Hyperglycemia, hyperlipidemia and hypertension have been evaluated extensively as risk factors for cardiovascular disease (CVD) in people with type 1 diabetes (T1DM). However, the impact of autoimmunity in T1DM on CVD has not been determined. We have generated several mice models of atherosclerosis including ApoE-/-/NOD, ApoE-/-/NOD (congenic non diabetes and non-autoimmune), ApoE-/-/NOD (autoimmunity with insulitis, nondiabetes) and ApoE-/-/NOD autoimmune diabetic mice. All groups of mice have high plasma lipids but only ApoE-/-/NOD diabetic mice had hyperglycemia. However, ApoE-/-/NOD (insulitis and nondiabetes) and ApoE-/-/NOD (insulitis and diabetes) had high titers of autoantibodies to IA2 compared to control CongApoE-/-/NOD mice or nondiabetic ApoE-/-/NOD mice (P<0.0001). For the the severity of atherosclerosis, the presence of hyperglycemia in ApoE-/-/NOD-DM mice showed greater levels of lipid deposition in the descending aorta (22%) by en face assessment as compared to nondiabetic ApoE-/-/NOD mice (P<0.01). Similarly, we also observed in the macrophage content of the descending aorta, was greater in numbers in the ApoE-/-/NOD mice than in ApoE-/-/CongNOD mice (P<0.05) but less than in ApoE-/-/NOD-DM mice. FACS of the descending aorta showed the elevated CD3+/CD28- T-cells (CD4 and CD8) by 4.5 folds and decreased CD3+/CD28+ Treg cells by 46% at the atherosclerotic plaques of ApoE-/-/NOD mice, compared to those of CongApoE-/-/NOD mice. To further confirm the elevated infiltrate and accumulated CD3+ T-cells in vivo, we will investigate the levels of macrophages and CD3+ T-cells in the arterial wall of the coronary artery from the Medalists group T1D and autoimmunity with positive HLA DR3/4 risk alleles and autoantibodies and lacking monogenic diabetic variants, as compared to the group lacking HLA DR3/4 risk alleles and autoantibodies. These studies suggest that autoimmunity exacerbates atherosclerosis in T1D, independently and synergically hyperglycemia.
K. Park: None. Q. Li: None. H. Park: None. R. St-Louis: None. J. Fu: None. C. Rask-Madsen: None. E. Maddaloni: Consultant; Self; Merck KGaA. Speaker’s Bureau; Self; Abbott, AstraZeneca, Pikdare. H. Yokomizo: None. S. Kissler: None. A.H. Lichtman: None. G.L. King: Research Support; Self; Janssen Pharmaceuticals, Inc.
National Institutes of Health (R01DK053105); Thomas J. Beatson, Jr. Foundation