Exp Clin Endocrinol Diabetes 2015; 123(10): 638-644
DOI: 10.1055/s-0035-1559759
Article
© Georg Thieme Verlag KG Stuttgart · New York

Combinatorial Treatment of Bone Marrow Transplantation and Regulatory T Cells Improves Glycemia in Streptozotocin-diabetic Mice

H. Min*
1   Center of Translational Medicine, Jiangsu Key Laboratory of Molecular Medicine, Nanjing University Medical School, China
,
J. Ding*
2   Department of Respiratory Medicine, The Affiliated Drum Tower Hospital of Nanjing University Medical School, Nanjing, China
,
Y. Wen§
1   Center of Translational Medicine, Jiangsu Key Laboratory of Molecular Medicine, Nanjing University Medical School, China
,
X. Ma
1   Center of Translational Medicine, Jiangsu Key Laboratory of Molecular Medicine, Nanjing University Medical School, China
,
Q. Gao§
1   Center of Translational Medicine, Jiangsu Key Laboratory of Molecular Medicine, Nanjing University Medical School, China
› Author Affiliations
Further Information

Publication History

received 17 May 2015
first decision 16 July 2015

accepted 12 August 2015

Publication Date:
01 December 2015 (online)

Abstract

Autologous hematopoietic stem cell transplantation (HSCT) has limited benefits in patients with a long-duration of diabetes. To test whether a T regulatory cells (Tregs) and syngeneic bone marrow transplantation (syn-BMT) co-transplantation regimen will be effective, BMT±Tregs infusion was performed in streptozotocin-diabetic mice with a long-duaration of diabetes. Diabetic status, pancreata morphometry and Tregs/Th17 balancing were tested on day 100 after transplantation. While hyperglycemia relapsed in mice receiving BMT monotherapy about 6 weeks after transplantation, combined therapy with BMT+Tregs improved hyperglycemia and C-peptides, preserved islet cell mass within 100 days after BMT. Although both groups BMT and BMT+Tregs induced Tregs/Th17 rebalancing, combined treatment of BMT+Tregs synergistically elevated TGF-β1 and FoxP3 expression compared with BMT monotherapy. The sustained rebalance of Tregs/Th17 may be one possible explanation for the longer benefits of the combined treatment of BMT+Tregs over BMT monotherapy to mice with a long-duaration of diabetes. This observation of the therapeutic potential of BMCs+Tregs treatment may have important implications for clinical therapy for patients with a long-duration of diabetes.

* These 2 authors contributed equally to this paper.


§ Co-corresponding author.


 
  • References

  • 1 Akash MS, Rehman K, Chen S. Role of inflammatory mechanisms in pathogenesis of type 2 diabetes mellitus. J Cell Biochem 2013; 114: 525-531
  • 2 Bettelli E, Carrier Y, Gao W et al. Reciprocal developmental pathways for the generation of pathogenic effector TH17 and regulatory T cells. Nature 2006; 441: 235-238
  • 3 Bhansali A, Asokumar P, Walia R et al. Efficacy and safety of autologous bone marrow-derived stem cell transplantation in patients with type 2 diabetes mellitus: a randomized placebo-controlled study. Cell Transplant 2014; 23: 1075-1085
  • 4 Bhansali A, Upreti V, Walia R et al. Efficacy and safety of autologous bone marrow derived hematopoietic stem cell transplantation in patients with type 2 DM: A 15 months follow-up study. Indian J Endocrinol Metab 2014; 18: 838-845
  • 5 Bluestone JA, Herold K, Eisenbarth G. Genetics, pathogenesis and clinical interventions in type 1 diabetes. Nature 2010; 464: 1293-1300
  • 6 Brusko TM, Putnam AL, Bluestone JA. Human regulatory T cells: role in autoimmune disease and therapeutic opportunities. Immunol Rev 2008; 223: 371-390
  • 7 Cao X, Han ZB, Zhao H et al. Transplantation of mesenchymal stem cells recruits trophic macrophages to induce pancreatic beta cell regeneration in diabetic mice. Int J Biochem Cell Biol 2014; 53: 372-379
  • 8 Couri CE, Oliveira MC, Stracieri AB et al. C-peptide levels and insulin independence following autologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus. JAMA 2009; 301: 1573-1579
  • 9 Ding Y, Shen S, Lino AC et al. Beta-catenin stabilization extends regulatory T cell survival and induces anergy in nonregulatory T cells. Nature medicine 2008; 14: 162-169
  • 10 Eizirik DL, Colli ML, Ortis F. The role of inflammation in insulitis and beta-cell loss in type 1 diabetes. Nat Rev Endocrinol 2009; 5: 219-226
  • 11 Ferraro A, Socci C, Stabilini A et al. Expansion of Th17 cells and functional defects in T regulatory cells are key features of the pancreatic lymph nodes in patients with type 1 diabetes. Diabetes 2011; 60: 2903-2913
  • 12 Jagannathan-Bogdan M, McDonnell ME, Shin H et al. Elevated proinflammatory cytokine production by a skewed T cell compartment requires monocytes and promotes inflammation in type 2 diabetes. J Immunol 2011; 186: 1162-1172
  • 13 Li L, Gu W, Zhu D. Novel therapy for type 1 diabetes: autologous hematopoietic stem cell transplantation. J Diabetes 2012; 4: 332-337
  • 14 Li L, Shen S, Ouyang J et al. Autologous hematopoietic stem cell transplantation modulates immunocompetent cells and improves beta-cell function in Chinese patients with new onset of type 1 diabetes. J Clin Endocrinol Metab 2012; 97: 1729-1736
  • 15 Marek-Trzonkowska N, Mysliwiec M, Dobyszuk A et al. Administration of CD4+CD25highCD127- regulatory T cells preserves beta-cell function in type 1 diabetes in children. Diabetes Care 2012; 35: 1817-1820
  • 16 Oram RA, Jones AG, Besser RE et al. The majority of patients with long-duration type 1 diabetes are insulin microsecretors and have functioning beta cells. 2014; 57: 187-191
  • 17 Rhodes CJ. Type 2 diabetes-a matter of beta-cell life and death?. Science 2005; 307: 380-384
  • 18 Sakaguchi S, Miyara M, Costantino CM et al. FOXP3+ regulatory T cells in the human immune system. Nat Rev Immunol 2010; 10: 490-500
  • 19 Sarkar D, Biswas M, Liao G et al. Ex Vivo Expanded Autologous Polyclonal Regulatory T Cells Suppress Inhibitor Formation in Hemophilia. Mol Ther Methods Clin Dev 2014; 1 pii: 14030
  • 20 Sia C, Hanninen A. Functional alterations of proinflammatory monocytes by T regulatory cells: implications for the prevention and reversal of type 1 diabetes. Rev Diabet Stud 2010; 7: 6-14
  • 21 Singer BD, King LS, D’Alessio FR. Regulatory T cells as immunotherapy. Front Immunol 2014; 5: 46
  • 22 Taneera J, Rosengren A, Renstrom E et al. Failure of transplanted bone marrow cells to adopt a pancreatic beta-cell fate. Diabetes 2006; 55: 290-296
  • 23 Voltarelli JC, Couri CE, Stracieri AB et al. Autologous nonmyeloablative hematopoietic stem cell transplantation in newly diagnosed type 1 diabetes mellitus. JAMA 2007; 297: 1568-1576
  • 24 Wang L, Zhao S, Mao H et al. Autologous bone marrow stem cell transplantation for the treatment of type 2 diabetes mellitus. Chin Med J (Engl) 2011; 124: 3622-3628
  • 25 Wen Y, Ouyang J, Li W et al. Time point is important for effects of syngeneic bone marrow transplantation for type 1 diabetes in mice. Transplant Proc 2009; 41: 1801-1807
  • 26 Wen Y, Ouyang J, Yang R et al. Reversal of new-onset type 1 diabetes in mice by syngeneic bone marrow transplantation. Biochem Biophys Res Commun 2008; 374: 282-287