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R G Gill

Publications and source records attributed to R G Gill.

At least 37 records · Page 2Linked to original sources
PubMed1996

Evidence of recurrent autoimmunity in human allogeneic islet transplantation.

We transplanted 10,000 isolated, handpicked human pancreatic islets into the subfascial compartment of the forearm muscle of a type I diabetic recipient who had received a successful renal transplant one year prior. The recipient was maintained on his usual immunosuppressive therapy of cyclosporine, azathioprine, and prednisone. A biopsy performed 7 days after transplantation showed normal islets with both insulin- and glucagon-staining cells present and no lymphocytic infiltration. A second biopsy performed 14 days after transplantation showed a dense mononuclear cell infiltrate with a preferential loss of insulin-staining cells relative to glucagon-staining cells in the islets. These data are consistent with recurrent autoimmune diabetes in an isolated islet allograft in an immunosuppressed type I diabetic recipient. In addition, this forearm subfascial site may be a useful means to monitor islet rejection and autoimmune recurrence in therapeutic intraportal islet allografts.

Adult↗
PubMed1996

T lymphocyte indifference to extrathymic islet allografts.

Although the deletion of self-reactive T cells maturing in the thymus is well documented, the nature of tolerance to Ags expressed exclusively on peripheral (extrathymic) tissues is less clear. Numerous studies have examined T cell reactivity to transgene-encoded Ags expressed in the periphery through tissue-specific promoters. These studies have yielded varied results concerning the degree and nature of tolerance induced to these Ags, ranging from T cell clonal deletion or inactivation to clonal "ignorance" of the peripheral transgene-encoded Ag. Furthermore, the relationship of these findings to the generation and maintenance of transplantation tolerance to extrathymic tissue allografts remains unclear. Whereas transgenic studies represent a developmental form of tolerance, grafted tissues are introduced into adult, nontolerant recipients. To relate these two model systems, we determined whether extrathymic tissue allografts could induce a developmental form of tolerance. As a model of extrathymic alloantigen expression, pancreatic islet allografts, depleted of donor APCs, were established in the periphery of severe combined immune-deficient (SCID) mice. We then examined the potential donor reactivity of adoptively transferred bone marrow-derived T cell precursors maturing in the presence of the established peripheral allograft. Such T cells were neither activated nor tolerized either in vitro or in vivo, suggesting that T cells are indifferent to Ags expressed by extrathymic islet allografts when presented in the absence of a second costimulatory signal.

Animals↗
PubMed1996

Autoimmune destruction of islet grafts in the NOD mouse is resistant to 15-deoxyspergualin but sensitive to anti-CD4 antibody.

Islet allografts transplanted into Type I diabetic recipients may be destroyed by allorejection or recurrent autoimmune diabetes. We studied islet transplantation in three murine models in order to determine the relative sensitivity of autoimmunity and alloimmunity to two immunosuppressive agents that may be useful in clinical islet transplantation: 15-deoxyspergualin (DSG) and anti-CD4 antibody (GK 1.5). In the model in which only allorejection occurs (BALB/c islets transplanted into streptozotocin-induced diabetic CBA or streptozotocin-induced diabetic NOD recipients), both DSG and anti-CD4 antibody treatment led to indefinite survival of allogeneic islets (>100 days in both treatments). In the second model in which only recurrent autoimmunity can destroy islet grafts (islets from NOD donors transplanted into spontaneously diabetic NOD recipients), only anti-CD4 treatment caused prolonged graft survival [MST 36.7 +/- 6.8 days vs 9.8 +/- 1.8 days (controls), P < 0.0002]. Treatment with DSG did not cause any increase in graft survival (MST 12.6 +/- 5.4 days, NS). Finally, using a model in which both autoimmunity and allorejection may occur (BALB/c to spontaneously diabetic NOD mice), treatment with anti-CD4 caused marked graft prolongation [42.0 +/- 14.5 days vs 7.2 +/- 0.8 days (control), P < 0.002] while DSG again did not prolong graft survival with respect to untreated recipients (9.8 +/- 3.0, NS). We conclude that recurrent autoimmunity in the NOD mouse involves a CD4+ T cell that is not sensitive to DSG. Anti-CD4 antibody may be useful in human clinical islet transplantation trials because it seems to prevent both allorejection and recurrent autoimmunity.

Animals↗
PubMed1996

Pancreatic islet allograft immunity and tolerance: the two-signal hypothesis revisited.

The principle assumption of this discussion is that costimulation (CoS) forms the primary stimulus that compels T cells to mount a response to their specific antigen. However, this response can be either positive or negative, depending on the developmental stage of the T cell and the microenvironment in which the antigen and CoS are received. Thus, both immunity and tolerance may represent different outcomes of a two-signal process. We would emphasize that CoS is a functional term and not a strict molecular definition. While many molecular interactions have been described as providing CoS activity, notably those involving the B-7 family of cell surface molecules, it is not yet clear what combination(s) of non-antigen-specific signals may fulfil this function. This point is important because many studies have achieved tolerance through strategies designed to inhibit specific CoS molecules. However, it may be that differential signaling through distinct CoS molecules, rather than a global inhibition of CoS per se, plays a role in the generation of active tolerance in such studies (Bluestone 1995). A corollary of this notion is that antigen (signal 1) delivery to T cells is a null event and so is not an inherently paralysing signal. Of course, if signal 1 is not itself a tolerogenic signal, then other mechanisms are necessary to explain many empirical observations of tolerance to allogeneic or self antigens. This is best illustrated by those forms of functional tolerance to either alloantigens or self antigens that do not appear to be the result of clonal deletion/inactivation. It would be relatively simple to invoke a model of tolerance whereby the relevant tissue-destructive cell is eliminated or inactivated; such a model would preclude the necessity to suggest active regulatory mechanisms of tolerance. However, in several model systems, including our own observations concerning tolerance induction to APC-depleted islet allografts, tissue-destructive T cells can persist in recipients tolerant to allogeneic or self antigens. Furthermore, there are key examples in which tolerance demonstrates a dominant phenotype; that is, tolerant cells can regulate the activity of naive, non-tolerant cells. This latter observation points to the function of an active, regulatory form of tolerance. As such, we would emphasize that tolerance should not be defined as unresponsiveness since the tolerant state is the consequence of very active immune reactions.

Animals↗
PubMed1995

Donor antigen-presenting cell-independent rejection of islet xenografts.

Donor-derived antigen-presenting cells (APC) are thought to serve as major stimulators for triggering the rejection of tissue allografts. However, the capacity of APC to stimulate xenogeneic T cells is generally deficient relative to the corresponding response from allogeneic T cells. For this reason, the contribution of donor-type APC to xenogeneic graft rejection remains unclear. Using a concordant species combination (rat to mouse), we examined the requirement for donor-type APC in triggering islet xenograft rejection. While the depletion of donor-type APC resulted in indefinite allograft survival, similar depletion of APC from xenogeneic rat islets resulted in only modest graft prolongation. Furthermore, APC-depleted rat xenografts were rejected by a CD8+ T cell-independent mechanism, as determined by appropriate depletion of T cell subsets through monoclonal antibody therapy. This contrasts with the dependence of islet allograft rejection on both CD4+ and CD8+ T cells. Although in vitro experiments show that rat APC can directly stimulate mouse T cells, rat APC do not appear to be required for xenograft immunity in vivo. We conclude that the mechanisms of islet allograft and xenograft rejection differ both in the dependence on donor-type APC and in the role of T cell subsets in the response.

Animals↗
PubMed1995

Epitope specificity, cytokine production profile and diabetogenic activity of insulin-specific T cell clones isolated from NOD mice.

T cells are known to play an important role in beta cell destruction in the nonobese diabetic (NOD) mouse model of Type I diabetes and islet-specific T cell clones have been demonstrated to be capable of adoptive transfer of diabetes. One important issue involves the identity of beta cell antigens that are recognized by nominally islet cell-specific T cell clones. We have previously reported that insulin-specific T cells are a predominant component of islet-specific T cells isolated from islet infiltrates of pre-diabetic NOD mice. In this report we examine six independently derived insulin-specific T cell clones established from islet infiltrates of pre-diabetic NOD mice in detail. All six clones were found to be specific to a region of the insulin molecule defined by a synthetic peptide encompassing residues 9-23 of the B chain. Despite this restricted specificity, each member of this panel exhibited a distinct receptor specificity defined either by V beta usage or antigen fine specificity. Five clones produced interferon (IFN)-gamma but not interleukin (IL)-4, placing them in the T helper type 1 (TH1)-like category whereas one clone produced both IL-4 and IFN-gamma, a characteristic of TH0 cells. All six clones were capable of either acceleration of diabetes in young NOD mice or adoptive transfer to NODscid mice. Taken together, these results suggest that spontaneously arising insulin-specific T cells participate in beta cell destruction during development of diabetes in NOD mice.

Amino Acid Sequence↗
PubMed1995

Prolongation of islet allograft survival with an antibody to vascular cell adhesion molecule 1.

BACKGROUND: The purpose of this study was to determine whether an antibody to vascular cell adhesion molecule 1 (VCAM1) prolongs the survival of neovascularized pancreatic islet allografts. METHODS: We treated CBA (H-2k) recipients of BALB/c (H-2d) islet allografts with anti-VCAM1 antibody (400 micrograms/day for 20 days). Sensitized recipients of islet grafts also were treated with anti-VCAM1. To study mechanism we performed mixed lymphocyte reactions (MLRs) with anti-VCAM1 and studied the graft infiltrate in treated recipients. RESULTS: Anti-VCAM1-treated CBA recipients showed prolonged graft survival with indefinite survival in five of nine cases. Anti-VCAM1 prevented proliferation in an MLR but not when added 36 hours after the beginning of the MLR. Anti-VCAM1 did not prolong allograft survival in sensitized recipients and did not prevent lymphocytic infiltration of the graft at 7 days. CONCLUSIONS: Anti-VCAM1 prolongs allograft survival in neovascularized islets in which the donor vascular endothelium plays little or no role in immunogenicity. VCAM1 appears to be important in the afferent phase (lymphocyte activation) of the allograft response. Once activated, either late in an MLR or in sensitized recipients, lymphocytes are not dependent on VCAM1 for function. Finally, anti-VCAM1 does not appear to affect the homing of lymphocytes to the allograft.

Animals↗
PubMed1994

Tolerance induction to cultured islet allografts. I. Characterization of the tolerant state.

The immunogenicity of murine pancreatic islets can be reduced by culture in 95% O2 prior to transplantation. Such cultured tissue can reverse diabetes indefinitely in nonimmunosuppressed, allogeneic recipients. Although the cultured graft does not trigger a rejection response, the graft retains recognizable alloantigens in that the graft is acutely rejected when the host is immunized with donor-type antigen-presenting cells. However, over time the recipients bearing cultured islet allografts become increasingly resistant to rejecting the established graft following APC challenge. Data show that this process of graft "stabilization" is a function of time postgrafting and initial graft mass. Graft stabilization is not due to a change in the vulnerability of the graft to immune recognition--that is, stabilization cannot be accounted for by the spontaneous adaptation of the long-term graft. Rather, graft stabilization is associated with a change in host reactivity (tolerance induction). This conclusion is based on the findings that (1) recipients of long-term established grafts (> 120 days) resist rejection of both the primary and secondary donor-type grafts, and (2) donor-specific tolerance can be transferred to severe-combined-immune-deficient (scid) recipient mice.

Animals↗
PubMed1994

Tolerance induction to cultured islet allografts. II. The status of antidonor reactivity in tolerant animals.

Murine islet tissue cultured in 95% O2 to eliminate/inactivate donor antigen-presenting cells can function indefinitely and induce a state of tolerance in nonimmunosuppressed, allogeneic recipients. Such cultured grafts represent a model of antigen presentation in which antigen (signal 1) is presented without the delivery of appropriate costimulatory activity (signal 2) necessary for T cell activation. As T cell inactivation has been proposed to result from this form of antigen presentation, we determined whether the tolerance generated in response to such cultured grafts was due to a passive (clonal deletion/inactivation) mechanism. We have shown that, although tolerant in vivo, animals bearing long-term cultured islet allografts are donor-reactive in vitro as assessed by (1) CTL precursor frequency, (2) antidonor proliferative and cytotoxic responses, and (3) lymphokine production (IL-2, IL-3, TNF, and IFN-gamma). In addition, tolerance does not appear to be tissue (islet)-specific in that primed, donor-reactive T cells from tolerant animals react to islet cells in vitro and are capable of destroying donor-type islet grafts in vivo. Thus, the notion that "signal 1" antigen presentation, as represented by cultured islet allografts, leads to the clonal deletion or inactivation (anergy) of donor-reactive T cells is not supported by these results. Since this form of tolerance does not appear to be an intrinsic property of the donor-specific lymphocyte, these results are more consistent with a model of active regulatory tolerance in vivo.

Animals↗
PubMed1994

Analysis of the spontaneous T cell response to insulin in NOD mice.

Insulin-specific T cells have been found to be present in high frequency among nominally islet-cell-specific T cells in the islet infiltrates that accumulate in NOD mice. In a previous report in which clones obtained from 7- and 12-week-old mice were examined, we identified a 15-residue peptide of the B chain as the dominent epitope for this response. Despite the fact that the response to insulin appears to be directed toward this single peptide, diverse TCR V beta usage was observed. That insulin-specific T cells contribute to beta cell damage is suggested by the fact that all clones tested could mediate beta cell destruction upon adoptive transfer. In the present report we extend this examination of insulin-specific T cells to lines and clones established from mice ranging in age from 4-12 weeks. These clones were found to be very similar to those from 7- and 12-week-old mice. The response was directed to the same peptide and most were found to produce IFN gamma, but none produced IL-4.

Age Factors↗
PubMed1993

Establishment of islet-specific T-cell lines and clones from islet isografts placed in spontaneously diabetic NOD mice.

One impediment to detailed characterization of islet-specific T cells from the NOD mouse model of diabetes is the difficulty encountered in isolation of such cells. This report describes a method that allows routine isolation of relatively large numbers of T cells highly enriched for reactivity toward islet antigens. The method involves renal subcapsular transplantation of spontaneously diabetic NOD mice with NOD islets. These grafts are rapidly destroyed in a tissue-specific manner and this destruction is accompanied by lymphocytic infiltration. Here we demonstrate that the islet graft infiltrates are an excellent source of islet-specific T cells and that islet-specific T-cell lines and clones can be established from these cells. Islet-specific T-cell clones isolated from a T-cell line established from the islet graft infiltrates were capable of adoptive transfer of diabetes to NOD/LtSz-scid recipients.

Animals↗
PubMed1993

Molecular mechanisms underlying diabetes and other autoimmune diseases.

Autoimmunity is a fascinating and complex phenomenon. The various mechanisms such as self tolerance, genetic and environmental regulation of the autoimmune phenotype, which govern the susceptibility to autoimmune disease were discussed at a recent workshop. Here, Ron Gill and Kathryn Haskins report on the new advances in this area.

Adult↗
PubMed1993

T-cell-T-cell collaboration in allograft responses.

T-cell-T-cell collaboration in allogeneic responses traditionally has been viewed as the requirement for CD4+ T helper cells in the activation of CD8+ cytotoxic T cells. In this regard, the role of the CD4+ T cell is primarily to provide growth factors, such as interleukin-2, on which the CD8+ T cell is dependent. However, expanding information concerning the function of T-cell subsets, and the roles of antigen-presenting cells and cytokines in regulating immune responses, requires that the basic tenets of T-cell interactions be re-evaluated.

Animals↗
PubMed1993

The maintenance of self-tolerance.

Two signal models for lymphocyte activation build on the Talmage/Burnet concept that receptor diversity is generated within the immune system by a random process, and that individual lymphocytes carry a single receptor on their surface that determines their specificity. Such models cannot use a concept of signal one anergy (or deletion) to explain the maintenance of self-tolerance in terms of the Bretscher/Cohn theory if they abandon the concept of associative recognition.

Allergy and Immunology↗