Follicular helper T cell profiles predict response to costimulation blockade in type 1 diabetes
- 3 August 2020
- journal article
- research article
- Published by Springer Science and Business Media LLC in Nature Immunology
- Vol. 21 (10), 1244-1255
- https://doi.org/10.1038/s41590-020-0744-z
Abstract
Follicular helper T (TFH) cells are implicated in type 1 diabetes (T1D), and their development has been linked to CD28 costimulation. We tested whether TFH cells were decreased by costimulation blockade using the CTLA-4–immunoglobulin (Ig) fusion protein (abatacept) in a mouse model of diabetes and in individuals with new-onset T1D. Unbiased bioinformatics analysis identified that inducible costimulatory molecule (ICOS)+ TFH cells and other ICOS+ populations, including peripheral helper T cells, were highly sensitive to costimulation blockade. We used pretreatment TFH profiles to derive a model that could predict clinical response to abatacept in individuals with T1D. Using two independent approaches, we demonstrated that higher frequencies of ICOS+ TFH cells at baseline were associated with a poor clinical response following abatacept administration. Therefore, TFH analysis may represent a new stratification tool, permitting the identification of individuals most likely to benefit from costimulation blockade.Keywords
Funding Information
- British Dietetic Association (15/0005253)
- RCUK | MRC | Medical Research Foundation (MR/N001435/1)
- Rosetrees Trust (M514)
- AstraZeneca
- EC | Horizon 2020 Framework Programme (675395)
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