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*
Department of Cell Biology and Immunology, Medical Faculty, Vrije Universiteit Amsterdam, Amsterdam,
Institute of Infectious Diseases and Immunology, Faculty of Veterinary Medicine, Utrecht University, Utrecht, and
Department of Immunohematology and Bloodtransfusion, Leiden University Medical Center, Leiden, The Netherlands; and
Department of Pathology, Immunology Division, University of Cambridge, Cambridge, United Kingdom
| Abstract |
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cell destruction in the
nonobese diabetic (NOD) mouse is preceded by the induction of
autoreactive T cells, which recognize a variety of autoantigens. The
60-kDa endogenous (murine) heat shock protein 60 (hsp60) has been
proposed to be one of the key autoantigens. Here we demonstrate that
subcutaneous immunization of normoglycemic NOD mice with highly
homologous mycobacterial or murine hsp60 activates T cells in the
spleen that produce high levels of IL-10 upon restimulation in vitro
with either hsp60 protein. In time, increasing levels of hsp60-induced
IL-10 could be detected in NOD mice, but not in age- and MHC class
II-matched BiozziABH mice, which lack any sign of pancreatic
inflammation. These results suggest that the IL-10 responses in NOD
mice are primarily driven by endogenous inflammation. Genetically
protected NOD-asp mice, showing a less progressive development of
insulitis, demonstrated a similar increase in hsp60-induced IL-10 in
time compared with wild-type NOD mice. Taken together, our results
suggest that endogenous hsp60 is not a primary autoantigen in diabetes
but is possibly associated with regulation of insulitis. Moreover, the
capacity to respond to (self) hsp60 is independent of the MHC class
II-associated genetic predisposition to
diabetes. | Introduction |
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cells in the pancreatic islets
of Langerhans. Among several candidate autoantigens, endogenous heat
shock protein (hsp) 60 is suggested to be involved in this process,
although strong evidence to support this hypothesis in IDDM patients is
lacking (1, 2). In the spontaneous nonobese diabetic (NOD)
mouse model for IDDM, it was indeed shown that naive NOD T cells could
be triggered by murine (self) hsp60 (m60), as well as by mycobacterial
(foreign) hsp60 (Mt60) (3). However, Tisch and coworkers
demonstrated that cellular and Ab responses to m60 in NOD mice were not
detected until 8 wk of age, whereas other autoantigens, e.g., GAD65,
elicited responses as early as 4 wk of age (4). These data
argue against a critical role for hsp60 as a primary autoantigen in
experimental diabetes. Mt60 shares a high degree of amino acid identity with the mammalian homologues (5). Therefore, immunization with Mt60 could result in the specific activation of cross-reactive T cells, recognizing conserved hsp60 epitopes. From experimental arthritis models in the rat, it has become clear that immunization with Mt60 results in the induction of arthritis-regulatory T cells (6), which respond to a conserved part of hsp60 present in both the microbial and mammalian protein (7). Despite the fact that cross-reactive T cell recognition is a well-accepted concept for the induction of autoimmunity (molecular mimicry), we hypothesize that conserved epitopes of hsps are involved in the maintenance of peripheral tolerance and regulation of inflammation via the selective induction of regulatory T cells (5). However, the phenotype and regulatory mechanism(s) of self hsp60-responding T cells remain to be elucidated.
Several reports by Cohen and coworkers have demonstrated that vaccination with either the complete Mt60 protein or two particular epitopes of human or m60, p277 and p12, can arrest diabetes development in the NOD model (8, 9, 10). On the contrary, p277-specific T cell clones were capable of inducing diabetes (11). These results suggest that a certain episode of acute autoimmunity may activate specific regulatory mechanisms that subsequently cope with the chronic autoimmune diabetogenic process (12).
To study our hypothesis that conserved hsp60 epitopes could be involved
in the regulation of inflammation such as insulitis (5),
we analyzed proliferative and cytokine responses to mycobacterial and
self (murine) hsp60 upon immunizing normoglycemic female NOD mice with
either hsp60 protein. Results from age-matched diabetes-susceptible NOD
mice were compared with results obtained from genetically protected
BiozziABH and MHC transgenic NOD mice. In the latter strain, the gene
encoding the A
has been mutated at position
57, in which the serine was changed into an aspartate, resulting in the
coexpression of wild-type I-Ag7 and
I-Ag7asp (NOD-asp). As a result of this
transgene, these mice have a marked reduction in spontaneous diabetes
incidence, despite the presence of cellular infiltrates in the
pancreatic islets, which is not affected by cyclosphosphamide treatment
(13). The importance of an aspartate at position 57 of the
HLA-DQ
chain (the human homologue of the
murine I-A
chain) in determination of IDDM
susceptibility was demonstrated by Todd and colleagues
(14). They suggested that the amino acid at this position
affects the overall structure of the DQ
chain
and the conformation of the peptide binding groove. Consequently,
the expression of the I-Ag7asp transgene could
have pronounced effects either on thymic negative selection by
eliminating autoaggressive T cells (13, 15, 16) or on
positive selection of regulatory T cells, which subsequently inhibit
diabetogenic T cells selected via I-Ag7 in the
periphery (17, 18). Alternatively, the peptide pool
presented in the periphery during an autoimmune response could be
altered, thereby affecting the phenotype of diabetogenic T cells
(19). Because genetic factors determining the capacity to
respond to self proteins are unknown, we evaluated
I-Ag7-restricted hsp60-specific T cell responses
in the presence or absence of insulitis, as well as in the presence or
absence of the protective I-Ag7asp molecule.
| Materials and Methods |
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Wild-type NOD (NOD-wt)/LtJ mice were either derived from the Department of Immunology, Erasmus Universiteit Rotterdam, The Netherlands (NOD/LtJ/eur), or from the Department of Pathology, Cambridge University (NOD/LtJ/cam); both lines were bred from a breeding nucleus provided by Dr. E. Leiter (The Jackson Laboratory, Bar Harbor, ME). Transgenic NOD-asp mice were generated as described before (13) and bred in the Department of Pathology, Cambridge University. BiozziABH/RijHsd mice were obtained from Harlan (Horst, The Netherlands). The mice were bred and kept under specific pathogen-free conditions in filter-top cages with free access to acidified water and irradiated food pellets. Female mice were used in the experiments, which were performed in compliance with the guidelines of the Animal Ethics Committee of the Vrije Universiteit Amsterdam.
Ags and immunizations
Purified recombinant hsp60 of Mycobacterium bovis bacillus Calmette-Guérin (identical with hsp60 of Mycobacterium tuberculosis) was generously provided by Dr. R. van der Zee, Utrecht University, The Netherlands (7). Escherichia coli bacteria transformed with a full-length m60 expression plasmid were obtained from Dr. R. Tisch, University of North Carolina, Chapel Hill, NC (4). Recombinant m60 was purified using the QIAexpress Ni-NTA protein purification system (Qiagen via Westburg, Leusden, The Netherlands). Hen egg lysozyme (HEL) was used as control Ag (Sigma via Brunschwig Chemie, Amsterdam, The Netherlands).
For immunization experiments, Ags were mixed in a 1:1 ratio with dimethyl dioctadecyl ammonium bromide (DDA; Eastman Kodak, Rochester, NY), which was prepared as a 20 mg/ml gel in sterile PBS and used as adjuvant (20). Mice were immunized s.c. in the base of the tail with 100 µg recombinant hsp60 or HEL protein mixed with DDA adjuvant. Spleens were collected 10 to 14 days later and cells were used after preparing a single-cell suspension to determine T cell responses in vitro.
T cell proliferation assays
To induce proliferative responses, splenocytes were cultured in
triplicate in a final volume of 200 µl/well in 96-well flat-bottom
microtiter plates (Costar, Cambridge, MA) at 2 x
105 cells/well in the presence of Ag or medium
alone. For induction of cytokines, 5 x 106
cells were cultured in a final volume of 0.5 ml/well in 24-well plates.
In all assays, cells were cultured in IMDM supplemented with 510%
heat-inactivated FCS, 2 mM L-glutamine, 100 U/ml
penicillin, 100 µg/ml streptomycin (all from Life Technologies,
Breda, The Netherlands), and 5 x 10-5 M
2-ME. Splenocytes were tested for proliferative responses to
recombinant hsp60 proteins at varying doses as indicated in figure
legends. As a positive control for T cell proliferation, mitogenic
stimulation with Con A (2.5 µg/ml final concentration) was performed.
To exclude the possibility that the in vitro responses resulted from
mitogenic stimulation by possibly contaminating levels of LPS in the
recombinant proteins, parallel spleen cell cultures were done in the
presence of 1 µg/ml LPS, which did not exceed results from cultures
done in medium alone (data not shown). For cytokine induction, cells
were stimulated with either 5 µg/ml ConA or 100 µg/ml Mt60 or m60.
Cultures were incubated for 96 (proliferation) or 72 (cytokines) hours
at 37°C in a humidified atmosphere containing 5%
CO2. Proliferation cultures were pulsed for the
final 1620 h with 0.4 µCi/well [3H]TdR with
a specific activity of 1 Ci/mmol (Amersham International, Bucks, U.K.).
TdR uptake was measured using a liquid scintillation beta counter, and
results are expressed as mean cpm. Responses to Ag were compared with
responses in cultures performed in the presence of medium alone.
Proliferative responses demonstrating a stimulation index (SI)
2 were
considered to be positive. From parallel cytokine cultures,
supernatants were harvested and stored at 70°C until further
analysis.
Cytokine measurements
To determine cytokine levels in culture supernatants, Nunc
Maxisorb plates (Nunc, Roskilde, Denmark) were coated overnight at
4°C with 5 µg/ml anti-mouse IFN-
(XMG1.2), 1 µg/ml
anti-mouse IL-10 (SXC1.1), or 2 µg/ml anti-mouse IL-4
(11B11), each diluted in PBS (21). Subsequently,
nonspecific protein binding was prevented by incubating the plates for
30 min at room temperature with a 1% BSA blocking solution in PBS.
After washing the plates with PBS containing 0.05% Tween 20 (PBT),
supernatants diluted in IMDM were incubated for 23 h at room
temperature. After washing with PBT, biotinylated anti-mouse
IFN-
(R46.A2, 2 µg/ml), anti-mouse IL-10 (JES5-2A5, 0.5
µg/ml), or anti-mouse IL-4 (BVD6-24G2, 0.5 µg/ml) was added for
an additional hour, followed by washing with PBT and addition of 1.6
µg/ml peroxidase-conjugated streptavidin (Dako, Glostrup, Denmark).
Abs were diluted in PBT. Finally, the plates were washed thoroughly
with PBT, and 2 mg/ml O-phenylenediamine-dihydrochloride
(Sigma) in 0.1 M phosphate-citrate buffer containing 0.015% hydrogen
peroxide was used for color development. The plates were read at 490
nm, and cytokine concentrations were determined with reference to a
standard curve constructed using serial dilutions of recombinant murine
IFN-
, IL-10, or IL-4 (all from Genzyme via Sanbio, Uden, The
Netherlands). The anti-cytokine Ab-producing hybridomas were kindly
provided by Dr. R.L. Coffman (DNAX, Palo Alto, CA).
Monitoring for development of diabetes
Mice were monitored weekly for clinical signs of diabetes using Gluko-Test reagent sticks, detecting the presence of glucose in the urine (Boehringer Mannheim, Almere, The Netherlands). On some occasions, blood glucose levels were determined using Haemo-Glukotest 1-44R reagent sticks and a Reflolux S glucometer (Boehringer Mannheim). Mice were considered diabetic when urine glucose levels exceeded 55 mmol/l or when plasma glucose levels exceeded 11 mmol/L on 3 different days within 1 wk.
Histology
Pancreatic tissue was snap frozen in liquid nitrogen and stored at -70°C until preparation of 8-µm cryostat sections, which were fixed in 10% formalin and subsequently stained with hematoxylin and eosin for the detection of insulitis in individual islets.
Statistical analysis
After log transformation, data were analyzed via two-way ANOVA and Students t test, using SPSS 5.0 software. Values of p < 0.05 were considered significant.
| Results |
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To investigate whether the T cell repertoire of NOD mice contains
T cells recognizing both m60 (self hsp60) and Mt60, we determined
proliferative and cytokine responses upon immunization of normoglycemic
female NOD mice with either Mt60 or m60. Subcutaneous immunization with
Mt60 (Fig. 1
) resulted in proliferative
responses to both Mt60 (SI 9.8) and m60 (SI 5.9) in draining (inguinal)
lymph node cultures (Fig. 1
, lower left). Splenocyte
cultures (Fig. 1
, upper left) demonstrated very low
proliferative responses to either Mt60 (SI 2.0) or m60 (SI 3.1). In
contrast, immunization of NOD mice with m60 induced clear recall
responses to m60 by both spleen (Fig. 1
, upper right, SI
5.5) and inguinal lymph node (Fig. 1
, lower right, SI 16.8)
cells, whereas the mycobacterial homologue induced much lower
proliferative recall responses (SI 2.0 for spleen and SI 3.5 for lymph
node cells).
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levels were most pronounced
after restimulation of inguinal lymph node cells (Fig. 2
) with the
hsp60 protein, which was used for immunization. However, the homologue
protein failed to induce similar levels of IFN-
. Splenic IFN-
levels (Fig. 2
) displayed the same recall-response pattern, but
the overall levels measured were
3-fold lower than measured in the
lymph nodes. In contrast to lymph node cells, spleen cells derived from
either Mt60- or m60-immunized mice displayed high levels of IL-10 in
response to both hsp60 proteins. Collectively, these results suggest
that immunization with (self) hsp60 activates T cells in the spleen
that produce high levels of IL-10 but low IFN-
upon recognition of
conserved determinants on both Mt60 and m60.
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Considering the typical anti-inflammatory splenic cytokine
profile observed upon immunizing prediabetic NOD mice with hsp60, we
performed a cohort analysis on hsp60-specific proliferation and
cytokine production (Fig. 3
) by spleen
cells from normoglycemic mice immunized with Mt60 at various ages
before onset of diabetes. At 5 wk of age, when the first signs of
perivascular infiltration are observed (data not shown), Mt60 elicited
clear dose-dependent proliferative responses (Fig. 3
, top).
At 11 wk of age, when most of the islets demonstrate peri-islet
infiltration, significant proliferation was observed only after
stimulation with the highest concentration of Mt60 (data not shown). At
14 and 17 wk of age, when an increasing number of islets is fully
infiltrated, significant proliferative responses to Mt60 could not be
detected, despite normal responses to mitogenic stimulation (ConA). At
5 wk of age, low levels of hsp60-induced IFN-
were measured, which
increased in time (Fig. 3
, center). At all time points
tested, hsp60-specific IL-4 levels were below the detection limit of
our ELISA (data not shown). IL-10 levels induced by Mt60 demonstrated a
clear significant increase between 5 and 14 wk of age (Fig. 3
, bottom). Interestingly, analysis of IL-10 responses in
cultures derived from normoglycemic mice immunized at 17 wk of age
demonstrated significantly lower levels of IL-10 when compared with
earlier time points. Around this time point, 3050% of the female NOD
mice in our NOD colony became overtly diabetic, indicating that the
onset of diabetes was accompanied by a reduction of hsp60-specific
IL-10 production.
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Comparison of MHC class II-matched BiozziABH and NOD mice.
Based on the observed kinetics and cross-reactive nature of
hsp60-induced IL-10 production, elevated IL-10 levels could result from
increased presentation of self hsp60 during ongoing inflammation
(22). Therefore, we analyzed IL-10 responses in
age-matched BiozziABH mice (Table I
),
which express the same I-Ag7 MHC class II
molecule as NOD-wt mice but lack any sign of insulitis or diabetes
(23). Groups of age-matched, female BiozziABH and NOD mice
were immunized with Mt60 or control HEL protein at 11 wk of age, at
which time point NOD mice displayed clear signs of peri-islet
infiltration. Mt60-restimulated splenocytes from Mt60-immunized
BiozziABH mice produced significantly less IL-10 when compared with NOD
mice (p < 0.05), whereas IFN-
production
was similar in both strains. Again, IL-4 levels were below the
detection limit of our ELISA (data not shown). In addition, we
determined Mt60-induced cytokine levels in spleen cell cultures derived
from HEL-immunized BiozziABH and NOD mice. NOD spleen cells were found
to produce significantly higher levels of cytokines, in particular
IL-10, whereas Mt60 stimulation hardly elicited cytokine production by
BiozziABH splenocytes. Because HEL-immunized NOD mice displayed equal
levels of HEL-specific IL-10 in time when compared with HEL-immunized
Biozzi mice, our data point out that the observed elevated IL-10
response in prediabetic NOD mice is specific for hsp60 only. Moreover,
these results demonstrate that priming of hsp60-specific
IL-10-producing cells occurs spontaneously in NOD mice and is affected
by additional subcutaneous immunization.
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and IL-10 levels were determined in parallel spleen cell
cultures from either NOD-wt or NOD-asp mice (Fig. 6
production in response to Mt60 was observed, which
coincided with a marked increase in IL-10 production. Stimulation with
m60 induced only low levels of IFN-
, which hardly varied in time.
Except for IL-10 levels measured at 15 wk of age, both hsp60 proteins
induced comparable IL-10 levels by either mouse strain despite major
differences in pancreatic insulitis (Table II| Discussion |
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but high amounts of IL-10, a cytokine well known for its
anti-inflammatory properties (25, 26, 27, 28). Interestingly,
several murine studies have demonstrated that this particular cytokine
profile is associated with regulation of immune responses
(29, 30, 31), although human T cells producing IL-10 in the
context of IFN-
are sometimes regarded as proinflammatory (32, 33). Because the IL-10 and IFN-
production could be blocked
in vitro by anti-CD4 and anti-MHC class II Abs (data not
shown), hsp60-specific T cells produce IL-10 either directly or
indirectly by activating APC to produce IL-10. Regulatory
IL-10-producing T cells (Tr1) and IL-10-producing APC have both been
reported to suppress Th1 responses (29, 34), suggesting a
role for Tr1 cells and/or IL-10-producing APC in regulation of
autoimmune phenomena such as insulitis.
Considering the insulitis-related increase in IL-10 production upon
subcutaneous immunization, one could hypothesize that increased
expression of endogenous hsp60 during progressive insulitis is driving
regulatory cytokine responses. Therefore, exogenously provided
cross-reactive epitopes presented upon immunization with Mt60 could
enhance the T cell response, which was initiated by endogenously
presented self hsp60 epitopes. Spontaneous development of insulitis is
known to coincide with elevated levels of endogenous hsp60 in the
cytoplasm of
cells (35) as well as
cell apoptosis
(36). It is conceivable that upon phagocytosis of
apoptotic
cells and migration to pancreatic draining lymph nodes,
APC prime endogenous hsp60-specific T cells, which subsequently migrate
to the spleen and pancreatic islets. This would account for the
presence of IL-10-producing hsp60-specific T cells in the spleens of
either naive or Mt60-immunized mice, but not in peripheral lymph nodes.
On the contrary, high IFN-
-producing T cells were found only in the
lymph nodes draining the site of immunization. Proinflammatory
conditions, as induced by using DDA adjuvant, favor the generation of
high IFN-
-producing T cells, perhaps by altering the selective
processing and/or presentation of conserved hsp60 epitopes. Analysis of
cytokines produced by pancreas-infiltrating hsp60-specific lymphocytes
at different stages during insulitis development would be helpful to
elucidate whether the IL-10-producing T cells as identified in the
spleen are indeed involved in local regulation of insulitis. Results
reported by Birk et al. (37) on transgenic NOD mice,
expressing an m60 transgene under the H-2E
class II promotor, demonstrated substantially reduced insulitis, rarely
progressing beyond the stage of peri-islet infiltration. These
observations indeed suggest an important role for hsp60 in preventing
complete infiltration of the islets. In addition, Kallmann et al.
(38) recently demonstrated that discordant twins without
signs of autoimmunity (e.g., islet cell Ab negative) produced
significantly higher levels of IL-10 upon stimulation with human hsp60
when compared with their diabetic cotwins, underlining a potential role
of hsp60 in regulation of type I diabetes in humans.
The remarkable differences in hsp60-induced IL-10 production and progression to overt diabetes around 18 wk of age between NOD/LtJ mice from two separate colonies suggest that successful maintenance of immune regulation modulates pancreatic inflammation and delays subsequent diabetes development. Inability to maintain high levels of IL-10 could be indicative of spontaneous alterations in the delicate balance between autoaggressive and immune-regulatory T cells as described previously (39). Intriguingly, we observed a correlation between IL-10 production and extent of insulitis at 18 wk of age. High production of IL-10 in the spleen was found to be associated with less affected pancreatic islets and slow progression to overt diabetes, whereas low IL-10 production was correlated with extensive insulitis and rapid onset of overt diabetes. These differences in disease kinetics in the two colonies might explain our failure to delay the rapid diabetes onset in the latter NOD mice by immunizing them with a single injection of Mt60 as described by Cohen and collegues (8).
The hsp60-specific IL-10 levels are not uniquely observed in the NOD mouse, as demonstrated by considerable production of IL-10 in Mt60-immunized diabetes-resistant BiozziABH mice (I-Ag7). In addition, CBA/J mice (I-Ak) were reported to produce similar levels of IL-10 after immunization with murine or chlamydial hsp60 (40) when compared with Mt60-immunized BiozziABH or young NOD mice. These results argue against an active role of hsp60-induced IL-10 in the induction of diabetes. Moreover, these results demonstrate that the peripheral T cell repertoire of various mouse strains contains (self) hsp60-recognizing T cells, whether or not the mouse strain is susceptible to autoimmune diabetes. NOD-asp mice demonstrated a clear delay in insulitis and progression to diabetes but displayed equal kinetics on IL-10 production in time when compared with age-matched NOD-wt mice. Apparently, (self) hsp60-recognizing T cells have not been eliminated in the thymus via I-Ag7asp. In line with our results, Singer and colleagues, demonstrating that spleen cells from Abd transgenic NOD mice, recognized m60 equally well in proliferation assays as NOD-wt mice (17). Collectively, these results suggest that despite the presence of protective MHC class II molecules, (self) hsp60-recognizing T cells are positively selected via I-Ag7 and remain functional in the periphery. Interestingly, NOD-asp mice produced similar levels of IL-10 when compared with NOD-wt mice at 11 wk of age, when the majority of islets even lack cellular infiltrates. At 15 wk of age, NOD-asp mice produce higher levels of IL-10, compared with NOD-wt mice, while displaying only minor peri-islet insulitis. As a consequence of the expression of the transgene, NOD-asp mice are perhaps able to induce IL-10-producing regulatory cells more rapidly or efficiently in response to only minor inflammatory events in the pancreas. In combination with possibly enhanced negative thymic selection of potentially autoaggressive T cells via the I-Ag7asp transgene (13, 15) and cytokines produced by I-Ag7asp-restricted T cells (19), this could favor a more stable balance between autoimmunity and immune regulation in the pancreatic islets, inhibiting subsequent progression of insulitis to overt diabetes. Because we have not analyzed recognition of other autoantigens in wild-type and transgenic NOD mice, we cannot exclude the possibility that additional regulatory T cells (e.g., selected via I-Ag7asp) with specificities other than hsp60 are participating in regulation of insulitis.
Collectively, our results argue against a role of endogenous hsp60 as a primary autoantigen in spontaneous diabetes in the NOD model. More likely, (self) hsp60 T cell reactivity is a consequence of inflammatory events in the pancreatic islets irrespective of the presence of protective MHC class II molecules.
| Acknowledgments |
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| Footnotes |
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2 Address correspondence and reprint requests to Dr. Astrid G. S. van Halteren, Department of Immunohematology and Blood Transfusion, E3Q LUMC, PO Box 9600, 2300 RC Leiden, The Netherlands. ![]()
3 Abbreviations used in this paper: IDDM, insulin-dependent diabetes mellitus; hsp, heat shock protein; NOD, nonobese diabetic; wt, wild type; Mt60, Mycobacterium tuberculosis hsp60; m60, murine hsp60; HEL, hen egg lysozyme; DDA, dimethyl dioctadecyl ammonium bromide; SI, stimulation index; PBT, PBS containing 0.05% Tween 20. ![]()
Received for publication March 13, 2000. Accepted for publication August 21, 2000.
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