Cristina Tortoioli

CTLA-4 gene polymorphism contributes to the genetic risk for latent autoimmune diabetes in adults

Abstract: Latent autoimmune diabetes in adults (LADA) is identified by the presence of GAD65 autoantibodies in diabetic patients who do not require insulin treatment for at least six months after the diagnosis. Previous studies have shown that the risk for LADA, similarly to type 1 diabetes mellitus (T1DM), is increased in subjects carrying the HLA‐DRB1*03‐DQA1*0501‐DQB1*0201 and/or HLA‐DRB1*04‐DQA1*0301‐DQB1*0302 haplotypes. In the present study, we investigated the association between LADA and the CTLA‐4 A/G polymorphism, another gene polymorphism associated with T1DM and other autoimmune diseases. The heterozygous A/G genotype was significantly more frequent among 80 LADA (69%) than among 85 healthy subjects of similar age and geographical provenience (47%) (OR = 2.47, corrected P= 0.023). Conversely, the homozygous A/A genotype was significantly less frequent in LADA subjects than in healthy controls (26% vs. 47%, OR = 0.4, corrected P= 0.028). The results of our study show that LADA is positively associated with the CTLA‐4 A/G genotype, similarly to T1DM, thus providing further supporting evidence of the autoimmune origin of this form of diabetes mellitus of the adult.

Cytotoxic T lymphocyte antigen-4 Ala17 polymorphism is a genetic marker of autoimmune adrenal insufficiency: Italian association study and meta-analysis of European studies

OBJECTIVE Cytotoxic T lymphocyte antigen-4 (CTLA4) gene polymorphism has been associated with human autoimmune diseases, but discordant data are available on its association with autoimmune Addisons disease (AAD). We tested the human leukocyte antigen (HLA)-independent association of CTLA4+49 (A/G) (Ala 17) and/or CTLA4 CT60 (A/G) polymorphism with AAD. DESIGN DNA samples from 180 AAD patients and 394 healthy control subjects from continental Italy were analyzed, and association statistical analyses and meta-analysis of published studies were performed. Methods TaqMan minor groove binder chemistry assays and PCR fragment length polymorphism assays were used. RESULTS Frequency of allele G of CTLA4+49 was significantly increased among AAD patients (40% alleles) than among healthy controls (27% alleles; P<0.0001). CTLA4 CT60 polymorphism was associated with AAD only in the heterozygous A/G individuals. The frequency of +49 AG+GG genotypes was significantly higher among AAD patients than among healthy control subjects, in both a co-dominant (P<0.0001) and G dominant model (P<0.0001). CTLA4+49 allele G was significantly associated with disease risk in both patients with isolated AAD and in patients with autoimmune polyendocrine syndrome. Multivariate logistic regression analysis showed that CTLA4+49 allele G was positively associated with AAD (P<0.0001, odds ratio (OR)=2.43, 95% confidence interval=1.54-3.86) also after correction for DRB1*03-DQA1*0501-DQB1*0201, DRB1*04-DQA1*0301-DQB1*0302, and sex. Meta-analysis of five studies revealed a significant association of CTLA4+49 allele G with AAD (P<0.0001) with an overall OR of 1.48 (1.28-1.71). CONCLUSIONS The CTLA4+49 polymorphism is strongly associated with genetic risk for AAD, independently from the well-known association with HLA class II genes.

MICA Gene Polymorphism in the Pathogenesis of Type 1 Diabetes

Abstract:  Type 1 diabetes mellitus (T1DM) is a typical autoimmune disease and results from the destruction of insulin‐producing β cells of the pancreas. It develops in the presence of genetic susceptibility, even though more than 85% of patients with T1DM do not have a close relative with the disorder. The etiology of T1DM is complex, and both genetic and environmental factors play important roles. A permissive genetic background is required for the development of the islet autoimmune process. The strongest genetic association idengified is that with HLA class II genes located on the short arm of chromosome 6. It is well known that both HLA DRB1*04‐DQA1*0301‐DQB1*0302 (DR4‐DQ8) and DRB1*03‐DQA1*0501‐DQB1*0201 (DR3‐DQ2) are positively, and DRB1*15‐DQA1*0102‐DQB1*0602 is negatively, associated with T1DM. However, only a minority of the subjects carrying the high‐risk haplotypes/genotypes develops the disease, which suggests that additional genes play a crucial role in conferring either protection or susceptibility to T1DM. Major histocompatibility complex (MHC) class I chain–related A (MICA) is located in a candidate susceptibility region and activates natural killer (NK) cells, T cells and γδ CD8 T cells by its receptor NKG2D. The polymorphism of the MICA gene is associated with T1DM in different populations as demonstrated in several papers published in the last 7 years.

A rapid qualitative method to assess in vitro immunobarrier competence of pancreatic islets containing alginate/polyaminoacidic microcapsules

A quick method for the qualitative evaluation of immunoisolatory properties associated with islet-containing alginate/poly-l-ornithine (AG/PLO) microcapsules is described. In particular, we examined a new AG/PLO coherent microcapsule (CM) prototype that was recently developed in our laboratory, although the procedure could be applicable to other capsule types as well. We observed no binding of immunoglobulins (Ig) contained in islet cell antibody (ICA)-positive human sera (>60 Juvenile Diabetes Foundation units, JDF U) to pig islets, enveloped within AG/PLO CM, under indirect immunofluorescence examination. Also, CM were shown to inhibit human lymphocyte proliferative capacity fully, as assessed by the3H-thymidine incorporation rate, in in vitro mixed xenogeneic pig islet/human lymphocyte co-cultures. These results provided us with a preliminary method to attempt standardization of basic physical/chemical properties which should be associated with an immunoisolatory membrane for islet allo/xenograft immunoprotection.

Association of genetic polymorphisms and autoimmune Addison’s disease

Autoimmune Addison’s disease (AAD) is a complex genetic disease that results from the interaction of a predisposing genetic background with as yet unknown environmental factors. The disease is marked by the appearance of circulating autoantibodies against steroid 21-hydroxylase. Mutations of the autoimmune regulator gene are responsible for the so-called autoimmune polyendocrine syndrome type I (APS I), of which AAD is a major disease component. Among genetic factors for isolated AAD and APS II, a major role is played by HLA class II genes: HLA-DRB1*0301-DQA1*0501-DQB1*0201 and DRB1*04-DQA1*0301-DQB1*0302 are positively, and RB1*0403 is negatively, associated with a genetic risk for AAD. The MHC class I chain-related gene A allele 5.1 is strongly and positively associated with AAD. Other gene polymorphisms contributing to genetic risk for AAD are MHC2TA, the gene coding for class II transactivator, the master regulator of class II expression, cytotoxic T lymphocyte antigen-4, PTPN22 and the vitamin D receptor.

Xenograft of microencapsulated Sertoli cells restores glucose homeostasis in db/db mice with spontaneous diabetes mellitus

Increased abdominal fat and chronic inflammation in the expanded adipose tissue of obesity contribute to the development of insulin resistance and type 2 diabetes mellitus (T2D). The emerging immunoregulatory and anti‐inflammatory properties of Sertoli cells have prompted their application to experimental models of autoimmune/inflammatory disorders, including diabetes.

Selenium and Cancer Stem Cells

Abstract Selenium (Se) is an essential micronutrient that functions as “redox gatekeeper” and homeostasis factor of normal and cancer cells. Epidemiology and experimental studies, in the last years suggested that both inorganic and organic forms of Se may have favorable health effects. In this regard, a protective action of Se on cellular systems that may help preventing cancer cell differentiation has been demonstrated, while the hypothesis that Se compounds may cure cancer and its metastatic diffusion appears speculative and is still a matter of investigation. Indeed, the overall actions of Se compounds in carcinogenesis are controversial. The recognition that cancer is a stem cell disease instigated major paradigm shifts in our basic understanding of cancer and attracted a great deal of interest. Although current treatment approaches in cancer are grounded in the need to kill the majority of cancer cells, targeting cancer stem cells (CSCs) may hold great potential in improving cancer treatment. In this respect, Se compounds have been demonstrated modulating numerous signaling pathways involved in CSC biology and these findings are now stimulating further research on optimal Se concentrations, most effective and cancer‐specific Se compounds, and inherent pathways involved in redox and metabolic regulation of CSCs. In this review, we summarize the current knowledge about the effects of Se compounds on CSCs, by focusing on redox‐dependent pathways and main gene regulation checkpoints that affect self‐renewal, differentiation, and migration responses in this subpopulation of cancer cells.

New role of oxysterols as regulators of adipogenic differentation in adipose-derived mesenchymal stem cells

Growing evidence indicates that adipose tissue (AT) represents a potential source of pluripotent mesenchymal stem cells. However, the mechanisms underlying the lineage-specific commitment of human adipose-derived stem cells (ASC) remain still not fully elucidated. Oxysterols are cholesterol oxide products resulting from non-enzymatic (ie, 7-Ketocolesterol) or enzymatic (ie, 5,6-Secosterol) oxidation of cholesterol, which are now emerging as reliable markers of adipose “oxidative stress” in vivo. Recent data suggest that, by regulating the adipogenic differentiation of ASC, lipid peroxidation products may play an important role in linking the adipose dysfunction with impairment of glucose homeostasis. In this study we combined a lipidomic approach with the subcutaneous (sc) microdialysis technique to characterize the adipose-derived profile of fatty acids (FA) and oxysterols in vivo. ASC were isolated from abdominal sc, mesemteric (MES) and omental (OM) fat specimens obtained from obese nondiabetic (OB) and type 2 diabetic (OBT2D) patients. Flow cytometry (FC) was used for the evaluation of cell viability, mitochondrial status and cell immunophenotyping. In AT interstitial fluid, abundant concentrations of oxysterols (7κC and 5,6-S) and fatty acids (lipokines) were found. Experimental challenging with 7κC and 5,6-S showed a different time-dose-response effect. Indeed, the MTT assay, we found that in ASC isolated from the sc depot 5,6-S (50 and 10μM) reduced cell viability after 24, 48 and 72 h, respectively. In contrast, in the same cell-type population, the effect of 7κC at 10μM was observed only after 72 h. FC analysis indicated a similar effect of both oxysterols even after short-time exposure either in ASC from the MES or the OM fat depot. Notably, cell challenge with 7κC and 5,6-S at 10, 5 and 1 μM, respectively, was accompanied by an impairment of mitochondrial status only in OM, but not in MES. Furthermore, both the oxysterols (10μM) downregulated the expression of stemness surface markers suggesting a different “susceptibility” of the ASC to lipid peroxidation cell damage. Accordingly, 7κC at 10 and 1μM impaired the adipogenic differentiation of sc and OM ASC isolated from either OB or T2DOB, and demodulated the mitochondrial activity of the differentiated adipocytes. Altogether, our results suggest human AT as a critical compartment for storage and secretion of lipokines and oxysterols, which, when in excess, appear to detrimentally modulate the mitochondrial activity and the adipogenic differentiation of adipose precursor cells. This work was partly funded from Fondazione Cassa di Risparmio di Perugia, project 2010.020.0098, “Ricerca Scientifica e Tecnologica”