2003 and 0.80 in 2005 (p = 0.0012), and median laboratory-assigned sensitivity was 26% in 2002, 36% in 2003 and 45% in 2005 (p < 0.0001). There was, however, marked variation between assays. The range of AUC was 0.36-0.91 and that of laboratory-assigned sensitivity was 22-57%. Concordance of ranking of patient serum samples was related to AUC (p < 0.001). Using an index related to common IAA and IA-positive or -negative control sera improved the concordance between assays (p < 0.0001). CONCLUSIONS/INTERPRETATION The overall performance of IAA assays has improved but there is still wide variation between laboratories. Concordance between assays would be improved by the use of a common reference reagent.
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Affiliation(s)
- M Schlosser
- Department of Medical Biochemistry and Molecular Biology, Research Group of Predictive Diagnostics, University of Greifswald, Greifswald, Germany
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Bonifacio E, Santonoi S, Zanini E. Soil Properties Required by Some Southern Africa Fruit Trees as Assessed by Discriminant Analysis. ACTA ACUST UNITED AC 2010. [DOI: 10.1080/089030600406662] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022]
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Winkler C, Bonifacio E, Grallert H, Henneberger L, Illig T, Ziegler AG. Wachstum im Kindesalter wird durch die Typ 2 Diabetes Risiko Gene HHEX-IDE und CDKAL1 beeinflusst. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253747] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Borg D, Weigelt M, Wilhelm C, Hommel A, Bonifacio E. Verbesserung der Transplantationsrate von Langerhansschen Inselzellen durch unterstützende mesenchymale Stammzellen. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253800] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Ludwig B, Ludwig S, Brendel M, Steffen A, Witzigmann H, Solimena M, Bonifacio E, Palm C, Passauer J, Leike S, Kersting S, Saeger HD, Bornstein S. Insel- und Pankreas/Nieren-Transplantation am Universitätsklinikum Dresden. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253950] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Theil A, Monti P, Guhr E, Platz A, Rank L, Bonifacio E. Effektive Expansion hochsuppressiver regulatorischer T-Zellen aus Nabelschnurblut. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253803] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Försch J, Monti P, Bonifacio E, Walter M, Achenbach P, Ziegler AG. Immunmodulierende Wirkung einer adjuvanten Behandlung mit 1α,25(OH)2Vitamin D3 auf dendritische Zellen bei Patienten mit neu manifestiertem Typ 1-Diabetes. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253789] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Krause SD, Chmiel R, Bonifacio E, Ziegler AG, Achenbach P. Affinität und Epitop-Spezifität von IA-2 Autoantikörpern bei Kindern mit Typ 1 Diabetes Risiko. DIABETOL STOFFWECHS 2010. [DOI: 10.1055/s-0030-1253797] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/19/2022]
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Monti P, Brigatti C, Heninger AK, Scirpoli M, Bonifacio E. Disengaging the IL-2 receptor with daclizumab enhances IL-7-mediated proliferation of CD4(+) and CD8(+) T cells. Am J Transplant 2009; 9:2727-35. [PMID: 19788505 DOI: 10.1111/j.1600-6143.2009.02825.x] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/25/2023]
Abstract
Allograft rejection is mainly driven by the production of IL-2, which expands T cells by linking the IL-2 receptor (IL-2R) composed of three subunits: CD25, CD122 and CD132. Daclizumab, widely used in immunosuppression, is a humanized anti-CD25 antibody that disrupts IL-2 signaling by binding to CD25 and preventing the assembly of the high-affinity IL-2R. Here we show that Daclizumab, while blocking the T-cell response to IL-2, increases CD4(+) and CD8(+) T-cell proliferative response to the homeostatic cytokine IL-7. The IL-7R shares CD132 with the IL-2R and blocking of CD25 by Daclizumab results in the enhanced formation of the IL-7R that in turn allows IL-7 to bind more efficiently on the cell surface. The consequently increased IL-7R signaling boosts intracellular phosphorylated STAT5 and T-cell proliferation. In addition, treatment with Daclizumab delays the internalization of CD127 upon IL-7 treatment, retaining T-cell sensitivity to IL-7 for a prolonged time. This effect of Daclizumab highlights the redundancy of the cytokine system, which may influence T-cell proliferation in transplanted patients, and provides information to improve future immunosuppressive strategies.
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Affiliation(s)
- P Monti
- Immunology of Diabetes Unit and Clinical Transplant Unit, San Raffaele Scientific Institute, Milan, Italy
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Winkler C, Marienfeld S, Zwilling M, Bonifacio E, Ziegler AG. Is islet autoimmunity related to insulin sensitivity or body weight in children of parents with type 1 diabetes? Diabetologia 2009; 52:2072-8. [PMID: 19641897 DOI: 10.1007/s00125-009-1461-1] [Citation(s) in RCA: 21] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 01/07/2009] [Accepted: 06/12/2009] [Indexed: 11/26/2022]
Abstract
AIMS/HYPOTHESIS It has been suggested that metabolic demand and insulin resistance play a role in the development of type 1 diabetes, including the onset of autoimmunity. The aim of the present study was to determine whether insulin demand is increased in children with islet autoantibodies. METHODS BMI standard deviation score (BMI-SDS) was measured from 2 years of age in 1,650 prospectively followed children of mothers or fathers with type 1 diabetes, including 135 who developed persistent islet autoantibodies. HOMA of insulin resistance (HOMA-IR) was determined using fasting samples from 777 of the children starting from age 5 years. RESULTS An increased HOMA-IR was associated with female sex (p = 0.0004), older age (p < 0.0001) and increased BMI-SDS (p < 0.0001). Children with islet autoantibodies did not have an increased HOMA-IR compared with age-matched islet autoantibody-negative children (age 8 years: mean 0.61 vs mean 0.72, respectively, p = 0.21; age 11 years: mean 0.96 vs mean 1.21, respectively, p = 0.07). Furthermore, after correction for age and sex, autoantibody positivity was associated with decreased HOMA-IR values (p = 0.01). BMI-SDS was similar between islet autoantibody-positive and -negative children at age 2 (mean 0.07 vs mean 0.16, respectively), 5 (mean 0.06 vs 0.08, respectively), 8 (mean - 0.09 vs mean 0.02, respectively), and 11 years (mean 0.22 vs mean 0.16, respectively) and similar to that of national reference values. CONCLUSIONS/INTERPRETATION Islet autoantibody-positive children in the BABYDIAB cohort are not insulin resistant and do not have an increased BMI around and early after islet autoantibody seroconversion. These findings are inconsistent with the notion that insulin resistance is a risk factor for islet autoimmunity.
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Affiliation(s)
- C Winkler
- Institut für Diabetesforschung der Forschergruppe Diabetes e.V., Helmholtz Center Munich, Neuherberg, Germany
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Achenbach P, Lampasona V, Landherr U, Koczwara K, Krause S, Grallert H, Winkler C, Pflüger M, Illig T, Bonifacio E, Ziegler AG. Autoantibodies to zinc transporter 8 and SLC30A8 genotype stratify type 1 diabetes risk. Diabetologia 2009; 52:1881-8. [PMID: 19590848 DOI: 10.1007/s00125-009-1438-0] [Citation(s) in RCA: 145] [Impact Index Per Article: 9.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/01/2009] [Accepted: 06/01/2009] [Indexed: 10/20/2022]
Abstract
AIMS/HYPOTHESIS Our aim was to determine the relationships between autoantibodies to zinc transporter 8 (ZnT8), genotypes of the ZnT8-encoding gene SLC30A8 and type 1 diabetes risk. METHODS ZnT8 autoantibodies (ZnT8A) were measured in sera of 1,633 children with a first-degree family history of type 1 diabetes and who were prospectively followed from birth. Antibodies were measured by Protein A-based radiobinding assays and COOH-terminal (R325, W325 or Q325 variants) or NH(2)-terminal constructs of human ZnT8. SLC30A8 genotyping at single-nucleotide polymorphism (SNP) rs13266634 was performed on 1,170 children. RESULTS Antibodies against COOH-terminal ZnT8 constructs (ZnT8A-COOH) developed in 58 children as early as 9 months of age (median 3 years). They were detected in 55 of 128 (43%) children with autoantibodies to insulin, GAD and/or insulinoma-associated protein 2 and 34 of 42 (81%) who progressed to diabetes. The additional presence of ZnT8A-COOH stratified diabetes risk in islet autoantibody-positive children (p < 0.0001). SLC30A8 genotype strongly influenced ZnT8A type and diabetes risk in ZnT8A-COOH-positive children. Antibody binding against the ZnT8 R325 variant was strictly correlated with the number of the corresponding SLC30A8 R325-encoding alleles, whereas binding against the W325 variant was highest in children who had SLC30A8 W325-encoding alleles (p = 0.001). Moreover, ZnT8A-COOH-positive children who carried homozygous SLC30A8 SNP rs13266634 genotypes progressed faster to diabetes than those who were heterozygous (59% [95% CI 42.3-75.7%] vs 22% [95% CI 0-44.3%] within 5 years; p = 0.01). CONCLUSIONS/INTERPRETATION Autoimmunity against the COOH-terminal region of ZnT8 is a highly relevant prognostic feature in childhood type 1 diabetes. Risk stratification in ZnT8A-COOH-positive children is further improved by SLC30A8 genotyping.
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Affiliation(s)
- P Achenbach
- Diabetes Research Institute of Forschergruppe Diabetes e.V., Helmholtz Center Munich, Ingolstaedter Landstr. 1, 85764, Neuherberg, Germany
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