Reversal of New Onset Type 1 Diabetes by Oral -Based Combination Therapy and Mediated by Regulatory T-Cells in NOD Mice.

Autoimmune diseases such as type 1 diabetes (T1D) involve the loss of regulatory mechanisms resulting in increased tissue-specific cytotoxicity. The result is destruction of pancreatic insulin-producing β-cells and loss of glucose homeostasis. We are developing a novel oral vaccine using live attenuated to deliver TGFβ， IL10， and the diabetic autoantigen preproinsulin combined with low-doses of anti-CD3 mAb. Here we show that oral administration of -based anti-CD3 mAb combined therapy reverses new-onset T1D in non-obese diabetic (NOD) mice. The therapeutic effect of the combined therapy was associated with induction of immune suppressive CD4CD25Foxp3 Treg and CD4CD49bLAG3 Tr1 cells. In adoptive transfer experiments， adding or depleting Treg or Tr1 cells indicated that both are important for preventing diabetes in combined therapy-treated mice， but that Tr1 cells may have a more central role. Furthermore， induced Tr1 cells were found to be antigen-specific responding to peptide stimulation by secreting tolerance inducing IL10. These preclinical data demonstrate a role for Treg and Tr1 cells in combined therapy-mediated induction of tolerance in NOD mice. These results also demonstrate the potential of oral -based combined therapy in the treatment of early T1D.