Costimulation blockade disrupts CD4+ T cell memory pathways and uncouples their link to decline in b-cell function in type 1 diabetes

Martin Eichmann*, Roman Baptista, Richard J. Ellis, Susanne Heck, Mark Peakman, Craig A. Beam

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

9 Citations (Scopus)


We previously reported that costimulation blockade by abatacept limits the decline of b-cell function and the frequency of circulating CD4+ central memory T cells (TCM) (CD45RO+CD62L+) in new-onset type 1 diabetes. In human subjects receiving placebo, we found a significant association between an increase in CD4+ TCM cells and the decline of b-cell function. To extend and refine these findings, we examined changes in human CD4+ and CD8+ naive and memory T cell subsets at greater resolution using polychromatic flow and mass cytometry. In the placebo group, we successfully reproduced the original finding of a significant association between TCM and b-cell function and extended this to other T cell subsets. Furthermore, we show that abatacept treatment significantly alters the frequencies of a majority of CD4+ conventional and regulatory T cell subsets; in general, Ag-naive subsets increase and Ag-experienced subsets decrease, whereas CD8+ T cell subsets are relatively resistant to drug effects, indicating a lesser reliance on CD28-mediated costimulation. Importantly, abatacept uncouples the relationship between changes in T cell subsets and b-cell function that is a component of the natural history of the disease. Although these data suggest immunological markers for predicting change in b-cell function in type 1 diabetes, the finding that abatacept blunts this relationship renders the biomarkers nonpredictive for this type of therapy. In sum, our findings point to a novel mechanism of action for this successful immunotherapy that may guide other disease-modifying approaches for type 1 diabetes.

Original languageEnglish
Pages (from-to)3129-3138
Number of pages10
JournalJournal of Immunology
Issue number12
Publication statusPublished - 15 Jun 2020


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