Measurement of cell viability by 7-AAD staining 24 h after thawing demonstrated that Teffs had a viability of 90%, whereas 70% of Tregs were viable (data not shown). We tested whether selleck the expression of any of the markers affected by GAD65 stimulation was related to clinical outcome of treatment. We found no significant correlation between expression of Treg markers used in this study and changes in stimulated C-peptide measured as ΔAUC or AUC 4 years after treatment. C-peptide secretion was not significantly different in patients where an FSChiSSChi population was induced by

GAD65 stimulation compared to those who did not respond in this way (data not shown). To test whether the function of Tregs in T1D children included in the Phase II trial was affected by GAD-alum or placebo administration, suppression assays

using sorted and expanded Tregs (CD4+CD25hiCD127lo) and Teffs (CD4+CD25–CD127+) were performed. Gates used to sort Tregs and Teffs are illustrated in Fig. 3a. Expanded Tregs from patients treated with GAD-alum suppressed proliferation of autologous Teffs to the same extent as Tregs from placebo patients Selleckchem MG 132 (Fig. 3b). Tregs from both groups of patients displayed dose-dependent suppression of proliferation. As reported previously [25, 27, 28], we further found that suppression in autologous cultures of Tregs and Teffs was reduced in all patients (n = 7, placebo and GAD-alum

combined) compared to a healthy control (seven repeated measurements, Fig. 3c, P < 0·0001). To determine whether this attenuated suppression was intrinsic to Tregs or Teffs, we tested the suppression of Tregs from T1D patients (either GAD-alum- or placebo-treated, with similar results; Fig. 3b,d), and from a healthy control in autologous and cross-over culture suppression assays. As shown in Fig. 3c, T1D Tregs exerted the same level of suppression on Teffs coming from either T1D or healthy subjects. Interleukin-2 receptor In the reverse experiment, healthy Tregs were able to suppress Teffs from healthy or T1D subjects to a similar degree. Taken together, these results suggest that attenuated suppression from Tregs of T1D patients is due to reduced Treg efficacy rather than to increased Teff resistance to suppression. To determine whether there was a difference in reduced Treg-mediated suppression due to treatment, we tested if the suppression exerted in cross-over cultures of T1D Tregs versus healthy Teffs and healthy Tregs versus T1D Teffs was different between treatment arms. There was no difference in suppression exerted by Tregs from GAD-alum-treated patients compared to placebo Tregs in cross-over cultures with healthy Teffs, nor in the suppression exerted by healthy Tregs cultured with Teffs from GAD-alum-treated patients and Teffs from placebo subjects (Fig. 3d).