title: Intradermal alpha1-antitrypsin therapy avoids fatal anaphylaxis, prevents type 1 diabetes and reverses hyperglycaemia in the NOD mouse model of the disease.
abstract: OBJECTIVE
  Human alpha1-antitrypsin (hAAT) gene therapy prevents type 1 diabetes in a NOD mouse model of diabetes. However, repeated i.p. injections of hAAT into NOD mice leads to fatal anaphylaxis. The aim of the study was to determine if an alternative route of administration avoids anaphylaxis and allows evaluation of hAAT's potential for diabetes prevention and reversal. We also sought to determine if the addition of granulocyte colony-stimulating factor (G-CSF), augments hAAT's capacity to prevent or reverse disease in the NOD mice.
  
  
  METHODS
  To evaluate hAAT pharmacokinetics, serum hAAT levels were monitored in NOD mice receiving a single dose (2 mg) of hAAT by i.p., s.c. or i.d. injection. For studies of type 1 diabetes prevention and reversal, mice received i.d. hAAT (2 mg/mouse/3 days) for 8 or 10 weeks or hAAT and G-CSF (i.p., 6 microg/day) for 6 weeks. Blood glucose determinations, glucose tolerance testing and insulin tolerance tests were performed.
  
  
  RESULTS
  Both i.p. and s.c. injections resulted in fatal anaphylaxis. The i.d. injection avoided anaphylaxis and i.d. injection of hAAT into 11-week-old NOD mice prevented disease (p = 0.005, AAT vs PBS at 40 weeks of age). Treatment of diabetic NOD mice with hAAT or hAAT plus G-CSF provided long-term (at least 100 days) reversal of diabetes in 50% of treated animals. G-CSF did not enhance the reversal rates of hAAT. Glucose tolerance and insulin levels were normalised in mice with hAAT prevention and reversal.
  
  
  CONCLUSIONS
  Intradermal hAAT prevents and reverses disease in a NOD mouse model of type 1 diabetes without inducing anaphylaxis.
authors.affiliation: College of Animal Science and Technology, Jilin Agricultural University, Changchun, Jilin, China.
authors.forename: H
authors.initials: H
authors.lastname: Ma
authors.forename: Y
authors.initials: Y
authors.lastname: Lu
authors.forename: H
authors.initials: H
authors.lastname: Li
authors.forename: M
authors.initials: M
authors.lastname: Campbell-Thompson
authors.forename: M
authors.initials: M
authors.lastname: Parker
authors.forename: C
authors.initials: C
authors.lastname: Wasserfall
authors.forename: M
authors.initials: M
authors.lastname: Haller
authors.forename: M
authors.initials: M
authors.lastname: Brantly
authors.forename: D
authors.initials: D
authors.lastname: Schatz
authors.forename: M
authors.initials: M
authors.lastname: Atkinson
authors.forename: S
authors.initials: S
authors.lastname: Song
mesh_terms: D000707:Anaphylaxis / Q000517:prevention & control*; D000818:Animals; D019540:Area Under Curve; D003922:Diabetes Mellitus, Type 1 / Q000188:drug therapy* / Q000517:prevention & control; D005260:Female; D018149:Glucose Intolerance / Q000188:drug therapy; D005951:Glucose Tolerance Test; D006943:Hyperglycemia / Q000188:drug therapy* / Q000517:prevention & control; D007150:Immunohistochemistry; D007328:Insulin / Q000097:blood; D051379:Mice; D016688:Mice, Inbred NOD; D000515:alpha 1-Antitrypsin / Q000493:pharmacokinetics / Q000627:therapeutic use*
chemical_list: D007328:Insulin; D000515:alpha 1-Antitrypsin