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Going to the source: pancreatic lymph nodes maintain stem-like CD8+ T cells in human type 1 diabetes
Fatoumata Samassa, Sylvaine You, Roberto Mallone
Fatoumata Samassa, Sylvaine You, Roberto Mallone
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Commentary

Going to the source: pancreatic lymph nodes maintain stem-like CD8+ T cells in human type 1 diabetes

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Abstract

Where does autoimmune persistence reside in type 1 diabetes (T1D)? Detailed investigation of the pancreas and pancreatic lymph nodes (PLNs) may provide more definitive answers, yet most studies in these target tissues have been confined to mouse models. In nonobese diabetic (NOD) mice, disease development is prevented by PLN ablation, and these LNs harbor a stem-like population of autoreactive CD8+ T cells. In this issue, Peters et al. identified stem-like CD8+ T cell populations enriched in PLNs from humans with T1D and provide evidence for a developmental continuum linking lymphoid and pancreatic immune compartments. Their findings extend concepts previously established in NOD mice and in cancer immunology to humans with T1D, wherein self-renewing T cell populations sustain long-term immune responses. While the precise relationship between these stem-like cells and pathogenic autoreactive clones remains unresolved, this work positions the PLN as a potential reservoir of autoimmune persistence in T1D and a target for immune intervention.

Authors

Fatoumata Samassa, Sylvaine You, Roberto Mallone

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Figure 1

A proposed stemness-to-effector/exhaustion tissue axis in T1D.

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A proposed stemness-to-effector/exhaustion tissue axis in T1D.
PLNs may ...
PLNs may serve as a reservoir for stem-like CD8+ T cells that sustain autoimmune responses in T1D. Building on the findings of Peters et al. (5) and previous observations in NOD mice, the model presented here proposes that limited β cell antigen availability in PLNs, combined with the intrinsically low affinity of autoreactive TCRs for β cell antigens, results in weak TCR signaling that favors partial differentiation and maintenance of stem-like properties. This state may be further supported by IL-15 signaling. Stem-like PLN CD8+ T cells (red) are characterized by the expression of CXCR3 and self-renewal–associated markers such as BCL2, BCL3, and BCL6, together with TCF1 and TOX. Whether circulating naive-like, islet-reactive CD8+ T cells (pink) represent a recirculating counterpart of this PLN cell population remains unknown. Upon migration to pancreatic islets, exposure to higher antigen loads and stronger TCR stimulation may promote further differentiation, acquisition of cytotoxic functions, and eventual exhaustion (brown cells). However, the developmental relationship between PLN stem-like cells and pancreatic effector/exhausted cells remains unresolved, as current evidence demonstrates phenotypic continuity but limited clonal overlap between the two compartments. The figure highlights key hypotheses and outstanding questions emerging from the study by Peters et al., including the roles of recirculation, clonal continuity, and the mechanisms governing the balance between stemness, effector differentiation, and exhaustion.

Copyright © 2026 American Society for Clinical Investigation
ISSN: 0021-9738 (print), 1558-8238 (online)

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