Miguel A. Medina-Serpas, Maigan Brusko, Gregory J. Golden, M. Campbell-Thompson, Trevor Rogers, Shay Reardon, Amanda L. Posgai, Rhonda Bacher, Eline T. Luning Prak, C Liu, Klaus H. Kaestner, Ali Naji, Michael R. Betts, Lauren M. McIntyre, Mark A. Atkinson, Todd M. Brusko
This study explores the inflammatory response observed in the pancreas and pancreatic lymph nodes (pLNs) during the natural history of type 1 diabetes (T1D). Using multicell-resolution spatial transcriptomics (ST), we profile individuals without diabetes (ND), at-risk autoantibody-positive (AAb+) individuals, and T1D donors. In the T1D pancreas, we observed global upregulation of inflammation-associated transcripts, including REG family genes, C3, SOD2, and OLFM4. In the T1D pLN, LTB was significantly upregulated within the lymphoid follicles. Using an orthogonal subcellular-resolution ST platform on an independent donor set, we identified follicular B cells as the primary source of LTB in the pLN and observed increased LTB expression in lymphocytes in insulitic lesions proximal to CCL19/CCL21-expressing endothelium. Collectively, these findings highlight lymphotoxin-β and downstream chemokine signatures in the pancreatic lymphatics as well as within the insulitic lesion, which can inform future therapeutic interventions.