Toxin-coupled MHC class I tetramers can specifically ablate autoreactive CD8⁺ T cells and delay diabetes in nonobese diabetic mice

There is compelling evidence that self-reactive CD8⁺ T cells are a major factor in development and progression of type 1 diabetes in animals and humans. Hence, great effort has been expended to define the specificity of autoimmune CD8⁺ T cells and to alter their responses. Much work has focused on tolerization of T cells using proteins or peptides. A weakness in this approach is that residual autoreactive T cells may be activated and exacerbate disease. In this report, we use a novel approach, toxin-coupled MHC class I tetramers. Used for some time to identify Ag-specific cells, in this study, we use that same property to delete the Ag-specific cells. We show that saporin-coupled tetramers can delete islet-specific glucose-6-phosphatase catalytic subunit-related protein (IGRP)-reactive T cells in vitro and in vivo. Sequence analysis of TCRβ-chains of IGRP⁺ cells reveals the repertoire complexity in the islets is markedly decreased as NOD mice age and significantly altered in toxic tetramer-treated NOD mice. Further tetramer ⁺ T cells in the islets are almost completely deleted, and, surprisingly, loss of tetramer⁺ T cells in the islets is long lasting. Finally, we show deletion at 8 wk of age of IGRP⁺ CD8 ⁺ T cells, but not dystophia myotonica kinase- or insulin B-reactive cells, significantly delays diabetes in NOD mice.