Cited by 258Diabetes and associated disordersT-cell and B-cell ImmunologyPancreatic function and diabetes

An autoimmune stem-like CD8 T cell population drives type 1 diabetes

Open access
Gearty, Sofia V., Dündar, Friederike, Zumbo, Paul, Espinosa-Carrasco, Gabriel, Shakiba, Mojdeh, Sanchez-Rivera, Francisco J., Socci, Nicholas D., Trivedi, Prerak +7 more·2022·Nature

Abstract

CD8 T cell-mediated autoimmune diseases result from the breakdown of self-tolerance mechanisms in autoreactive CD8 T cells 1. How autoimmune T cell populations arise and are sustained, and the molecular programmes defining the autoimmune T cell state, are unknown. In type 1 diabetes, β-cell-specific CD8 T cells destroy insulin-producing β-cells. Here we followed the fate of β-cell-specific CD8 T cells in non-obese diabetic mice throughout the course of type 1 diabetes. We identified a stem-like autoimmune progenitor population in the pancreatic draining lymph node (pLN), which self-renews and gives rise to pLN autoimmune mediators. pLN autoimmune mediators migrate to the pancreas, where they differentiate further and destroy β-cells. Whereas transplantation of as few as 20 autoimmune progenitors induced type 1 diabetes, as many as 100,000 pancreatic autoimmune mediators did not. Pancreatic autoimmune mediators are short-lived, and stem-like autoimmune progenitors must continuously seed the pancreas to sustain β-cell destruction. Single-cell RNA sequencing and clonal analysis revealed that autoimmune CD8 T cells represent unique T cell differentiation states and identified features driving the transition from autoimmune progenitor to autoimmune mediator. Strategies aimed at targeting the stem-like autoimmune progenitor pool could emerge as novel and powerful immunotherapeutic interventions for type 1 diabetes.

Integrity signals

Registry

Crossref · 10.1038/s41586-021-04248-x

Cites

57 of 57 references verified0 citation errors · 0 not checkable

Statistics

Nothing to recompute.

Claims the paper makes

21 of 36 cited sources checked · 8 supported · 0 flagged · accuracy not yet measured

  • Interpretationown data

    A similar model to TCF1hi progenitor CD8 T cells giving rise to TCF1lo differentiated progeny described in chronic viral infections and cancers applies to T1D.

    “TCF1hi progenitor CD8 T cells that give rise to TCF1lo differentiated progeny have been described in chronic viral infections and cancers3 and our study reveals that a similar model applies to T1D.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [3] Philip, M. & Schietinger, A. CD8+ T cell differentiation and dysfunction in cancer. Nat. Rev. Immunol. https://doi.org/10.1038/s41577-021-00574-3 (2021). source

      The ‘Late dysfunction molecular programmes’ section reports that TCF1+ progenitor-like cells give rise to TCF1low differentiated cells in chronic viral infection. It also describes TCF1+ early dysfunctional tumour T cells differentiating into TCF1low late dysfunctional cells, but says evidence for a stable tumour-reactive progenitor population is lacking. The citation supports the differentiation pattern in cancer, not the stronger characterization of those tumour cells as established progenitors; the T1D finding is attributed to the citing authors’ own study. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Premisecitation

    β-cell-specific CD8 T cells in NOD mice are primed in the pancreatic draining lymph node (pLN) before they infiltrate the pancreas.

    “β-cell-specific CD8 T cells in NOD mice are primed in the pancreatic draining lymph node (pLN) before they infiltrate the pancreas6,11.”
    Quote in the paperNot a substantial claim1 of 2 sources checked
    • cites [6] Anderson, M. S. & Bluestone, J. A. The NOD mouse: a model of immune dysregulation. Annu. Rev. Immunol. 23, 447–485 (2005). source
    • cites [11] Ferris, S. T. et al. A minor subset of Batf3-dependent antigen-presenting cells in islets of Langerhans is essential for the development of autoimmune diabetes. Immunity 41, 657–669 (2014). source

      The Results report proliferation of β-cell-antigen-specific 8.3 CD8+ T cells in the pancreatic lymph node of NOD mice, and the Discussion describes CD8+ T-cell priming there. The paper does not establish that these CD8+ T cells are primed before infiltrating the pancreas; in the reported transfer experiment, the 8.3 cells did not enter the islets. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
  • Premisecitation

    β-cell-specific CD8 T cell responses have notable longevity, as shown by T cell-mediated destruction of islet transplantations in patients with longstanding T1D.

    “β-cell-specific CD8 T cell responses have notable longevity, which has been shown by the T cell-mediated destruction of islet transplantations in patients with longstanding T1D23.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [23] Ehlers, M. R. & Rigby, M. R. Targeting memory T cells in type 1 diabetes. Curr. Diab. Rep. 15, 84 (2015). source

      The Immunopathology of T1D section describes long-lived autoreactive memory T cells, beta-cell destruction in failed grafts, and antigen-specific CD8+ and CD4+ T cells identified after transplantation. It does not specify that the transplant recipients had longstanding T1D, and it presents the T-cell findings as strong evidence of recurrent autoimmunity rather than direct proof that CD8+ cells alone destroyed the grafts. Page numbers are unavailable in our copy. (LLM, conf=0.84)

      Experimental — accuracy not yet measured
  • Premisecitation

    In type 1 diabetes, β-cell-specific CD8 T cells destroy insulin-producing β-cells.

    “In type 1 diabetes, β-cell-specific CD8 T cells destroy insulin-producing β-cells.”
    • Also stated in: § Abstract · plain
      “The pathogenesis of T1D is complex and involves immune cell infiltration of the pancreas: β-cell-specific CD8 T cells destroy insulin-producing β-cells in the pancreatic islets of Langerhans, leading to insulin deficiency and loss of glucose homeostasis4.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [4] Bluestone, J. A., Herold, K. & Eisenbarth, G. Genetics, pathogenesis and clinical interventions in type 1 diabetes. Nature 464, 1293–1300 (2010). source

      The Pathophysiology of type 1 diabetes in mouse and human section (page unavailable) says autoreactive, islet-antigen-reactive T cells play a dominant role in the disease and that CD8+ cells appeared to dominate infiltrates in one study of human pancreases. But it also says the mediators of islet destruction have not been precisely defined; it does not establish that β-cell-specific CD8 T cells directly destroy the β-cells. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • Findingcitation

    Based on comparisons of single-cell transcriptomes, pLN TCF1hi AP in T1D have globally distinct gene-expression patterns compared with TCF1hi progenitor exhausted CD8 T cells in chronic viral infection.

    “However, based on comparisons of single-cell transcriptomes, pLN TCF1hi AP in T1D have globally distinct gene-expression patterns compared with TCF1hi progenitor exhausted CD8 T cells in chronic viral infection24 (Extended Data Fig. 10).”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [24] Yao, C. et al. Single-cell RNA-seq reveals TOX as a key regulator of CD8+ T cell persistence in chronic infection. Nat. Immunol. 20, 890–901 (2019). source
  • Classified as probably not a substantial claim. 16
  • May combine two claims. 27
  • Classified as probably not a substantial claim.

    Premisecitation

    CD8 T cell-mediated autoimmune diseases result from the breakdown of self-tolerance mechanisms in autoreactive CD8 T cells.

    “CD8 T cell-mediated autoimmune diseases result from the breakdown of self-tolerance mechanisms in autoreactive CD8 T cells1.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [1] Bluestone, J. A., Bour-Jordan, H., Cheng, M. & Anderson, M. T cells in the control of organ-specific autoimmunity. J. Clin. Invest. 125, 2250–2260 (2015). source
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    T1D becomes clinically evident when the majority (over 80%) of β-cells have been destroyed, requiring a prolonged latent period of β-cell killing over time (months to years in humans).

    “T1D becomes clinically evident when the majority (over 80%) of β-cells have been destroyed, requiring a prolonged latent period of β-cell killing over time (months to years in humans)5.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [5] Herold, K. C., Vignali, D. A., Cooke, A. & Bluestone, J. A. Type 1 diabetes: translating mechanistic observations into effective clinical outcomes. Nat. Rev. Immunol. 13, 243–256 (2013). source

      The paper’s opening discussion (page unavailable in our copy) describes a long prediabetic period during which β cells are killed over many years. But it says that as much as 30% of β-cell mass may remain at onset, so it does not support the claim that clinical disease requires destruction of over 80%. (LLM, conf=0.88)

      Experimental — accuracy not yet measured
  • May combine two claims.

    Premisecitation

    The non-obese diabetic (NOD) mouse model is a clinically relevant model of T1D and shares many features with the human disease, including spontaneous CD4 and CD8 T cell responses to many of the same β-cell antigens.

    “The non-obese diabetic (NOD) mouse model is a clinically relevant model of T1D6,7 and shares many features with the human disease, including spontaneous CD4 and CD8 T cell responses to many of the same β-cell antigens6–9.”
    Quote in the paperSubstantial claim2 of 4 sources checked
    • cites [6] Anderson, M. S. & Bluestone, J. A. The NOD mouse: a model of immune dysregulation. Annu. Rev. Immunol. 23, 447–485 (2005). source
    • cites [7] Unanue, E. R. Antigen presentation in the autoimmune diabetes of the NOD mouse. Annu. Rev. Immunol. 32, 579–608 (2014). source

      The Introduction and Conclusions describe NOD mice as a spontaneous model of T1D with important similarities to human disease. The Diabetogenic CD4 T Cells section reports broad β-cell autoreactivity and identifies both CD4 and CD8 T cells in NOD mice; Human Studies also reports insulin-reactive T cells in people with T1D. But the paper does not establish spontaneous CD4 and CD8 responses to many of the same β-cell antigens in both species, and the Conclusions explicitly leave the human counterpart of a described NOD CD4 response as an open question. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
    • cites [8] Tsai, S., Shameli, A. & Santamaria, P. CD8+ T cells in type 1 diabetes. Adv. Immunol. 100, 79–124 (2008). source
    • cites [9] Zakharov, P. N., Hu, H., Wan, X. & Unanue, E. R. Single-cell RNA sequencing of murine islets shows high cellular complexity at all stages of autoimmune diabetes. J. Exp. Med. 217, e20192362 (2020). source

      The Introduction describes NOD diabetes as chronic and similar to human T1D, and the Discussion says both have CD4 and CD8 T cells in their islets. The Discussion reports responses to insulin and other β-cell antigens in NOD mice, but says this study did not determine T-cell specificity; it does not establish that mouse and human T cells respond to many of the same antigens. No page numbers are available in our copy. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    Haematopoietic, somatic and cancer stem cells in mice and humans have been identified via serial transplantation of limiting cell numbers into immunodeficient mice.

    “Haematopoietic19, somatic14 and cancer stem cells20 in mice and humans have been identified via serial transplantation of limiting cell numbers into immunodeficient mice.”
    Quote in the paperNot a substantial claim1 of 3 sources checked
    • cites [19] Graef, P. et al. Serial transfer of single-cell-derived immunocompetence reveals stemness of CD8+ central memory T cells. Immunity 41, 116–126 (2014). source

      The Discussion describes this study’s serial single-cell transfers as modeled on hematopoietic stem-cell studies, and the Results compare its recovery rate with that of single hematopoietic stem cells. Those passages support the hematopoietic analogy, but do not establish the claimed use of immunodeficient mice to identify hematopoietic stem cells in both mice and humans. The separately cited somatic and cancer stem-cell claims are not assessed here. (LLM, conf=0.83)

      Experimental — accuracy not yet measured
    • cites [14] van Loosdregt, J. & Coffer, P. J. The role of WNT signaling in mature T cells: T cell factor is coming home. J. Immunol. 201, 2193–2200 (2018). source
    • cites [20] Lapidot, T. et al. A cell initiating human acute myeloid leukaemia after transplantation into SCID mice. Nature 367, 645–648 (1994). source
  • Classified as probably not a substantial claim. May combine two claims.

    Premisecitation

    In autoimmunity, self-reactive T cells acquire cytotoxic effector functions and cause destruction of self.

    “In autoimmunity, self-reactive T cells acquire cytotoxic effector functions and cause destruction of self1.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [1] Bluestone, J. A., Bour-Jordan, H., Cheng, M. & Anderson, M. T cells in the control of organ-specific autoimmunity. J. Clin. Invest. 125, 2250–2260 (2015). source

      The Conclusion (Figure 1; page unavailable) says autoreactive T cells are more prone to activation in autoimmune disease and that autoreactive ex-Foxp3 cells may contribute to tissue destruction. It describes those cells producing pro-inflammatory cytokines, but does not establish that self-reactive T cells acquire cytotoxic effector functions as the claim specifies. (LLM, conf=0.82)

      Experimental — accuracy not yet measured
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    TOX has been described as a key driver of CD8 T cell exhaustion in tumours and chronic infections, settings of persistent antigen encounter.

    “TOX has been described as a key driver of CD8 T cell exhaustion in tumours and chronic infections, settings of persistent antigen encounter3.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [3] Philip, M. & Schietinger, A. CD8+ T cell differentiation and dysfunction in cancer. Nat. Rev. Immunol. https://doi.org/10.1038/s41577-021-00574-3 (2021). source
  • Classified as probably not a substantial claim.

    Premisecitation

    TCF1hi progenitor CD8 T cells that give rise to TCF1lo differentiated progeny have been described in chronic viral infections and cancers.

    “TCF1hi progenitor CD8 T cells that give rise to TCF1lo differentiated progeny have been described in chronic viral infections and cancers3”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [3] Philip, M. & Schietinger, A. CD8+ T cell differentiation and dysfunction in cancer. Nat. Rev. Immunol. https://doi.org/10.1038/s41577-021-00574-3 (2021). source

      The ‘Late dysfunction molecular programmes’ section says that TCF1+ progenitor-like CD8+ T cells give rise to TCF1low differentiated cells during chronic viral infection. For cancer, it describes TCF1+ early dysfunctional tumour-infiltrating cells differentiating into TCF1low late dysfunctional cells, but says evidence for a stable population of tumour-reactive TCF1+ progenitors within tumours is lacking. Page numbers are unavailable in our copy. (LLM, conf=0.86)

      Experimental — accuracy not yet measured
  • Classified as probably not a substantial claim.

    Premisecitation

    In cancers or chronic viral infections, contexts in which T cells encounter persistent antigen, T cells enter a hyporesponsive state generally referred to as T cell exhaustion or dysfunction.

    “In cancers or chronic viral infections, contexts in which T cells encounter persistent antigen, T cells enter a hyporesponsive state generally referred to as T cell exhaustion or dysfunction3.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [3] Philip, M. & Schietinger, A. CD8+ T cell differentiation and dysfunction in cancer. Nat. Rev. Immunol. https://doi.org/10.1038/s41577-021-00574-3 (2021). source
  • Classified as probably not a substantial claim.

    Premisecitation

    The gold-standard assay to evaluate stem cell functions remains serial transplantation in animal models.

    “The gold-standard assay to evaluate stem cell functions remains serial transplantation in animal models.”
    Quote in the paperSubstantial claim1 of 3 sources checked
    • cites [19] Graef, P. et al. Serial transfer of single-cell-derived immunocompetence reveals stemness of CD8+ central memory T cells. Immunity 41, 116–126 (2014). source
    • cites [14] van Loosdregt, J. & Coffer, P. J. The role of WNT signaling in mature T cells: T cell factor is coming home. J. Immunol. 201, 2193–2200 (2018). source
    • cites [20] Lapidot, T. et al. A cell initiating human acute myeloid leukaemia after transplantation into SCID mice. Nature 367, 645–648 (1994). source
  • Classified as probably not a substantial claim.

    Premisecitation

    Anti-CD3 treatment (teplizumab) has been shown to induce long-term protection (currently up to six years) from T1D in at-risk individuals.

    “Moreover, anti-CD3 treatment (teplizumab) has been shown to induce long-term protection (currently up to six years) from T1D in at-risk individuals, but the mechanisms responsible for this long-term protection remain incompletely understood29,30”
    Quote in the paperSubstantial claim2 of 2 sources checked
    • cites [29] Herold, K. C. et al. An anti-CD3 antibody, teplizumab, in relatives at risk for type 1 diabetes. N. Engl. J. Med. 381, 603–613 (2019). source

      The Results (Efficacy; page not provided) show that teplizumab delayed diagnosis of type 1 diabetes in high-risk relatives, and the Discussion reports a median delay of two years. The paper does not establish protection lasting six years: median follow-up was 745 days, although the longest follow-up was 2683 days (Results, Participants; page not provided). It describes delayed progression, not prevention of diabetes. (LLM, conf=0.87)

      Experimental — accuracy not yet measured
    • cites [30] Sims, E. K. et al. Teplizumab improves and stabilizes beta cell function in antibody-positive high-risk individuals. Sci. Transl. Med. 13, eabc8980 (2021). source

      The Results section reports a sustained delay in T1D among high-risk relatives treated with teplizumab; eight treated participants followed beyond five years remained undiagnosed. It does not establish protection specifically through six years, and describes delayed diagnosis rather than permanent prevention. Page numbers were not provided in our copy. (LLM, conf=0.85)

      Experimental — accuracy not yet measured
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Premisecitation

    In acute infections, antigen-specific CD8 T cells differentiate into functional cytotoxic effector and memory T cells.

    “In acute infections, antigen-specific CD8 T cells differentiate into functional cytotoxic effector and memory T cells2.”
    Quote in the paperNot a substantial claim1 of 1 sources checked
    • cites [2] Kaech, S. M. & Cui, W. Transcriptional control of effector and memory CD8+ T cell differentiation. Nat. Rev. Immunol. 12, 749–761 (2012). source
  • Classified as probably not a substantial claim.

    Premisecitation

    TCF1 is a transcription factor critical for T cell memory, longevity and self-renewal.

    “TCF1 is a transcription factor critical for T cell memory, longevity and self-renewal13.”
    Quote in the paperSubstantial claim1 of 1 sources checked
    • cites [13] Escobar, G., Mangani, D. & Anderson, A. C. T cell factor 1: a master regulator of the T cell response in disease. Sci Immunol 5, eabb9726 (2020). source
  • May combine two claims.

    Findingown data

    The pLN TCF1hi population is highly clonally diverse compared with the pLN and pancreas TCF1lo populations and contains an abundance of rare, unexpanded clones that are exclusive to the pLN TCF1hi pool.

    “The pLN TCF1hi population was highly clonally diverse compared with the pLN and pancreas TCF1lo populations and contained an abundance of rare, unexpanded clones that were exclusive to the pLN TCF1hi pool (Fig. 4e, Extended Data Fig. 9c–e).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Cells with high and low expression of Tcf7 are at opposite ends of the trajectory; Tcf7hi cells display a stem-like transcriptional program, whereas Tcf7lo cells harbour a terminally differentiated and cytotoxic program.

    “Clustering and trajectory analyses revealed that cells with high and low expression of Tcf7 were at opposite ends of the trajectory; Tcf7hi cells displayed a stem-like transcriptional program, whereas Tcf7lo cells harboured a terminally differentiated and cytotoxic program (Fig. 4a, b, Extended Data Fig. 8a–d).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Donor 8.3 cells bifurcate into TCF1hiCD39lo and TCF1loCD39hi populations in the pLN, whereas only TCF1loCD39hi T cells emerge in the pancreas, recapitulating the same phenotypes of endogenous IGRP CD8 T cells in wild-type NOD mice.

    “Donor 8.3 cells bifurcated into TCF1hiCD39lo and TCF1loCD39hi populations in the pLN, whereas only TCF1loCD39hi T cells emerged in the pancreas, recapitulating the same phenotypes of endogenous IGRP CD8 T cells in wild-type NOD mice (Extended Data Fig. 5b–d).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    FTY720-treated mice lost half of the initial pancreatic CD8 T cell population, whereas control mice had significantly more CD8 T cells in the pancreas compared with the beginning of treatment.

    “FTY720-treated mice lost half of the initial pancreatic CD8 T cell population, whereas control mice had significantly more CD8 T cells in the pancreas compared with the beginning of treatment (Fig. 3h, Extended Data Fig. 6e–g).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    NOD/SCID hosts that received pLN TCF1hi cells became diabetic whereas hosts that received TCF1lo cells did not.

    “NOD/SCID hosts that received pLN TCF1hi cells became diabetic whereas hosts that received TCF1lo cells did not (Fig. 3b, Extended Data Fig. 6a).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Intermediate cell states along the trajectory retained Tcf7 expression but lost some stemness-associated genes and upregulated genes associated with the Tcf7lo cluster.

    “We identified intermediate cell states along the trajectory, which retained Tcf7 expression but lost some stemness-associated genes and upregulated genes associated with the Tcf7lo cluster (Fig. 4a, b, Extended Data Fig. 8b–f).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    High Sell (CD62L) and Entpd1 (CD39) RNA transcript and protein expression mark the opposite ends of the differentiation trajectory, while intermediate cell states do not express Sell (or CD62L) or Entpd1 (or CD39).

    “High Sell (which encodes CD62L) and Entpd1 (which encodes CD39) RNA transcript and protein expression marked the opposite ends of the differentiation trajectory, while intermediate cell states did not express Sell (or CD62L) or Entpd1 (or CD39).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Insulin B-chain-specific CD8 T cells also bifurcate into distinct TCF1hiCD39loPD1lo and TCF1loCD39hiPD1hi populations in the pLN and display a consistently TCF1loCD39hiPD1hi phenotype in the pancreas.

    “Insulin B-chain-specific CD8 T cells also bifurcated into distinct TCF1hiCD39loPD1lo and TCF1loCD39hiPD1hi populations in the pLN and displayed a consistently TCF1loCD39hiPD1hi phenotype in the pancreas (Extended Data Fig. 2c, d).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Mice treated with FTY720 were completely protected from T1D and had significantly reduced insulitis compared with control mice.

    “Mice treated with FTY720 were completely protected from T1D and had significantly reduced insulitis compared with control mice (Fig. 3f, g).”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    By 15-20 weeks, approximately 80% of NOD mice in the authors' colony have developed T1D.

    “by which time approximately 80% of NOD mice in our colony have developed T1D (Extended Data Fig. 1b).”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Findingown data

    As few as 100 TCF1hi cells were sufficient to induce T1D, whereas as many as 100,000 TCF1lo cells were not.

    “Even as few as 100 TCF1hi cells were sufficient to induce T1D, whereas as many as 100,000 TCF1lo cells were not (Fig. 3b).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Despite expression of inhibitory markers, IGRP T cells are highly functional and produce high levels of IFNγ and TNF upon ex vivo stimulation.

    “Despite the expression of these inhibitory markers, IGRP T cells were highly functional and produced high levels of IFNγ and TNF upon ex vivo stimulation (Fig. 1c).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    TCF1hi and TCF1lo cells comprise approximately 80% and 20% of the IGRP-specific population in the pLN, respectively, and can be identified as early as 5 weeks of age and persist throughout disease progression and mouse lifespan (25 to 30 weeks).

    “TCF1hi and TCF1lo cells, comprising approximately 80% and 20% of the IGRP-specific population, respectively, could be identified in the pLN as early as 5 weeks of age, and persisted throughout disease progression and mouse lifespan (25 to 30 weeks).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    GSEA and gene ontology classification show pLN TCF1hi cells are enriched for pathways involved in MYC and E2F signalling and DNA replication, whereas pLN TCF1lo cells are enriched for pathways associated with T cell activation, cytotoxicity and apoptosis.

    “Gene set enrichment analyses (GSEA) and gene ontology classification showed that pLN TCF1hi cells were enriched for pathways involved in MYC and E2F signalling and DNA replication, whereas pLN TCF1lo cells were enriched for pathways associated with T cell activation, cytotoxicity and apoptosis (Extended Data Fig. 3b, c).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    Select clones shared between the pLN TCF1hi and other populations expanded significantly in size upon downregulation of TCF1; consequently, the majority of clonotypes found in TCF1lo cells were shared with the TCF1hi population.

    “The select clones that were shared between the pLN TCF1hi and other populations expanded significantly in size upon downregulation of TCF1; consequently, the majority of clonotypes found in TCF1lo cells were shared with the TCF1hi population (Extended Data Fig. 9f).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    pLN IGRP T cells express moderate levels of TOX and pancreatic IGRP T cells express minimal levels of TOX, in contrast to exhausted and dysfunctional T cells in chronic viral infections and tumours.

    “pLN IGRP T cells expressed moderate levels of TOX and pancreatic IGRP T cells expressed minimal levels of TOX, in contrast to exhausted and dysfunctional T cells in chronic viral infections and tumours (Fig. 1d, Extended Data Fig. 1d).”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Findingown data

    IGRP-specific CD8 T cells can be found in the pLN and pancreas as early as 5 weeks of age, and their frequency increases over time, peaking at around 0.3% and 20% of CD8 T cells in the pLN and pancreas by 15-20 weeks, respectively.

    “IGRP-specific CD8 T cells (hereafter referred to as IGRP T cells) can be found in the pLN and pancreas as early as 5 weeks of age, and their frequency increases over time, peaking at around 0.3% and 20% of CD8 T cells in the pLN and pancreas by 15–20 weeks, respectively”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Findingown data

    Transferred donor T cells were not detected in pancreas before day 12 after transfer into NOD Scid hosts.

    “(note: transferred donor T cells were not detected in pancreas before day 12)”
    Quote in the paperNot a substantial claim
  • May combine two claims.

    Interpretationown data

    pLN TCF1hi cells can both self-renew and produce differentiated progeny.

    “demonstrating that pLN TCF1hi cells can both self-renew and produce differentiated progeny.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Premisecitation

    Although CD4 T cells initiate pancreatic infiltration and provide help to CD8 T cells, the CD8 T cells are primarily responsible for β-cell destruction.

    “Although CD4 T cells initiate pancreatic infiltration and provide help to CD8 T cells, the CD8 T cells primarily responsible for β-cell destruction8”
    Quote in the paperSubstantial claim0 of 1 sources checked
    • cites [8] Tsai, S., Shameli, A. & Santamaria, P. CD8+ T cells in type 1 diabetes. Adv. Immunol. 100, 79–124 (2008). source
  • May combine two claims.

    Interpretationreasoning

    AP are necessary to generate and replenish the pool of pancreatic AM, which are short-lived and thus unable to independently sustain the prolonged β-cell destruction that causes T1D.

    “AP are necessary to generate and replenish the pool of pancreatic AM, which are short-lived and thus unable to independently sustain the prolonged β-cell destruction that causes T1D.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationreasoning

    The induction and maintenance of diabetogenic T cell responses requires two functionally distinct populations: short-lived pancreatic AM to destroy β-cells and self-renewing pLN AP to replenish the AM population, thereby enabling sustained β-cell damage that culminates in T1D.

    “We propose that the induction and maintenance of diabetogenic T cell responses requires two functionally distinct populations: short-lived pancreatic AM to destroy β-cells and self-renewing pLN AP to replenish the AM population, thereby enabling sustained β-cell damage that culminates in T1D.”
    Quote in the paperSubstantial claim
  • May combine two claims.

    Interpretationown data

    pLN TCF1hi cells represent a stem-like autoimmune progenitor (AP) population that self-renews long-term and gives rise to terminally differentiated pancreatic TCF1lo autoimmune mediators (AM) that destroy β-cells.

    “In conclusion, pLN TCF1hi cells represent a stem-like autoimmune progenitor (AP) population that self-renews long-term and gives rise to terminally differentiated pancreatic TCF1lo autoimmune mediators (AM) that destroy β-cells (Fig. 4f).”
    Quote in the paperSubstantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    No statistical methods were used to pre-determine sample size.

    “No statistical methods were used to pre-determine sample size.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing).

    Study design and conductnone given

    The investigators were not blinded to allocation during experiments and outcome assessment.

    “The investigators were not blinded to allocation during experiments and outcome assessment.”
    Quote in the paperNot a substantial claim
  • Probably not a substantial claim: may not pass S3 (load-bearing). May combine two claims.

    Premisecitation

    TCF1 is one of the targets of canonical Wnt signalling, which maintains stemness in adult tissue stem cells, tumours, and peripheral T cells.

    “TCF1 is one of the targets of canonical Wnt signalling, which maintains stemness in adult tissue stem cells, tumours, and peripheral T cells14,15.”
    Quote in the paperNot a substantial claim0 of 2 sources checked
    • cites [14] van Loosdregt, J. & Coffer, P. J. The role of WNT signaling in mature T cells: T cell factor is coming home. J. Immunol. 201, 2193–2200 (2018). source
    • cites [15] Reya, T. et al. A role for Wnt signalling in self-renewal of haematopoietic stem cells. Nature 423, 409–414 (2003). source
  • May combine two claims.

    Premisecitation

    FTY720 is a sphingosine-1-phosphate receptor agonist that blocks lymph node egress and has been shown to protect NOD mice from T1D.

    “FTY720, a sphingosine-1-phosphate receptor agonist that blocks lymph node egress and has been shown to protect NOD mice from T1D21,22”
    Quote in the paperSubstantial claim0 of 2 sources checked
    • cites [21] Maki, T., Gottschalk, R., Ogawa, N. & Monaco, A. P. Prevention and cure of autoimmune diabetes in nonobese diabetic mice by continuous administration of FTY720. Transplantation 79, 1051–1055 (2005). source
    • cites [22] Brinkmann, V. et al. Fingolimod (FTY720): discovery and development of an oral drug to treat multiple sclerosis. Nat. Rev. Drug Discov. 9, 883–897 (2010). source
  • May combine two claims.

    Interpretationown data

    Stem-like functionality of pLN TCF1hi CD8 T cells and generation of differentiated TCF1lo CD8 T cells are independent of lymphopenic conditions.

    “Stem-like functionality of pLN TCF1hi CD8 T cells and generation of differentiated TCF1lo CD8 T cells are independent of lymphopenic conditions.”
    Quote in the paperSubstantial claim
40 of 40
  • The paper relies on this without support.

    How autoimmune T cell populations arise and are sustained, and the molecular programmes defining the autoimmune T cell state, are unknown.

    “How autoimmune T cell populations arise and are sustained, and the molecular programmes defining the autoimmune T cell state, are unknown.”
  • The paper relies on this without support.

    Despite presumed chronic self-antigen exposure on normal tissues, autoimmune T cells do not become dysfunctional, but retain effector functions and progressively destroy the tissue.

    “Despite presumed chronic self-antigen exposure on normal tissues, autoimmune T cells do not become dysfunctional, but retain effector functions and progressively destroy the tissue.”
2 of 2

Claims other papers make about this one

Each is checked against this paper’s own text: does it say what the citing paper says it does?

  • Exhausted CD8 and CD4 T cells are present in inflamed tissues of T1D and SLE models.

    “and exhausted CD8 and CD4 T cells are present in inflamed tissues of T1D 36,62 and systemic lupus erythematosus (SLE) 63 models.”

    From Autoantigen-specific CD4+ T cells acquire an exhausted phenotype and persist in human antigen-specific autoimmune diseases (2024) · cites this paper as [62]

    The Abstract says autoimmune T cells retain effector function rather than becoming dysfunctional. In “Phenotype of IGRP-specific CD8 T cells” (page unavailable), pancreatic CD8 T cells have minimal TOX expression, in contrast to exhausted T cells. This source therefore makes a contrary point about CD8 cells in the T1D model; it does not establish the sentence’s CD4 or SLE claims. (LLM, conf=0.88)

    Checked by a reasoning model — may be wrong.

    Experimental — accuracy not yet measured

Self-check

Percentages, sums and reported differences re-computed from the paper’s own numbers.

Each contradiction between two passages listed here was confirmed by an independent check.

  • Conflicting accession numbers for the acute and chronic infection dataset

    Minor

    The Methods identify the day-7 acute and chronic infection data as GEO accession GSE119940, while Data availability identifies the corresponding published dataset as GSE119943.

1 of 1

Cites

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Cited by

Sorted by citations

Authors
Gearty, S. V., Dündar, F., Zumbo, P., Espinosa-Carrasco, G., Shakiba, M., Sanchez-Rivera, F. J., Socci, N. D., Trivedi, P., Lowe, S. W., Lauer, P., Mohibullah, N., Viale, A., DiLorenzo, T. P., Betel, D., & Schietinger, A.
Affiliations
  • Memorial Sloan Kettering Cancer Center (US)
  • Weill Cornell Medicine (US)
  • Aduro BioTech (United States) (US)
  • Albert Einstein College of Medicine (US)
Corresponding author
  • Betel, Doron
  • Schietinger, Andrea
Venue
Nature
Published
2021-11-30
Volume
602
Issue
7895
Pages
156-161
ISSN
  • 0028-0836 (ISSN-L)
  • 1476-4687
OpenAlex
W3216791550
Cited by
257
References
56
Citations by year
2026: 52 · 2025: 74 · 2024: 61 · 2023: 45 · 2022: 25
FWCI
18.48
Type
journal article
Language
en
Open access
Locations
  • Nature (publishedVersion)
  • PubMed (publishedVersion)
  • PubMed Central (acceptedVersion)
  • Cold Spring Harbor Laboratory Institutional Repository (Cold Spring Harbor Laboratory) (submittedVersion)
  • RePEc: Research Papers in Economics (submittedVersion)
Funders
  • National Cancer Institute (T32CA160001, DP2CA225212, P30CA008748)
  • National Institute of General Medical Sciences (T32GM007739)
  • National Institute of Allergy and Infectious Diseases (R01AI123730)
  • National Institute of Diabetes and Digestive and Kidney Diseases (P01DK052956, F30DK122691, P30DK020541)
Topics
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Genetics › Diabetes and associated disorders
  • Life Sciences › Immunology and Microbiology › Immunology › T-cell and B-cell Immunology
  • Health Sciences › Medicine › Surgery › Pancreatic function and diabetes
Keywords
type 1 diabetes, CD8+ T cells, beta cell destruction, self-renewal, NOD mice, immunotherapy, autoimmunity
MeSH terms
Cell Self Renewal, Animals, Clone Cells, Diabetes Mellitus, Type 1, Disease Models, Animal, Female, Glucose-6-Phosphatase, Lymph Nodes, Male, Receptors, Antigen, T-Cell, Stem Cells, CD8-Positive T-Lymphocytes, Stem Cell Transplantation, Insulin-Secreting Cells, Mice, Hepatocyte Nuclear Factor 1-alpha, Single-Cell Analysis, Transcriptome

About these checks

Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.

Claims read by deepseek-v4.1-flash under definition version 3 (extract-v3) on 2026-10-29.

Classified by jev-1.13-20260917 (gold-guideline-v0.2) on 2026-10-29.

Cited sources are checked by gpt-6-sol.

Statistics and arithmetic are recomputed, not judged.

Confidence bands are shown only for fields calibrated on our annotated test set. None is calibrated yet, so no band is shown.

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