Second, autoimmune responses are dynamic and the features of the response to a given antigen can vary within different windows of time and within different tissues.[31] Therefore, our results could have been influenced by
the timing of our sampling or by the fact that only the periphery could be sampled. In spite R428 order of these limitations, the results of our study provide a practical means to address important hypotheses in human subjects with T1D. Our results demonstrate a diversity of GAD65 responses: at least 12 DR0401-restricted epitopes that can be processed and presented from intact protein. As summarized in TableĀ 4, a limited panel of epitopes could detect responses to more than one GAD65 epitope in virtually every subject, allowing visualization and comparison of responses in healthy subjects click here and in subjects with T1D using tetramers. Recent technical advances in our laboratory and by other groups allow the direct phenotypic analysis of tetramer-positive cells following ex vivo magnetic enrichment.[32, 33] Applying these methods with this selection of epitopes would provide an excellent tool to measure the frequencies, phenotypes and dynamics of autoreactive T cells in human subjects. It would be of particular interest to identify clear phenotypic
attributes of autoreactive T cells that are associated with disease progression or that correlate with therapeutic outcomes. Ongoing work should focus on identifying imbalances in particular T-cell subsets (Treg cells, T helper cells types 1, 2 or 17), or variations in cytokine production, activation status or homing markers that are a prelude to disease onset. These future studies are likely to provide important insights into disease mechanism and opportunities for monitoring disease progression and therapeutic intervention. We thank the staff of the JDRF Center for Translational Research and the Benaroya Research Institute Translational Research programme for subject recruitment and sample management. We thank Ms Diana Sorus for assisting with preparation of the manuscript. This work was supported in part by
a grant from the JDRF (Center for Translational Research P-type ATPase at Benaroya Research Institute; 33-2008-398). The authors declare that there are no conflicts of interest. “
“Common variable immunodeficiency (CVID) is a clinically and molecularly heterogeneous disorder with a varied clinical presentation [1]. The age of onset varies from early childhood to much later in life, and the disease is characterized by recurrent bacterial infections, hypogammaglobulinaemia and impaired antibody responses. In addition to recurrent infections, which can be mild or serious, CVID patients often develop inflammatory and autoimmune disorders, malignancies and systemic granuloma formation, as well as gastrointestinal (GI) problems [2]. Most CVID cases are sporadic, but there are also families with more than one affected member.