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ObjectiveType 1 diabetes (T1D) is an autoimmune disease caused by the destruction of pancreatic β-cells producing insulin. Both T1D patients and animal models exhibit gut microbiota and mucosa alterations, although the exact cause for these remains poorly understood. We investigated the production of key cytokines controlling gut integrity, the abundance of segmented filamentous bacteria (SFB) involved in the production of these cytokines, and the respective role of autoimmune inflammation and hyperglycaemia.DesignWe used several mouse models of autoimmune T1D as well as mice rendered hyperglycaemic without inflammation to study gut mucosa and microbiota dysbiosis. We analysed cytokine expression in immune cells, epithelial cell function, SFB abundance and microbiota composition by 16S sequencing. We assessed the role of anti-tumour necrosis factor α on gut mucosa inflammation and T1D onset.ResultsWe show in models of autoimmune T1D a conserved loss of interleukin (IL)-17A, IL-22 and IL-23A in gut mucosa. Intestinal epithelial cell function was altered and gut integrity was impaired. These defects were associated with dysbiosis including progressive loss of SFB. Transfer of diabetogenic T-cells recapitulated these gut alterations, whereas induction of hyperglycaemia with no inflammation failed to do so. Moreover, anti-inflammatory treatment restored gut mucosa and immune cell function and dampened diabetes incidence.ConclusionOur results demonstrate that gut mucosa alterations and dysbiosis in T1D are primarily linked to inflammation rather than hyperglycaemia. Anti-inflammatory treatment preserves gut homeostasis and protective commensal flora reducing T1D incidence.

International audience;

International audience; Type 1 diabetes (T1D) is an autoimmune disease characterized by the selective destruction of pancreatic islet β-cells that produce insulin, in the context of an underlying multigenetic inheritance 1. When most of the β-cells are destroyed or non-functional, the ensuing lack of insulin results in hyperglycemia and requires lifelong insulin-replacement therapy 1. The physiopathology of T1D involves inappropriate activation of both the innate immune system and adaptive immune system, which induces loss of self-tolerance and islet destruction 2-5. T1D is characterized by the presence of anti-islet autoantibodies and auto-reactive T cells. Innate immune cells are involved at various stages of the disease and are particularly important for the initiation of the local immune response in the pancreas and the pancreatic lymph nodes (PLNs) 2,4. Published data have highlighted the role of the intestinal microbiota in T1D by transfer experiments in mice of the non-obese diabetic (NOD) strain 6-8 and gut microbiota differences in children that are associated with the development of T1D 9-11. Several studies have also described alterations to the gut mucosa in NOD mice and patients with T1D 12-16. Mucosal-associated invariant T cells (MAIT cells) are innate-like T cells that recognize bacterial metabolites derived from the synthesis of riboflavin and presented by the monomorphic major histocompatibility complex (MHC) class-I-related protein MR1 (refs. 17-19). These non-conventional T cells express a conserved αβ T cell antigen receptor (TCR) that consists of an invariant TCR α-chain (α-chain variable region 7.2 and α-chain joining regions 33, 20 and12 (V α 7.2-J α 33,20,12) in humans and V α 19-J α 33 in mice) with a restricted set of TCR β-chains. MAIT cells produce various cytokines, such as TNF, IFN-γ, IL-17 and granzyme B (GzB), that participate in tissue inflammation and cell death 17,20-28. The nearly complete absence of MAIT cells in germ-free mice 17,29 and their physiological localization at mucosal sites, including the gut 17,21 , suggest a strong interaction with the microbiota. Here we found alterations in MAIT cells in patients with T1D and, through the use of NOD mice, revealed a protective role for MAIT cells directed against T1D. The localization and function of MAIT cells highlight their key role in the maintenance of gut integrity whereby they control the development of autoimmune responses to pancreatic β-cells. RESULTS Alterations in MAIT cells in children with recent-onset T1D We first began our investigation of MAIT cells in T1D by analyzing the frequency and phenotype of MAIT cells in fresh peripheral Type 1 diabetes (T1D) is an autoimmune disease that results from the destruction of pancreatic b-cells by the immune system that involves innate and adaptive immune cells. Mucosal-associated invariant T cells (MAIT cells) are innate-like T-cells that recognize derivatives of precursors of bacterial riboflavin presented by the major histocompatibility complex (MHC) class I-related molecule MR1. Since T1D is associated with modification of the gut microbiota, we investigated MAIT cells in this pathology. In patients with T1D and mice of the non-obese diabetic (NOD) strain, we detected alterations in MAIT cells, including increased production of granzyme B, which occurred before the onset of diabetes. Analysis of NOD mice that were deficient in MR1, and therefore lacked MAIT cells, revealed a loss of gut integrity and increased anti-islet responses associated with exacerbated diabetes. Together our data highlight the role of MAIT cells in the maintenance of gut integrity and the control of anti-islet autoimmune responses. Monitoring of MAIT cells might represent a new biomarker of T1D, while manipulation of these cells might open new therapeutic strategies.

International audience; Autoimmune and inflammatory diseases have complex etiologies not fully understood. Both innate and adaptive immune cells are involved in the pathogenesis of these diseases. Mucosal-associated invariant T (MAIT) cells express an invariant TCRa chain (Va7.2-Ja33 in humans and Va19-Ja33 in mice) and recognize the conserved MHC-I-related molecule MR1 presenting bacterial metabolites derived from the synthesis of vitamin B. MAIT cells harbor tissue homing properties and produce inflammatory cytokines, suggesting that MAIT cells may play a key role in autoimmune and inflammatory diseases. In this review, we described the current knowledge on MAIT cells in these pathologies, based on patients analyses as well as mouse models. While most of the studies support a deleterious role of MAIT cells in tissue inflammation and destruction, a few reports suggest a protective role of MAIT cells. MAIT cells could represent a new biomarker of disease progression, and a better knowledge of their function might open new avenues for therapeutic strategies based on their manipulation.

International audience; Type 1 and type 2 diabetes are growing public health problems. Despite having different pathophysiologies, both diseases are associated with defects in immune regulation. Invariant natural killer T (iNKT) cells are innate-like T cells that recognize glycolipids presented by CD1d. These cells not only play a key role in the defense against pathogens, but also exert potent immunoregulatory functions. The regulatory role of iNKT cells in the prevention of type 1 diabetes has been demonstrated in murine models and analyzed in diabetic patients. The decreased frequency of iNKT cells in non-obese diabetic mice initially suggested the regulatory role of this cell subset. Increasing the frequency or the activation of iNKT cells with agonists protects non-obese diabetic mice from the development of diabetes. Several mechanisms mediate iNKT regulatory functions. They can rapidly produce immunoregulatory cytokines, interleukin (IL)-4 and IL-10. They induce tolerogenic dendritic cells, thereby inducing the anergy of autoreactive anti-islet T cells and increasing the frequency of T regulatory cells (Treg cells). Synthetic agonists are able to activate iNKT cells and represent potential therapeutic treatment in order to prevent type 1 diabetes. Growing evidence points to a role of immune system in glucose intolerance and type 2 diabetes. iNKT cells are resident cells of adipose tissue and their local and systemic frequencies are reduced in obese patients, suggesting their involvement in local and systemic inflammation during obesity. With the discovery of potential continuity between type 1 and type 2 diabetes in some patients, the role of iNKT cells in these diseases deserves further investigation.

In the version of this Article originally published, the asterisks indicating statistical significance were missing from Supplementary Figure 6; the file with the correct figure is now available.