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| ID | Type | Description | Link |
|---|---|---|---|
| 2024-A00696-41 | Other Identifier | ID-RCB |
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| Name | Class |
|---|---|
| URC-CIC Paris Descartes Necker Cochin | OTHER |
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Type 1 diabetes (T1D) is caused by an autoimmune response leading to the destruction of pancreatic beta cells. The disease association with particular HLA class II alleles, particularly HLA-DQ8, indicates the implication of CD4 T cells in its aetiology. The hypothesis is therefore that T1D starts by the loss of tolerance in autoreactive CD4 T cells. This might result from alterations in conventional autoreactive CD4 T cells (Tcons), which drive disease, or autoreactive regulatory CD4 T cells expressing the transcription factor FOXP3 (Tregs), which normally maintain immune tolerance. The investigators expect that the characterization of HLA-DQ8-restricted Tcons and Tregs in recent onset HLA-DQ8+ T1D patients shall shed light on the molecular mechanisms underpinning T1D development. This knowledge will guide the development of novel cell therapies harnessing the power of genetically engineered Tregs expressing the relevant antigen receptor to restore immune homeostasis upon cell transfer. The ultimate goal is to reach a curative effect
During the development of type 1 diabetes (T1DM), regulatory T cells (Treg) are modified and their protective role is no longer optimal, particularly against pathology-specific autoreactive antigens. The hypothesis is that in patients with T1DM, the function and phenotype of Treg cells, as well as their receptor repertoire for the antigen to which they are specific (TCR), no longer allow them to control tolerance. The in-depth study of these cells, at both genetic and molecular levels, will enable a major breakthrough in our understanding of the pathophysiology of T1DM, and in the development of targeted cell therapy.
The investigators expect major/important differences between patient Tregs and those of the control population in this study, at the molecular, phenotypic and functional levels. These differences will highlight the TCRs recognizing the target self-antigens. In this way, investigators expect to be able to select a limited number of Treg TCRs that could ultimately be used in cell therapy to restore the protective role of Tregs in these patients.
Thus, this knowledge will enable to propose in the future a more effective immunotherapy with a long-term effect, in order to improve the management of patients with autoimmune diabetes and potentially cure them.
Accordingly, yhe investigators will study insulin-specific Tregs in T1DM patients and control individuals, as well as conventional T cells directed against the same antigen, which in patients are implicated in the disease. This will include a study of their functional status, their transcriptomic profile, as well as their TCRs and their fine recognition properties of the major diabetes self-antigen, insulin.
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| Label | Type | Description | Intervention Names |
|---|---|---|---|
| Newly diagnosed T1DM group | Other | children aged 2 to under 18 on the day of inclusion, with a recent diagnosis of type 1 diabetes |
|
| Control group | Other | children aged 2 to under 18 on the day of inclusion, with no history of type 1 diabetes |
|
| Name | Type | Description | Arm Group Labels | Other Names |
|---|---|---|---|---|
| Frequency of Treg and Teffs | Biological | additionnal blood sampling at inclusion |
|
| Measure | Description | Time Frame |
|---|---|---|
| Frequency and phenotype of Tregs | study the frequency and phenotype of insulin-specific autoreactive Tregs lymphocytes among CD4+ T lymphocytes in children with T1DM and compare these values with those of controls. These parameters will be analyzed by flow cytometry using immune cells from blood samples taken from the T1DM and control groups. | Within 4 weeks of T1DM diagnosis |
| Measure | Description | Time Frame |
|---|---|---|
| HLA testing | Description : the HLA of T1DM and controls will be analyzed by qPCR. This will make it possible to associate the results obtained during the analysis of the main criteria with the HLA of each individual. | Within 4 weeks of T1DM diagnosis |
| Isolate insulin-specific Tregs and Teffs cells |
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Inclusion Criteria:
Newly diagnosed T1DM group:
Control group :
Exclusion Criteria:
Newly diagnosed T1DM group:
Control group :
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| Name | Role | Phone | Extension | |
|---|---|---|---|---|
| Jacques BELTRAND, MD, PhD | Contact | +33 1 40 61 53 20 | jacques.beltrand@aphp.fr | |
| Sarah BOUCHARD | Contact | + 33 1 42 19 28 79 | sarah.bouchard@aphp.fr |
| Name | Affiliation | Role |
|---|---|---|
| Simon FILATREAU, PhD | Institut National de la Santé Et de la Recherche Médicale, France | Study Director |
| Facility | Status | City | State | ZIP | Country | Contacts |
|---|---|---|---|---|---|---|
| Hôpital Necker Enfants Malades | Recruiting | Paris | 75015 | France |
| PubMed Identifier | Type | Citation | Retractions |
|---|---|---|---|
| 30483858 | Background | Patterson CC, Harjutsalo V, Rosenbauer J, Neu A, Cinek O, Skrivarhaug T, Rami-Merhar B, Soltesz G, Svensson J, Parslow RC, Castell C, Schoenle EJ, Bingley PJ, Dahlquist G, Jarosz-Chobot PK, Marciulionyte D, Roche EF, Rothe U, Bratina N, Ionescu-Tirgoviste C, Weets I, Kocova M, Cherubini V, Rojnic Putarek N, deBeaufort CE, Samardzic M, Green A. Trends and cyclical variation in the incidence of childhood type 1 diabetes in 26 European centres in the 25 year period 1989-2013: a multicentre prospective registration study. Diabetologia. 2019 Mar;62(3):408-417. doi: 10.1007/s00125-018-4763-3. Epub 2018 Nov 28. | |
| 32296622 |
| Label | URL |
|---|---|
| Related Info | View source |
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| Phenotype of Treg and Teffs | Biological | additionnal blood sampling at inclusion |
|
| RNA seq analysis | Biological | additionnal blood sampling at inclusion |
|
| HLA typing | Biological | additionnal blood sampling at inclusion |
|
| beta-cell autoantibody dosage | Biological | additionnal blood sampling at inclusion |
|
| Glycated haemoglobin (HbA1C) dosage | Biological | additionnal blood sampling at inclusion |
|
| blood glucose dosage | Biological | additionnal blood sampling at inclusion |
|
| C-peptide dosage | Biological | additionnal blood sampling at inclusion |
|
Insulin-specific Tregs and Teffs cells will be isolated by flow cytometry |
| Within 4 weeks of T1DM diagnosis |
| Treg and Teffs transcriptome | their transcriptome and TCR will be determined by single-cell transcriptomics analysis (scRNAseq). | Within 4 weeks of T1DM diagnosis |
| Full TCR repertoire of Tregs and Teffs | Following flow cytometry, the different repertoires will be compared between the DT1 and control groups. | Within 4 weeks of T1DM diagnosis |
| Machine learning analysis | Machine learning analysis of the data obtained (TCR, transcriptome, frequency and phenotype of insulin-specific Tregs and Teffs) to predict the relationship between TCR and functional properties of Tregs and Teffs in patients and controls | Within 4 weeks of T1DM diagnosis |
| Background |
| Mobasseri M, Shirmohammadi M, Amiri T, Vahed N, Hosseini Fard H, Ghojazadeh M. Prevalence and incidence of type 1 diabetes in the world: a systematic review and meta-analysis. Health Promot Perspect. 2020 Mar 30;10(2):98-115. doi: 10.34172/hpp.2020.18. eCollection 2020. |
| 30657336 | Background | Foster NC, Beck RW, Miller KM, Clements MA, Rickels MR, DiMeglio LA, Maahs DM, Tamborlane WV, Bergenstal R, Smith E, Olson BA, Garg SK. State of Type 1 Diabetes Management and Outcomes from the T1D Exchange in 2016-2018. Diabetes Technol Ther. 2019 Feb;21(2):66-72. doi: 10.1089/dia.2018.0384. Epub 2019 Jan 18. |
| 25998289 | Background | Miller KM, Foster NC, Beck RW, Bergenstal RM, DuBose SN, DiMeglio LA, Maahs DM, Tamborlane WV; T1D Exchange Clinic Network. Current state of type 1 diabetes treatment in the U.S.: updated data from the T1D Exchange clinic registry. Diabetes Care. 2015 Jun;38(6):971-8. doi: 10.2337/dc15-0078. |
| 3125434 | Background | Bougneres PF, Carel JC, Castano L, Boitard C, Gardin JP, Landais P, Hors J, Mihatsch MJ, Paillard M, Chaussain JL, et al. Factors associated with early remission of type I diabetes in children treated with cyclosporine. N Engl J Med. 1988 Mar 17;318(11):663-70. doi: 10.1056/NEJM198803173181103. |
| 10097932 | Background | Parving HH, Tarnow L, Nielsen FS, Rossing P, Mandrup-Poulsen T, Osterby R, Nerup J. Cyclosporine nephrotoxicity in type 1 diabetic patients. A 7-year follow-up study. Diabetes Care. 1999 Mar;22(3):478-83. doi: 10.2337/diacare.22.3.478. |
| 31180194 | Background | Herold KC, Bundy BN, Long SA, Bluestone JA, DiMeglio LA, Dufort MJ, Gitelman SE, Gottlieb PA, Krischer JP, Linsley PS, Marks JB, Moore W, Moran A, Rodriguez H, Russell WE, Schatz D, Skyler JS, Tsalikian E, Wherrett DK, Ziegler AG, Greenbaum CJ; Type 1 Diabetes TrialNet Study Group. An Anti-CD3 Antibody, Teplizumab, in Relatives at Risk for Type 1 Diabetes. N Engl J Med. 2019 Aug 15;381(7):603-613. doi: 10.1056/NEJMoa1902226. Epub 2019 Jun 9. |
| 15972866 | Background | Keymeulen B, Vandemeulebroucke E, Ziegler AG, Mathieu C, Kaufman L, Hale G, Gorus F, Goldman M, Walter M, Candon S, Schandene L, Crenier L, De Block C, Seigneurin JM, De Pauw P, Pierard D, Weets I, Rebello P, Bird P, Berrie E, Frewin M, Waldmann H, Bach JF, Pipeleers D, Chatenoud L. Insulin needs after CD3-antibody therapy in new-onset type 1 diabetes. N Engl J Med. 2005 Jun 23;352(25):2598-608. doi: 10.1056/NEJMoa043980. |
| 18566595 | Background | Vignali DA, Collison LW, Workman CJ. How regulatory T cells work. Nat Rev Immunol. 2008 Jul;8(7):523-32. doi: 10.1038/nri2343. |
| 19751267 | Background | Corthay A. How do regulatory T cells work? Scand J Immunol. 2009 Oct;70(4):326-36. doi: 10.1111/j.1365-3083.2009.02308.x. |
| 27815439 | Background | Visperas A, Vignali DA. Are Regulatory T Cells Defective in Type 1 Diabetes and Can We Fix Them? J Immunol. 2016 Nov 15;197(10):3762-3770. doi: 10.4049/jimmunol.1601118. |
| 26606968 | Background | Bluestone JA, Buckner JH, Fitch M, Gitelman SE, Gupta S, Hellerstein MK, Herold KC, Lares A, Lee MR, Li K, Liu W, Long SA, Masiello LM, Nguyen V, Putnam AL, Rieck M, Sayre PH, Tang Q. Type 1 diabetes immunotherapy using polyclonal regulatory T cells. Sci Transl Med. 2015 Nov 25;7(315):315ra189. doi: 10.1126/scitranslmed.aad4134. |
| 22723342 | Background | Marek-Trzonkowska N, Mysliwiec M, Dobyszuk A, Grabowska M, Techmanska I, Juscinska J, Wujtewicz MA, Witkowski P, Mlynarski W, Balcerska A, Mysliwska J, Trzonkowski P. Administration of CD4+CD25highCD127- regulatory T cells preserves beta-cell function in type 1 diabetes in children. Diabetes Care. 2012 Sep;35(9):1817-20. doi: 10.2337/dc12-0038. Epub 2012 Jun 20. |
| 34324441 | Background | Dong S, Hiam-Galvez KJ, Mowery CT, Herold KC, Gitelman SE, Esensten JH, Liu W, Lares AP, Leinbach AS, Lee M, Nguyen V, Tamaki SJ, Tamaki W, Tamaki CM, Mehdizadeh M, Putnam AL, Spitzer MH, Ye CJ, Tang Q, Bluestone JA. The effect of low-dose IL-2 and Treg adoptive cell therapy in patients with type 1 diabetes. JCI Insight. 2021 Sep 22;6(18):e147474. doi: 10.1172/jci.insight.147474. |
| 27192577 | Background | Kieback E, Hilgenberg E, Stervbo U, Lampropoulou V, Shen P, Bunse M, Jaimes Y, Boudinot P, Radbruch A, Klemm U, Kuhl AA, Liblau R, Hoevelmeyer N, Anderton SM, Uckert W, Fillatreau S. Thymus-Derived Regulatory T Cells Are Positively Selected on Natural Self-Antigen through Cognate Interactions of High Functional Avidity. Immunity. 2016 May 17;44(5):1114-26. doi: 10.1016/j.immuni.2016.04.018. |
| 23744306 | Background | Krischer JP; Type 1 Diabetes TrialNet Study Group. The use of intermediate endpoints in the design of type 1 diabetes prevention trials. Diabetologia. 2013 Sep;56(9):1919-24. doi: 10.1007/s00125-013-2960-7. Epub 2013 Jun 7. |
| 26272854 | Background | Noble JA. Immunogenetics of type 1 diabetes: A comprehensive review. J Autoimmun. 2015 Nov;64:101-12. doi: 10.1016/j.jaut.2015.07.014. Epub 2015 Aug 10. |
| 1469084 | Background | Caillat-Zucman S, Garchon HJ, Timsit J, Assan R, Boitard C, Djilali-Saiah I, Bougneres P, Bach JF. Age-dependent HLA genetic heterogeneity of type 1 insulin-dependent diabetes mellitus. J Clin Invest. 1992 Dec;90(6):2242-50. doi: 10.1172/JCI116110. |
| ID | Term |
|---|---|
| D003922 | Diabetes Mellitus, Type 1 |
| ID | Term |
|---|---|
| D003920 | Diabetes Mellitus |
| D044882 | Glucose Metabolism Disorders |
| D008659 | Metabolic Diseases |
| D009750 | Nutritional and Metabolic Diseases |
| D004700 | Endocrine System Diseases |
| D001327 | Autoimmune Diseases |
| D007154 | Immune System Diseases |
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| ID | Term |
|---|---|
| D000092386 | Single-Cell Gene Expression Analysis |
| D006650 | Histocompatibility Testing |
| D006442 | Glycated Hemoglobin |
| ID | Term |
|---|---|
| D059010 | Single-Cell Analysis |
| D003584 | Cytological Techniques |
| D008919 | Investigative Techniques |
| D020869 | Gene Expression Profiling |
| D005821 | Genetic Techniques |
| D007159 | Immunologic Tests |
| D019411 | Clinical Laboratory Techniques |
| D019937 | Diagnostic Techniques and Procedures |
| D003933 | Diagnosis |
| D007158 | Immunologic Techniques |
| D000093422 | Glycated Serum Proteins |
| D000093844 | Glycated Proteins |
| D017127 | Glycation End Products, Advanced |
| D006001 | Glycoconjugates |
| D002241 | Carbohydrates |
| D006023 | Glycoproteins |
| D006454 | Hemoglobins |
| D001798 | Blood Proteins |
| D011506 | Proteins |
| D000602 | Amino Acids, Peptides, and Proteins |
| D005914 | Globins |
| D006420 | Hemeproteins |
| D014118 | Toxins, Biological |
| D001685 | Biological Factors |
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