Sensitization to Gliadin Induces Moderate Enteropathy and Insulitis in Nonobese Diabetic-DQ8 Mice

Celiac disease (CD) is frequently diagnosed in patients with type 1 diabetes (T1D), and T1D patients can exhibit Abs against tissue transglutaminase, the auto-antigen in CD. Thus, gliadin, the trigger in CD, has been suggested to have a role in T1D pathogenesis. The objective of this study was to investigate whether gliadin contributes to enteropathy and insulitis in NOD-DQ8 mice, an animal model that does not spontaneously develop T1D. Gliadin-sensitized NOD-DQ8 mice developed moderate enteropathy, intraepithelial lymphocytosis, and barrier dysfunction, but not insulitis. Administration of anti-CD25 mAbs before gliadin-sensitization induced partial depletion of CD25+Foxp3+ T cells and led to severe insulitis, but did not exacerbate mucosal dysfunction. CD4+ T cells isolated from pancreatic lymph nodes of mice that developed insulitis showed increased proliferation and proinflammatory cytokines after incubation with gliadin but not with BSA. CD4+ T cells isolated from nonsensitized controls did not response to gliadin or BSA. In conclusion, gliadin sensitization induced moderate enteropathy in NOD-DQ8 mice. However, insulitis development required gliadin-sensitization and partial systemic depletion of CD25+Foxp3+ T cells. This humanized murine model provides a mechanistic link to explain how the mucosal intolerance to a dietary protein can lead to insulitis in the presence of partial regulatory T cell deficiency.

[1]  T. Waldmann,et al.  Co-adjuvant effects of retinoic acid and IL-15 induce inflammatory immunity to dietary antigens , 2011, Nature.

[2]  Werner Müller,et al.  Intestinal tolerance requires gut homing and expansion of FoxP3+ regulatory T cells in the lamina propria. , 2011, Immunity.

[3]  D. Gibson,et al.  Gut barrier disruption by an enteric bacterial pathogen accelerates insulitis in NOD mice , 2010, Diabetologia.

[4]  R. Uibo,et al.  The geoepidemiology of type 1 diabetes. , 2010, Autoimmunity reviews.

[5]  Y. Setiady,et al.  In vivo depletion of CD4+FOXP3+ Treg cells by the PC61 anti‐CD25 monoclonal antibody is mediated by FcγRIII+ phagocytes , 2010, European journal of immunology.

[6]  D. Schuppan,et al.  Celiac disease: from pathogenesis to novel therapies. , 2009, Gastroenterology.

[7]  I. Mackay,et al.  Clustering and commonalities among autoimmune diseases. , 2009, Journal of autoimmunity.

[8]  G. P. Morris,et al.  Naturally-existing CD4(+)CD25(+)Foxp3(+) regulatory T cells are required for tolerance to experimental autoimmune thyroiditis induced by either exogenous or endogenous autoantigen. , 2009, Journal of autoimmunity.

[9]  K. McCoy,et al.  Host Responses to Intestinal Microbial Antigens in Gluten-Sensitive Mice , 2009, PloS one.

[10]  Jonathan H. Esensten,et al.  T-bet-Deficient NOD Mice Are Protected from Diabetes Due to Defects in Both T Cell and Innate Immune System Function1 , 2009, The Journal of Immunology.

[11]  Robert A Kyle,et al.  Increased prevalence and mortality in undiagnosed celiac disease. , 2009, Gastroenterology.

[12]  J. McCluskey,et al.  Resistance to Celiac Disease in Humanized HLA-DR3-DQ2-Transgenic Mice Expressing Specific Anti-Gliadin CD4+ T Cells1 , 2009, The Journal of Immunology.

[13]  A. Green,et al.  Incidence trends for childhood type 1 diabetes in Europe during 1989–2003 and predicted new cases 2005–20: a multicentre prospective registration study , 2009, The Lancet.

[14]  Jeroen Visser,et al.  Tight Junctions, Intestinal Permeability, and Autoimmunity , 2009, Annals of the New York Academy of Sciences.

[15]  E. Keely,et al.  Diabetes-Specific HLA-DR–Restricted Proinflammatory T-Cell Response to Wheat Polypeptides in Tissue Transglutaminase Antibody–Negative Patients With Type 1 Diabetes , 2009, Diabetes.

[16]  A. Aderem,et al.  The Toll-Like Receptor Signaling Molecule Myd88 Contributes to Pancreatic Beta-Cell Homeostasis in Response to Injury , 2009, PloS one.

[17]  C. Parish,et al.  Use of the intracellular fluorescent dye CFSE to monitor lymphocyte migration and proliferation. , 2002, Current protocols in immunology.

[18]  R. Plenge Shared genetic risk factors for type 1 diabetes and celiac disease. , 2008, The New England journal of medicine.

[19]  Cisca Wijmenga,et al.  Shared and distinct genetic variants in type 1 diabetes and celiac disease. , 2008, The New England journal of medicine.

[20]  O. Vaarala Leaking gut in type 1 diabetes , 2008, Current opinion in gastroenterology.

[21]  S. Zheng,et al.  Natural and TGF-beta-induced Foxp3(+)CD4(+) CD25(+) regulatory T cells are not mirror images of each other. , 2008, Trends in immunology.

[22]  Å. Lernmark,et al.  Annual screening detects celiac disease in children with type 1 diabetes , 2008, Pediatric diabetes.

[23]  P. Green Where Are All Those Patients With Celiac Disease? , 2007, The American Journal of Gastroenterology.

[24]  L. Cooper,et al.  Spontaneous myocarditis mimicking human disease occurs in the presence of an appropriate MHC and non-MHC background in transgenic mice. , 2007, Journal of molecular and cellular cardiology.

[25]  S. Zheng,et al.  IL-2 Is Essential for TGF-β to Convert Naive CD4+CD25− Cells to CD25+Foxp3+ Regulatory T Cells and for Expansion of These Cells1 , 2007, The Journal of Immunology.

[26]  M. Kagnoff Celiac disease: pathogenesis of a model immunogenetic disease. , 2007, The Journal of clinical investigation.

[27]  B. Bäckström,et al.  Partial Depletion of CD69low‐expressing Natural Regulatory T Cells with the Anti‐CD25 Monoclonal Antibody PC61 , 2007, Scandinavian journal of immunology.

[28]  S. Majumdar,et al.  Health Care Use and Costs in the Decade After Identification of Type 1 and Type 2 Diabetes , 2006, Diabetes Care.

[29]  R. Paroni,et al.  Increased intestinal permeability precedes clinical onset of type 1 diabetes , 2006, Diabetologia.

[30]  R. Planas,et al.  Reg (regenerating) gene overexpression in islets from non-obese diabetic mice with accelerated diabetes: role of IFNβ , 2006, Diabetologia.

[31]  Shimon Sakaguchi,et al.  Foxp3+CD25+CD4+ natural regulatory T cells in dominant self‐tolerance and autoimmune disease , 2006, Immunological reviews.

[32]  Dario Iafusco,et al.  Zonulin Upregulation Is Associated With Increased Gut Permeability in Subjects With Type 1 Diabetes and Their Relatives , 2006, Diabetes.

[33]  Giuseppe Iacono,et al.  Gliadin, zonulin and gut permeability: Effects on celiac and non-celiac intestinal mucosa and intestinal cell lines , 2006, Scandinavian journal of gastroenterology.

[34]  R. Troncone,et al.  Identification of Immunodominant Epitopes of α-Gliadin in HLA-DQ8 Transgenic Mice following Oral Immunization1 , 2005, The Journal of Immunology.

[35]  L. Melton,et al.  Celiac disease in type 1 diabetes mellitus in a North American community: prevalence, serologic screening, and clinical features. , 2005, Mayo Clinic proceedings.

[36]  G. Corazza,et al.  Coeliac disease , 2005, Journal of Clinical Pathology.

[37]  M. Rewers,et al.  Risk of celiac disease autoimmunity and timing of gluten introduction in the diet of infants at increased risk of disease. , 2005, JAMA.

[38]  J. Neu,et al.  Changes in Intestinal Morphology and Permeability in the BioBreeding Rat Before the Onset of Type 1 Diabetes , 2005, Journal of pediatric gastroenterology and nutrition.

[39]  K. Donaghue,et al.  Use of HLA typing in diagnosing celiac disease in patients with type 1 diabetes. , 2005, Diabetes care.

[40]  Ronald H. Zielke,et al.  Role of the intestinal tight junction modulator zonulin in the pathogenesis of type I diabetes in BB diabetic-prone rats. , 2005, Proceedings of the National Academy of Sciences of the United States of America.

[41]  M. Camilleri,et al.  A new model for dermatitis herpetiformis that uses HLA-DQ8 transgenic NOD mice. , 2004, The Journal of clinical investigation.

[42]  W. Malaisse,et al.  A waxing and waning skin rash , 2004, Gut.

[43]  Heather J Cordell,et al.  Absolute risk of childhood-onset type 1 diabetes defined by human leukocyte antigen class II genotype: a population-based study in the United Kingdom. , 2004, The Journal of clinical endocrinology and metabolism.

[44]  I. Cohen,et al.  Regulation of experimental autoimmune encephalomyelitis by CD4+, CD25+ and CD8+ T cells: analysis using depleting antibodies. , 2004, Journal of Autoimmunity.

[45]  G. Corazza,et al.  Intraepithelial lymphocytes in the villous tip: do they indicate potential coeliac disease? , 2004, Journal of Clinical Pathology.

[46]  C. Piccirillo,et al.  Cornerstone of peripheral tolerance: naturally occurring CD4+CD25+ regulatory T cells. , 2004, Trends in immunology.

[47]  S. Jalkanen,et al.  Diabetogenic T cells are primed both in pancreatic and gut‐associated lymph nodes in NOD mice , 2003, European journal of immunology.

[48]  M. Rewers,et al.  Timing of initial cereal exposure in infancy and risk of islet autoimmunity. , 2003, JAMA.

[49]  T. Flotte,et al.  Systemic Overexpression of IL-10 Induces CD4+CD25+ Cell Populations In Vivo and Ameliorates Type 1 Diabetes in Nonobese Diabetic Mice in a Dose-Dependent Fashion 1 , 2003, The Journal of Immunology.

[50]  J. Murray,et al.  Prevalence of celiac disease in at-risk and not-at-risk groups in the United States: a large multicenter study. , 2003, Archives of internal medicine.

[51]  S. Virgiliis,et al.  Early effects of gliadin on enterocyte intracellular signalling involved in intestinal barrier function , 2003, Gut.

[52]  Y. Kudva,et al.  Accelerated diabetes in rat insulin promoter-tumor necrosis factor-alpha transgenic nonobese diabetic mice lacking major histocompatibility class II molecules. , 2003, Diabetes.

[53]  J. Murray,et al.  HLA-DQ Determines the Response to Exogenous Wheat Proteins: A Model of Gluten Sensitivity in Transgenic Knockout Mice1 , 2002, The Journal of Immunology.

[54]  Y. Kudva,et al.  Modulation of insulitis and type 1 diabetes by transgenic HLA-DR3 and DQ8 in NOD mice lacking endogenous MHC class II. , 2002, Human immunology.

[55]  Ethan M. Shevach,et al.  Cutting Edge: Depletion of CD4+CD25+ Regulatory T Cells Is Necessary, But Not Sufficient, for Induction of Organ-Specific Autoimmune Disease , 2002, The Journal of Immunology.

[56]  T. Yılmaz,et al.  The prevalence of manifest and latent celiac disease in type 1 diabetes mellitus. , 2002, The Turkish journal of gastroenterology : the official journal of Turkish Society of Gastroenterology.

[57]  J. Seissler,et al.  General screening for celiac disease is advisable in children with type 1 diabetes. , 2002, Hormone and metabolic research = Hormon- und Stoffwechselforschung = Hormones et metabolisme.

[58]  J. Ilonen,et al.  Prevalence of coeliac disease in siblings of patients with Type I diabetes is related to the prevalence of DQB1*02 allele , 2001, Diabetologia.

[59]  T. Not,et al.  Gluten-dependent diabetes-related and thyroid-related autoantibodies in patients with celiac disease. , 2000, The Journal of pediatrics.

[60]  G. Gemme,et al.  Importance of gluten in the induction of endocrine autoantibodies and organ dysfunction in adolescent celiac patients , 2000, American Journal of Gastroenterology.

[61]  L. Wen,et al.  In Vivo Evidence for the Contribution of Human Histocompatibility Leukocyte Antigen (Hla)-Dq Molecules to the Development of Diabetes , 2000, The Journal of experimental medicine.

[62]  K. Buschard,et al.  Gluten‐free diet prevents diabetes in NOD mice , 1999, Diabetes/metabolism research and reviews.

[63]  L. Greco,et al.  Duration of exposure to gluten and risk for autoimmune disorders in patients with celiac disease. SIGEP Study Group for Autoimmune Disorders in Celiac Disease. , 1999, Gastroenterology.

[64]  L. Harrison,et al.  Cow's milk and type 1 diabetes: the real debate is about mucosal immune function. , 1999, Diabetes.

[65]  G. Oberhuber,et al.  Changes in Gastrointestinal Permeability in Celiac Disease , 1998, Digestive Diseases.

[66]  S. Jalkanen,et al.  Mucosal addressin is required for the development of diabetes in nonobese diabetic mice. , 1998, Journal of immunology.

[67]  J. Danska,et al.  Independent genetic regulation of T-cell and antigen-presenting cell participation in autoimmune islet inflammation. , 1998, Diabetes.

[68]  E. Leiter The NOD Mouse: A Model for Insulin‐Dependent Diabetes Mellitus , 1997, Current protocols in immunology.

[69]  D. Schuppan,et al.  Identification of tissue transglutaminase as the autoantigen of celiac disease , 1997, Nature Medicine.

[70]  O. Simell,et al.  Mucosa-Associated (βT-integrinhigh) Lymphocytes Accumulate Early in the Pancreas of NOD Mice and Show Aberrant Recirculation Behavior , 1996, Diabetes.

[71]  O. Simell,et al.  Recirculation and homing of lymphocyte subsets: dual homing specificity of beta 7-integrin(high)-lymphocytes in nonobese diabetic mice. , 1996, Blood.

[72]  Xiaojian Huang,et al.  Induction of type I diabetes by interferon-alpha in transgenic mice. , 1993, Science.

[73]  J. Visakorpi,et al.  The diagnosis of coeliac disease. A commentary on the current practices of members of the European Society for Paediatric Gastroenterology and Nutrition (ESPGAN). , 1979, Archives of disease in childhood.

[74]  F. Shanahan,et al.  Coeliac disease and diabetes mellitus: a study of 24 patients with HLA typing. , 1982, The Quarterly journal of medicine.

[75]  J. Murray Gluten sensitivity: from gut to brain , 2011 .

[76]  S. Jalkanen,et al.  Immunopathology and Infectious Disease Islet-Cell-Specific T Cells Can Use Different Homing Mechanisms to Infiltrate and Destroy Pancreatic Islets , 2010 .

[77]  N. Rivard,et al.  Polymeric binders suppress gliadin-induced toxicity in the intestinal epithelium. , 2009, Gastroenterology.

[78]  J. Murray,et al.  Gliadin-dependent neuromuscular and epithelial secretory responses in gluten-sensitive HLA-DQ8 transgenic mice. , 2008, American journal of physiology. Gastrointestinal and liver physiology.

[79]  L. Adorini,et al.  Animal models of spontaneous autoimmune disease: type 1 diabetes in the nonobese diabetic mouse. , 2007, Methods in molecular biology.

[80]  E. Bonifacio,et al.  Gluten-free diet in subjects at risk for type 1 diabetes: a tool for delaying progression to clinical disease? , 2005, Advances in experimental medicine and biology.

[81]  A. Ziegler,et al.  Elimination of dietary gluten and development of type 1 diabetes in high risk subjects. , 2004, The review of diabetic studies : RDS.

[82]  E. Bonifacio,et al.  Six months of gluten-free diet do not influence autoantibody titers, but improve insulin secretion in subjects at high risk for type 1 diabetes. , 2003, The Journal of clinical endocrinology and metabolism.

[83]  J. Partanen,et al.  Celiac disease risk in the USA: high prevalence of antiendomysium antibodies in healthy blood donors. , 1998, Scandinavian journal of gastroenterology.

[84]  D. Cheţa,et al.  Animal Models of Type I (Insulin-Dependent) Diabetes Mellitus , 1998, Journal of pediatric endocrinology & metabolism : JPEM.

[85]  M N Marsh,et al.  Gluten, major histocompatibility complex, and the small intestine. A molecular and immunobiologic approach to the spectrum of gluten sensitivity ('celiac sprue'). , 1992, Gastroenterology.

[86]  H. Oksa,et al.  High frequency of coeliac disease in adult patients with type-I diabetes. , 1989, Scandinavian journal of gastroenterology.