Cytokines play a prominent role in mediating the inflammatory response related to injury, infection, and physiological processes from reproduction (1) to suntanning (2). Their impact on the target tissue can be destructive or protective depending on local concentrations, the spectrum of cytokine responses, and accompanying contact-mediated cellular inflammatory processes (3,4). In this issue of Diabetes, Ortis et al. (5) examine the transcriptional response of isolated primary β-cells after 6 and 24 h to mixtures of interleukin (IL)-1β and interferon (IFN)-γ or tumor necrosis factor (TNF)-α and IFN-γ under conditions culminating in extensive apoptosis by 72 h. None of these cytokines individually cause apoptosis, and the objective was to define a transcriptional inflammatory signature that links their combination to oxidative stress, endoplasmic reticulum (ER) stress, and cell death.

Upwards of 20% of the β-cell transcriptome is altered by these cytokines, resulting in deterioration in the function of the cell and a reversal of the β-cell phenotype toward a dedifferentiated state. The authors observe downregulation of Krebs cycle enzyme transcripts that could impact oxidative phosphorylation and stimulus secretion coupling, downregulation of transcription factors involved in β-cell lineage determination and insulin gene transcription, and downregulation of incretin and hormone receptor transcripts that modulate β-cell mass in response to diet and pregnancy. By contrast, the production of cytokines and chemokines by β-cells through a synergistic effect of TNFα and interferon signaling on IRF-7 seems to tell a different story. It fits with the authors hypothesis of a dialogue among the cellular elements affected by viral infection or immune attack that may act to amplify or squelch the local inflammatory response (6). Are we witnessing the death knell of a cell destined to undergo apoptosis or an act of self-preservation through energy conservation and a call for help?

In a parallel experiment the authors evaluated alternative splicing of pancreatic β-cell transcripts using Affymetrix Rat Exon 1.0 ST microarrays. Some 3,000 genes, one fifth of the rat β-cell transcriptome, showed alternative splicing. More remarkably, around 300 of these exhibited changes in the relative expression of splice variants in response to cytokines. These included inducible nitric oxide synthase (iNOS) (Δ exon 8), argininosuccinate synthetase (Δ exon 1), and NFΚB2 (Δ exon 22), three of the primary downstream targets of IL-1β and TNF that impact biochemical pathways leading to nitric oxide (NO) production. Previous studies have documented four common splice variants of human iNOS that show differential tissue-specific expression and are inducible by cytokines and lipopolysaccharide (7). Because homodimerization of iNOS is essential for enzyme activity, heterodimer formation between the alternatively spliced variants may regulate iNOS kinetics. The relative and absolute changes in the splice variants of the three target genes in β-cells were extensive, dynamic, and differentially regulated by the cytokine cocktail (see Fig. 7 in the accompanying article). By contrast, changes in a panel of 20 gene transcripts related to the splicing machinery were modest, arguing against global dysregulation of splicing and suggesting the existence of yet-to-be-identified regulatory elements.

The ability of cytokines to induce alternate splicing in purified β-cells has broader ramifications for the development of autoimmunity in type 1 diabetes. The islet autoantigen (IA)-2, a transmembrane protein of insulin secretory granule, is transcribed and translated as a shorter Δ exon 13 variant (8). This results in a 73aa in-frame deletion including its transmembrane domain and subsequent secretion of IA-2. In the thymus only the Δ exon 13 form is found (9), which correlates with lack of immune tolerance to T-cell and B-cell epitopes encoded by exon 13 in type 1 diabetes (10). The islet autoantigen islet-specific glucose-6-phosphatase–related protein (IGRP) (11) is another example for which different splice variants are expressed in islet and the thymus (12). Five of seven IGRP splice variants disrupt the reading frame and likely alter the topology of this nine-transmembrane ER protein. Alternate splicing of IGRP might also give rise to enhanced self-antigen presentation of MHC class I epitopes through immunoribosome-based surveillance (13). A survey of 45 autoantigens associated with other autoimmune disorders showed that all were subject to alternative splicing compared with 42% in a reference set (14) and that 80%, like IGRP (15), show noncanonical splicing compared with 1% in the nonantigen population.

Alternative splicing, in addition to regulating the β-cell proteome, may also play a critical role in the maintenance of peripheral immune tolerance. Peripheral tolerance depends upon the expression of tissue-specific antigens in secondary lymphoid tissues in a manner that triggers functional deletion of autoreactive T-cells. The autoimmune regulator (AIRE) protein is the best known transcriptional regulator of this process (16); however, a second, independent regulator Deaf1 was recently identified (17). A Deaf1 splice variant acts as a dominant inhibitor of the wild-type protein and is upregulated in the pancreatic-draining lymph nodes of pre-diabetic NOD mice and subjects with type 1 diabetes. Yet another class of splice variant associated with autoimmunity is that involved in immune recognition and regulation of T-cell viability including PD-1 (18), FAS (19), CD45 (20), and the T-cell receptor ζ chain (21).

The specific experimental model used here may be of greater relevance to the cytokine storm that accompanies acute rejection of islet transplants (22) than the slow and specific attrition of β-cells in type 1 diabetes. Nevertheless, many of the same cytokines are involved including the primary assailants produced by T-cells, macrophages, and antigen-presenting cells. The downstream network of cytokines and chemokines produced by the β-cells is potentially the same, but the islet in autoimmunity is also likely to encounter protective cytokines arising from regulatory T-cells in the lesion and other counterregulation from within the islet and beyond. Cytokine-mediated alternative splicing now clearly emerges as a potential regulatory mechanism and one that can operative on different time scales depending on mRNA and protein stability. It could certainly amplify the autoimmune response through generation of neoantigens and epitope spreading in existing β-cell immune targets. It is worth considering that similar processes might be at work also in response to inflammation triggered by infection, gluco-lipotoxicity (23), or a β-cell toxin like streptozotocin, which when used in low doses induces an immune-like destruction of β-cells (24).

See accompanying original article, p. 358.

No potential conflicts of interest relevant to this article were reported.

1.
Haider
S
,
Knöfler
M
:
Human tumour necrosis factor: physiological and pathological roles in placenta and endometrium
.
Placenta
2009
;
30
:
111
123
2.
Yoshizumi
M
,
Nakamura
T
,
Kato
M
,
Ishioka
T
,
Kozawa
K
,
Wakamatsu
K
,
Kimura
H
:
Release of cytokines/chemokines and cell death in UVB-irradiated human keratinocytes, HaCaT
.
Cell Biol Int
2008
;
32
:
1405
1411
3.
Kutlu
B
,
Cardozo
AK
,
Darville
MI
,
Kruhøffer
M
,
Magnusson
N
,
Ørntoft
T
,
Eizirik
DL
:
Discovery of gene networks regulating cytokine-induced dysfunction and apoptosis in insulin-producing INS-1 cells
.
Diabetes
2003
;
52
:
2701
2719
4.
Sarkar
SA
,
Kutlu
B
,
Velmurugan
K
,
Kizaka-Kondoh
S
,
Lee
CE
,
Wong
R
,
Valentine
A
,
Davidson
HW
,
Hutton
JC
,
Pugazhenthi
S
:
Cytokine-mediated induction of anti-apoptotic genes that are linked to nuclear factor kappa-B (NF-kappaB) signalling in human islets and in a mouse beta cell line
.
Diabetologia
2009
;
52
:
1092
1101
5.
Ortis
F
,
Naamane
N
,
Flamez
D
,
Ladrière
L
,
Moore
F
,
Cunha
DA
,
Colli
ML
,
Thykjaer
T
,
Thorsen
K
,
Ørntoft
TF
,
Eizirik
DL
:
Cytokines interleukin-1β and tumor necrosis factor-α regulate different transcriptional and alternative splicing networks in primary β-cells
.
Diabetes
2010
;
59
:
358
374
6.
Eizirik
D
,
Colli
M
,
Ortis
F
:
The role of inflammation in insulitis and beta-cell loss in type 1 diabetes
.
Nature Rev Endocrinol
2009
;
5
:
219
226
7.
Eissa
NT
,
Strauss
AJ
,
Haggerty
CM
,
Choo
EK
,
Chu
SC
,
Moss
J
:
Alternative splicing of human inducible nitric-oxide synthase mRNA. tissue-specific regulation and induction by cytokines
.
J Biol Chem
1996
;
271
:
27184
27187
8.
Park
YS
,
Kawasaki
E
,
Kelemen
K
,
Yu
L
,
Schiller
MR
,
Rewers
M
,
Mizuta
M
,
Eisenbarth
GS
,
Hutton
JC
:
Humoral autoreactivity to an alternatively spliced variant of ICA512/IA-2 in Type I diabetes
.
Diabetologia
2000
;
43
:
1293
1301
9.
Diez
J
,
Park
Y
,
Zeller
M
,
Brown
D
,
Garza
D
,
Ricordi
C
,
Hutton
J
,
Eisenbarth
GS
,
Pugliese
A
:
Differential splicing of the IA-2 mRNA in pancreas and lymphoid organs as a permissive genetic mechanism for autoimmunity against the IA-2 type 1 diabetes autoantigen
.
Diabetes
2001
;
50
:
895
900
10.
Peakman
M
,
Stevens
EJ
,
Lohmann
T
,
Narendran
P
,
Dromey
J
,
Alexander
A
,
Tomlinson
AJ
,
Trucco
M
,
Gorga
JC
,
Chicz
RM
:
Naturally processed and presented epitopes of the islet cell autoantigen IA-2 eluted from HLA-DR4
.
J Clin Invest
1999
;
104
:
1449
1457
11.
Arden
SD
,
Zahn
T
,
Steegers
S
,
Webb
S
,
Bergman
B
,
O'Brien
RM
,
Hutton
JC
:
Molecular cloning of a pancreatic islet-specific glucose-6-phosphatase catalytic subunit-related protein
.
Diabetes
1999
;
48
:
531
542
12.
Dogra
RS
,
Vaidyanathan
P
,
Prabakar
KR
,
Marshall
KE
,
Hutton
JC
,
Pugliese
A
:
Alternative splicing of G6PC2, the gene coding for the islet-specific glucose-6-phosphatase catalytic subunit-related protein (IGRP), results in differential expression in human thymus and spleen compared with pancreas
.
Diabetologia
2006
;
49
:
953
957
13.
Yewdell
JW
,
Nicchitta
CV
:
The DRiP hypothesis decennial: support, controversy, refinement and extension
.
Trends Immunol
2006
;
27
:
368
373
14.
Ng
B
,
Yang
F
,
Huston
DP
,
Yan
Y
,
Yang
Y
,
Xiong
Z
,
Peterson
LE
,
Wang
H
,
Yang
XF
:
Increased noncanonical splicing of autoantigen transcripts provides the structural basis for expression of untolerized epitopes
.
J Allergy Clin Immunol
2004
;
114
:
1463
1470
15.
Martin
CC
,
Bischof
LJ
,
Bergman
B
,
Hornbuckle
LA
,
Hilliker
C
,
Frigeri
C
,
Wahl
D
,
Svitek
CA
,
Wong
R
,
Goldman
JK
,
Oeser
JK
,
Leprêtre
F
,
Froguel
P
,
O'Brien
RM
,
Hutton
JC
:
Cloning and characterization of the human and rat islet-specific glucose-6-phosphatase catalytic subunit-related protein (IGRP) genes
.
J Biol Chem
2001
;
276
:
25197
25207
16.
Gardner
JM
,
Devoss
JJ
,
Friedman
RS
,
Wong
DJ
,
Tan
YX
,
Zhou
X
,
Johannes
KP
,
Su
MA
,
Chang
HY
,
Krummel
MF
,
Anderson
MS
:
Deletional tolerance mediated by extrathymic Aire-expressing cells
.
Science
2008
;
321
:
843
847
17.
Yip
L
,
Su
L
,
Sheng
D
,
Chang
P
,
Atkinson
M
,
Czesak
M
,
Albert
PR
,
Collier
AR
,
Turley
SJ
,
Fathman
CG
,
Creusot
RJ
:
Deaf1 isoforms control the expression of genes encoding peripheral tissue antigens in the pancreatic lymph nodes during type 1 diabetes
.
Nat Immunol
2009
;
10
:
1026
1033
18.
Nielsen
C
,
Ohm-Laursen
L
,
Barington
T
,
Husby
S
,
Lillevang
ST
:
Alternative splice variants of the human PD-1 gene
.
Cell Immunol
2005
;
235
:
109
116
19.
Drappa
J
,
Vaishnaw
AK
,
Sullivan
KE
,
Chu
JL
,
Elkon
KB
:
Fas gene mutations in the Canale-Smith syndrome, an inherited lymphoproliferative disorder associated with autoimmunity
.
N Engl J Med
1996
;
335
:
1643
1649
20.
Jacobsen
M
,
Hoffmann
S
,
Cepok
S
,
Stei
S
,
Ziegler
A
,
Sommer
N
,
Hemmer
B
:
A novel mutation in PTPRC interferes with splicing and alters the structure of the human CD45 molecule
.
Immunogenetics
2002
;
54
:
158
163
21.
Nambiar
MP
,
Enyedy
EJ
,
Warke
VG
,
Krishnan
S
,
Dennis
G
,
Kammer
GM
,
Tsokos
GC
:
Polymorphisms/mutations of TCR-zeta-chain promoter and 3′ untranslated region and selective expression of TCR zeta-chain with an alternatively spliced 3′ untranslated region in patients with systemic lupus erythematosus
.
J Autoimmun
2001
;
16
:
133
142
22.
Nicolls
MR
,
Coulombe
M
,
Diamond
AS
,
Beilke
J
,
Gill
RG
:
Interferon-gamma is not a universal requirement for islet allograft survival
.
Transplantation
2002
;
74
:
472
477
23.
Ehses
JA
,
Ellingsgaard
H
,
Böni-Schnetzler
M
,
Donath
MY
:
Pancreatic islet inflammation in type 2 diabetes: from alpha and beta cell compensation to dysfunction
.
Arch Physiol Biochem
2009
;
115
:
240
247
24.
Kiesel
U
,
Kolb
H
:
Suppressive effect of antibodies to immune response gene products on the development of low-dose streptozotocin-induced diabetes
.
Diabetes
1983
;
32
:
869
871
Readers may use this article as long as the work is properly cited, the use is educational and not for profit, and the work is not altered. See http://creativecommons.org/licenses/by-nc-nd/3.0/ for details.