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Proinsulin-reactive CD8+ T cells are cytotoxic lymphocytes that recognize and target peptides from proinsulin, the precursor of insulin, presented by HLA class I molecules on pancreatic β cells. These T cells are a major contributor to autoimmune β cell destruction in Type 1 diabetes, both in human patients and in animal models[1][2][3][4][5]. Their presence and activation are linked to disease onset and progression, and they exhibit heterogeneity in functional phenotype and memory state[2]. Their antigen specificity, frequency, and functional properties serve as key biomarkers for T1D risk and activity, and they are active areas of study for antigen-specific therapy aimed at re-establishing immune tolerance or selectively depleting pathogenic T cell clones[3][5]. The challenge in therapeutics is to induce long-term tolerance in these cells without wider immune suppression or off-target autoimmune effects.
Drug-induced immune tolerance: Therapies aim to induce an unresponsive or tolerogenic state in these T cells by exposing them to antigen in a noninflammatory context (e.g., through antigen-presenting cells, engineered peptides, or tolerogenic dendritic cells)[3]; Immunomodulation: Strategies may include checkpoint inhibitors, costimulatory blockade, or immune cell depletion, though these have broader effects.
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