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Matthias von Herrath

Publications and source records attributed to Matthias von Herrath.

At least 19 recordsLinked to original sources
PubMed2006

Anti-CD3 and nasal proinsulin combination therapy enhances remission from recent-onset autoimmune diabetes by inducing Tregs.

Safe induction of autoantigen-specific long-term tolerance is the "holy grail" for the treatment of autoimmune diseases. In animal models of type 1 diabetes, oral or i.n. immunization with islet antigens induces Tregs that are capable of bystander suppression. However, such interventions are only effective early in the prediabetic phase. Here, we demonstrate that a novel combination treatment with anti-CD3epsilon-specific antibody and i.n. proinsulin peptide can reverse recent-onset diabetes in 2 murine diabetes models with much higher efficacy than with monotherapy with anti-CD3 or antigen alone. In vivo, expansion of CD25(+)Foxp3(+) and insulin-specific Tregs producing IL-10, TGF-beta, and IL-4 was strongly enhanced. These cells could transfer dominant tolerance to immunocompetent recent-onset diabetic recipients and suppressed heterologous autoaggressive CD8 responses. Thus, combining a systemic immune modulator with antigen-specific Treg induction is more efficacious in reverting diabetes. Since Tregs act site-specifically, this strategy should also be expected to reduce the potential for systemic side effects.

Administration, Intranasal↗
PubMed2006

Progress in the development of immune-based therapies for type 1 diabetes mellitus.

Between ten and twenty million people worldwide have type 1 diabetes mellitus (T1DM), which has previously been called juvenile diabetes, childhood diabetes, and insulin-dependent diabetes mellitus. T1DM is undoubtedly a multifactorial disease affecting predisposed individuals with genetic susceptibilities; it is also associated with environmental factors leading to unbalanced immune responses. This chronic disorder is caused by auto-aggressive T lymphocytes entering the pancreatic islets of Langerhans where they destroy the insulin-producing beta-cells. A wide variety of immuno-interventions cure T1DM effectively in different animal models when given early in disease development. However, few of these interventions are efficacious in humans at a later stage of the disease. Indeed, only three immunotherapeutic compounds have demonstrated both safety and efficacy in phase II/III clinical trials. Although much time and resources have been spent on generating potent immune therapies, none of the patients enrolled in these trials have achieved normoglycemia in the absence of insulin injections. Many reasons can account for such a disappointing conclusion. Firstly, the dynamics of disease pathogenesis differs significantly from patient to patient, which directly impacts the therapeutic efficacy. Also, at trial entry, the percentage of remaining pancreatic beta-cells in T1DM patients often reflects the odds of responding positively to treatment. Based on the knowledge we have gained from preclinical studies and clinical trials, several steps have been made in the development of safer and more efficient immune-based therapies. There are, however, a number of concerns that should be addressed in order to improve future therapeutic strategies.

Animals↗
PubMed2005

Different diabetogenic potential of autoaggressive CD8+ clones associated with IFN-gamma-inducible protein 10 (CXC chemokine ligand 10) production but not cytokine expression, cytolytic activity, or homing characteristics.

Type 1 diabetes mellitus is an autoimmune disease characterized by T cell-mediated destruction of the insulin-producing beta cells in the islets of Langerhans. From studies in animal models, CD8(+) T cells recognizing autoantigens such as islet-specific glucose-6-phosphatase catalytic subunit-related protein, insulin, or glutamic acid decarboxylase (GAD) are believed to play important roles in both the early and late phases of beta cell destruction. In this study, we investigated the factors governing the diabetogenic potential of autoreactive CD8(+) clones isolated from spleens of NOD mice that had been immunized with GAD65(515-524) or insulin B-chain(15-23) peptides. Although these two clones were identical in most phenotypic and functional aspects, for example cytokine production and killing of autologous beta cells, they differed in the expression of IFN-gamma-inducible protein-10, which was only produced at high levels by the insulin-specific clone, but not by the GAD65-specific clone, and other autoantigen-specific nonpathogenic CD8 T cell clones. Interestingly, upon i.p. injection into neonatal mice, only the insulin B-chain(15-23)-reactive CD8(+) T clone accelerated diabetes in all recipients after 4 wk, although both insulin- and GAD-reactive clones homed to pancreas and pancreatic lymph nodes with similar kinetics. Diabetes was associated with increased pancreatic T cell infiltration and, in particular, recruitment of macrophages. Thus, secretion of IFN-gamma-inducible protein-10 by autoaggressive CD8(+) lymphocytes might determine their diabetogenic capacity by affecting recruitment of cells to the insulitic lesion.

Animals↗
PubMed2005

How viral infections affect the autoimmune process leading to type 1 diabetes.

Despite a large body of evidence describing associations between viruses and the development of type 1 diabetes (T1D) in genetically prone individuals, clearly defining causative infectious agents has not been successful. A likely explanation is that the link between infections and autoimmunity is more multifaceted than we initially assumed. Viral footprints might be hard to detect systemically or in the target organ once autoimmunity has been initiated, and several infections might have to act in concert to precipitate clinical autoimmunity. Furthermore, cells cross-reactive between viral and self-antigens might express low avidity T cell receptors and only be present transiently in the blood of affected individuals. In addition, there are two new observations from animal models that we should take into account at this point: first, viral infections alone might not be able to induce disease in the absence of other inflammatory factors (supporting the "fertile field hypothesis" [M.G. von Herrath et al., Microorganisms and autoimmunity: making the barren field fertile? Nat. Rev. Microbiol. 1 (2003) 151-157, ]). Second, increasing evidence indicates that viruses can play a role in preventing rather than enhancing T1D development (supporting the "hygiene hypothesis" [J.F. Bach, Protective role of infections and vaccinations on autoimmune diseases. J. Autoimmun. 16 (2001) 347-353]). In this article we will present an overview of the early events and requirements that could account for T1D predisposition and development, and explain how these can be modulated by viral infections. Focusing on coxsackie B and lymphocytic choriomeningitis virus infections, we will discuss new data that can hopefully help us understand how virus-induced inflammation can positively or negatively affect the clinical outcome of islet-autoimmunity and T1D.

Animals↗
PubMed2005

E1-INT (Transition Therapeutics/Novo Nordisk).

Transition Therapeutics (through its acquisition of Waratah Pharmaceuticals), in collaboration with Novo Nordisk, is developing E1-INT, an injectable islet neogenesis therapy comprising an epidermal growth factor analog and a gastrin analog, for the treatment of insulin-dependent (type 1) and non-insulin-dependent (type 2) diabetes. The compound is currently undergoing phase II clinical trials.

Animals↗
PubMed2004

Regulatory T cells and type 1 diabetes.

A resurgent interest in T cells with regulatory activity has prompted many recent investigations into their potential role in pathogenesis and prevention of type 1 diabetes. While some studies have suggested that regulatory T cells participate in the preservation of active tolerance to autoantigens, findings obtained in multiple animal models for type 1 diabetes have documented the therapeutic induction of protective regulatory T cells. A review of the proposed mechanisms operative in regulatory T cell-mediated diabetes prevention indicates a common theme of localized regulatory T cell activation and subsequent suppression of pathogenic T cell trafficking, differentiation, and/or effector function. However, adaptation of experimental protocols for regulatory T cell induction to clinical applications faces several challenges. Immunization with self-antigens carries obvious risks especially in the face of multiple variables that can affect generation, trafficking, and regulatory activity of autoantigen-specific T cells. We also emphasize that the frequent use of lymphopenic recipients of adoptively transferred pathogenic and regulatory T cells constitutes a potentially confounding variable that further complicates translation into clinical settings. The therapeutic induction of regulatory T cells in prediabetic individuals carries great potential but is currently limited by the risks associated with deliberate generation of autoimmune responses that may exacerbate rather than ameliorate the autoimmune process. However, in vitro amplification and autologous regulatory T cell therapy might soon become a clinical reality.

Animals↗
PubMed2004

Tolerance tag team.

Explore the source record for details and available documents.

Administration, Oral↗
PubMed2004

Satisfaction (not) guaranteed: re-evaluating the use of animal models of type 1 diabetes.

Without a doubt, rodent models have been instrumental in describing pathways that lead to pancreatic beta-cell destruction, evaluating potential causes of type 1 diabetes and providing proof-of-principle for the potential of immune-based interventions. However, despite more than two decades of productive research, we are still yet to define an initiating autoantigen for the human disease, to determine the precise mechanisms of beta-cell destruction in humans and to design interventions that prevent or cure type 1 diabetes. In this Perspective article, we propose that a major philosophical change would benefit this field, a proposition that is based on evaluation of situations in which rodent models have provided useful guidance and in which they have led to disappointments.

Animals↗
PubMed2004

Molecular and cellular control of T1/T2 immunity at the interface between antimicrobial defense and immune pathology.

The immune system evolved to rapidly recognize infectious threats and promptly mobilize cellular effectors to the infection site. Establishment of a robust T1-type immunity is a prerequisite for effective defense against most viruses and intracellular bacteria. However, accumulating evidence shows that T1 and T2 responses during such infections are not mutually exclusive. A possibility may be that the dual T1-T2 nature of antiviral immune responses is merely a byproduct of less than perfect crossregulatory mechanisms. Herein, we discuss molecular and cellular mechanisms of T-cell differentiation along with recent evidence supporting the hypothesis that rather than representing an epiphenomenon, coinduction of virus-specific T2 cells plays a significant homeostatic role. Thus, molecular pathways that regulate IL-4 production during influenza virus infection monitor T1-mediated immune responses in vital organs such as lungs and prevent immune pathology that may otherwise interfere with recovery from disease. Such evidence suggests that coinduction of T2 immunity maintains immune homeostasis during T1-mediated defense reactions. Finally, we outline implications on the earlier concept of T1/T2 dichotomy, supporting a model in which these two subsets, rather than being mutually antagonistic, together facilitate the recovery from infection.

Cell Differentiation↗
PubMed2004

Islet regeneration needed for overcoming autoimmune destruction - considerations on the pathogenesis of type 1 diabetes.

How many new beta-cells need to be generated in order to withstand the attack of an 'average-strength' destructive autoimmune response? An answer to this question is central for the design of intervention approaches aimed at dampening or redirecting parts of the autoimmune response and allowing for the generation of new beta-cells. In this article, we consider quantitative and spatial restrictions of destructive T-cell activity, in balance with the regenerative capacity and neogenesis of beta-cells. We assume that the initial interaction between specific autoaggressive cytotoxic T-lymphocytes (CTL) and beta-cells is a terminal event leading to the elimination of the beta-cell and removal from the pool of potential sources for beta-cell replenishment. Furthermore, we propose that there may be no way to save an individual islet from complete destruction, once a few activated CTL effectors have gained entry, based on the fact that activated CTL are 'committed killers' and hard to turn off. Thus, mechanisms that restrict CTL access to islets or provide 'immune privilege' to defined locations within islets and/or ductal tissue are critical to allow beta-cell regeneration in the face of ongoing autoimmune destruction. The key to halting progression of type 1 diabetes pathogenesis should build on the observation that islets die in a highly non-synchronized fashion, at least during the more chronic disease course. These considerations suggest a compartmentalized view of the diseased pancreas so that substantial histopathological differences among individual islets may be exploited to facilitate preservation and/or regeneration of selected islets. The recent development of novel technologies will allow more precise quantification of in vivo destruction and regeneration in order to test these hypotheses.

CD8-Positive T-Lymphocytes↗
PubMed2003

Antigen-driven effector CD8 T cell function regulated by T-bet.

Type 1 immunity relies on the differentiation of two major subsets of T lymphocytes, the CD4+ T helper (Th) cell and the CD8+ cytotoxic T cell, that direct inflammatory and cytotoxic responses essential for the destruction of intracellular and extracellular pathogens. In contrast to CD4 cells, little is known about transcription factors that control the transition from the CD8 naïve to effector cell stage. Here, we report that the transcription factor T-bet, known to regulate Th cell differentiation, also controls the generation of the CD8+ cytotoxic effector cell. Antigen-driven generation of effector CD8+ cells was impaired in OT-I T cell receptor transgenic mice lacking T-bet, resulting in diminished cytotoxicity and a marked shift in cytokine secretion profiles. Furthermore, mice lacking T-bet responded poorly to infection with lymphocytic choriomeningitis virus. T-bet is a key player in the generation of type 1 immunity, in both Th and T cytotoxic cells.

Animals↗
PubMed2003

Regulation of viral and autoimmune responses.

We have studied the induction and effector function of Th2-like regulatory cells in mouse models for type 1 diabetes (NOD and RIP-LCMV). CD4+ lymphocytes with specificity for insulin can be induced by immunization with the insulin B chain via the oral route or by DNA vaccination. Such cells are protective upon adoptive transfer and prevent diabetes development in syngeneic pre-diabetic recipients. In comparison to non-regulatory insulin B-specific cell lines, they produce high amounts of interleukin (IL)4 and IL10, whereas interferon (IFN)gamma and tumour necrosis factor (TNF)alpha levels are comparable. Indeed, IL4 is essential for the protective capability, as evidenced by use of IL4-deficient mice and sorting of IL4+ versus IL4- lymphocytes prior to transfer. Mechanistically, these cells act as bystander suppressors in the pancreatic draining node, the location where their cognate antigen, insulin B, is presented during the pre-diabetic inflammatory process. As a consequence, the autoaggressive response is locally dampened. We propose that this is achieved by modulation of antigen presenting cells that lose the ability to propagate aggressive responses after exposure to IL4 or IL10 in vitro. The clinically attractive side of our strategy is that it only acts as the site of inflammation, thus circumventing systemic side effects. In order to avoid induction of insulin B-specific autoaggressive T cells we have demonstrated that administration of IL4 or IL10 at the time of immunization is beneficial and therefore should be part of a potential future clinical application. Interestingly, these Th2-like regulators share in our systems no features with the so-called CD25+ regulatory cells, whose antigen specificity is still unclear. However, we have recent evidence that virus specific CD25+ cells can be generated and are able to affect antiviral responses in vivo.

Animals↗
PubMed2003

Introducing baselines for therapeutic use of regulatory T cells and cytokines in autoimmunity.

The concept of therapeutic immune regulation aiming to treat autoimmune diseases has been validated in multiple animal models, yet, the development of strategies for treatment of human autoimmune diseases remains problematic. Main obstacles are the contradictory findings in different model systems, as well as the contrasting functions of regulatory lymphocytes and cytokines. By drawing examples primarily from experimental type 1 diabetes, we propose that regulatory cells and cytokines can be classified according to the baseline at which they operate in healthy individuals and disease states that are not accompanied by severe systemic immune deficiency or skewing. Consequently, deletion or neutralization of regulatory cells or cytokines operative at high levels to maintain systemic homeostasis should constitute a therapeutic strategy for immune enhancement (e.g. tumor- and pathogen-specific immunity), whereas boosting these factors will have limited effects if the therapeutic goal is a downmodulation of immune responses (e.g. autoimmunity). Conversely, regulatory cells and cytokines operative at low homeostatic levels should unfold therapeutic capacities by further embellishment but not additional reduction.

Animals↗
PubMed2002

Endogenous expression levels of autoantigens influence success or failure of DNA immunizations to prevent type 1 diabetes: addition of IL-4 increases safety.

Administration of autoantigens through DNA immunizations or via the oral route can prevent progression of islet destruction and lower the incidence of type 1 diabetes in animal models. This beneficial effect is mediated by autoreactive regulatory CD4 lymphocytes, and it is known that their induction depends on the precise dose and route of antigen administration. However, it is not clear which endogenous factors determine when such immunizations lead to activation of regulatory versus aggressive autoreactive lymphocytes and how a deleterious outcome can be avoided. Here we describe novel observations made in an animal model for virally induced type 1 diabetes, showing that the endogenous expression levels of the islet antigens and glutamic acid decarboxylase determine whether immunization with these antigens is beneficial or detrimental. Lower expression levels in beta-cells support immune regulation resulting in induction of autoreactive, regulatory cells characterized by increased IL-4 production (Th2-like), whereas higher levels favor Th1-like autoaggressive responses characterized by augmented IFN-gamma generation. Co-immunization with an IL-4-expressing plasmid reduces the risk of augmenting autoaggression and in this way increases the safety margin of this immune-based therapy. Our findings will be of importance for designing safe antigen-specific interventions for human type 1 diabetes.

Animals↗