{
  "abstract": "Immune checkpoint inhibitor-diabetes (CPI-D) is an acute and non-resolving immune-related adverse event (irAE) initiated primarily by disrupting the programmed death-1 (PD-1)/programmed death-ligand 1 (PD-L1) axis with monoclonal antibodies. A major limitation in understanding CPI-D is the lack of access to pancreatic tissue from patients experiencing this complication. We report a unique patient with no prior history of diabetes or autoimmune disease whose treatment with CPI for metastatic melanoma was complicated by CPI-D requiring insulin therapy. The patient then went on to develop pancreatic cancer. In the setting of the pancreatic cancer treatment, we were able to perform detailed single-cell RNA sequencing and immunophenotyping within the surgically resected pancreas. This revealed substantial lymphocytic infiltration associated with the islets, suggestive of an autoimmune rather than autoinflammatory mechanistic origin for CPI-D.",
  "authors": [
    {
      "affiliations": [
        "Department of Medicine, University of California San Francisco, San Francisco, California, USA",
        "Diabetes Center, University of California San Francisco, San Francisco, California, USA"
      ],
      "name": "Zoe Quandt"
    },
    {
      "affiliations": [
        "Diabetes Center, University of California San Francisco, San Francisco, California, USA",
        "Huntsman Cancer Institute, University of Utah, Salt Lake City, Utah, USA",
        "Division of Microbiology and Immunology, Department of Pathology, University of Utah, Salt Lake City, Utah, USA"
      ],
      "name": "Arabella Young"
    },
    {
      "affiliations": [
        "Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA",
        "Department of Pathology, Stanford University School of Medicine, Stanford, California, USA"
      ],
      "name": "Graham Larson Barlow"
    },
    {
      "affiliations": [
        "Diabetes Center, University of California San Francisco, San Francisco, California, USA"
      ],
      "name": "Jennifer A Smith"
    },
    {
      "affiliations": [
        "Department of Pathology, Immunology and Laboratory Medicine, University of Florida Diabetes Institute, Gainesville, Florida, USA"
      ],
      "name": "Irina Kusmartseva"
    },
    {
      "affiliations": [
        "Diabetes Center, University of California San Francisco, San Francisco, California, USA"
      ],
      "name": "Shen Dong"
    },
    {
      "affiliations": [
        "Department of Pathology, Immunology and Laboratory Medicine, University of Florida Diabetes Institute, Gainesville, Florida, USA"
      ],
      "name": "Melanie R Shapiro"
    },
    {
      "affiliations": [
        "Diabetes Center, University of California San Francisco, San Francisco, California, USA"
      ],
      "name": "Jee Hye Kang"
    },
    {
      "affiliations": [
        "Department of Pediatrics, Division of Pediatric Endocrinology and the Herman B. Wells Center for Pediatric Research, Indiana University School of Medicine, Indianapolis, Indiana, USA",
        "Center for Diabetes and Metabolic Diseases, Indiana University School of Medicine, Indianapolis, Indiana, USA"
      ],
      "name": "Jamie L Felton"
    },
    {
      "affiliations": [
        "Diabetes Center, University of California San Francisco, San Francisco, California, USA",
        "Department of Surgery, University of California San Francisco, San Francisco, California, USA"
      ],
      "name": "Vinh Q Nguyen"
    },
    {
      "affiliations": [
        "Diabetes Center, University of California San Francisco, San Francisco, California, USA",
        "Department of Surgery, University of California San Francisco, San Francisco, California, USA"
      ],
      "name": "Greg Szot"
    },
    {
      "affiliations": [
        "Department of Surgery, California Pacific Medical Center, San Francisco, California, USA",
        "Department of Surgery, Zheen International Hospital, Erbil, Iraq"
      ],
      "name": "Assad A Hassoun"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Yale University, New Haven, Connecticut, USA",
        "Internal Medicine, VA Connecticut Healthcare System, West Haven, Connecticut, USA"
      ],
      "name": "Ana Luisa Perdigoto"
    },
    {
      "affiliations": [
        "Department of Internal Medicine, Yale University, New Haven, Connecticut, USA",
        "Department of Immunobiology, Yale University, New Haven, Connecticut, USA"
      ],
      "name": "Kevan C Herold"
    },
    {
      "affiliations": [
        "Department of Pathology, Stanford University School of Medicine, Stanford, California, USA"
      ],
      "name": "Garry Nolan"
    },
    {
      "affiliations": [
        "Division of Infectious Diseases and Geographic Medicine, Department of Medicine, Stanford University School of Medicine, Stanford, California, USA"
      ],
      "name": "Paul L Bollyky"
    },
    {
      "affiliations": [
        "Department of Pathology, Immunology and Laboratory Medicine, University of Florida Diabetes Institute, Gainesville, Florida, USA",
        "Department of Pediatrics, University of Florida, Gainesville, Florida, USA",
        "Department of Biochemistry and Molecular Biology, University of Florida, Gainesville, Florida, USA"
      ],
      "name": "Todd M Brusko"
    },
    {
      "affiliations": [
        "Department of Immunology and Microbiology, University of Colorado School of Medicine, Aurora, Colorado, USA",
        "Barbara Davis Center for Childhood Diabetes, University of Colorado School of Medicine, Aurora, Colorado, USA"
      ],
      "name": "Maki Nakayama"
    },
    {
      "affiliations": [
        "Liver Center, University of California San Francisco, San Francisco, California, USA",
        "Division of General and Transplant Hepatology, California Pacific Medical Center, San Francisco, California, USA"
      ],
      "name": "Stewart Cooper"
    },
    {
      "affiliations": [
        "Department of Medicine, University of California San Francisco, San Francisco, California, USA",
        "Diabetes Center, University of California San Francisco, San Francisco, California, USA"
      ],
      "name": "Mark S Anderson"
    }
  ],
  "title": "Autoimmune origin for immune checkpoint inhibitor-diabetes revealed by deep immune phenotyping of the pancreas",
  "uid": "70bb3560-a99f-5355-9532-554eb658188c"
}