During the progression of autoimmune (type 1) diabetes,T cells and macrophages infiltrate the pancreas,disrupt islet function,and destroy insulin-producing beta cells. B-lymphocytes,particularly innate like B-cell populations such as marginal zone B cells and B-1 cells,have been implicated in many autoimmune diseases,and non-obese diabetic (NOD) mice that lack B cells do not develop spontaneous autoimmune diabetes. Hence,inhibitors of B cell signaling pathways could be useful for limiting the autoimmune processes that contribute to type 1 diabetes. Signaling via phosphoinositide 3-kinase (PI3K) regulates many cellular processes. The p110$\delta$ isoform of PI3K is expressed primarily in cells of hematopoietic origin and the catalytic activity of p110$\delta$ is important for B cell migration,activation,proliferation,and antigen presentation. Because innate-like B cells are particularly sensitive to inhibition of p110$\delta$ activity,and p110$\delta$ inhibitors also suppress pro-inflammatory functions of other cell types that contribute to autoimmunity,we tested whether a p110$\delta$ inhibitor could delay the onset or reduce the incidence of autoimmune diabetes in NOD mice. We found that long-term preventative treatment of pre-diabetic NOD mice with IC87114,a highly selective small molecule inhibitor of p110$\delta$,reduced the infiltration of inflammatory cells into the pancreatic islets and,accordingly,delayed and reduced the loss of glucose homeostasis. Moreover in a therapeutic treatment mode,IC87114 treatment conferred prolonged protection from progression to overt diabetes in a number of animals. These findings suggest that PI3K$\delta$ inhibitors could be useful for managing type 1 diabetes.
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