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Taming Autoimmunity: Alpha-1 Antitrypsin Overexpressing Mesenchymal Stem/Stromal Cells Promote Regulatory T Cell Crosstalk to Reverse Diabetes
Journal article   Peer reviewed

Taming Autoimmunity: Alpha-1 Antitrypsin Overexpressing Mesenchymal Stem/Stromal Cells Promote Regulatory T Cell Crosstalk to Reverse Diabetes

Hua Wei, Wenyu Gou, Judong Kim, Suganya Subramanian, Tiffany Yeung, Paramita Chakraborty, Ahmed Lotfy, Shikhar Mehrotra, Stefano Berto, Charlie Strange, …
Molecular therapy, Vol.online ahead of print
03/31/2026
PMID: 41918165

Abstract

Mesenchymal stem/stromal cell (MSC) therapy holds promise as a therapeutic option in diabetes treatment. The anti-inflammatory and immunomodulatory activities are enhanced when MSCs are engineered to overexpress alpha-1 antitrypsin (AAT-MSCs). Because a single infusion of AAT-MSCs reversed new-onset diabetes in over 50% of the female nonobese diabetic (NOD) mice, we used singlecell RNA sequencing, flow cytometry, and functional analyses to characterize how AAT-MSCs modulate CD4+ and CD8+ T cells in pancreatic lymph nodes (PLNs) and islets. AAT-MSC treatment increased T regulatory cells (Tregs) and more effectively suppressed T cell proliferation when stimulated with anti-CD3/CD28 antibodies. Treated mice exhibited reduced T helper 1 (Th1) cells and CD8+ cytotoxic T cells. In vitro studies confirmed the capacity of AAT-MSCs to promote Treg expansion in both mouse and human cells, drive CD8+ T cells toward an exhausted phenotype, and enhance mouse and human islet cell survival. Cellchat analysis showed that AAT-MSC therapy strengthens intercellular communication, especially signals originating from Tregs toward other PLN and islet cell populations. These findings clarify how AAT-MSCs modulate immune response and support their potential clinical application for type 1 diabetes and other autoimmune or inflammatory conditions.

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