Insulin-induced remission in new-onset NOD mice is maintained by the PD-1-PD-L1 pathway

Brian T. Fife, Indira Guleria, Melanie Gubbels Bupp, Todd N. Eagar, Qizhi Tang, Helene Bour-Jordan, Hideo Yagita, Miyuki Azuma, Mohamed H. Sayegh, Jeffrey A. Bluestone

Research output: Contribution to journalArticlepeer-review

263 Scopus citations


The past decade has seen a significant increase in the number of potentially tolerogenic therapies for treatment of new-onset diabetes. However, most treatments are antigen nonspecific, and the mechanism for the maintenance of long-term tolerance remains unclear. In this study, we developed an antigen-specific therapy, insulin-coupled antigen-presenting cells, to treat diabetes in nonobese diabetic mice after disease onset. Using this approach, we demonstrate disease remission, inhibition of pathogenic T cell proliferation, decreased cytokine production, and induction of anergy. Moreover, we show that robust long-term tolerance depends on the programmed death 1 (PD-1)-programmed death ligand (PD-L)1 pathway, not the distinct cytotoxic T lymphocyte-associated antigen 4 pathway. Anti-PD-1 and anti-PD-L1, but not anti-PD-L2, reversed tolerance weeks after tolerogenic therapy by promoting antigen-specific T cell proliferation and inflammatory cytokine production directly in infiltrated tissues. PD-1-PD-L1 blockade did not limit T regulatory cell activity, suggesting direct effects on pathogenic T cells. Finally, we describe a critical role for PD-1-PD-L1 in another powerful immunotherapy model using anti-CD3, suggesting that PD-1-PD-L1 interactions form part of a common pathway to selectively maintain tolerance within the target tissues. JEM

Original languageEnglish (US)
Pages (from-to)2737-2747
Number of pages11
JournalJournal of Experimental Medicine
Issue number12
StatePublished - Nov 2006

ASJC Scopus subject areas

  • Immunology and Allergy
  • Immunology


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