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Combined therapy with GABA and proinsulin/alum acts synergistically to restore long-term normoglycemia by modulating T-cell autoimmunity and promoting β-cell replication in newly diabetic NOD mice.

Abstract
Antigen-based therapies (ABTs) fail to restore normoglycemia in newly diabetic NOD mice, perhaps because too few β-cells remain by the time that ABT-induced regulatory responses arise and spread. We hypothesized that combining a fast-acting anti-inflammatory agent with an ABT could limit pathogenic responses while ABT-induced regulatory responses arose and spread. γ-Aminobutyric acid (GABA) administration can inhibit inflammation, enhance regulatory T-cell (Treg) responses, and promote β-cell replication in mice. We examined the effect of combining a prototypic ABT, proinsulin/alum, with GABA treatment in newly diabetic NOD mice. Proinsulin/alum monotherapy failed to correct hyperglycemia, while GABA monotherapy restored normoglycemia for a short period. Combined treatment restored normoglycemia in the long term with apparent permanent remission in some mice. Proinsulin/alum monotherapy induced interleukin (IL)-4- and IL-10-secreting T-cell responses that spread to other β-cell autoantigens. GABA monotherapy induced moderate IL-10 (but not IL-4) responses to β-cell autoantigens. Combined treatment synergistically reduced spontaneous type 1 T-helper cell responses to autoantigens, ABT-induced IL-4 and humoral responses, and insulitis, but enhanced IL-10 and Treg responses and promoted β-cell replication in the islets. Thus, combining ABT with GABA can inhibit pathogenic T-cell responses, induce Treg responses, promote β-cell replication, and effectively restore normoglycemia in newly diabetic NOD mice. Since these treatments appear safe for humans, they hold promise for type 1 diabetes intervention.
AuthorsJide Tian, Hoa Dang, An Viet Nguyen, Zheying Chen, Daniel L Kaufman
JournalDiabetes (Diabetes) Vol. 63 Issue 9 Pg. 3128-34 (Sep 2014) ISSN: 1939-327X [Electronic] United States
PMID25146474 (Publication Type: Journal Article, Research Support, N.I.H., Extramural, Research Support, Non-U.S. Gov't)
Copyright© 2014 by the American Diabetes Association. Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered.
Chemical References
  • Alum Compounds
  • Blood Glucose
  • Interleukin-10
  • Interleukin-4
  • aluminum sulfate
  • Proinsulin
Topics
  • Alum Compounds (administration & dosage)
  • Animals
  • Autoimmunity (drug effects, immunology)
  • Blood Glucose (metabolism)
  • Cell Division (drug effects)
  • Diabetes Mellitus, Type 1 (drug therapy, immunology)
  • Drug Therapy, Combination
  • Female
  • Interleukin-10 (biosynthesis)
  • Interleukin-4 (biosynthesis)
  • Mice
  • Mice, Inbred NOD
  • Proinsulin (administration & dosage)
  • T-Lymphocytes, Regulatory (immunology)

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