PD-L1 genetic overexpression or pharmacological restoration in hematopoietic stem and progenitor cells reverses autoimmune diabetes

• Published in: Science translational medicine Vol. 9; no. 416
• Main Authors: Ben Nasr, Moufida, Tezza, Sara, D'Addio, Francesca, Mameli, Chiara, Usuelli, Vera, Maestroni, Anna, Corradi, Domenico, Belletti, Silvana, Albarello, Luca, Becchi, Gabriella, Fadini, Gian Paolo, Schuetz, Christian, Markmann, James, Wasserfall, Clive, Zon, Leonard, Zuccotti, Gian Vincenzo, Fiorina, Paolo
• Format: Journal Article
• Language: English
• Published: United States 15.11.2017
• Subjects: Animals; Autoimmunity - genetics; Autoimmunity - physiology; B7-H1 Antigen - genetics; B7-H1 Antigen - metabolism; Diabetes Mellitus, Type 1 - metabolism; Genetic Therapy; Hematopoietic Stem Cells - cytology; Hematopoietic Stem Cells - metabolism; Humans; Hyperglycemia - genetics; Hyperglycemia - metabolism; Mice; Mice, Inbred C57BL; Stem Cells - cytology; Stem Cells - metabolism
• ISSN: 1946-6242
• DOI: 10.1126/scitranslmed.aam7543

Immunologically based clinical trials performed thus far have failed to cure type 1 diabetes (T1D), in part because these approaches were nonspecific. Because the disease is driven by autoreactive CD4 T cells, which destroy β cells, transplantation of hematopoietic stem and progenitor cells (HSPCs) has been recently offered as a therapy for T1D. Our transcriptomic profiling of HSPCs revealed that these cells are deficient in programmed death ligand 1 (PD-L1), an important immune checkpoint, in the T1D nonobese diabetic (NOD) mouse model. Notably, the immunoregulatory molecule PD-L1 plays a determinant role in controlling/inhibiting activated T cells and thus maintains immune tolerance. Furthermore, our genome-wide and bioinformatic analysis revealed the existence of a network of microRNAs (miRNAs) controlling PD-L1 expression, and silencing one of key altered miRNAs restored PD-L1 expression in HSPCs. We therefore sought to determine whether restoration of this defect would cure T1D as an alternative to immunosuppression. Genetically engineered or pharmacologically modulated HSPCs overexpressing PD-L1 inhibited the autoimmune response in vitro, reverted diabetes in newly hyperglycemic NOD mice in vivo, and homed to the pancreas of hyperglycemic NOD mice. The PD-L1 expression defect was confirmed in human HSPCs in T1D patients as well, and pharmacologically modulated human HSPCs also inhibited the autoimmune response in vitro. Targeting a specific immune checkpoint defect in HSPCs thus may contribute to establishing a cure for T1D.